05019 (SFD)4
P.O. BOX 1504 No. 05019
Building 78-105 CALLE ESTADO
Address $ 5 -087 TR1.1 iera LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Sunrise Cem ` nv BUILDING: TYPE CONST. OCC: GRP.
Address
Ai—Ann i. :..+~ C. f+ A.P. Number Ste=re`�=aa
City Zip .. fref. _ - -
n.; t,< _ � .y .� �;,� S •�. � Legal Description
Contractor +.. Project Description Platt A
National Mortgage
Address
a ra,a
City Zip Tela
State Lic. City
& Classif. 288130 Lic. # 328 .- _ Sq.'Ft. 2353 No: , No. Dw.
Arch., Engr., Size - Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70(10) of Division 3 of the Business and Professions Code, and my license is in full force and
effect
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Buslmess and Professions Code: Any city or county which requires a
permit to construct, alter, h Wrove, demolish, or repair any structure, poor to its issuance also
requires the applicant for such permit to Me a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any vOk-dion of Section 7031.5 by 'any applicant for a permit
subjects the appEcant to a civilpenalty of Trot more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or irIoroves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered .for sale. If, however, the building
or brprovement is sold within one year of completion, the owner -budder will have the burden
of proving that he did not build or improve for the purpose of safe.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
❑ Copy is filed with the city. ❑ 'Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date owner
NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should becoe
subject to the Workers' Compensation provisions of the Labor Code, you must forthwitmh
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lenders Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certity that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS
di#`axi 1
RAIL ,0011 Y YY3iti J.r. 1 T"
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
Estimated Valuation
S i 7t3 s. 3 78
PERMIT
Issued by:
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
3 497.78
Const.
610.50
Mech.
39. LD
Electrical
92,01
Plumbing
114.00
S.M.I.
11 9A
Grading
Driveway Enc.
Infrastructure
t3,833.51
1 916.76
I.mizn
>t?
TOTAL
fiot_2%fl qq
3
REMARKS
di#`axi 1
RAIL ,0011 Y YY3iti J.r. 1 T"
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
12120/88
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
A.C. UNIT
2ND FL. SO. FT.
LAB GRADE J
YARD SPKLR SYSTEM
BONDING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
STORAGE TANK
FORMSWER
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
DUCT WORK
DRAINAGE PIPING
CAR P. I SQ. FT. ®
GAS (ROUGH)
METER LOOP
WALL SO. FT.
DRINKING FOUNTAIN.
SO. FT. ®
. STEEL
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used Es property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VICE tltl
WATER SOFTENER
VENT SYSTEM FAN: EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
LUMBER GR.
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B. 7.U.
SO. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TO—AL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLUMBIN
Q UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE J
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSWER
OR SEPTI A
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
UND. REINF.` —f �I -�
OROEINF
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
. STEEL
I INAL)
J TEMP. POLE
GROUT
WATER HEATE V
VICE tltl
�
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
=$
LUMBER GR.
FINAL INSP.
F AMING
FINAL INSP.
OFING
2
//��
W�
/Z
/ —
71 5;
`7 }7/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
R. FIREWALL
THING
MESH
SOLATION/SOON
FI SH GRADING
INAL INSPECTION `7
1
CERT. OCC. %
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL