06981 (SFD)Building 5'i 490 RLViera
Address
Owner Sumlae Coupes
T4ti�t
cQQ
P.O. BOX 1504 N o . 06981
981
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address 42-600 Conk St., #200 _
City Zip Tel.
.. Plalm Desert 92260 568 2$2£
Contractor
National Mortgage
Tel.:
State Lic. City
& Classif. 2$$1313 Lic. # 32$
Designer
Address Tel.
City( Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions -Code, and my license is in full force and
effect,
SIGNATURE.` DATE
r OWNER -BUILDER DECLARATION
1 hemlbi'affirm that I am exempt from the Contractor's License Law for the following
reason: (Seca 'fir,
and Professions Code: Any city or county which requires a
permit to .construct, after, improve, demolish; or repair any structure, prior to its issuance also
requires the applicant for such ,permft to rile 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 violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not 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 Improves 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 improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
O I, 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ 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
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. ,Company
❑ Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed ff the permit Is for one hundred dollars (S100) 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: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that 1 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
11L6ING: TYPE CONST. -0CC. GRP.
P..Number PGA �7"t Watt 218"-4
,Legal Description
Project Description
»
Phase 35A '" 1'1 4MR
Sq. Ft. 1918
Size
No. _ No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$132,816
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 5". 26
Const.
755.00
Mech.
S1.00
Electrical
112.04
Plumbing
131.00
S.M.I.
9.31
Grading
Driveway Enc.
Infrastructure
$2,988.36 1,494.18
iless Credit
1,494.18
TOTAL
$3.116.79
REMARKSt�.
;� c �e r a rx'1? ,'i a �f=�•_i}�I €+)
P_s. CASH x 10101, 1
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
2/1190
Issued by: - Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
GROUND PLUMBING
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. ® $
SLAB GRADE
UNITS
BONDING
2ND FL SQ. FT. ®
FORMS
YARD SPKLR SYSTEM
POR. SO. FT. ®
DUCT WORK
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
METER LOOP
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
WALL SQ. FT.
GROUT
WATER HEATER
DRINKING FOUNTAIN.
SQ FT ®
BOND BEAM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
r
WATER PIPING
NOTE Not to be used as property tax valuation
FINAL INSP.
FRAMING
FLOOR DRAIN
MECHANICAL FEES
ROOFING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
REMARKS:
SIGN
WASHER(AUTONDISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ® c
BATH TUB
FINISH GRADING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
CERT. OCC.
SQ.FT.GAR ® V4c
HOUSE SEWER
FENCE FINAL
GAS PIPING
PERMIT FEE
GARDEN WALL FINAL
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE
PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP_
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ Plus -x$_=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1
rt ,r
CITY OF LA QUINTA
a DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
y� Sunrise Company
tractor National Mortgage
nit Number 6980
POST ON JOB IN CONSPICUOUS PLACE
ISPECTOR MUST SIGN ALL APPLICABLE SPACES
IADDRESS 55-490 Riviera
SFD - Plan 4MR
TYPE OF INSPECTION DATE INSP.
NDATION & SETBACK
TING STEEL
d GROUND SYSTEM
BUND PLUMBING -17�-- 2 -y _, r
40T POUR CONCRETE UNTIL ALLABOVEBA&RE.EN.$IGism
CRETE SLAB
TS & GIRDERS
'TRICAL GROUND WORK
40T POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
GH ELECTRIC
GH PLUMBING
GH GAS & GAS TEST p
SING & VENT -A/C
PLACE
F --
'D BEAM
TO WRAP
JT ❑4' ❑8'
LING
LATION
ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
VALL INTERIORAl- U .Y
RIOR LATH
PRE PLASTER
FENCE & GATE
:R SEPTIC TANK
TRICAL
IBING
. GAS TEST
ING - A/C
IE NUMBERS
;OMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
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