12479 (CP)4
P.O. BOX 1504 No. 12479 "
Building78-105 CALLE ESTADO
Address 56-'100 Riviera' LA QUINTA, CALIFORNIA 92253
Owner
Sunrise Company
BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address 42-640 Cock Street #200 A.P. Number
City Zip Tel.
Palm Desert, CA 92260 1 568-2828 Legal Description
Contractor Project Description Change pool heater Pool 1H
Trident Pools
AdWs
645 Mockingbird Trail
City Zip El
Indian Wells. CA 922141127
State Lic.
& Classif. 260950 351 Sq. Ft. 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 I1_am licensed under provisions of Chapter 9 (commencing with Section
7000) of Divisi/on.3°6f'the pBusineesrsdand Professio yCode, and my license is 'n' full,-�force.arzld
effect. ( �`!.y j
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation $1000.00
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also AMOUNT
requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT -
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business ad Professions Code, or that. he is exempt therefrom, and the basis
n
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.
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 Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
Professions Code: The Contractor's License Law does not apply to an owner of property who r
builds or improves thereon and who does such work himself or through his own employees, tY • v
provided that such improvements are not intended or offered for sale. If, however, the building Mech.
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing h.
struci 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 S. M. 1.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date owner Infrastructure
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. ❑ Certified copy is hereby furnished. n
• TOTAL "' " 0
CERTIFICATE OF EXEMPTION FROM REMARKS
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 thq 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 ZONE: BY: -
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center -Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
Ihereby affirm that there is a construction lending agency for the performance of the r
work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from p Line
Lender's Name i
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE I CT
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. Issued : b Date Ae Permit
I agree to comply with all city and county ordinances and state laws relating to building y ry
construction, and hereby authorize representatives -of this city to enter the above..
mentioned property for inspection purposes. Validated by: '
Signature of applicant Date t _
Mailing Address Validation: >"»
City, State, Zip
h
3 CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
t
IST FL. SO. FT. @ $
UNITS.
SLAB GRADE
I 1 ` 0. 0 r
BONDING
HEATING (ROUGH)
2ND FL. SQ. FT.
.FORMS
YARD SPKLR SYSTEM
I
POR. SO. FT.
MOBILEHOME SVC.
BAR SINK
z
GAR. SQ. FT.
POWER OUTLET
ROOF DRAINS
{
CAR P. SQ. FT.
OTHER APPJEQUIP.
DRAINAGE PIPING
IWALL
TEMP. POLE
SQ. FT.
GROUT
DRINKING FOUNTAIN.
SQ FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
_
FLOOR DRAIN
t MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
VENTILATION
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ® c
BATH TUB
GAR. FIREWALL
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
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
LOLL, 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$-=$-
lusx$=$ROOFING
_
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS: ;
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
"
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
&INALIN 7 PECTIO
CC "
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
p
a. GARDEN WALL FINAL