07018 (SFD)Building
Address—�
Owner
Sunrise,
Address -flim Cwk St. Su k.
'e Zt}-'.r'
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City Zip Tel.
Palm Deser° 92260 1
568-2828
Contractor
Hational Hortwe & Land
Same
el.
State Lic. City
& Classif. 2MI30 Lic. # 398
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 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
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason_ (Sec. 7031.5,Busbness 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 permit to file 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).
❑ 1, 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, Susness 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 himseff or through his own employees,
provided that such improvements are not intended or offered for safe. It, however, the building
or improvement is sold within one year of completion, the owner -budder will have the burden
of provitg that he did not build or improve for the purpose of sale.)
❑ 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 buhl& or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
hereby affirm that 1 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 (pmpany
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(ibis section need not be completed If the permit is for one hundred dollars (5100) valuation
or fess_) . .
I certify that in the performance of the work for which this permit is issued, 1 shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California-
Date-Owner
aliforniaDateOwner
NOTICE TO APPLICANT. H, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Coda, you must forthwith
campy 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, Cial 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 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
BUILDING: TYPE CONST
,2-i-1 -
N0. 0708
OCC: GRP.;
A.P. Number
Legal Description iidt x$
Project Description Phase -2H — Plan H3
Sq. Ft. 2899 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $214,923
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bali
0
Const.
t aU`1440 VIIJ
Mech.
7 3. 00
Electrical
132.71
Plumbing
10 0. bu
S.M.I.
T15705
Grading
Driveway Enc.
Infrastructure
vbS Lri t4Cf
»s . i ti
Q7
TOTAL
REMARKS
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
2/9/90
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SD. Ff.
WALL SO. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)" -//.!1
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1Y4 c
SEWAGE DISPOSAL
c
01'e -To
SQ.FT.GAR ® 3/4c
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
(QUND PLUMBIq
UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE 3 /C/ k
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
v kWER OR SE I 1
/O
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
�/,�FOUND. REINF� ��
W �REINF.
GAS (ROUGH)" -//.!1
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—X$—=$
LUMBER GR.
l /,FJNAL INSP.'
7 AMING�Z-
FINAL INSP.
�OFING.L -02b `�
c
01'e -To
REMARKS:
VENTILATION
FIRE ZONE ROOFING :
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING ro
MESH
INSULATION/SOUNDS S -7
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL