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BLCK (10309)P.O. BOX 1504 No 10309 ' Building7&105 CALLE ESTADO ' Addres79.985 keri©23 LA QUINTA, CALIFORNIA 92253 Owner .-'Sunrise-Desert Pa. -them. Mailing ' Address 42-600 Cook St Suite 200, City Zip Tel. - ..Palm Desert .92260 564-6716 Contractor Nati6mil_14o : tgage & Land CO. .Address . Same City Zip Tel.: BUILDING`. TYPE CONST.. '"_ OCC: GRP. A.P. Number " Legal Description Project Description > 85' of 6' block call State Lic. City & Classif. , 28$1'30 Lic. # 328, Sq. Ft. No. No. Dw. Size ^ Stories Units Arch., Engr., ` Designer . ' New ❑ Add.❑ Alter. El Repair ❑. Demolition ❑" Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I,ayl licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of'tthe/Bjusinessland Professions Code, .and my license is iinn,�(ull forrce,and • effect.. /O/ �C .fl 1 .1 • Y%.R'�✓T� �f/ ✓ .�/ _SIGNATURE DATE OWN ER•BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following' .•.reason:, (Sec. 7031.5,Business and Professions Code: Any. city or county which requires a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also ' requires the applicant for such permit to file a signed statement that beds 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 dollan (5500). .. 0 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. ti; -however; the building.. Estimated Valuation 4 " Ci2 .PERMIT AMOUNT _ 2 - - .- Plan Chk. Dep. - 'Plan Chk• Bal.' - ' Const: g r - % `� • �� ` Mech. • -, - - Electrical - ,. 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.). ,• Plumbing ❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. t. P.C. for this reason - •+ S.M.I. Grading, , 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:) e . . Policy No. Company Copy is filed with the city. .❑ Certified copy is hereby furnished. ; TOTAL .5.4.30 .. = _ - CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION'INSURANCE REMARKS ry - - �' ' (This section need not be completed If the permit is for. one hundred dollars (8100) valuation • or less.) I -certify that in the performance of.thg 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. t: a y��? - x _.. g Ol:u� r °c°!s�'3 Fj-i:'` q {� •u , ; k g 4 - _ 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. - - ZONE: BY: MIRIfT1Um Setback DlSt—BY: • ' - `-. .. Front.Setback from Center. Line ' Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction. lend i ng. agency for -the performance of the _ work for which this permit is. issued. (Sec. 3097, Civil Code.) ~ Side Street Setback from Center Line Slde Setback from Property.Llrle Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. FINAL DATE INSPECTOR, ' 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._ Issued by:Date Validated by:,- y:Signature Permit- " Signatureof applicant Date Mailing Address Validation: + 1 City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. FOR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. ® SO. 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) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRYTRAY 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. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SO.FT.GAR ® V4c HOUSE SEWER REMARKS: 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 COLL, AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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. F NCE FINAL / JINSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL