08463 (SFD)d`9 f .. pi7P�1hi +�8i.iTdF
P.O. BOX 1504. No. .08463 -
Buildingt'f rr 78-105 CALLE ESTADO `
Address Vt.i +KERI ON LA QUINTA, CALIFORNIA 92253
Owner
SUNRISE COMEMY
BUILDING: -TYPE-CONST-_. OCC:';GRP. -.
Mailing=:•
Address
.42-60TP 200 A.P.. Number Pru w m — Tut 0244q-1.3
City:. Zip Tel. ti
.. Legal Description
Contractor Project Description ' PHASE 3E -- 'LAN ORR
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W
Address'SA'"
m , _..
City Zip TeL:
• State Lic. ' •.._
City
& Classif. 3Q
Lic. #
Sq. Ft. No. No. Dw.
Size - Stories • Units
Arch., Engr:;' 7 ; '• s
Designer
New ❑ Add-E] , - Alter ❑ Repair ❑ Demolition'O
Address , F'
Tel.
' City
Zip.
State --
t
..
Lic. #
1
4
f LICENSED CONTRACTOR'S DECLARATION •
affirm
,
•, . ;r
�I hereby that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Busin�ess/end Professions Code, -and lice. in full force
my suis and
~
SIGNATUREAf- a,"' DATE
OWNER-BUILDER DECLARATION
Estimated Valuation.
'
243
_'
• I hereby affirm that'l am exempt from thelContractors License Law for the following
reason:. (Sec. 7031.5 Business and Professions'LCbde: Any city,or county which requires 5%,
permit to construct, ,alter, 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
PERMIT.• . _ AMOUNT ,
the provisions of lie Contractor's License Law, Chapter 9 (commencing _ with Section 7000) of
r -
' Division 3 of the Business and Professions Code, or that. he is exempt therefrom,. and the basis'
fpr'the alleged exemption. Any Section 7031.5 by 'any for
.,
Plan Chk. Dep.
violation of applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars.($500).
Plan Chk. Bal.
❑ I, as ownerof.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,
Mech.
- provided that such improvements are. not intended or offered for sale. If, however, the building
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.) I
Plumbing
O 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
S.M,I.
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.) -
Grading
O I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
' Date Owner
Infrastructure
LESS GgEID 2:
. �
WORKERS' COMPENSATION DECLARATION
-Q
Phereby 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.)
. PUB
e w ra EA
Policy No. - .Company
` .,0 Copy is filed with the city. p Certified copy is hereby furnished.
a
TOTAL •`� f� '
REMARKS
CERTIFICATE OF EXEMPTION FROM
W ORKERS' COMPENSATION INSURANCE
a 3 t r44[�,.... gs etia ;q; ,
(Thor less.) ss.section need not be completed if the permit is for one hundred dollars ($100) valuation
I certify that in the performance of thg work for which this permit is issued, I shall not
.ta*.:.•.rr d.�
�aY�..Ka *�:^y'a
AV , L��s�iif f ! 4J��h i. � �!°��rY ¢•cr� "�'v
-MTA
employ any person in any manner so as to become subject to the Workers' Compensation.
-
Laws of California.
Date Owner
-
: NOTICE TO APPLICANT: If, after making this Certificate of Exemption you .should become
ZONE: - - BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or thispermit shall be deemed revoked.
Minimum Setback Distances:
Front. Setback from Center Line
•
Rear Setback from Rear, Prop.' Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
hereby affirm that there is a construction lending agency for the performance of the
work for which this permit, is-issued. (Sec. 3097, Civil code.)
Side Setback from Property Line
Lender's Name
e s
DATE INSPECTOR M1r
Lenders AddressFINAL
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is'correct.
Issued by: Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter . the above-.
mentioned property for inspection purposes.
.-Validated by:
Signature of applicant Date
Mailing Address
',iValldatlOn:
City, State, Zip
xjo I{. .yk vL � .. i. 1 ,},^iY�t� �. .�y, J � X, M ,N �. �.'t 1 .y � i
a .C- _�+>'''.
yC•S 'i
1t t\.�. t ; -Y' v r � CYG ;,•• r-_ � G7 � � y. ,1: •., f
yj C�'\. :c 4:.S •"
,Y • -. . .. - -..-.3$ 1,w - a . _, h'�-'sir'
s .-c'.''" t ;.�^�x�{act.'a �. ^•.Sri F :1"
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. S0. 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.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
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
S0. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/e c
SEWAGE DISPOSAL
, 1
/ 1
SO.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
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
ROCKSTORAGE
Yk_FOUND. REIN F 16/,o
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
, 1
/ 1
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