14534 (PLBG)J
P.O. BOX 1504
Building 51-425 Contrino 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Owner KSL . La Quinta Corporation
Mailing
Address P.O. Box 559
City Zip Tel.
La Quinta, CA. 12253 564-1088
Contractor
Sunray' Unlimited
API!M Sox 1135
.T.h Quinta, CA zip 92253 Te564-3535
state Ljc.384099 City
& Classif. Lic. #
f
Arch., Engr., f
Designer
Address I Tel.
City l Zip j.State
I I Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
X7000) of Division 3 of thhe, Businessland Professions Code, -and my license is in full force and
/SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirin that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buskress 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
requires the applicant for such permit to Ole a signed statement that he is licensed pursuant to
the provfsfons of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Divislon 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 Ove 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 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
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Worker's Cggipensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Pollq ItIpCompany
py is filed with the city. O Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thF 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: ff, 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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES, UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
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
No. 14534
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
,Legal Description
Project Description Run. water and sewer to
comfort stations on golf course
Citrus Course
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $2,500.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
33.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
33.00
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Pi�ro . Line
Side Street Setback fro rrl�Ge to ine
Side Setback from Propel Line
FINAL DATE I
Issued by: Date_
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW%3 FEES
IST FL. SO. FT. ® $
UNITS
&. 't.
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. ®
GROUT
I
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
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.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
F NISH GRADING
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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
' �^A
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
^^ /, ,/J
�` t— /q eA �Gw
v 1 ( L
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
F NISH GRADING
/
,VZFINAL INSPECTION 5
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
.,
1
Mailing Address: Box 1255 PALM DESERT, CA 82261
Phone: 328-6718 / 346-6916
Calif. State Contractors' license No. 310813
❑wner
Name - � oTenant Blllto
Job at t At
City '4-40 l t) r &/'r Zip City Zip
N? 65740
DATE /- ( 2
WORK " -
Old Customer ❑ New Customer
Classification
Telephone ( )
WORK AUTHORIZATION - I / We hereby authorize the work described along with
the necessary materials and.parts
WORK ORDERED:
Time
From
To
Hours MATERIAL USED
AMOUNT
Mon.
Tues.
Wed.
2?a
Thurs.
,
_
Fri.
Sat
�.
Sun.
Total Hours
ENTERED
Invoice
Journal
Ledger
Cards
WAIVER OF RIGHT TO CANCEL
Having Initiated a contract in conned'on,with emergency
repairs or service for the immediate protection of persons or
real and persanar property, I hereby state that the following
emergency situation exists, requiring Immediate attentiom
Pursuant to Section 1689.13 of the California Civil Code, 1
agknowle lge and hereby waive all rights to cancel the sale
wtlhin three days. i
Dated Buyees Signature :_—
i
TO OUR CUSTOMERS: Sendoe men are required to have work slip signed. This Is done In order to protect you, the workmen, and ourselves, and
to enable us to give you absolute satisfactory service. You are respectfully requested to examine material and labor statement before workmen
leave the job, and if you find everything satisfactory, okay this ticket andtee service
ayIs unsatisfactory, in any wa , please phone our
and Affiber goffice
Immediallepay aso Inab/e des for oollectYonnGuUin meysefees /n the m of my defaree to
ult �r A PENALe on PTY WILL. BE CHARGresentation o ED AT THE RATE OF
1trz°% PER MONTH ON UNPAID BALANCES AFTER 30 DAYS OF INVOICE DATE. ANNUAL PERCENTAGE RATE 18%.
Contractors are required by law to be licensed and regulated by
the Contractors'State License Board. Anyquestions concerninga signed
contractor may be referred to the registrar of the board whose
address is: Contractors' State License Board, 9835 Goethe Road, BY
Sacramento, CA 95827, P.O. Box 26000, Sacramento, CA 95826.
Total Material
Tax
Service
Permits- Insurance
Trucks -Equipment
TOTAL
Copyrlyht 1993 by Johne. Reeves 8 son s Rea ws ousmos FoRa s • aw warner o&*. Cuwr M. CA 80292
Form 31 WAC