04072 (SATT)4 44ol Q9&&
Building rrt-,` 23 `h4'Tr-, 5,ili k
Address
Owner
Mailing
Address ;' 3-•'105 Country Club rF; ive.
City Zip Tel.
9?a.im nose t
Contractor tj y t
Address
ly l Zip I Tel.
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST
A.P. Number
Legal Description
State Lic. City
& Classif. — Lic. # 3 211
Arch., Engr.,
Designer
Address Tel.
City I
Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under pvisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Pro
feroBatons
Code, and my license is in full force and
effect.
SIGNAT MR _ DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt From the Contractor's License Law for the following
reason: (Sec. 7031.5,2ualness and Professions Code: Any city or county which requires a
permit to corralruct, after. Improva, domaiish, or repair arty structure, prior to as issuanca else
inquires the appr)canr for such permit to his a signed statement that he is licensed pursuant to
Me provisions of the Contractor's License Law, Chapter 9 (commoncrng with Section 7000) of
Oivisron 3 at the Busrness and Procession Code, or Mar he is exempt therefrom, and the bases
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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
de the work, and the structure Is not intended or offered Far sale. (Sac. 7044, Bussness and
Pmfassions Code: The Conlracfor's Llconne Law does not apply to an owner of property who
bdids or improves rhsmon and who. does such work himself or through his awn employees,
provided that such improvements are not kkanded or offered for sale. ff. tmwevBr, rho building
or Irnprovamenl Is sold within one year of Camplatlon, the owner -builder wit have the bufdan
of proving that he did not build or improve for the purpose of Sala.)
Cl 1, as owner of the property, am exclusively contracting with licensed cornitactors to con-
slrucl the project. (Sac. 7044. Business: and Prolesslans Cade: The Conrractor's: License Law
does not apply to an owner of property who builds or improves thereon, and who cor0mc(s for
such prolacts with a contraclbt(n) AcensedpursutW to the Confraclar's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
W less,)
I certify that in the performance of the 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: 11, after making this CerfiAcela of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or (his permit shall be doomed 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, Civil 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.
lagree 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
Description
OCC. GRP.
Phase 11B, Plan 40M.'
Sq. Ft. 3142
Size
No. No. Dw,
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
723.
Mech.
5 _ •' -
Electrical
2R.63
Plumbing
1 .50
S.M.I.
;5.�
Grading
Driveway Enc.
Infrastructure
It
TOTAL
43 J • `f `
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
/lS?�
Issued by: Date Permit
Validated by:
Validation:
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO
ELECTRICAL FEES
NO
PLUMBING F:ES
1ST FL SO FT rp
2ND FL SO FT
POR SO FT Cr
GAR SO FT a
CAR P SO FT
WALL SO FT rC
50 FT a
ESTIMATED CONSTRUCTION VALUATION
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
$
WATER PIPING
NOTE, Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP COOL HOOD
SIGN
WASHER(AUTOYDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM BIT U
TEMP USE PERMIT SVC
WATER CLOSET
,COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B T.U.
SO. FT @ c
BATH TUB
SO FT. g c
WATER HEATER
MAX HEATER OUTPUT, B.T U
SO FT. RESID C 1Ii. c
SEWAGE DISPOSAL
SO.FT.GAR @ '/. c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES MICRO FEE
MECH.FEE
k.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
HOUGH WIHING
DUCT WORK
HOCK SIOHAGE
FOUND REINF
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP
BOND BEAM
WATER SYSTEM
GRADING
cu yd
$ plus x$
=S
LUMBER GR.
FINAL INSP
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
ECTION
CERT OCC
FENCE FINAL
INSPECTOR'S SIGNATURt=SIINITiALS
GARDEN WALL FINAL
ti
CITY OF LA OUINTA
h -
or DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
5642346
24-HOUR NOTICE FOR INSPECTIONS
Owner. Sunrise Company
Contractor National Mortgage
Permit Number 4072
POST ON JOB IN CON 4CUOLIG PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS SQ -6.23 Cherry Hills
"Single Family Dwelling"
TYPE OF INSPECTION I DATE I INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
PRE-GUNITE
DO NOT POUR CONCRETE UNTILABOVE HAS BEEN SIGNED
CONCRETE'SLAB AVCS
JOISTS & GIRDERS
DO' NOT POUR CONGRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST f
HEATING & VENT -.A1C
ROOF
BOND BEAM
O.K. TO WRAP /e% 777V
GROUT ❑ V ❑ V
FRAMING ick ry
PRE -ROOF I I -
COVER NO WORK UNTIL ABOVE HAS BEEN S ONED
DRYWALL INTERIOR.
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE &GATE
SEWER SEPTIC TANK
FINALS
PLUMBING
FINAL GAS TEST
HEATING - A1C
HOUSE NUMBERS
JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING