04062 (SATT)ng
w
T4ht
P.O. BOX 1504
00-647 Merry Mills LA.QUINTA. CALIFORNIA 92253
Su=ise Company
Mailing
Address 75-005 Count-vClub D_dare
City Zip Tel,
Palm Desert 92260 M,6$-2828
Contractor
National mortgaw
Zip
c. city
&tate Cla s�if. � � � � I Lic. #
Arch., Engr.,
Designer
Address Tel.
City I Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that, I I am licensed under provisions of Chapter 9 (commencing with Section
70 of Division 3 of the Business and Profession Code, and my license Is In full force and
effect:
a16NATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's. License law for the following
reasom, (Sec. 7031.5;Buainesa and Professbna Code: Any city or aounly which requires a
permff to construct alter, Improve, demolish, or repair any structure, prior to he Issuance also
requires Me appacanf rot such permit to file's signed statement that he b licensed pursuant to
the provisions of the Contractor's License Law, Chapter 8 (comxnarncing with Section 7000) of
Division 3 of the Business and. Professions Code, or that- he is exempt therefrom, and the basis
for Me alleged exemption. Any violation of Section 7031.5 by 'any applicant for a p9mW
subjects the apptkant to a cit/ penalty of not. more Man five hundred doileis ($500).
❑ I, as owner of the property, or my employees with wages as their solecompensation, will
do the work, and the structure Is not Intended or offered for sale. (Sec. 7044, Buraness and
Professions Code: The Contractor's Ucense Law does not appy to an owner of properly who
bxr/kds 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. f, however, Me building
or improvement Is sold within one year of completion, the owner -builder wlp have the burden
of proving that tie did, not,bu#d or.lmprove for Me purpose of sale.)
❑ I, as owner of the property, amexclusively contracting with licensed contractors to con,
struct the project. (Sec. 7044, Business, and Professions Code: The Contractors License new
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. a, & P.C. for this reason
Date Owner,
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, ora certified copy thereof. (Sec. 3800; Labor Code.)
Policy No. Company
❑ Copy is filed with the city. O, Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
.(This section :need not be completed /f the permit Is for one hundred dollars ,($100) vefustlon
or IBS-.)
1 certify that In the performance of the work for which this permit In issued, I shall not
employ any person many manner so as to become subject toi4he Workers' Compensation
Laws of Call ornla.
Date_ Owner
NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you shouAd become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply w/M such provisions or M/s permit: snap be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there Is a construction lending agency for the performance of the
workYorwhich this permit Is Issued. (Sec: 3097; Civil Code.)
Lender's Name
Lender's
Address
This Isa building permit when properly filled out; signed and validated, and Is'subject to
expiration. It work thereunder is suspended for ISO days.'
I certify that I have read this application -and state that the above Infometlon.1s 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
LDING: TYPE CONST. OCC: GRP.
P. NumberLDGA Want
Description
t Description Phase 1133' Plan 20M
Sq. Ft. 2596 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $179 8 I
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
52 e
Const.
533 •
Mech.
55 . UU
Electrical
9
Plumbing
z . J
S.M.I.
o
Grading
Driveway. Enc.
Infrastructure
TOTAL
5 4 5 17. 13 1l .%.
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 IN�S�EG�TOR
Issued by: Date J X3°3 Permit
Validated by:
Validation:
WHITE - FINANCE, PINK APPLICANT, GREEN BUILDING, GOLDENROD. - ASSESSOR'S OFFICE, HARD COPY FILE
M
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL - SO FT (p f
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTOM
2ND Fl SO FT. 8
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEMOME SVC,
BAR SINK
POR
GAS (ROUGH)
METER LOOP
GAR SO. FT. M
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CARP SO FT M
GROUT
WATER HEATER
WALL SO. FT. m
FINAL INSP:
DRINKING FOUNTAIN
BOND BEAM
WATER SYSTEM
URINAL
SO. FT. M
= $
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION f
FINAL INSP.
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(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED.
FIRE ZONE ROOFING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIREPLACE
KITCHEN SINK
ABSORPTION SYSTEM B.T.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. ®e
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT. B.T.U.
SO. FT. REBID 4 1 % c
SEWAGE DISPOSAL
SO.FT.GAR a 3Ac
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
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 APP./EOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP:
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
f plus xf
= $
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR,
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
TIO
CERT.
FENCE FINAL
INSPECTOR'S SIGNATURESIINRIALS
GARDEN WALL FINAL
CITY OF LA OU I NTA
DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
-564-2246
244HOUR NOTICE FOR INSPECTIONS
Owner Sunrise Company
Contractor National Mortgage
Permit Number 4062
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 80-647 Cherry Hills
"Single Family Dwelling"
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL -
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTILABOVE HAS BEEN SIGNED
CONCRETE SLAB S&— Xu-
JOISTS
uJOISTS &GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ABOVE HAS SEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GASTEST (( _
HEATING & VENT -A/C
FIREPLACE
BOND BEAM
O.K. TO WRAP-
GROUT ❑ 4' ❑ 8'
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING- A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING