04066 (SFD)Building
Address
Owner
Mailing
Address
City
V [ilm
State Lic.
& Ciassif.
80-707 Cherry Hills
0� i Se
Arcn., tngr.,
Designer
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Zip Tel.
92260 1
5se-
288130 1 E0* 32 8.
City ( Zip ( State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
70pD) of Division 3 of the Business and Professions Code, and my license,is in full force and
of}act. ,
SIGNATl1RE DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5;13usiness and Professions Code: Any city or county which requires a
permit to construct, alter, Improve, demolish, or repair any structure, prior to ft Issuance also
requires tho applicant for such permit to the a sh ed statement that he is licensed pursuant to
Me prov/skxns of Me Contractor's License Law; Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that, he Is exempt Merefran, and Me basis
for the alleged exemption. Any vkilatlon o/ SecObn 7091.5 by` "any appdeant !ora pemdt
subjects the applicant toa civil penalty of not more Man lire hundred dollars ($500):
0.1, 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, Sureness end
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 safe. ll, however; Me building
or improvement is sold within -one year of completion, the owner-bulider will have the burden
of "proving that he "did notbulld or knprove for the purpose of.sale.)
0 I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of property who builds or Improves thereon, and who contracts for
such pro)ecfs with a contiactor(s)'llcensed pursuant to the Contractor's License Law.)
❑ Uam exempt under Sec. B, tic 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, 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 Pam* Is for one hundred dollars ($100) valuation
or lose:)
I certify that In the performance of the work for which this permit is Issued„ 1 shall not
employ any person in any manner as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: N, atter making this CertHFcate of Exemption you shouts became
subject to the. Nbrkers' Compensation .provisions of Me Labor gods, you must forthwith
comply with such provisions or this permit shall be doomed revoked.
CONSTRUCTION LENDING'AGENCY
Ihereby affirm that there Is a construction lending agency for the performance. of the
work forwhich this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is abuilding 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 Infor iatlon Is comecL
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives bf this city to enter the above-
mentioned property for inspection1purposes..
Signature of applicani Date
Halling Address
City, State, Zip
✓t �': � lb
BUILDING: TYPE CONST.
A.P. Number PGA West
Legal Description
Project Description ?%til pial .I
OCC. GRP.
Y^r?t . ' M ATI 10M
Sq,_Ft, 2825
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
- •
Const.
a .
Mech.
o
Electrical
•71
Plumbing
e ST
S.M.I.
•
Grading
Driveway Enc.
Infrastructure
4,,3 a o•
TOTAL
a
•
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
INS7?Cl8A
Issued by: Date Permit
Validated by:
Validation:
1
WHITE - FINANCE, PINK- APPLICANT, GREEN -BUILDING,-GOLDENROD.- ASSESSOR'S OFFICE, HARD COPY -:FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO Fl y s
UNITS
IP
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT.0
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR 60 FlM
GA '(ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT.
TEMP. POLE
GROUT
DRAINAGE PIPING
CARP SO FT Q
FINAL INSP.
WALL SO FT . -6
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu.yd.
= plus xi
=s
URINAL
SO. FT, M,
FINALINSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION S
WATER PIPING
NOTE: Not to be used as properly tax valustion
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTONDISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRYTRAY
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT. B.T.U.
SO. FT. RESID Q I% c
SEWAGE DISPOSAL
SO.FT.GAR 3Ac
HOUSE SEWER
INSPECTIO
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE LCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR GOND. 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.
GA '(ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP:IEOUIP.
REINF. STEEL
S (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu.yd.
= plus xi
=s
LUMBERGR.
FINALINSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR.. FIREWALL
LATHING
MESH
INSULATIONISOUND
FI SH GRADING
INSPECTIO
CERT. OCC.
FENCE' FINAL
INSPECTOR'S SIONATURESIINRIALS
GARDEN WALL FINAL 71
CIT
FOF LA QUINTA
o E P!A'kMikf 6� PLANNINGA I)MLOPMENT
-BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
11 -vi -c // 0 -,84 .2
T
owngr- Sunrise Compan
Contractor National Mortgage
Pernift Number 4066
F08T ON JOB IN CONWICUOUS KACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOBADDRESS 80-707 Cheriv Hills
"Single Family Dwellingn
- TYPE OF INSPECWN DATE INSP.
FOUNDATION & SETBACK
MAIN GROUND SYSTEM I I
GROUND PLUMBING I rgp_24w_ylo� I"JPC
DO NOT POUR CONCRETE UNTILANOVE HAS BEEN WONEII)
CONCRETE SLAB 6ggdO�w- -
4_
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
00 NOT POUR CONCRETE UNTILASME HAS DUN SIGNED
ROUGH GAS'& GAS TEST 4 2 -
HEATING &VENT- AIC
BOND BEAM
O.K. TO WRAP 7ZF'
GROUT 13 4! 13 V
INSULATION
COVER NO WORK UNTIL ABOW HAS BEEN NONED
DRYWALL INTERIOR /0/, 7 tece
EXTERIOR LATH
POOL PRE PLASTER
FENCE& GATE -
FINAL GAS TEST
NUMBERS
MPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING