04698 (ELEC)T� 4
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 5S 821 pinehurat LA QUINTA, CALIFORNIA 92,253
Owner
Mailing
sunrise Desert Partners BUILDING: TYPE `CONST. OCC. GRP.
Address 7115-005 Country Club A.P. Number 1015A. "est
CityZip Tel.
Palm Desert, 92260 �08_« L*428 Legal Description
ContractorProject Description 100 ami I'n aroa electrical
lqatinaal Mortgage
Address
iwic'3TdM pedestal
City Zip Tel.
State Lic. City
& Classif. 2881�r.30 Lic. # 328 Sq. Ft. No. No. Dw.
Size Stories" Units
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm thal_I am licensed,under provisions of Chapter 9 (commencing with Section
7000) of Divisioon`,3 oflt/he-Business and Professions Code, and my license is in full force and
effect.>t /.I X� ,
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business 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 file a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
• Division 3 of the Business and Professions Code, or thathe is exempt therefrom, and the basis pian Chk. De
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan
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 Plan Chk. Bal.
do the work,'?arid„the-structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.Professionsde:
•Co-�,T,Ae"Contractor's License Law does not apply to an owner of property who
bullds� or: improWs-,dhereon and who does such work himself or through his own employees, Mech.
provided,- fhar'sach improvements are not intended or offered for sale. If, however, the building -
or improveine'nt is sold within one year of completion, the owner -builder will have the burden Electrical . O
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner.of the property, am exclusively contracting with licensed contractors to con- Plumbing
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 fhereon, and who contracts for S.M,I,
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure
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 certified3copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company �vf;
❑ Copy is filed with the city. ❑ CerUfie�°is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS i,�ko o 4?_T-! -A TYi`l••`i7§ — iA i +,h 4 1
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) valuation
or less.)
I certify that in the performance of thg 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: 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 Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) Side Setback from Property Line
Lender's Name
Lender's AddressFINAL DATE INSPECT R
This is a building permit when properly filled out, signed and validated, and is subject to 071 y
expiration if work thereunder is suspended for 180 days.
fe is
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 Validation:
City, State, Zip
w WHITE 7 FINANCE, PINK '= APPLICANT, GREEN -. BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1S7 FL SO FT @r S
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. a
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT Qr
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OUTLET
ROOF DRAINS
GAR SO. FT. orPOWER
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO FT. 6
FINAL INSP.
WALL SO. FT. a
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus x$
_ $
URINAL
SO. FT. 0
FINAL INSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(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, TEMIPERM
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 g 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR 3/4c
HOUSE SEWER
FINAL INSPECTION
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 8 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.IEOUIP.
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
. SPARK ARRESTOR,
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESANITIALS
,
GARDEN WALL FINAL