05070 (SATT)Building
Address � 541 an -436 Tl.evaood
Owner
Sunrise Company
Mailing
Address 42-600 Cook St,
CityZip
Palm' Desert 922..
Contractor
1Qas {f' 91 ts�asr 9 1wFnr! rssa x*s�t
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City Zip Tela
State Lic. City
& Classif. 288130 Lic. # 328,
Arch., Engr.,
Designer
Address Tel.
CityZip I
State
I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
i I hereby affirm that I am licensed under. provisions of Chapter 9 (commencing with Section
7L10� of Division 3 of the Businessland Professions Code, and my license is in full force and
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from theContractor's License Law for the following
reason: (Sec. 7031.5,Bdsiness and Processions 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 Me a signed statement that he is licensed 'pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Busirress 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 aopi=it to a civil penally or not more than five 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
!wilds or hproves 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 or completion, the owner -builder will have the burden
or proving that he did not build or improve for the purpose or sale.)
❑ 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 or property who builds or improves thereon, and who contracts for
such projects with a conbactor(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
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
(ibis section need not be completed ff the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the perfornance 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 t x Owner
NOTICE TO APPLICANT: d, after making this Certfticate of Exemption you should become
sub)ecr to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply wNn such Provisions or this Permit shall be deemed 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
Lenders 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.
1 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. 050.70
11LDING: TYPE CONST. OCC: GRP. -
P. Number PCA Aleat -- Plane. 31A
(gal Description
oject Description P't rill 9G
REMARKS
stdbtfsi3� itlti
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Sq. Ft. 2.489
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
12/227t/88
Issued by:
Date Permit
Validated by:
Validation:
Estimated Valuation
$17 1,208
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 500. 90
Const.
610.50
Mech.
33.00
Electrical
113. a2
Plumbing
111.00
S.M.I.
11.94
Grading
Driveway Enc.
Infrastructure
$3 9 829 . fiS
1..%14.84
Less Credit
1.914.84
TOTAL
93.295.70
REMARKS
stdbtfsi3� itlti
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
12/227t/88
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
,ST FL. J SQ. FT. ® $
UNITS
66 B GRADESi
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
ER OR SEPT q1W7
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
S (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN
WALL SO. FT. ®
_$
LUMBER GR.
FINAL INSP.
RAMING 6
URINAL
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
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
SPARK ARRESTOR
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREWALL
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
FI S GRADING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
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
ND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
66 B GRADESi
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ER OR SEPT q1W7
ROUGH WIRING
DUCT WORK
ROCK STORAGE
OUND. REINF.
S (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
NAL) 1
/
TEMP. POLE
GROUT
WATER HEATER
IVICE 7
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
RAMING 6
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
FIREWALL
HIN 7
MESH
NSULATIONISOUND 7
FI S GRADING
�AL INSPECTION
CERT. OCC.
FENCE FINAL
\
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL