04467 (SATT)(f400ty,,, 4' 044*
P.O. BOX 1504
Building > �, ` ` E ' 6�t�i�4 _ M-105 CALLE ESTADO
Address LA.QUINTA,,CALIFORNIA 92253
Owner
Sunrise comany
Mailing
Address Country C1W
Alri Desert Zip 92260
Contractor
National Mortgaqo
Aaaress
City Zip
State Lic.
& Classif. 280130
Arch., Engr.,
Designer
Address
BUILDING: TYPE CONST. OCC. GRP.
Drive A.P. Number PGG Wootk - The Greene" kk
Tel
Legal Description
Project Description Vhase 'stn Plan 8y.1
City y
Lic. # 3 a .a .. Sq. Ft. • . 1700 No. 2 No. Dw'' '
" Size' Stories Units
Tel.
New ❑ Add ❑ Alter ❑
Repair ❑ / Demolition ❑
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
"
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effec•
t.
'
SIGNATURE DATE
OWNER -BUILDER DECLARATION
` 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
o
permit tconstruct, alter, improve, demolish, or repair any structure, prior to its issuance alsog.
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
Estimated Valuatio$120,769
_• y;
•-
, 769
PERMIT
'AMOUNT' "
the provisions o! the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business 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
Plan Chk. Dep.
"
subjects the applicant to a civil penalty of not more than live hundred dollars (8500).
O I, as owner of the property, or my employees with wages as their sole compensation, will
Plan Chk. Bal.
-
Const.
it Ji/
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
Mech.
39i.00
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 sale. If, however, the building
Electrical
'.� ,-�.'
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
Plumbing
_ ,
105 p'�Q •
❑ 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 of property who builds or improves thereon, and who contracts for
. S.M.I.
8..4.4
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
'
O 1 am exempt under Sec. B. & P.C. for this reason
Grading
Driveway Enc.
Date owner
y �y
$F.�j o,7i! .32
.Infrastructure
WORKERS' COMPENSATION DECLARATION
L11(21V ,Lire X i `b1r*X,"i=U-Vt$
Q •' 000
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
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
g -�ry
grey�«rv,.Jl r,4-l'ry f.i J
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars (S100) valuation
REMARKS
1
-
,�{ IR�'pa�yy �iy .i
•- A. 01 �3;va8,Y9'dt 11 l�f`'3"i i�'r •Rt `�' �"r3' "I FIA i � �-L
C� �y��1�t y�, 11"'W
or 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: If,, after, making, this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Minimum Setback Distances: '
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 11
Lender's„ Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
• expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is 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-
bovementioned property for inspection purposes:' .
mentioned
FINAL DATE
Issued by:Date
Validated by:,
INSPECTOR
`, t
f Permit
- ,
Signature of applicant Date
MailingAddress
Validation:
GOLDENROD ASSESSORS OFFICE, HARD COPY - FILE i
.e -.9"...F:- ,K'_'L.:.. .._ .- t.:-' ... • '�t�l ._. .. .. .s ..3.�:[•.e ♦..5 �. •(:•-.. ...-1..- . > wY_: •, ..... .... .—
City,• State, Zip
�;; , , n WHITE FINANCE PINK -APPLICANT, GREEN BUILDING,
{.'.Y" -;G. �•.•�� :�'4,w 1'2.7'{.'' - _}�.:- •....: .:"':L -. r ..�:.-<._,.L _.d?n'itG, {> ,-. A.. �`:'.: r.. .� ...F`_ - ,,.
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO Fl h $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL SO FT. la
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR SO FT a
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR SO. FT. Fb
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SO FT. f4
WALL SO. FT. @
DRINKING FOUNTAIN
SERVICE
FINAL INSP.
URINAL
SO. FT. (a
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ plus x$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTONDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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. g c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID IIA c
SEWAGE DISPOSAL
SO.FT.GAR ar 3i:c
HOUSE SEWER
INSULATION/SOUND
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 SEPTI-- 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
�JEI 10�
vCERT.
OCC.
FENCE FINAL
INSPECTOR'S SIGNATI/1ESIINITIALS
GARDEN WALL FINAL