04341 (SATT)I P.O. BOX 1504
Building 55-2,13 TaU �.e�+ood 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA,92253 Jr, f
Owner - . V
sunrise Company-
BUILDING: `TYPE CONST. OCC. GRP. -
Mailing ,, ~
Address :115"" 0,05 t:ot't83tg•v Cl UJEii i . - A.P. Number VCA West The.. rcians
City Zip Tel. :
Palm ])Gsogt 02,260 322'-1020 Legal Description ,
Contractor Project Description iori R =- 'Phai§e ifx
National mortamm
Address
City Zip Tel.
State Lic. r City
& Classif. 288.130 Lic. # 398 t y Sq. Ft. 1536 No.. No. Dw A
Size ` Stories Units `
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ • 'Demolition ❑
Address Tel. r
City Zip State r
Lic. #
LICENSED CONTRACTOR'S DECLARATION f
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
effect. y. 'f ..x. Ys5 . r r ! i
SIGNATURE' +DATE
OWNER -BUILDER DECLARATION Estimated Valuation
1' hereby affirm that I am exempt from,the Contractor's License Law for the following $108,P516
reason: (Sec. 7031.5,Susiness 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 rile a,'signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Law,'• hapter 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.
y subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. - �.��' -
O 1, as owner of the property, or my employees with wages as their sole compensation, will
,rdo-the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 455.50 ,
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, Mech. .,39#0 0
?.. provided that such improvements are not intended or offered for sale. If, however, the building �D
„or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 145..5 da
of proving that he did not build or improve for the purpose of sale.) 77 ,
❑ I, as owner of theproperty, am exclusively contracting with licensed contractors to con- Plumbing . 9 a r, 00 ,
struct the project. (Sec. 7044,,Business and Professions Code: The Contractor's License Law y s �a
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. •7 _i .60
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) '
- Grading •
❑ 1 am exempt under Sec. B. t; P.C. for this reason
Driveway Enc.
Date Owner Infrastructurei��4!1.
l
as ( `fit It IiJ.W.0 W
WORKERS' COMPENSATION DECLARATIONJUer. I nxras cruQ i7riure Arr 44 5 U A
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.) f
Policy No. Company r
Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
wii �.+;�,.k��'nf{�''.,7E';'f•;�'i�•_•,:R �, �a
(This section need not be completed if the permit Is for one hundred dollars ($100) valuation
or less.)
_ ... ., ... ._ .. .- ....,. .. _,....._ .. ,._-.
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.,
Date Owner
NOTICE TO APPLICANT. If, alter making this Certificate of Exemption you should become
ZONE:
BY: - -
subjectto the Workers' Compensation- provisions of the Labor Code, you must forthwith
- comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCT10ii LENDING AGENCY
Side Street Setback from Center Line'
I hereby affirm that there is a construction lending agency for the performance of the
+ work for which this permit is'issued. (Sec. 3097, Civil Code.)
Side Setback from Property Line .•
h; Lender's Name
y
Lender's Address'
FINAL DATE
r
I, -
This is a building permit when properly filled out, signed and validated, and is subject to
7 241 4.R
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
ISSued.by:
Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of .this city to •enter the above-
bovementioned
mentionedproperty for inspection purposes.
Validated by:
Signature of applicant " Date
•J
Mailing Address
Validation: . `
GOLDENROD ASSESSORS OFFICE HARD COPY -. FILE ., �7
t, City, State, Zip
` ----,WHITE -FINANCE, PINK APPLICANT, GREEN -.BUILDING,
kt
..�.. dr: ^_�• ..; i -._...n::.,. �,..••r.'.a .3. :_ .. +:4: :✓f'$.r. ,,.':,l.:: lr .::9i•' ,y;N'
-;
� ;..t i•r:�Jew �?-'_
:.. n .:cp1n. _ti_�.Yv.� 4.. :;,....w- id'+':;�r....:/ii,+r. .ii ti:r.. uu,?.,.-a.,-:..._t_..'
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
ISI FL SO Fl rp S
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. R
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FTa
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT. Cl
TEMP. POLE
GROUT
DRAINAGE PIPING
CARP. SO FT. �
FINAL INSP.
WALL SO. FT. f7
WATER SYSTEM!
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus xa
=$
URINAL
SO. FT. (I
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
WASHER(AUTO)(DISH)
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
IAMPERES 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 @ l IA c
SEWAGE DISPOSAL
SO.FT.GAR a 3/.c
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 8 AIR COND. SOLAR
SETBACK
GROUND PLUMEING
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 xa
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
,FIREPLACE
SPARK ARRESTOR'
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESJINITIALS
GARDEN WALL FINAL