04361 (SATT)44 -4361
K.- P.O. BOX 1504
Building 455#„303 Tim �.eit old 78-105 CALLE ESTADO
Address LA QUINTA,CALIF„ORNIA,92253
Owner
Sunrise Company
Mailing y BUILDING"TYPE CONST. OCC. GRP.
Address ?;'-005 COU AtrV CIU D3:iV a .. . .. _ A.P. Number PGS: West. a- T.8 Oreens
City Zip Tel.
;
ilra Des rt 92260 568-282g.Legal Description
Contractor if1 ` I Thilse W;
National KoftgageProject Description
Address w
City... Zip Tel.
State Lic. ? - City 1700 2
& Classif. Lic. # .. 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 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 Win -full force and
effect. - : � .d � .•; � ;;x'.� sc�--�•i.,. """�' j'+ •:�; ,�
SIGNATURE, - DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following $129t769
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 that. he is exempt therefrom, and the basis . plan Chk. De
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit p
subjects the applicant to a civil penalty of not more than live hundred dollars (E500).
O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. :-,-'Z 1
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. f;
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, ! -
1 provided that -such Improvements are not intended or offered for sale. If, however, the. building Mech.•ry3 axx
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical (.uFc�u�r
f4 _ of proving that he did not build or improve for the purpose of sale.) - t
I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing ?a•
'-".-- 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.
such projects with a contractor(s) licensed pursuant fo4he Contractor's License Law.) ,
f
❑ lam exempt under Sec. B. 8 P.C. for this reason Grading '
Driveway Enc.
Date Owner Infrastructure •*,� v.717. -1
t:31L8 ��f�j 1i'S• � �.",t �1i } Clio .
WORKERS' COMPENSATION DECLARATION Ilet Infras rw tures
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.)
R61 icy No. .Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
•1, TOTAL 2 14 1 U a 31 ti ,i y LA
' CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
'
j`,
f -"i;. i
x ��'«r•Y lV
(This section neednotbe completed if the permit is for one hundred dollars ($100) valuation
•
or less.)
-
I certify that in the performance of tha 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 r
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.
r
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTIONLENDINGAGENCY
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.)
$Ide Setback frOfTl PTOperty Line
., Lender's _ Name "
j Lender's Address
FINAL DATE
I SPECTOR j
This is a building permit when properly filled out, signed and validated; and is subject to,
y
6
$. expiration if work thereunder is suspended for 180 days.2i
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
i
.construction, and hereby 'authorize representatives of this city to enter the above-
mentioned property for inspection purposes.
-
Validated by:
Signature of applicant Date
-
tir•
Mailing Address
Validation: -
City, State, Zip
WHITE FINANCE PINK APPLICANT, GREEN - BUILDING GOLDENROD ASSESSORS OFFICE HARD COPY - FILE R y
l,a' W .I,.�t4.�1-. .e..-�•� �A ».. � �, . � ..�,. ..'J/,- - ..,.c.. t:.q. ....it; �•• _! C-. , s. ...r, r ,..•41..tiW. , b :.r - .:�: .a4fit:- - r s -
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
ISI FL SO FT N $
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. 6
FORMS
SEWER OR SEP—IC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT. m
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT. Cl
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO FT. 0
FINALANSP.
'
WALL SO. FT. (a
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus x$
=$
URINAL
SO. FT. IB
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(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
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 C 1 V. c
SEWAGE DISPOSAL
SO.FT.GAR @ JVc
HOUSE SEWER
N TION
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 SEP—IC 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
FINALANSP.
'
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
INSULATIONISOUND
FINISH GRADING
N TION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNA URESIINITIALS
,
GARDEN WALL FINAL