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07030 (SFD)44 P.O. BOX 1504 N o . Building„ 7&105 CALLE ESTADO AddressW243 Sboai Creek LA QUINTA, CALIFORNIA 92253 Owner Sun r4 se Company Addres42-600 Cook St. Suite 200 City Zip Tel. Pais Desert 92260 568-2828 Contractor . . National iklirtgage & tand .Address . BUILDING: TYPE CONST. OCC: GRP. ' A.P. Number P&A WEST - Phase 25A Legal Description Trace~ 24317-2 Project Description Plan - City 07030 Policy No Company • ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ff the permit is for one hundred dollars (41100) valuation ` or less.). ' I certify that in the performance of th0 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 „ TOTAL REMARKS 4 Z.Q? --her e NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become ZONE: BY: •'� subject to the Workers' Compensation provisions of the Labor Code,, you must forthwith comply with such provisions or this permit shall be deemed revoked- ip . T Tel.: Front Setback from Center -Line Rear Setback from Rear Prop. Line - CONSTRUCTION LENDING AGENCY State Lic. & Classif.288130 City Lic. # 328 Sq. Ft. 1627, No. No. Dw. work for which this permit is issued. (Sec. 3097, Civril Code.) Size - Stories Units -Arch:, Engr., Lenders Address This is a building permit when properly. filled out; signed and validated, and is subject to '. Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ - Address Tel. 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 r City Zip State mentioned property for inspection purposes. • Validated by: Lic. # Signature of applicant Date' LICENSED CONTRACTOR'S DECLARATION Mailing Address _ Validation: I hereby affirm that I am licensed under provisions of Chapter (commencing with Section. . 7000) of Division 3 of the Business and Professions Code, and my license is in full force and City,- State; Zip effect ' SIGNATURE - DATE OWNER -BUILDER DECLARATION Estimated Valuation' I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which requires a ' permit to construct, after, hnprove, demolish, or repair any structure, prior to its issuance also ' requires the for to the that he is licensed PERMIT•' �` , applicant such permit a signed statement pursuant to I the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of AMOUNT , Division 3 of the Business and Professions Code, or that. he s exempt therefrom, and the bass for the Any Section 7031.5 by 'any Plan Chk. Dep. alleged exemption. violation of applicant for a permit - subjects the applicant to a civil penalty of not more than five hundred dollars (41500). - Plan Chk. Bal.„ y y • erg ❑ 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 Const.Professions �+ s Code: The Contractor's License Law does not appy to an owner of property who _ .i builds or improves thereon and who does such work himself or through his own employees,• McCh. �• • provided that such Improvements are not intended or offered for safe. ff. however, the building A4 w or improvement is sold within one, year of completion, the owner -budder wig have the burden Electrical - aVA • Ati. of proving that he did not build or improve for the purpose of sale.) •+ ❑ 1; as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing s' ” 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 to the Contractor's License Law.) Grading ❑ I am exempt under Seca. & P.C. for this reason ' ' Driveway Enc. ; VIVA Date owner InyfraStrugj!jeJs ��/ ;'p9 'w �} ';`r ` yr r b�4•.�• v •,. - � ' WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of _ Workers 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 (This section need not be completed ff the permit is for one hundred dollars (41100) valuation ` or less.). ' I certify that in the performance of th0 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 „ TOTAL REMARKS 4 Z.Q? --her e NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become ZONE: BY: •'� subject to 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 - CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the. i work for which this permit is issued. (Sec. 3097, Civril Code.) Side Setback from Property Line Lenders Name Lenders Address This is a building permit when properly. filled out; signed and validated, and is subject to -FINAL DATE IN$P TO`� `O Si 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 r 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 , CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS COLL. AREA G SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SQ. FT. ® HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE OUND. REINF. (— J'% / / `J POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) DRAINAGE PIPING CAR P. SQ. FT. ® GROUT WATER HEATER DRINKING FOUNTAIN. WALL SQ. FT. FINAL INSP. BOND BEAM WATER SYSTEM URINAL SQ FT ® GRADING cu. yd. $ plus x$ =$ ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation `L./� yy�� 4<ROOFING L `�C .� �'VV�� FLOOR DRAIN MECHANICAL FEES �G� WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRY TRAY AIR HANDLING UNIT CFM FIREPLACE 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® V/ac 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 O&ROUND PLU U W UNDERGROUND A.C. UNIT COLL. AREA G SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR ROUGH WIRING DUCT WORK ROCK STORAGE OUND. REINF. (— J'% / / `J GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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 6 � FINAL INSP. `L./� yy�� 4<ROOFING L `�C .� �'VV�� w. •,� S S �G� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING r MESH SULATIONISOUND�Va FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL