06816 (SFD)414a
• P.O. BOX 1504 N o . 06816 •
I
Addrdess�2�/ Shoal Greek LA QUINTAing 78-105 CCCALIFORNIA 92253
Owner
Sunri se Comany
Mailing
CityZip
Palm Desert .226€
Contractor
. iia lienal Land & }ior
Address
Same
City Zip
568-2828
BUILDING: -TYPE CONST. OCC: GRP.
A.P. Number PG. WEST " Phase 2
Legal Description
Project Description Tract 20717-39 Plan 4C
State Lic.
& Classif. 2W130
f
City
Lic. # 328
Sq. Ft. 191$
Size
No. No. Dw.
Stories A Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑ '
Address-
Tel.
Side Street Setback from Center Line
1 City
Zip
State
Lic: #
1/90P
Issued by:
Date Permit
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
!
Validation:
_
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirlm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,8uskness and Professions Code: Any city or county which requires a
'Permit to construct, after, 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
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Dfvfsfon 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
^ subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
,j ❑ 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, Suisness and
' 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,
_ provided that' such improvements are not intended or offered for sale. I/, however, the building
or improvement is sold within one year of completion, the owner -budder will have the burden
' of proving that he did not build or improve for the purpose of 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 of property who builds or improves thereon, and who contracts for,
• 'such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
,..
Estimated Valuation
4 ��
1 > 81
'
PERMIT
-• �?
AMOUNT
Plan Chk. Dep.
-•
Plan Chk. Bal.
_
Const.
x
�• _� s
_ Mech.
M U-
Electrical
Plumbing
!331.Ua -
S.M.I.
• -
Grading
f
Driveway Enc.
Date -owner
Infrastructure
•. WORKERS' COMPENSATION DECLARATION
• I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
r 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
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
TOTAL
REMARKS
x+�s�:.6#<`5 ; jti 11f5.7, f5i g•i_ SEI
-
g
.w - .§.+6'!u 1 t.f I i=r<.. • i ay f i'1: s ! :' r
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: ff., after making this Certificate of Exemption you should become
subject to the Workers' Cmpensation provisions of the Labor Code, you must forthwith
comply with 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
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that 1 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.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address '
City,. State, Zip
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
1/90P
Issued by:
Date Permit
Validated by:
Validation:
r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
FOR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. Fr. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT.
LUMBER GR.
F INSP
URINAL
Sp. FT. @
ROOFING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3Vsc
HOUSE SEWER
CERT. OCC.
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
GROUND PLUMBING
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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
F INSP
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1