04957 (SFD)S
P.O. BOX 1504 No, 049ST
Building 78-105 CALLE ESTADO
Address 54-863 Shoal Creek LA QUINTA, CALIFORNIA 92253
Owner
Sunrice Company
Mailing
Address �..
City Zip Tel.
Palm ticserir 92260 'g68a-28 8
Contractor
iilR.ir�AT3lPt� i�A1iQP'� �
Address
City Zip Tel."
State Lic. City
& Classif. 288130 Lic. # 328
Arch., Engr.,
Designer
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number PCA Nest - Tract 20717-3
Legal Description
Project Description Pharme 17A. Plan SIC
,Sq. Ft. 2439 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair. ❑ Demolition ❑
Address
Tel.
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
City
Zip
State
FINAL DATE
Lic. #
12/8/86
LICENSED CONTRACTOR'S DECLARATION
Date Permit
Validated by:
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:
effect. „! � .r r � ,rr --j fv • 5
SIGNATUREDATE
OWNI7FBUILDER DECLARATION
Estimated Valuation
I hereby affirm that 1 am exempt from the Contractors License Law for the following
r
reason: (Sec. 7031.5,13usness and Professions Code: Any city or county which requires a
41-70,208
permit to construct, after, hprove, denicksh, or repair any structure, prior to its issuance also
requires the applicant for such permit to lie 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 lius ness and Professors Code, of that. he is exempt therefrom, and the basis
for the alleged Any Section 7031.5 'any
Plan Chk. Dep.
exemption. vfofatim of by applicant for a permit
subjects the applicant to a civilpenally of not more Oran five hmdfed dollars ($500).
❑ 1, the
Plan Chk. Bal.
(.
as owner of property,
p party, ar 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
Professions Code: The Canbactors
COr1St.
610.50
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.
provided that such improvements are not rderded or offered for safe. If, however, the building
33.00
orimprovement is sold withh one year of canpletonn, the owner -builder will have the burden
Electrical
of proving that he did not build or irprove for the purpose of sale.)
113.52
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbingg
Q�
struct the project (Sec. 7044, Business ad professions Code: The Contractor's License Law
does not apply to an owner of properly who bolds' or improves thereon, and who contracts for
S. M. 1.
f 1 9 G
such projects with a contrader(s) licensed pursuant to the Contractor's License Law.)
Grading
• ❑ I am exempt under Sec_ B. & P.C. for this reason
Driveway Enc.
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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 empieted if the pemxt 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: t, after making this Certificate of Exemption you should become
subject to the Workers' Conpe safim 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.)
Lenders Name
Lenders 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 certity that I have read this application and state that the above information is correct.
1 agree to comply with all city arid county ordinances and state laws relating to building
construction, and hereby authortm representatives of this city to enter the above-.
mentioned property for inspection purposes
Signature of applicant Date
Mailing Address
City, State, Zip
Infrastructure $3.8.89.613 T gr 14.84
Leas 1-914.RA
TOTAL
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
12/8/86
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
tST FL. SQ. FT. ® i
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SQ FT ®
GAS ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
TE P. POLE
GROUT
DRAINAGE PIPING
CAR P. I SQ. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN
WALL SQ. FT. ®
LUMBER GR.
FINAL INSP.
FRAMING
URINAL
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
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(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SPARK ARRESTOR
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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
FI H GRADING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
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
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
(FINAL)
TE P. POLE
GROUT
WATER HEATER
Z VICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
y -Plus-X$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FI H GRADING
NAL INSPECTION ,
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL