05100 (SFD)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-996 Shoal Crack LA QUINTA, CALIFORNIA 92253
No. 05100
Sunrise toppany
BY:
Minimum Setback
BUILDING: -TYPE CONST. OCC: GRP.
A.P. Number PIRA WLitott •- Wha no IIAA
Legal Description
Project Description '01;0- t )SME
}
Mailing
Address ',t3tlc6ok St., stilra 200
City Zip Tel.
!P
Contractor
#�AM. S A • � � MA
Address
Q
87.
SO
City "
Zip
1.060.25
Tel.:
Issued by:
12/27588
Date Permit
State Lic.
B Classif. 288130
City
Lic. #
328
Sq. Ft. $330. 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 is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affiryn that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,&tiress and Professions Code: Any city or county which requires a
permit to construct, alter, rrpiove, demolish, or repair any structure, prior to -its issuance also
requires the applicant for such permit to Me a signed statement that he is licensed pursuant to
the provkA m 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
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the spoil c it to a ciW perggy of not more than Five hundred dollars (8500).
❑ 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
Professions Code: The Contractors License Law does not apply to an owner of property who
builds or mproves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. IF, however, the building
or urprovanent is sold within one year of completion, the owner -builder will have the burden
of proving that he did not buil or move for the purpose of sale.)
❑ I, as owner of the properly, 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 Ser -_B. & P.C. for this reason
Estimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
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
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No C,bmpany
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(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 thg 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 Caldomia.
Date Owner
NOTICE TO APPLICANT: 9, after ma" this Certificate of Exemption you should become
subject to the Ntorkers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this pemrft shag be deemed revoked.
j
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 abuilding permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 1110 days. '
I certify that I have read this application and state that the above information is correct.
1 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 Addrrs
City, State, Zip
AMOUNT
BY:
Minimum Setback
� i
ar>i•
Front Setback from Center Line
4
Q
87.
SO
Side Setback from Property Line
1.060.25
INSPECTOR
Issued by:
12/27588
Date Permit
REMARKS {{
t r� r,
-Jta.l
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
Issued by:
12/27588
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT. ®
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
AS (ROUGH) 4617�97
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. I SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN
WALL SO. FT. ®
=$
LUMBER GR.
FINAL INSP.
F MINGS 57--��
URINAL
SO. 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(AUTO)(DISH)
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.
SO. FT. ® c
BATH TUB
FINISH GRADING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE 1 L.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.
AS (ROUGH) 4617�97
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
VICE 7
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
F MINGS 57--��
FINAL INSP.
ROOFING
'
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA HING
M SH
42 ULATIONISOUND 5---`/
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINRIALS
GARDEN WALL FINAL