06766 (ELEC)P.O. BOX 1504 N O . a' 67 6-6.
Building 55%-215 Zouthem Hills 78-105 CALLE ESTADO
Address• -LA QUINTA, CALIFORNIA 92253 '
Owner
Sunrise Desert Partners
" Mailing - BUILDING:=TYPE CONST. - OCC: GRP.
Address 4E-600 Cdok .Street, 0200 A.P. Numbe(. PGA ?mat Tract 22432-4
City Zip Tel.
Palm Desert 92260 568-2528 Legal Description "
ContractorProject Description ' Phase ~19B si8etrt£a% ' service
National Land & Nortagme
Address —12W am meter) for pool/spa 6 demon area
Cama►
Zi��tt8.
� ,
City
Zip
Tel.
State Lic.
& Classif• 285139.
City
Lic. #, , .._328, •., .
Sq..Ft.
•
No. No. Dw...
Size I~
Stories, - - Units -
Arch., Engr.,
Designer
New ❑ Add ❑
`Alter ❑ Repair ❑ 'Demolition':❑
Address'
Tel.
City
Zip
State
'
Lic. # '
LICENSED CONTRACTOR'S DECLARATION .
i
1 hereby affirm that 1 am licensed under provisions of Chapter!) (commencing with,Section
7000) of bhnsion 3 of the'Business and: Professions Code, and my license is fulLforce andA ,
•effect �' i y f i in / ,,..,1
lo
SIGNATURE - - k.e �•^- & _V :i*^'Y 1�11: f I /DATE
- y
OWNER -BUILDER DECLARATION
hereby affirm that 1 am exempt from the Contractors License Law for the following
reason: (Sec., 7031-5.Bussess and Professions Code: Any city or county which requires a
Estimated Valuation
permit to construct, alter, improve, demolish, or repair any structure,. prior to.its issuance also
requires the applicant for such permit to Me � a signed statementr that he is licensed pursuant to �
• the Provisions of the Contractor's License.taw, Chapter 9 (commencing with' Section 7000) of
PERMIT
AMOUNT
' Division 3 of the toss 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
Plan Chk. Dep.
subjects the app&ard to a civil penalty of not more than rive hundred dollars ($500).
❑ I, as owner of the properly, or my employees with wages as their sole compensation, will
Plan Chk. Bal.
Const.
"
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Ouisness and
' Professions Code: The Contractors License -Law does not apply to an owner of property who
Mech.
builds, or improves M rem and who does such work himself or through his own employees,
'provided that such inpvovernents are not intended or offered for sale. If, however, the building
Electrical
or improvements sold whin one year of completion, the owner -builder will have the burden
of proving that he did not did of improve for the purpose of sale.)
Plumbing
❑ I, as owner of the property, am exclusively contracting with licensed contractors to cors,
struct the project (Sec. -7044, Business and Professions Code: The Contractor's License Law
S.M.1.
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects w0fm a.eondrador fs) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec R- & P.C. for this reason
Grading
Driveway Enc.
r ,
Date owner
Infrastructure
`•
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 copyis'tiereby fumished.
-
TOTAL
CERTIFICATEOFEXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.) ..
REMARKS
., ;•:,; e_kya. a.rt. ..:_"S1 .43�i._:..' #,
-
-
I certify that in the perfortnance'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 mating this Certificate of Exemption you should become
' - subject to the Workers' Compensation provisions of cine Labor Code, you must forthwith
COMMy wahSuch Provisions erthis permit shall be deemed revoked.
ZONE: BY: '
Minimum Setback Distances:
Front Setback from Center Line
`
Rear Setback from Rear Prop. Line I
coNsrnucnoN LENDING AGENCYSide
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is - issued. (Sec.3097,CWCode.)
Street Setback from Center Line
Side Setback from. Property Line a
Lenders Name
FINAL DATE
Issued by: '
Validated by:
INSPECTOR "
�2 Zlyg
Date Permit
Lenders Address
'This is a building permit when property filled out, signed and validated, and is'subject to
expiration it work thereunder is suspended for 180 days.�2
1 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 ycity to enter the. -above.. '
mentioned property for inspection purposes
Signature of applicant Date
Mailing Addles
Validation:
;i,
City,. State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST 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. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
WALL SO. FT.
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ -Plus-X$-=$
URINAL
SO FT ®
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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
FINAL INSPECTION-
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 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
FINAL INSP.
ROOFING
J
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION-
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL