07414 (SFD)Building '578 'St9uftllern Hills
Owner
Sunrise Cwpny
Mailing I-
Address 42-$ C� SIM
City lZip
8�R3rt 92
Contractor
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ite 2
Tel.
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P.O. BOX 1504 No.- 07414
78-105 CALLE ESTADO _
» • L-A.QUINTA, CALIFORNIA 92253 I
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number P4A At Tha$t!. I'M
�+$ Legal Description
-28
Project Description Tinct 25500-1 Plan Id
Aaaress
City Zip Tel.w
yt'
State Lic. City
& Classif. MUD:, ;� ,� • • Lic. # 328 _
Arch., Engr.,
Designer
a'
Address ".. Tel.
City Zip State
Lic. #
. LICENSED CONTRACTOR'S'DECLARATION
I hereby affirm that I am licensed under.piovisions 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. .. t
SIGNATURE i 'i DATE
OWNERmBUILDER DECLARATION
I hereby affirm that I'amrexempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
.permit to construct, alter, - Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he islicensed pursuant to
the•provisions 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 iviolation of Section 7031.5 by 'any applicant for apermit
subjects the applicant to.a civil penalty of not more than rive hundred dollars ($500).
❑ 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'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. If, however, the building
or improvement is sold wit Ain one, year of completion, the owner -builder 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-
' Strutt the project. (Sec. 7044,- Business and Professions Code: The Contractor's License Law
does not apply to an owner or 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
Date Owner
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. Company.
❑ Copy is.filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE— '
(This section need not be completed if the permit is for one,hunUred dollars (S100)a.valuationor 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'b'ecome subject Eo the Workers' Compensation
Laws of Califoinia. I r :' :1
Date �.. •y: 7d 'Owner �: S .�•,.
NOTICE TO APPLICANT. If,, after 'maklog this`Certificate of Exemption you sh`ogld become.
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. i
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 properly filled out, signed and: validated, and is subject to
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:
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
Sq. Ft. t288 Nd. No. Dw. fi
Size Stories, Units
New ❑ Add ❑ -Alter ❑' Repair ❑ Demolition O
gee Petit,:- 0050 for fees.
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS .
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
3/27/9
Issued by:
Date ermit
Validated by:
Validation: '
Y
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
AS (ROUGH �{�
/
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
INAL INS �l� z_;*'_'_cu.
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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
/
LMATHING
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'
4. SETBACK
OUND PLUVrNr"j?�'
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
/
SEWER OR SE T16xfo)
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REIN
!!! ���
AS (ROUGH �{�
/
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
yd.
$ plus x$
=$
LUMBER GR.
INAL INS �l� z_;*'_'_cu.
FRAMING
FINAL INSP.
ROOFING
//�
!L� -
_��
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/
LMATHING
MESH
�ISULATIONISOUN991"/51 GU
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURE'SIINITIALS
GARDEN WALL FINAL