05967 (SFD)Building
Address 55-431 Soutlu
Owner
suneise Co.
Mailing ,
Address 75-005
City
P. D. 192250
sane
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
175--
No. 45967
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number PCA T1*8IL
Tel.
el.:
State Lic. I City
& Classif. 288130 Lic. # 320.
Arch., Engr.,
;,.. Designer
` I Tel.
City Zip State
Lic. # "
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
700ffectof Division 3 of the Business and Professions Code, and my license is in full force and
.SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec..7031.5,8usi nese and Professions Code: Any city or county which requires a
Permit to construct, after. Improve, derroGsh, 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
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 applicant to a cwd penalty of not more than five hundred dotiars ($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 or 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 safe. 11, however, the building
or improvement is sold within one year of completion. the owner -budder wig have the burden
_ of proving that he did not build or Improve for the purpose of safe.)
❑ 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 bidds or Improves thereon, and who contracts for
such projects with a contractors) 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, ora certified copy thereof. (Sec. 3800, Labor Code.) .
Policy NoCompany
❑ 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
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 Oviner
NOTICE TO APPLICANT: ff. after mabV this Certificate of Exemption you should 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.
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 certity'that I have read this application and state that the above information is correct.
I agree to comply withallcity 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
Legal Description
Project Description PhWes I7 Pl= 30M
Sq.,Ft., 2825 No.. No. Dw.
Size Stories Units
New E Add ❑ Alter ❑ Repair ❑ "Demolition.❑
Estimated Valuation 24,62.00
PERMIT .
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
2.•1 ` r
Const.
9 1 Z. TO
Mech.
82. TV--
V-Electrical
Electrical
142.41
Plumbing
24.00
S.M.I..
Date6'1'^$9 Permit
Grading
Driveway Enc.
Infrastructure
$C$dlr
hie
...'
TOTAL
REMARKS , nx s nr4 .•,•rt s.r a r a n r r x mama -: r. r.
Z'4.`++.. ayyrygky y.r+.,•8s�.r .i"x'Y'i�.'v yc.a ,:v rgVr a i:Rr..
-ZONE:
BY:
M inimumeSetback'Di§tances:.
Front Setback from Center Line
Rear Setback -from Rear Prop. Line
Side Street Setback from Center Line
Side Setback feom Property Line
FINAL DATE.-=''
INSPECTOR
Issued by:
Date6'1'^$9 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
DUCT WORK
ROCK STORAGE
FOUND. REI
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
i
REINF. STIE g
GAS (FINAL) TEMP. POLE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. SO. FT. @
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
WALL SQ. FT.
LUMBER GR.
DRINKING FOUNTAIN.
Gv MING
FINAL INSP.
URINAL
SQ FT ®
REMARKS:
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
LAUNDRY TRAY
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
CERT. OCC.
SQ.FT.GAR ® V4c
HOUSE SEWER
FENCE FINAL
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
UND PLUMBIN UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE `
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
7
ER OR SEPT ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REI
AS (ROUGH) _/ _ METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
i
REINF. STIE g
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
Gv MING
FINAL INSP.
7�_
FING
✓I��
O(�'I V {N y(•y'll/� 1
�J
2FIREVENTILATION s' v' ` 1(2—
REMARKS:
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING
MESH
G�INSULATION/SOUND/ a( -
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL