06000 (SFD)Building
Address 54--$91
Sunrise Co,
4
P.O. BOX 1504
78-105 CALLE ESTADO
y LA QUINTA, CALIFORNIA 92253
Address 75-345 entry Club
CityZip Tel.
.D. 92260 1 56$�-2$23
Contractor
Address
Zip I Tela
State Lic.. I City
Classif._. 258130 Lic. # 32$
Designer,..
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 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 affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Busimess and PrWessions Cede: Any city or county which requires a
permit to construct, after, mprove, dernoish, or repair any structure. prior to its issuance also
requires the applicant for such permit to fie a signed statement that he is licensed pursuant to
the provisions of the Contractors License Law, Chapter 9 (eormnencumg with Section 7000) of
Division 3 o the Business and Professions Code, or that. he is exempt Merehom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by Any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). '
❑ 1, 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 appty to an, owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that* such improvementsare not intended. or offered for safe. lf, however, the building
or improvement is sold within one yearof completion, the owner -budder will have the burden
of proving that he did not build or inprove for the purpose of sale.)
O 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 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_ R_.& 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
O Copy is filed with the city_ ❑ Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE
(This section need not be completed r7 the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT: If, after making this Certdrate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must -. forthwith
comply with such provisions or this pend shat be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, C&HCode.)
Lender's Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. '
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby'authorae representatives wf this city to enter the above-.
mentioned property for inspection purposes
Signature of applicant Date'
Mailing, Address
city, State, Zip
No. 06000
LDING: TYPE CONST. • OCC: GRP.
Number _ FGA V68$
Legal Description
Project Description hwe 19B Paan 20
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from. Center Line-
ine
Sq.,Ft. 259 »
Size
No.
Stories
No. DIN.-
Units
New15 Add O
Alter O Repair O -Demolition 0 -
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date"1�"$ Permit .
Validated by:
Validati n:
Estimated
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
_ •+~
Const.
915.5,
Mech.
$2
Electrical k
�`�•
Plumbing
%•'
S.M.I.
Grading
Driveway Enc.
Infrastructure
�• �_
.Less Cmir
Infra Due
2022 i.
TOTAL
•tail
�/� �` �` f� .
REMARKS
�.z.-._�-,__'ti...rci..nt�.�
4, V0
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from. Center Line-
ine
-Rear
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date"1�"$ Permit .
Validated by:
Validati n:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
GRADERO
YARD SPKLR SYSTEM
2ND Fl SQ. FT. ®
HEATING (ROUGH)
STORAGE TANK
F MS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
OU REINF.
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEE
DRAINAGE PIPING
CAR P. SQ. FT. ®
GROUT
DRINKING FOUNTAIN.
WALL SD. FT.
FINAL INSP.
BOND BEAM
URINAL
SQ. FT.
GRADING
cu. yd.
$ plus x$
=$
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FI L INSP. •U
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.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
FINISH GRADING
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 PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
GRADERO
GH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
F MS
R OR SEPT
ROUGH WIRING
DUCT WORK
ROCK STORAGE
OU REINF.
UGH) /
/
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEE
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
MING r�13 A 25
FI L INSP. •U
'
OOFING 1p 6 �61�
� !<
REMARKS:
/ VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
MESH
SULATION/SOUND 1 c 7
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATORESIINITIALS
GARDEN WALL FINAL