05414 (SFD)P.O. BOX 1504 NU
Building 78-105 CALLE ESTADO -
Address 54-051, S0`13`rHm. ams LA'QUINTA, CALIFORNIA 92253
Owner
SUN iT3. COMPANY
-
�,
..
BUILDING: TYPE CONST. OCC: GRP.
Mailing -
Address • 42--600 COOK S ET, STE 200 -
Y • A.P.'Number
city PALM
DESPRT ]Zip
9226E301 Legal Description M A
Contractor NATZOFAt momrb� Project Description s S.
_
Address .�.
City Zip Tela
State Lic.
& Classif. 288�0
Arch., Engr.,
Designer
Address'
City
Lic. # 208
Tel.
Cit Zip . I State
Lic. #'
UICEIL%D CONTRACTOR'S DECLARATION
I aftirm,that I am liceirsed under provisions of Chapter 9 (commencing with Section -
70 )M of Division.3 of the Business and, Professions. Code, and my licen'se•is in,full force: and
effect.; %^ i 7'' ,'1 F .• r ° « }� '_ :` . :. _ r '
SIGNATURE' DATE
OWNEWBUILDER DECLARATION
hereby affirm that 1 am exempt from the Contractors License Law for the following
' reason: (Sec- 7031.5,Bushessand Professions Code: Any city or county which requires a .
permit to construct,- ate► inprove,. demolish,- or repair any structure, prior to its issuance also
requires 1110 appGard for such permit to tie a signed statement that he is licensed pursuant to
Me provisions of the C rdractors License Law, Chapter 9 (commencing with' Section 7000) of
Sq. Ft. 34� No.
Size. _Stories
[New ❑ - Add. ❑ ''•,, � Alter ❑
No. Dw. '
'Units =
Repair ❑ 'Demolition•❑
l>tvkbn 3 of the Business and PhOessit Code, or that. he is exempt therefrom, and the basis
for the alleged exenptioa Any violation of Section 7031.5 by any applicant for a permit
Plan Chk. Dep.
- -
•� -
y subjects the applicant to a civilpenally of not more than five hundred dollars.($500).
Plan Chk..Bal.
-
q •�
• O I, as owner of the properly, 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
Const..Protessions
9 Oil •
. , Code: Tft Contractor's License,taw•does.not apply to an owner of property who
_
• builift or irproves thereon and who does such work himself or through his own employees,
Mech:
- • -
provided Drat such krprovements am not intended or offered for sale. If, however, the building
-
' or brprovement is sots wlthrr am year of completion, the owner -builder will have the burden
Electrical'
$3 • '
of provvrg drat he did not build of improve W the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con•
Plumbing
- struct the project (Sec 7044, Business and Professions Code: The Contractor's License Law
does not appy to an owner of property who bug& or improves thereon, and who 'contracts for
S.M.I.
17M
• such projects wlth a cmdracter(s) Gcersed pursuant to the Contractor's License Law.)
Grading
11 I am exempt under Sec a• g P.C. for this reason
-
Driveway Enc.
Date - ' owner
Infrastructure
3, 4• "
Less e[2,727.341
WORKERS' COMPENSATION DECLARATION
Infira Vue
s Z G
hereby affirm that 1 have a certificate of consenYto self -insure, or a certificate. of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
_
Policy Na Company
❑ Copy -is filed with the city- ..p Certified copy is hereby furnished.
'
TOTAL
cEffnRcATEOF EXEMPTION FROM
REMARKS
WORKERS'COMPENSATION INSURANCE
(this section need not be crouWillefed if the permit is for one hundred dollars ($100) valuation
r• .Y vol d., 'F'J� } ' j ' -T`, •'y' (1.4 `i(„ } - +'
or fess.)
1 certify that in the performance of ttlp 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 primer
NOTICE TO APP'LICANr: t, after making this Certificate of Exemption you should become
ZONE:
BY: -
surl0ect to the Nrorkers' Compensation provisions of the Labor Code, you must forthwith
with such
cQnrpywim aorOtspemotshagbedee
- - -
s_medrevoked. Minimum Setback Distances: • '
Front Setback from Center Line
Rear -Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from.Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work forwhich this permit is issued. (Sec. 3097, CtnlCode.)
Side Setback from Property Line
Lenders Name
Lenders Address
FINAL DATE
INSPECTOR
This is a building permit when property filled out, signed and.validated, and is subject to
'
expiration if work thereunder is suspended for 160 days.
3,3/ 89
MANY that 1 have read this application and state that the above information is correct. •
I to all
Issued by:
Date Permit'
agree comply with city and county -ordinances and state laws relating to building
u
constructiM and hereby authorize representatives -of this city to enter -the above•: -
~ '
+
mentioned property for inspection purposes 1
Validated by:
Signature of applicant Date
. Idling Add
Validation:
City. State, Zip „
y
t
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST SQ. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
B GRADE
YARD SPKLR SYSTEM
2ND FL SQ. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
EWER OR SEW47 47
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR_ SQ. FT. ®
OUGH)
METER LOOP
DRAINAGE PIPING
CAR P. SQ. Ff. ®
REINF. STEEL
WALL SQ. FT.
TEMP. POLE
DRINKING FOUNTAIN.
URINAL
SQ. FT.
WATER HEATER
VICE
R/
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
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
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
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 ® 3Vic
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE ___jCONST.
FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE
RO H LOMB.��
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR SEW47 47
ROUGH WIRING
DUCT WORK
ROCK STORAGE
CIVAD_ REINF.
OUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
FINAL) '�
TEMP. POLE
GROUT
WATER HEATER
VICE
R/
G
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUM ER GR.
FINAL INSP.
ING Z
FINAL INSP.
efZOFING 0
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
AR. FIREWALL
IN
MESH
ULATIONISOUND `
FI ISH GRADING
W AL INSPECTION l
CERT. OCC,
FENCE FINAL
INSPECTOR'S SIGNATURESANITIALS
GARDEN WALL FINAL