05418 (SFD)P.O. BOX 1504 No. 05418
Building 54-�371 SOMEn HILLS78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
SUNRISE cmaM.
Mailing ' BUILDING: TYPE CONST. OCC: GRP.
Address 42-W COU STMT, bT -200
A.P. Number'
CityZip ITe'-5,,-
PALMIDESERT92260 2S Legal Description G1 A
Contractor Project Description MSE lE SPD
Address
SAM
City Zip Tel.' ,p
State Lic. City
& Classif. 28$330 Lic. # 2ti8 t Sq. Ft. 3401 No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address' Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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 . , " t . r
r"
_SIGNATURE - - DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which requires a
permit to construct, after, improve, demolish, 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 Contractors 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 civil penally of not more than rove hundred dollars (8500).
❑ 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 Contractors 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 within one year of completion, the owner -builder will have the burden
or proving that he did not build or knprove for the purpose of sale.)
❑ 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 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. ❑ 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.thg work for which this permit is issued, 1 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 making 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
Lenders 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 certity 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
IEstimated valuation 242,430
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
LAWS >;.lreal
Infr&iDue
TOTAL I .sX,.,v.ca✓ 1 Raz ato b,D
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 DATEINSPECTOR
Issued by: Date 3/3/89 Permit.
Validated by:
Validation:_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
RO GH PLUMB.
BONDING
HEATING (ROUGH)
YARD SPKLR SYSTEM
2ND FL SQ. FT.
R OR SEPT
ROUGH WIRING
DUCT WORK
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
METER LOOP
HEATING (FINAL)
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT. ®
WATER HEATER
SERVICE
WALL SQ. FT.
DRINKING FOUNTAIN.
WATER SYSTEM
URINAL
SQ. FT.
LUV ER GR.
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
�AL INSP. - O-�O
2/
WATER PIPING
NOTE: Not to be used as property tax valuation
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FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRY TRAY
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® Vic
HOUSE SEWER
14
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
NECH.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
SLAB GRADE �✓
RO GH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
R OR SEPT
ROUGH WIRING
DUCT WORK
ROCK STORAGE
ND. REINF. D
(E ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-x$-=$
LUV ER GR.
FINAL INSP.
-YeOAMINGt C l/1
``ff��
�AL INSP. - O-�O
2/
OFING74 7121
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GFIREWALL
,HING A
MESH
INSULATIOWSOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATOR=SIINITIALS
'
GARDEN WALL FINAL