11143 (SFD)P.O. BOX 1504
Building 57._900 I$!ctarlache'k78-105CALLEESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
nrise Company
Mailing
Address 4.2-600 Cook St 1200
City Zip Tel.
Pam Desert 1 92260 1 564-6716-
Address
64 -6716
Address
City
State Lic. City
& Classif. 288130 Lic. # 323
Arch:, Engr.,
Designer
Address Tel.
City Zip State
- Lic. # '
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed uunder provisions of Chapter 9 (commencing with Sfiction
70(10) of Divisio of,the Business and Professions Codd! d my license is/inn full foo(ce and
effect. � " Qi/ sit✓/rl _ t/ -7! f i/ ! lY
SIGNATURE `�/ e` " �'- •' + P y '! DATE'S
OWNER -BUILDER DECLARATION '. t"
I hereby affirm that I am exempt 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 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 civil penalty of not more than five 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 Improvementis sold within one year of completion, the owner-bu8der 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-
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.)
0 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
O 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 (5100) valuation
or less.) -
I certify that in the performance of the work for which this permit is. issued, I shall not
employ any pon in any manner so as to become subject to the Workers" Compensation
Laws of Califeornirsa.
Date Owner
NOTICE TO APPLICANT. If, 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
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
LDING: TYPE CONST
P. Number
No. 11143
OCC: GRP.
Legal Description Tract 25499--3
Project Description Flinn T3B Phase 5T
Sq. Ft. 1903 No. No. Dw.
Size Stories Units
0
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
tstimated valuation
148.153.20
PERMIT.
Plan Chk. Dep.
Plan Chk. Bal.
Const..
Mech:.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
T:,t-ss Credit
Atir4tz iin 'PlIhi
TOTAL
AMOUNT
667.97
811.00
£2_00
140.41
150.00
14.90
1666.73
1pO_3R
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_
Issued by: Date Permit.
Validated by: tla
Validation:
,r
CONSTRUCTION ESTIMATE
r- NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEWPERM
LAVATORY '
r
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
SQ.FT.GAR ® 3/ic
HOUSE SEWER
REMARKS:
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (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$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT.,OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Plan T3S Phase 5T V4, 3�
CITY OF u OUINTA
a DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISJQN
564-22246 W%j►
24-HOUR NOTICE FOR INSPNS
AJ,,11.7.�W4
Owner Sunrise Compan4� ' ono,
Contractor Same
Permit Number 11143
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 57-900 Interlachen
Permit does not include any
block walls or pool
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
.FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING j
DO NOT POUR CONCRETE UNTIL ALL ABOVE HA.S.BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS &GAS TEST
2 de
HEATING & VENT- A/C 11
Dcol�
BEAM
O.K. TO WRAP Z6 L
GROUT ❑ 4' ❑ 8'
FRAMING OU2—
INSULATION
ZINSULATION 2 L
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS B ENS NED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINAL GAS TEST
HEATING - A/C
nuvac I'lumor-no
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING '
a!ea