10973 (SFD)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 57-526 Inter lachen LA QUINTA, CALIFORNIA 92253
Sunrise Desert Partners
Mailing
Address 426.00 Cook. St
City Zip Tel.
Palm Desert 92260 564-6716
Contractor
Same
Address
Zip I Tel.:
State Lic. City
&Classif. 28130 Lic.# 328
Arch., Engr.,
Designer
Address Tel.
City JZip State
Lic.Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed,under provisions of Chapter 9 (commencing
7000) of Division 3 ohthe,Busin T';and Professions Code, and my license is in
effect. . le, I _r' � f. _ , . -. 1 11�_
OWNER -BUILDER DECLARATION f
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: ,(Sec. 7031-5,Businessand Professions Code: Any city or county which requires a
permit to construct, atter, 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 rive hundred dollars.(E500)- .
❑ 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 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. It, however, • the building
orimprovement is sold within one year of completion, the owner -builder will have the burden
or proving that he, did not build or improve for the, purpose or 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 or 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 1 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 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 Owner
NOTICE TO APPLICANT: It, 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
1 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
No. 10973 .,
BUILDING: TYPE CONST. OCC: GRP.
Number
I Description
Project Description
Trophies Model Plan TSR
Sq. Ft. 3142 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Parmit does not include block walls or
pool
stimatedValuation
1$2+124o0
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk.'Bal.
530.14
Const.
930.00
Mech.
109.00
Electrical
159.76
Plumbing
192.00
S.M.I.
18-30
Grading
—0—
Driveway Enc.
—0 --
Infrastructure
4097.81
2048.9l. -
Less Credit
2040.91
Arts in Public C
205.31
TOTAL
4443.42
4193.41
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:
Validation:
A CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING Ff;ES
1ST FV_ SO. FT. ® $
2ND FL SO. FT.
POR. SO. FT. ®
GAR. SO. FT. @
CAR P. SO. FT.
WALL SO. FT. ®
SO 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 APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR' HP
POLE, TEMIPERM
LAVATORY
r _
HEATING SYSTEM- FORCED 'GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ®c
BATH TUB
-
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL „
SO.FT.GAR ® 3/ic
HOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES -
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB: FEE`
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLUMBI a
UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE 2
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 APPJEOUIP.
.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
:J
_ CITY o7 '.A QUIHTA
DEPARTMENT OF PLANNING & DEVELOPMENT . Y
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
GO Av04uigA
Owner Sunrise Desert.]RPL s
Contractor Same l
PermitNumber10 9 7 3 � r
POST OWo
N _7
IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 57-526 Interlachen
Permit does not include block walls or
pool
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL e
MAIN GROUND SYSTEM
GROUND PLUMBING _ 1
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB CJ
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST - G
HEATING & VENT- A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 81
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR STH C
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST.
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
.TURN ON UTILITIES OR OCCUPY BUILDING
4!ee