11139 (SFD)Building 57--720 -1nteAacben
Address ,- .
P.O. BOX 1504 -
7&105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owne
S1rrnxise Company
Mailing
Address 42-600 -Cook St #200
City Zip Tel.
Palm.Desert 1.92260 1 564-6716-
Contractor
64-6716Contractor
Same
Address _.
Zip I Tel.:
State Lic. City
& Classif. 288130 Lic. # 328
Arcn.,-tngr.,
Designer
• Address Tel.
City Zip State
• Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licepsed"under Provisions of Chapter 9 (commencing with Section
7000) of Division`3 of the Buslness and Professions Code, and my license isoon full force and
��-
SIGNATURE �• 6/ - r � r * /�-DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or counfy , whfcb requires a.
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to tile. a signed statement that he is %eased 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, of that. he is exempt therefrom, and the basis
-for the alleged exemption. Any violation or Section 7031.5 by 'any applicant for a Permit
." subjects the applicantto a civil penalty of not more than rove hundred dollars .($500).'
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will
do thework, and the structure is not intended or offered for sale. (Sec. 7044, Busness arid.
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. fl, however, the bLddxg
or improvement is sold within one yearof completion, the owner -builder wig have the burden
of proving that he did not build or improve 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 Contractors LFcarse Law
r does not apply to an owner of property :who builds or improves thereon, and who conbaGs for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑.l 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. O Certified copy is hereby furnished. .
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE -
(This section need not be completed it the permit is for one hundred dof s ($100) valuation
or less.)
.I certify that in the performance of the 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: If, after making this Certificate of Exemption you should become
subject to the 'Workers' Compensation provisions or 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
No. 11139
NG: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description Tract 25499-3
Project Description Plan T3B Phase 4T
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
1
Validated by:
Validations. i
Sq. Ft. 1 g 03
Size
No. No. Dw.
Stories Units
New ❑ Add.❑
Alter ❑ Repair ❑
Demolition ❑
Permit does
teat inclu� e a zv
lack 1waxls
or pool
Estimated Valuation
1481,153.20
PERMIT
AMOUNT
Plan Chk. Dep:
Plan Chk. Bal.
667.97.
Const.
811.00
Mech.
62.00
Electrical
140.41
Plumbing
150.00
•s.M.l.
14.90
Grading
.00
Driveway Enc.
.00
,Infrastructure
3¢+.3cc33.45
1656.73
Ti.
Less it
� 1666-. 73
.Arta in Pub ' c
120.38'
TOTAL
3633.39
_33`817S91—
REMARKS
) g;••.
5
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
1
Validated by:
Validations. i
• CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. _ SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
2ND FL SQ. FT.
FORMS
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
OTHER APPJEQUIP.
DRAINAGE PIPING
WALL SQ. FT. ®
TEMP. POLE
DRINKING FOUNTAIN,
Sq FT ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
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
LAUNDRYTRAY
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..
SO. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
LATHING
SO.FT.GAR ® 3/<c
HOUSE SEWER
MESH
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-
CcRT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESJINITIALS '
GARDEN WALL FINAL
CITY OF LA OUINTA
a DEPARTMENT OF PLANNING A DEVELOPMENT
BUILDING DIVISION
564-
24-HOUR NOTICE FOR j,�$PECTIONS
Owner Sunrise Com
Contractor Same,,,_ - -
Permit Number I 11-139 l
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 57-720 Interlachen
Permit does not include any
block walls or pool
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
.FOOTING STEEL
MAIN GROUND SYSTEM '
GROUND PLUMBING 20
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS..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
HEATING & VENT -A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING ''
INSULATION - 2
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR J .<-
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
PLUMUINU
FINAL GAS TEST
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTIL (TIES OR OCCUPY BUILDING "
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