11148 (SFD)4
P.O. BOX 1504
Building 57-706 Interlachen 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
uprise Company
Mailing
Address 42-•600 Cook St 0200 T.
City Zip Tel:
Pales Desert 92260 1 564-6716
Contractor
Same
Address. . ......
City lZip
State Lic. City
& Classif. .288130 Lic. # 328
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed'tihder provisions of Chapter 9 (commencing_ with Section
7000) of Division 3•of he Business:and Professions Code,. d.my license is i full force.and
effect. / 9 . ut!! = irs. �.tr/ri_.
'OWNER -BUILDER DECLARATION 1
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, 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 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.($500).
O 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 improvement is sold .within one year of completion, the owner -builder 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 torr
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 Contractors -License Law.)
01 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'COMPENSATIONINSURANCE
(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, I shall not
employ -any person in any manner so as to become subject to the Workers' Compensation
Laws of California
'DateOwner `
NOTICE TO APPLICANT: If, alter. 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. 11148
BUILDING: TYPE CONST. OCC: GRP.
P. Number
Legal Description Tract 25499-3
Project Description Plan T4AR .Phase 4`1.`
Sq. Ft. 2182 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does not include any
blocs mails or 'pool
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
737.36
Const.
891.00
Mech.
102.50
Electrical
153.27
Plumbing
174.00
S.M.I.
16.90
Grading
A0
Driveway Enc.
.00
Infrastructure
379.3.14.896.57
Leas � f:G it
1896.57 -
-rA
9
TOTAL
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:
Vdlidation:
h
CONSTRUCTION ESTIMATE
' NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
1
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SO. 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 APPIEQUIP.
LAUNDRY -TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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 ® 3/sc
HOUSE SEWER -
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
qMECH.FEEPL.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 APPIEQUIP.
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
lk-D
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. CCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Plan T4AR Phase 4T i
a `
CITY OF LA OUINTA
DEPARTMENT OF PLANNING & DEVELOPMENT
' BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR IN ,48
t/ ft5f
owner_ Sunrise Company zqp,,
Contractor Same—,
Permit Number 11148
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOBADDRESS 57-706 Interlachen
Permit does not include any
block walls or pool
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
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
G��--
HEATING & VENT- A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
Z!
/-/L
GROUT ❑ 4' ❑ 8'
FRAMING
L.
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
I R-- C,,. �7 Z
1-1■mf"Id.'Fr .
PLUMBING
FINAL GAS TEST
HOUSE NUMBERS
Ivo vvmrL-c 1 Qu . I • I
ti3
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
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