10970 (SFD)Building
Ot♦ri rocc 57-430 lnterlache
4
P.O. BOX 1504 No. 10970
7&105 CALLE ESTADO
T3 LA QUINTA, CALIFORNIA 92253 - 1
Sunrise Company
Mailing'
Address 42--600 Cools St. 0200
City Zip Tel.
-Palm Desert 92260 1564-6716
Contractor
Same
Address,
City Zip Tel.:
State Lic. City
& Classif. 288130 Lic. # 328
Baron., tngr., '
Designer '
Address Tel.
City 7_7
ip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (cc
7 o Division 3l of the Businessland Professions Code, an#d my lit
effect. - � i f d 1
'' OWNER -BUILDER DECLARATION A
I hereby affirm that I am exempt from the Contractor's License Law. for the following
reason: (Sec. 7031.5,Busl7ess and Professions Code: Any city or county which requires a
Permit toconstruct, atter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such peril to We a signed statement that he is licensed pursuant to
the provisions of the Contractor'sLicense Law; Chapter 9 (commencing with Section 7000) or
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the allegedexemption. Any violation of Section 7031.5 by 'any applicant for a peril
subjects the applicant to a civil penalty of not more than live hundred dollars ($500). '
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Coder The Contractor's License Law does not, apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that'. such improvements *are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -budder wid have the burden
of proving that he did not build or improve for the purpose of sale.) . _
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property -who builds or improves thereon, and who contracts for
such projects with a contractor(s) dcensedpursuant to the Contractor's License Law.)
O 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificete..of consent to self -insure, or a certificate of
Worker's Compensation, Insurance, or a certified copy. thereof. (Sec. 3800, -Labor Code.)
Policy No.
61Copy is filed with the city. C ified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the permit is for one hundred dollars ($too) 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
Date Owner
NOTICE TO APPLICANT: N, after making this Certificate' of Exemption you sloukl 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 it 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.
Sign ture of applicant Date
Mailing Address
C,iity, State, Zip
Y
;l
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number
Legal Description
Project Description Trophies Mcdel Plan
r�
Sq. Ft.1706 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolitiori ❑
Permit does not include any bock walls
or pool
Estimated Valuation
132.437.70
PERMIT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
2979.135
T A .,c; -rca i tr
I A R 9 4
Farts in Public
TOTAL
3301.69
REMARKS
AMOUNT
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES C
1ST FL. SO. FT. ® $
2ND FL. S0. 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 i
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.000L 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,TEM/PERM
LAVATORY
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 ® 11% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3yic
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.
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACKOUND
PLUMBIN". 1?
UNDERGROUND
A.C. UNIT
COLL. AREA
.SLAB GRADE �i —� —�
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF. �� 2
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.
n' /^� �1
P.KROOFING q IJs/
/ 6 c
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
• MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE €INAL
INSPECTOR'S SIGNATURESlINITIALS
-GARDEN WALL FINAL
_t
.� N
�7G
C'TY C LA OUINTA
DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
24-HOUR NOTICES FOR INSPEC
,,��
NYzy
Owner Sunrise Desert Parto,-
Contractor Same
Pewit Number 10970
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
Permit ADDRESS d enot57-480 includenanrlblock
or pool Y walls
TYPE OF INSPECTION
FOUNDATION & SETBACK DATE INSP.
FOOTING STEEL
MAiN GROUND SYSTEM J
GROUND PLUMBING
UU 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
COVER NO WORK UNTIL ABOVE HAS BEEN
DRYWALL INTERIOR
EXTERIOR LATw J - n
POOL PRE PLASTER
POOL FENCE & cAT;
FINAL GAS TEST
HEATING A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
4!88
TURN ON UTILITIES OR OCCUPY BUILDING
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