10550 (PAT)44f . 4 4w a"
P.O. BOX 1504
78.105 CALLE ESTADO
Address 52-880 Villa LA QUINTA, CALIFORNIA 92253
M/M Griffith
ling '
Iress Sc mr=
City IZI
Contractor
Sun -Boss Corp
Address
2313 Hall Ave.
City Zli
Riverside
State Lic.
o ell— _—Is
Designer
Address
No. 10550
BUILDING: TYPE CONST. OCC: GRP..-
A.P. Number
p Tel.
92.253 564--3498Legal Description
Project Description
925G9
310674
714/684—
Clty
Lic. #
Sq. No.
SizeFt.546 Sto
I New ❑ Add ❑ Alter ❑ Repair ❑
City
Zip
State
9Copy Is flied with the city. ❑ Certified copy Is hereby furnished.
1.LIc. #
164.15
LICENSED CONTRACTOR'S DECLARATION
REMARKS
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Buslnese and Professions Code, and my license Is In full force and
effactY "^
P IONATURE - DATE
1 fi �' 4'N- '3 -(Q-M, i 1 A4., 1 '
OWNER -BUILDER DECLARATION
Estimated Valuatl
'-%,.• I hereby affirm that I am exempt from the Contractors License Law for the•following
ZONE: BY:
Minimum Setback Distances:
'.reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires e
PERMIT
'- permit to construct, alter, Improve, demolish, or repair any.structure, prior to Its Issuance also
'requires the for to file that he Is. licensed
applicant such permit a signed statement pursuant to
. the provisions of the Contractor's License Lew, 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 Any Section 7031.5. 'eny for
Plan Chk.. Dep.
alleged exemption. violation of by applicant a permit
subjects the applicant to a civil penalty of not'more than five hundred dollars.($500).
Plan Ch.k. Bal.
❑ 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, Bulsness and
Const.
. Professions Code: The Contractor's License Lew. does not apply to an owner of property who
INSPECTOR
builds or Improves thereon and who does such work himself or through his own employees,
Mach.
provided that such Improvements are not intended or offered for sale. If, however, the.bullding
Signature of applicant Date
Malling Address
or Improvement Is sold within one year of completion, the owner -builder will have the burden •
Electrical
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 LlcenseyLaw
Plumbing
does not apply to an owner of property who builds or Improves thereon, and who contracts for
S.M.I. -
such projects with a contractor(s) licensed pursuant to the Contractor's License Lew.) •
�
Grading
❑ I am exempt under Sec. B. & P.C..for this reason
Driveway Enc.
Infrastructure
Date owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, ora certificate of
Worker's.Compensatlon Insurance,.or a certified.copy thereof. (Sec. 3800; Labor Code.)
on
Dw.
-Demolition ❑
AMOUNT
64.35
99.010
5
"o, '
Policy No. •Company
9Copy Is flied with the city. ❑ Certified copy Is hereby furnished.
TOTAL
164.15
CERTIFICATE OF EXEMPTION FROM
WORKERS'. COMPENSATION INSURANCE
(This section need not—be completed If the permit Is for one hundred dollars ($100) valuation
I certify that In the performance of th0 work for which thio permit is Issued, I shall not
employ any pparson In any manner so'as to' become subject to the Workers' Compensation
Laws of California.
REMARKS
1 fi �' 4'N- '3 -(Q-M, i 1 A4., 1 '
Date Owner "
NOTICE TO APPLICANT: If, after making this Certificate of Exemption. you should become
' subject to the Workeis' Compensation. provisions or the labor . Code, you must forthwith'
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
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.
Side Street.SE'tback from Center Line
Side Setback from Property Line
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.
FINAL DATE
INSPECTOR
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.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Malling Address
Validation:
v City, State, Zip r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. FT. ®c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ec
HOUSE SEWER
^ /; ^
FRAMING a as (/1L !�
YJ� y
FINAL INSP.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE JELECT.JFEE
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 rr2VSEWER
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 a as (/1L !�
YJ� y
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION O�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL