04099 (3&4)----------- ------- -----_------------ ------------------------------------ ---
4�
04OS9
P.O. BOX 1504
ESTADO
Address 54-873 rirestone LA QUINTA, CALIFORNIA 92253
Sunrise Coppany
' " " " '
BUILDING: TYPE CONST.
A.P.•Number • -
Legal Description
OCC. GRP.
PGi0. We st
Mailing
Address 75-005 Country Club AriJe , .. __.
City
Desert
Zip
92260!6181-72$28
JTeI_.Palk
Project Description
Phatso 18D, Plan 30CP
Contractor
National Mortgage'
Address w
City
Zip
Tel.
State Lic. 288130
& Classif.
City 3282815
Lic. # -
Sq. Ft.
No. No. Dw.
Size
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect. r e f t
SIGNATURE DATE
OWNER•BUILDERDECLARATION
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; alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions oftheContractor'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 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. 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 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) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason
Estimated Valuation
} Ca j�;1;
��
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
9 �y
t� {. L., * .4 V
wI eJJ
Const.
1
'1 ! a r bu
Mech.
bzi • 00
Electrical
12121 .71
Plumbing
•9 C n
YJ6 . 5O
S.M.I.
)
13 *GIC
Grading
-
Driveway Enc.
Date owner
Infrastructure
4t380.51
WORKERS' COMPENSATION DECLARATION
1 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. ❑ Certified copy is hereby furnished.
-
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
ter.
jE�A�i f xlal � itf�Giaf AGt"ifA-•� sryY - o I i 11
- (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: If, 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.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
1
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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 Setback from Property Line
Lender's Name
FINAL DATE
INSPECTOR
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.16/7/88
1 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
Mailing Address
Validation:
GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
City, State, Zip
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT N S
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
Y
YARD SPKLR SYSTEM
2ND FL SO FT. 4t
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT. (V
GAS (ROUGH)
METER LOOP
GARSO. FT. rp
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO FT. a
GROUT
WATER HEATER
WALL SO. FT. Q
FINAL INSP.
DRINKING FOUNTAIN
BOND BEAM
10
WATER SYSTEM
URINAL
SO. FT. ra
=3
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE' Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTONDISHI
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
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
SO. FT. 4& c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO, FT. RESID @ I 1 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/.c
HOUSE SEWER
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 8 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 APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
VICE S
FINAL INSP.
BOND BEAM
10
WATER SYSTEM
V
GRADING
cu. yd.
S _plus_x$
=3
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FI SH GRADING
�r
INSPECTION/
((/
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL 71
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DAVE STEAVENS
Inspection Services
PROJECT-?,--, A t.a„3 E �5T -,L 4 PROJECT #
ADDRESS -5q 915. f3i f , P -.q '307
Page f of
.2 vol - 09
CLIENT 6 A tJ C .57'/�0-4
DATE f ..-"e L Y Z, -4<,Z
BLDG. PERMIT # ARCHITECT 60 4.814 la El < J`j
ENGINEERa u f. SA Jo ft~ /+J �-. CONTRACTOR `L f*rl,4,?
INSPECTION TYPE f
INSPECTION REPORT `
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CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted,
substantially complies with approved plans, specifications and applicable sections of the building codes. This report covers
the locations of the work inspected only and does not constitute engineering opinion or project control.
CERT. NO. /) e i k? 3 L !' T'L) INSPECTOR NAME * � J L S 1 z\
(Pint Clearly) --.
DATE h 7-�- C '�f 2l INSPECTOR SIGNATURE .� `�..�++►_ l �.rw•-^�.J