05063 (SFD)34 C&tyl Q"
r.
P.O. BOX 1504 No. 05€63
Building 78-105 CALLE ESTADO
Address 54-251 Inverness LA QUINTA, CALIFORNIA 9.22_53
Owner
Sunrise C* nv BUILDING: TYPE CONST. w OCC: GRP.
Mailing•
Address t) C . t- st,R �,F, A.P. Number Ano gCd 1~1arc+t
City Zip Tel.
a����O. �>R�9R�R Legal Description
Contractor Project Description sit ^dl4 3C1
Address
t
City
Zip
Tela
State Lic.
City
& Classif. 2$8130 #
Lic. # 32&
Sq. Ft. 1527 No. No. Dw.
Size' Stories' Units -
Arch., Engr.,
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Designer
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) lot Division Division 3 of the Business and Professions Code, and my license is in full force and
effec�- f
SIGNATURE DATE
OWNEWBUILOER 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 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 fife 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 five hundred dollars ($500).
❑ 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
Contractor's License Law does not apply to an owner or 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 'reprove for the purpose of sale.)
Estimated Valuation
$113.727
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. S 380.44
Const.
468.00
Mech. � �Q
Electrical 67.41
Plumbing $ 7 50
❑ 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
S.M.I. 7.95
does not apply to an owner of property who buifft 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
Grading
Driveway Enc.
Date owner
Infrastructure $2,558.86 1,279.43
Less Credit 1.279.43
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers 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 $2,324-73 7,',;UJI .r 1 -``j
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This'section need not be completed If the permit is for one hundred dollars (8100) valuation
' or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ anyCalifperson in any manner so as to become subject to the Workers' Compensation
Laws of ornia.
' Date 'Owner 4 ! t
NOTICE TO APPLICANT: n, after making this+Ce'rtificate 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.
o- -
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, ChdCode.)
Lenders Name
Side Street Setback from Center Line
Side Setback from Property Line
I
FINAL DATE INSPECTOR
a
12/27/88 2 / 2 7 / & 8
Lenders 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.
1 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.
Issued by: Date Permit
Validated by:
Signature of applicant Date
Mailing Address
Validation:
`
City, State, Zip
I'!
' CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
15' FL. SO. FT. ® $
UNITS
LAB GRADE 4 ��
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
STORAGE TANK
FORMS
ER OR I
MOBILEHOME SVC.
BAR SINK
POR. S0. FT. ®
ROCKSTORAGE
ND. REINF. (� �`�}
C
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEOUIP.
DRAINAGE PIPING
CARP. SO. FT. @
I
I
WALL SO. FT.
DRINKING FOUNTAIN
SO FT ®
ERVICE ((�
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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 ® V4c
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
SETBACKOLIND
PLUMBIN�Z7 UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE 4 ��
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ER OR I
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
ND. REINF. (� �`�}
C
AS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
AS (FINAL)
T_FgMP. POLE
f7 X
GROUT
WATER HEATER
ERVICE ((�
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.
RAMING %
cv
FINAL INSP.
ROOFING
�✓�O %/% 7
(�J/ � !/(GL/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
R. FIREWALL
RING (/
MESH
SULATION/SOUND
F ISH GRADING
NAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL