05059 (SFD)T it
P.O. BOX 1504
Building54-2 t 1 ZYi 7 rT!@ S 7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Sunrise -Company
Mailing
Address 42-600 Cote St., Suite 20
City Zip Tel.
Contractor
Aoaress _11
Zip I Tel.' ' ^
�w
State Lic. City
& Classif. 288130 Lic. # 328, T .
Arch., Engr.,
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) t.of Division 3 of the Business and Professions Code, and my license is in full force and
effec
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 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, demofish, 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).
❑ 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 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.)
❑ 1 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, ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(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 lhp 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. i r.
Date t IOwner
NOTICE TO TO APPLICANT: 1f, after making • this. -Certificate of Exemptionou should become
y
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, Cin? Code.)
Lender's Name
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that 1 have read this application and state that the above information is corr t.
I agree to comply with all city and county ordinances and state laws relating to build
construction, and hereby authorize representatives .of this city to enter the abov
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
0, -
No. 05059 .,
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number PGA test Phase 40A
(Legal Description
Project Description PlArk 16
Sq. Ft. 1330 No. _ No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
IEstimated Valuation $94,224
s
PERMIT
BY:
AMOUNT
Plan Chk. Dep.
Front Setback from Center Line
Plan Chk. Bal.
Rear Setback from Rear Prop. Line
$ 342149
Const.
418.00
Mech.
• IINNAL DATE
34.00
Electricals
12/27/88
9.99
Plumbing
ated by:
87.50
S.M.I.
,Validation:
5.52
Grading
Driveway Enc.
Infrastructure
$2,120,49
1,060.25
Lelia; Credit
. 1 060.25
TOTAL
$2.008.85
REMARKS
t�1�?��B��awJ`�11�>'"7��""�•irf:+J t'cxc�f�
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
• IINNAL DATE
INSPECTOR
`
12/27/88
Issued by:
Date Permit
ated by:
,Validation:
i
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1S'i FL. SO. FT. ® $
UNITS
SLAB GRADE Z
RO GH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
F MS
EWER OR SEPTIC
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
G (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TE P. POLE
GROUT
DRAINAGE PIPING
CARP. SO. FT. ®
FINAL INSP.
WALL Sp. FT.
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ -Plus-x$-=$
URINAL
SO. FT. ®
NG `
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
REMARKS:
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
I
IKITCHEN 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
INSULATIONISOUND
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3Ac
HOUSE SEWER
CERT. OCC.
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
SETBACK
UND PLUMBIN 2
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE Z
RO GH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
F MS
EWER OR SEPTIC
ROUGH WIRING
DUCT WORK
ROCK STORAGE
ND. REINF.-�/��
G (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
AS A
TE P. POLE
GROUT
ER HEATE
s1LICE `
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-x$-=$
LUMBER GR.
FINAL INSP.
NG `
FINAL INSP.
ROOFING
/
J,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
R. FIREWALL
TH G
MESH
INSULATIONISOUND
SH GRADING
,��AL INSPECTIO '
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL