05060 (SFD)T a 0 .
I,-?/ . 4tyl 4 4 Q" -
Building
Address 54_391 Inverness
Owner
Sunrise C(J>jrpany
Mailing
Address 42-600
,— 00Cook �� -
City lZip
Contractor
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 05.060
BUILDING: TYPE CONST. OCC: GRP.-
i'iio A.P. Number PITZA 'WAar — ?'hs)�,qe .AAA
Legal Description
Project Description
Address - - - - -- -- - -.. -
>
City '"" Zip Tel:
State Lic. City
& Classif. 8 i 3{f Lic. # 326 Sq. Ft. 1548 No. No. Dw.
Arch.; Engr., Size Stories Units
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
SIGNATURE- DATE
OWNER -BUILDER DECLARATION
1 hereby affign that I am exempt from the Contractor's License Law for the following
reason_ (Sec- 7031.5,E and Professions Code: Any city or county which requires a
pemM 10 Construct after. improve, danxi". or repair any structure, prior to Its issuance also
requires the applicant for such permit to fie a signed statement that he is licensed pursuant to
the provisions of the CCnbactoes 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 crvl penally of not morn 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 riot intended or offered for sale. (Sec. 7044, Suisness and
Professions Code: The Contractors Lioemse ,Law does not apply to an owner of property who
builds or improves, thereon and who Wes such work himself or through his own employees,
provided that such irprovernerds are not Intended or offered for sale. g, however, the building
Of srprovarment is sold within one year of completion, the owner -budder will have the burden
of provkg that he did not build or imarove for the purpose of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sea 7044, Business and Professions Code: The Contractor's License Law
does not appy to at owner of properly who odds or improves thereon, and who contracts for
such projects with a contractor(s) Ecensedpwsuard to the Contractor's License Law.)
❑ 1 am exempt under Sec_________j3_ & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
hereby affirm that 1 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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(oris section need not be completed ff the pend is for one hundred dollars ($100) valuation
or less.) -
1 certify that in the performance of th6'work for which this permit is issued, 1 shall not
=California-.
mploy any person in any manner so as to become subject to the Workers' Compensation
Laws of California ,
Date 'Owner 1
N077CE TO APPLICANT: f . alta rnakng � this Certificate of Exemption you should become
subject to the H4vkas' Compensation provisions of the Labor Code, - you must forthwith
Comply with such Prov mm or this Permit shaft 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.)
Lenders 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 100 days.
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.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS qto yoil qp yy, t T 1 1
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
12/27/8#
Issued by: Date Permit
Validated by:
'Validation:_
Estimated Valuation
$!08.545
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 370.,98
Const.
455.50
Mech.
34,00
Electrical
65.44
Plumbing
87.50
S.M.I.
71.60
Grading
Driveway Enc.
Infrastructure
$2,442.28
1,231.14 ,
Lens Credit
1,221.14
TOTAL
$2,241-.76
REMARKS qto yoil qp yy, t T 1 1
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
12/27/8#
Issued by: Date Permit
Validated by:
'Validation:_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1SVL. SO. FT. $
UNITS
LAB GRADE O
ROUGH 'Pt6MB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. Ff.
f
F MS
Cf
ER OR SEPTIC T K
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
IROOF DRAINS
HEATING (FINAL)
OTHER APPJEOUIP.
DRAINAGE PIPING
CARP. SO. FT.
TEMP. POLE
WALL SO. Ff.
GROUT
DRINKING FOUNTAIN
SO FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
=$
FLOOR DRAIN
MECHANICAL FEES
F MING �ij
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
MESH
SO.FT.GAR ® 3/ic
HOUSE SEWER
f�INSULATIONISOUNE�-5—V
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
GROUND PLUMBING3
NDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE O
ROUGH 'Pt6MB.
BONDING
HEATING (ROUGH)
STORAGE TANK
f
F MS
Cf
ER OR SEPTIC T K
ROUGH WIRING
DUCT WORK
ROCK STORAGE
OUND. REINF. Z<
9W(ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
rAS (FINAL)
TEMP. POLE
GROUT
ER HEATER
ERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
F MING �ij
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LAT ING
MESH
f�INSULATIONISOUNE�-5—V
FIN GRADING
SPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
t