05090 (SFD)Tj-ht 4 4 a"
Building
Address 54.489 Inverness
Owner
Sunrise - iozaa13v
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address
Ir
City a Zip, Tel.
1x �r M nmrt01s A r't lX
Contractor
Address . ..�, •-. » .
No. 05094
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number nr�A . 4o� _ saa.S��M
Legal Description
Project Description 1n1 o inti
City Zip Tel.:
�Y
State Lia City
& Classif. 288130 Lic. # 328 r Sq. Ft. 3489 No. No. Dw.
Arch., Engr., Size - Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City I Zip I 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
>
i }y
SIGNATURE' " DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,9us ness 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 /He a signed statement that he is licensed pursuant to
the provisions of the Contractor's license Law. Chapter 9 (commencing with Section 7000) of
1! Division 3 0l 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 rxvilpenalty of not more than five hundred dollars (E500).
❑ 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 Contractors 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 wig have the burden
of proving that he did not build or inprove 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
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
(This section need not be completed N the permit is for one hundred dollars (5100) valuation
or less.)
1 certify that in the perfor iance.of HGV 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 ti1tir..-,
NOTICE TO APPLICANT: lf, 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.
J'
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
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.
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.
Signature of applicant Date
Mailing Address
City, State, Zip
stimatea valuation
n flit
PERMIT
Distances:
Plan Chk. Dep.
Front Setback from Center Line
Plan Chk. Bal.
Rear Setback from Rear Prop. Line
Const.
Side Street Setback from Center Line
Mech.
Side Setback from Property Line
Electrical
INSPECTOR
Plumbing
12/27/88
S.M.I.
Date Permit
Grading
Driveway Enc.
Infrastructure
Less Credit
1,914.84
TOTAL
$3,,295.710
AMOUNT
500.90
610.50
• 33.00
113.'52
111.00
11.94
1,9.4.84
REMARKS r "
r'�lis�3fsJ ctflfi� z."1i x:'�a�'>-t'41.i••f#iiib:s.- ter, i�j
y:v u ,v,r .a .•.Ia cb+ w .��.. �s a.r
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
12/27/88
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. ® $
UNITS
SLAB GRADE
H PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT.
FORMS
EWER OR PTIC TN
ROUGH WIRING
SVC.
BAR SINK
POR. SO. FT. @MOBILEHOME
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
(FINAL)
TEMP. POLE
DRAINAGE PIPING
CARP. SO. FT. ®
GROUT
WATER HEATIR
WALL SO. FT. ®
FINAL INSP.
DRINKING FOUNTAIN
SO FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
RAMING Z
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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. Ff. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® t Vi c
SEWAGE DISPOSAL
ULATIONISOUND S�
SO.FT.GAR (g 3Yic
HOUSE SEWER
FI SH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
H PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR PTIC TN
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
(FINAL)
TEMP. POLE
GROUT
WATER HEATIR
RVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
RAMING Z
FINAL INSP.
OOFING iZs
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
AR. FIREWALL
LAT _( 7 -
MESH MESH
ULATIONISOUND S�
FI SH GRADING
NAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL