05087 (SFD)P.O. BOX 1504 N Q . .05087
Building 78-105 CALLE ESTADO
Address 54-539 Inverness _ ,LA QUINTA, CALIFORNIA 92253
Owner + '
Mailing
Sunrise COmpa lty BUILDING: -TYPE CONST. OCC: GRP.
'
Address
49-1500 xs ,e, ? A.P. Number rr.A 'FExsint plxa,etss `?QA
City Zip Tel. .. .. .
Legal Description
7A 1JQ
Contractor
Project Description T►t nq >nr
National Mortgage
Address
Same �»
City Zip Tel.
State Lic. City
& Classif. 28.8130 Lic. # 328 Sq. Ft. 1627 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
a 7000) of Division 3 of the Business and Professions Code, and,my license is in: full force and
effect <1 [ . � ` "��'" t s _ � ' _ %' k • '••';`
SIGNATURE} '
`�-� DATE
f OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Buse7ess 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 Me 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 Mat. 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 n of 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 Contractors License Law does no 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 blended or offered for sale. ff, however, .the building
or improvement is sold within one year of completion, the owner -budder will have the burden
of proving that he did not build at improve for the purpose of sale.)
❑ 1, 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) dcensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec- R. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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
(This section need not be completed N the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg 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. r
Date ' 1, ="'Owner • -'L-�.
NOTICE TO APPLICANT: ff. after inking 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.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Cava Code.)
Lenders Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 1110 days.
I certify that 1 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
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Estimated Valuation
si13,727
PERMIT
INSPECTOR
AMOUNT
Plan Chk. Dep.
Validated by:
Plan Chk. Bal.
Validation:
A 180.44
Const.
468.00
Mech.
0
Electrical
G
Plumbing
0
S.M.I.
Grading
Driveway Enc.
Infrastructure
$ , 558. 86
1.279.43
t C -
Q
TOTAL
? 12A 7
3 i.� ? ( . 12 2;i
REMARKS
{{..
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
Issued by:
12/27/38
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
PLUMBING FEES
1ST FL. , SQ. FT. ® $
UNITS
r
R GH PLUMB.
d9 X
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
EWER OR S I A K
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
INAL)
TEMP. POLE
DRAINAGE PIPING
CARP. SQ. FT. ®
GROUT
WATER HEATA
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN
SQ FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING
FLOOR DRAIN
MECHANICAL FEES
O`�i i _tai' �,ZS�Q
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
INSULATION/SOUNDS- 31
SQ.FT.GAR ® V4c
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE 111PL.CK.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
R GH PLUMB.
d9 X
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR S I A K
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
INAL)
TEMP. POLE
GROUT
WATER HEATA
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
O`�i i _tai' �,ZS�Q
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
ESH
INSULATION/SOUNDS- 31
FINISH GRADING
L INSPECTION 7
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL