04634 (SFD)04634
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address S4_40 xav=rOss LA QUINTA, CALIFORNIA 92253
Owner
Mailing
BUILDING: TYPE CONST. OCC. GRP.
Address i tis 001rfty Mab ' " RM
" A P'Number `*
City Zip Tel.
Paim Desert 92266 ,.S6Ew OZB; Legal Description
Contractor� 28AF I�UA 21,T,m P Project Description
Address
Sam
City Zip Tel. M~
State Lic. City
& Classif. 280130 Lic. # ,�� _ Sq. Ft.1330 No. ); No. Dw.
Arch., Engr.; .,
Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
i 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
effect. "I r t __1 - t r_% f
SIGNATURE- DATE
OWNER -BUILDER DECLARATION
I hereby affirrn.that I 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, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file 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).
O 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.)
O 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) licensed pursuant to the Contractor's License Law.)
O 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, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. O 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 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.
Date Owner
NOTICE TO APPLICANT: If, 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.
,timated Valuation
92A
$94t244
Side Street Setback from Center Line
PERMIT
AMOUNT
Plan Chk. Dep.
Side Setback from Property Line
Plan Chk. Bal.
4'f +�► -
Const.
FINAL DATE
•
Mech.
•
Electrical
3•:7►
Plumbing
Issued by:
tx ,W
S.M.I.
•
Grading
Driveway Enc.
Validated by:
Infrastructure
41*
5 r
Validation:
City, State, Zip
WHITE - FINANCE, PINK - APPLICANT, GREEN -BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
TOTAL
REMARKS
• �t�.+,r,Lt}�•�,�t �"`T'�r'n�v ;7 t"�►S�u',s, a. xti
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE
INSPECTO
This is a building permit when properly filled out, signed and validated, and Is subject to
To
expiration it work thereunder is suspended for 180 days.
-
I certify that I have read this application and state that the above information is correct.
Issued by:
Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the, above-
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
WHITE - FINANCE, PINK - APPLICANT, GREEN -BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
ISI FL SO FT ip S
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC
BAR SINK
POR SO FTer
GAS (ROUGH)
METER LOOP
GAR SO. FT. CC
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CARP. SO FT. 9f
GROUT
WATER HEATER
WALL SO FT. Q
FINAL INSP.
DRINKING FOUNTAIN
BOND BEAM
WATER SYSTEM
URINAL
SO FT @
=$
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSF( I�
WATER PIPING
NOTE Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
ISIGN
WASH ER(AUTOXDISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
IKITCHEN 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. a c
WATER HEATER
MAX. HEATER OUTPUT. B.T.U.
SO. FT. RESID g I,/, c
SEWAGE DISPOSAL
SO.FT.GAR (g qac
HOUSE SEWER
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 PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus xS
=$
LUMBER GR.
FINAL INSF( I�
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL 7d
CITY OF LA OUINTA
DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
5642246
24-HOUR NOTICE FOR INSPECT]O
Owner Sunrise Co>Tipa7y
Contractor National Mortgage
Permit Number 4634
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 54-689 Inverness
"Phase 28A, Plan DIR"
TYPE OF INSPECTION DATE INV.
FOUNDATION 6 SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
DO NOT POUR CONCRETE UNTIL ALLAB.OVE-KAS BEEN SIGNED
CONCRETE SLAB
8
GROUND
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS 8 GAS TEST
HEATING d VENT- A/C
FIREPLACE
ROOF
GROUT ❑ 4' ❑ 8'
FRAMING
PRE -ROOF I 11-x1 Z�/fit` c%
COVER NO. WORK UNTIL ABOVE HAS BEEN SIGNED/ -
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE A GATE
SEWER SEPTIC TANK /
FI
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBER!
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4/88 :. y L/- (f Z
CITY OF LA QUINTA
DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
Owner Sunrise Conipaly
Contractor National Mortgage
Permit Number 4633
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 54-685 Inverness
"Phase 28A, Plan 1M"
TYPE OF INSPECTION I DATE INSP.
FOUNDATION 8 SETBACK
MAIN GROUND SYSTEM
GROUND PLUMBING /v Z6?/ 'g';w
DO NOT POUR CONCRETE UNTIL ALL.ABOVE.HAS BEEN SIGNED
CONCRETE SLAB
JOISTS d GIRDERS
WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNEU
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS 3 GAS TEST I vG
HEATING d VENT- A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP r `�
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF QL _..
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL. INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE d GATE
SEWER SEPTIC TANK -7
FI
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
ABO APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4/88 r-Af, - /