003215 (SFD)4
P.O. BOX 1504 No, 003215
Building 78-105 CALLE ESTADO
Address 54-884 Inverness LA QUINTA, CALIFORNIA 92253
Owner
Sunrise Comvan`f _ BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address,f�+ , « ,�* .r,'"'i€a 71V iYza A.P. Number
City Zip Tel.-
Palm -Deser% -92260 5'Ci--282£ Legal. Description_ . _ -
ContractorPlan 3g1
Project Description g�2a3e 26Aa
Address.
City JZip Tel'... .
State Lic. City
& Classif. Lic. # � Sq. Ft. 'a�� G162% No. No. Dw.
Size • r -424 Stories Units
Arch.,_Engr.
Designer New ❑. Add ❑ Alter ❑- Repair ❑ Demolition ❑
Address Tel.
City JZip State
_ Lic. #
jy! LICENSED CONTRACTOR'S DECLARATION. ,.
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section v
7000) of Division 3 of the Business and /P.rofessions' Code, and my license is in full force and "
effect. � `/. `i�..J# •v(-a'�_•' i ~i.�1 •!_ .% _
SIGNATURE - f DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm 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 - ` 3 -177-on
permit to construct, alter, improve, demolish, or repair any structure,: prior ,lo )ts Issuance also _ r
requires theapplicant for such permit tofile a signed statement that.he is licensed pursuant to • PERMITAMOUNT -
the provisions o/ the Contractor's License Law, Chapter 9 (commencing- with Section 7000), of a�
Division 3 o/ the Business and Professions Code, or that. he is exempt therefrom, and'tlie .basis - - • .
for the alleged exemption. Any violation o/ Section 7031.5 bp 'any applicant for a' permit Plan Chk. Dep.
••s subjects the'applicant to a civil penalty of not more than five hundred dollars ($500). I - ' . - -
Plan Chk. Bal.
p - I, as owner. of the property, or my employees with wages as their sole compensation, will , • � -- 3RO.. 4A
do the work, and the structure is not intended or offered for. sale. (Sec. 7044, Buisness and COf1St.
Professions Code: The Contractor's License - Law does not apply to an owner o/ property who rrr . i3
builds or improves thereon and who does such work himself or through his 'own employees,- Mech..
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 Electrical '
of proving that he did not build or improve for the purpose o/ sale.) A i; , Al
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con. Plumbing _
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's 'License Law -
does not apply to an owner o/ property who builds or improves thereon, and who contracts for S. M. 1.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - - .
Grading
.. ❑ I am.exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date owner Infrastructure
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
❑ Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS , `-'I U,4 AV
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ the permit 1s'lor one hundred dollars ($100) valuation
or less.) .. _ .. ..
certify that in the performance of the 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: I/, after making this Certificate of Exemption you should become - 'ZONE: BY: -
subject to the Workers' Compensation provisions of the Labor- Code,•you must forthwith Minimum Setback Distances: -
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback frorn'Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center.Llne
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
This is's building permit when properly filled out, signed and validated, and.is subject to FINAL DATE INSPECTOR
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: Date1 l0.7 Permit
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 -
men
tioned property for inspection purposes. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. @ $
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ. FT. @
CARP. SQ. FT.
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
A
/ _
`
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER ,
VENT SYSTEM . FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROCK STORAGE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
i S (ROUE Z Q
LAUNDRYTRAY
AIR HANDLING UNIT CFM
OTHER APP./EQUIP.
KITCHEN 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.
SQ. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/ac
HOUSE SEWER
ROOFING /
�
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 PL NG I7rp
UNDERGROUND-
A.C. UNIT
COLL. AREA
SLAB GRADE
A
/ _
`
OUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
S ER ORS TI A
A A 41t mo
ROUGH WIRING /,0/6 0;r i X*T WORK
ROCK STORAGE
FOUND. REINF.
i S (ROUE Z Q
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF: STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. Z
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING f'Q
FINAL INSP.
ROOFING /
�
�A // /
7 / ��/v • /
I
i/nryryry
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 1174V
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS. '
GARDEN WALL FINAL
'