003792 (SATT)• �W
P.O. BOX 1504 N o . '
Building 78-105 CALLE ESTADO
Address
bbled1r _ LA QUINTA, CALIFORNIA 92253.
-
Owner _
...
Sunrise Comoi' nv BUILDING: TYPE CONST. OCC: GRP. -
Mailing
Address 15-0`05 (:ountSy. Clul -Drive _ a__ r - _ A.P-Number._ . _ ._PGA- eSt
CityZip
-Palm- Desert-' 922613 Legal Description
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Contractor... I *laze w.
Project Description oZ�D' Plaw. 30 M
Mor toaae a Land
Address _
J.a�rnr�+
City Zip Tela
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• State Lic. City
& Classif.. 210 Lic. #
Arch Engr -- -
Sq. Ft. DWG 2825 No.
Size• , • (;AR - !;fia Stories -
No.,Dw..
Units
..Designer
New ❑ Add ❑ '' Alter ❑' Repair ❑ •' ', Demolition ❑•
Address
Tel.
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City
Zip
State _
Front Setback from. Center Line
Lic'. #
Rear Setback from Rear Prop. Line
• LICENSED CONTRACTOR'S DECLARATION
Side Street Setback from Center Line'''
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
r•• e•
• effect. ..
INSPECTOR'
SIGNATURE DATE
'• 4161$ -
Date Permit
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following1�
Estimated Valuation
•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 opursuant to
•. PERMIT - •• 'AMOUNT
the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/
-
Division 3 o/ the Business arid'Professions Code, or: that. he. is exempt therefrom, and'the basis
for the Any Section 7031.5 by'any for
-
Plan Chk: Dep... •-
alleged exemption. violation of applicant a permit
' subjects the applicant to a civil penalty of not more than five-hundred.dollars ($500). .." - •..
-
.
Plan Chk. Bal. It
❑ I, as owner of the property, or my employees with.wages as their sole compensation, will,.
S �S .. 0
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
COr1St: «�A
`..)•
- Professions Code: The Contractor's License Law does not apply to an owner o/ property who __
lS/
builds or improves thereon and who does such work tilmself or through his own employees,
provided that such. improvements are not intended or.offered for sale. If, however, the building_
Mech. 55.'0A
,or improvement is sold within one year o/ completion, the owner -builder will have the• burden
Electrical - ` ' - '1 ->1 171
o/ proving that he did not build or improve for the purpose o/ sale.) ..
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-..
Plumbing 136 • 50
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.I. - 13x.674
• o such projects with a contractor(s) licensed pursuant to the. Contractor's License Law.)
Grading
.. Do am exempt under Sec. B.& 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
O Copy is filed with the city. ..❑ Certified copy is hereby furnished.'
TOTAL $5.933000 . -t4, Z.,0 1.5-A .o "t
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE "
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.) ` . ..
I certify that in the performance of th0 work for which this permit'is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation -4t
Laws of California.
Date Owner '
NOTICE TO APPLICANT: It, after making this Certificate of Exemption you should become `
subject to' the Workers' Compensation - provisions of the Labor ' Code, you must forthwith
• comply with such provisions or this permit shall be deemed revoked. - -
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) • _
Lender's Name -
Lender's Address
' This is a building permit'when'properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.,
I certify that I have read this application and state that the.above information is correct.
I agree to comply'with all city and county ordinances and state laws' relating to building
construction, and hereby authorize representatives:of this city to enter the above-.
mentioned property for inspection purposes. =
Signature of applicant - Date
Mailing Address
City, State, Zip
HARD COPY
REMARKS
,
AV
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ZONE:
—BY:,.
Minimum Setback Distances:
Front Setback from. Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line'''
Side Setback from Property Line
',FINAL DATE
INSPECTOR'
• -
-'Issued by— �
'• 4161$ -
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. p $
2ND FL. SQ. FT. ®
POR. SQ. FT. ®
GAR. SQ. FT. @
CARP. SQ. FT.
WALL SO. FT. ®
SO. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
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
REMARKS:
VENTILATION
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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
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
inarc� i v n a om nq v u ncanm i uNw_
GARDEN WALL FINAL