06549 (SFD)�
C&ti�v 4 4 0 5(-
P.O. BOX 1504 N Q . 06549
Building 78-105 CALLE ESTADO
Address 54-070 Riviera LA QUINTA, CALIFORNIA 92253
Owner
Sunrise C Many BUILDING: TYPE CONST.
Mailing OCC: GRP.
Address 42-600 wok A.P. Number PGA West " Tract 24317-1
CityZip Tel. w
P IM: Desert 192260 Legal Description
Contractor Project Description fhLm$1.M OUR
Natfonal Mortgage
Address ..
SamCity Zip Tel.:
State Lic. City
& Classif. 288130 Lic. # 328. Sq. Ft. 3831 No.. No. Dw.
Arch., Engr.; Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONT'RACTOR'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.
SIGNATURE DATE
OYIINEWBUILDER DECLARATION Estimated Valuation Q272,f3
1 hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,®uSbess and Rolessions 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 appficant for such permit to fie a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions of the contractors License law, Chapter 9 (commencing with Section 7000) o/
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 Plan Chk. Dep.
subjects the applicant to a clivi penally of not more than five hundred dollars ($500).
❑ 1, as owner of the property, or Plan Chk. Bal. $2 my employees with wages as their sole compensation, will d M s010 •30
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Duisness and COf1St. 2s)) ¢ Art
Professions Code: The Cwz&actars License Law does not apply to an owner of property who 1 ! 2Y5
builds or improves thereon and who does such work himself or through his own employees, Mech. � 5
provided that such nprmrements are not intended or offered for sale. If, however, the building •.
orImprovement is soil within one year of completion, the owner -builder will have the burden Electrical
of proving that he did no: buil or improve for the purpose of sale.) 2M.45
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing �g$ 5�
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 S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading 19.11
❑ I am exempt under Sec_ R, 8 P.C. for this reason
Driveway Enc.
Date owner Infrastructure $6,000.00 3,000.00
Less Credit 31000.00
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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. ❑ Certified copy is hereby furnished.
TOTAL $3,754.86 fl ,< 1 .j r%
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be conpleted if the permit is for one hundred dollars ($100) valuation `f V i.tI.;M t f !.1$ KL
or less.)
1 certify that in the performance of the work for which this permit is issued, I shall not
employ any person in arty manner so as to become subject to the Workers' Compensation
Laws of California.
Date owner
NOTICE TO APPLICANT: 6, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
Comply With Stich Provisions or this permit shaffbedeemedrevoked. 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• CIO Code.) Side Setback from Property Line
Lender's Name
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180 days. 10/16/89
I ceriily 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
ateMailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL. SO. FT.
DUCT WORK
ROCK STORAGE
FOUND. REINF,9 �v
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
REINF. STEEL
GAS (FINAL) TEMP. POLE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. I SO. FT. ®
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
WALL SQ. FT.
LUMBER GR.
DRINKING FOUNTAIN.
SQ FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDiSH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SPARK ARRESTOR
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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.
SO. FT. ® c
BATH TUB
FINISH GRADING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 31Lc
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 PLUMBIN /� UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
WER OR SIJA11 ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF,9 �v
�CGAS (ROUGH) % METER LOOP
HEATING (FINAL)
OTHER APPIEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
INAL INSP. AV
FRAMING
FINAL INSP.
ROOFING
tL - -
p� 7`4 wK�,o �l` d al -z U x�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
�ATHING
MESH
INSULATION/SOUNd/ —,,2, S�q
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
t