04762 (SFD)04762.
P.O. BOX 1504
Building
Address SS.„ 269 Riviera LA QUINTA, CALIFORNIA 92253
Owner
Sunrise Camnanv
Mailing -
BUILDING:' TYPE CONST. OCC. GRP.
Address 75-005 Cauntry Club
A.P. Number
Legal Description
Project Description
PGA Wast — Phase 2PS
Plan FFA
City
t int Deem
Zip
920650
Tel.
,
Contractor
National Mortgage
Address
Sar
City
Zip
Tel.
State Lic. 288130
& Classif.
City 398
Lic. #
2645
Sq. Ft.
" No- No. DW.
Size
Stories Units
Arch., Engr.,
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Designer
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
7000) of Division 3 of the Business and Professions Code, and my license is in full force and,
effect.
�GNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Susiness 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 thathe is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by Any applicant for a permitPlan
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 or completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
Estimated Valuation
Ap
S! V
PERMIT
'
AMOUNT
Chk. Dep.
Plan Chk. Bal.
536.00
Const.
j1j�j yC4y
•
Mech.
.♦
•
Electrical
a �,
Plumbing
0
11400
O I, 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 I am exempt under Sec. B. 8 P.C. for this reason
S.M.I.
13.37
Grading
Driveway Enc.
Date Owner
Infrastructure
64 r 2755 505 2,1.37.53
Deas Credit
2,137.53
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.
TOTAL
$3400.01
REMARKS
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 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.
t 1�y A�,,��kY ,g �r�
0.15il rho Mlirilj1. P3—Moo .41110
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.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
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.)
Side Street Setback from Center Line
Side Setback from Property Line
Lender's Name
FINAL DATE
INSP �TO
A. f "�4
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.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address
Validation:
GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
City, State, Zip
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
ISI FL SO F1 rp 1
UNITS
SLAB GRADE
2ND FL SO FT. @
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR SO FT a
DUCT WORK
ROCK STORAGE
GAR SO. FT. Car
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP.IEOUIP.
DRAINAGE PIPING
CAR P. I SO FT. 6
TE . POLE
WALL SO. FT. rd
GROUT
DRINKING FOUNTAIN
SO FT (B
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
=$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
VENTILATION
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
GAR. FIREWALL
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID rg 1 V: c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/4C
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 8 AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA .,
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SE ER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
AS (ROUGH) 23 } V
(
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TE . POLE
GROUT
WATER HEATER
ICE 5_ l
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
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL