07075 (SATT)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 79-865 flortiymd LA QUINTA, CALIFORNIA 92253
Sunni se Company
Address 42-600 Cook St. Suite 200
City Zip Tel.
Pal® 8eser 92250 558-2828
Contractor
Rational ft-tQace A Land
Same
Tela
State Lic. I City
& Classif.,288130 Lic. # 328.
Arch., Engr.,
Designer
Address Tel.
City IZip I 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.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Busiress and Professions Code: Any city or cowry which requires a
permit to constrict, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to Me 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 vbtation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civ8 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, Duisness and
Professions Code: The Contractors 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.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to corn
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.)
❑ 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
❑ Copy is filed with the city. ❑ 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.)
1 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: ff. after making this Certificate of Exemption you should become
subject to the Workers' Cortpensation Provisions of the Labor Code, you must forthwith
comply with such Provisions or Oris permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Chd Code.)
Lender's Name
Lender's Address
This is a building permit when property 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
&Lj�) �,
No. 07075
BUILDING: TYPE CONST. OCC:. GRP.
A.P. Number PGA WEST
Legal Description Tract 21
Project Description Phase 34B " Plan MR
REMARKS T L ^ . _rpy y. ;
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: Date 2/13/90 Permit
Validated by:
Validation:
Sq. Ft. 2826
Size
No.
Stories
No. DIN.
Units
New ❑ Add ❑
Alter ❑
Repair 0 Demolition ❑
L
Estimated Valuation
$194,692
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ g .11
Const.
_ +.' -
Mech.
• 50
Electrical
44. l
Plumbing
2041W
S.M.I.
3�qJ
Grading
Driveway Enc.
d
_
I frastrugture,
`�'^� '�
2a 24
LC;t t"Til
w
_
TOTAL
REMARKS T L ^ . _rpy y. ;
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: Date 2/13/90 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE G `il( - ry
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL Sp. FT.
FORMS
AWER OR W
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
J7�rn_S (RDUGF�. ��%/
!/V
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT. ®
GROUT
WATER HEATER
WALL Sp. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$�V`/ROOFING
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP. �U 7u
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
JL/LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
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
OUND PLl1 B -
UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE G `il( - ry
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
AWER OR W
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
qj�k`FOUND. REINFA/ 5-
J7�rn_S (RDUGF�. ��%/
!/V
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$
=$�V`/ROOFING
LUMBER GR.
FINAL INSP. �U 7u
RAMING
10J/FRAMING
FINAL INSP.
^
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
JL/LATHING
MESH
Pjlt!NSULATIONISOUN ,_4p�e,?(5f
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
I