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04449 (SATT)04449, P.O. BOX 1504 78-105 CALLE ESTADO ddrdess"4�� • LA QUINTA, CALIFORNIA 92253 ;,Owner sunrise copuany _ BUILDING: -TYPE CONST. OCC. GRP. +, Mailing Address 75-005 Co4w Cly A.P. Number PGA West � The Greens-, t City, Zip Tel. 4 . _ Pa sort 9226 .56,8 -2028_: Legal Description Contractor P -t D t' � ase �40 — Plan C ' Vational Address Safes City Zip State Lic: $xQ & Classif. Arch., Engr., Designer Address Tel. w;. City Lic. If ., ... Cityy;X J. Zip State <•>i � * `��" Lic. # ?` LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70 130) 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 Contractor's License Law for the following reason: (Sec.' 7031.5,Business and Professions Code: Any city or county which requires a rojec escrlp Ion Sq. Ft. • .1400 No. « No. Dw. ,. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $110 a 574 t+ • permit to construct, atter, 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 PERMIT �'•` �.,f. AMOUNT . the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of ' 3 Division of the Business and Professions Code, or that he is exempt therefrom, and the basis '• Any Section 7031.5 'any for Plan Chk. Dep. - r for the .alleged exemption. violation of by applicant a permit re subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. ` ❑ 1, 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 Const. _411W • yV '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. Mech. provided that such improvements are not intended or offered for sale. If, however, the building - - or improvementis sold within one year of completion, the owner -builder will have the burden Electrical _ 0 t;u • of proving that he did not build of improve for the purpose of sale.) .0'I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 1r�tg ' astruct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law to builds improves thereon, for S.M.I. does not apply an owner of property who or and who contracts '• such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - • Grading -- r ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. h Date Owner fid% 1,4 0 1Infrastructure i:4�`ic F Ce: Ci11Li:�.'I'w .ft 4 ' .,j< 0 � • WORKERS' COMPENSATION DECLARATION rw—,t ,Intrastru >ture .� 443,* yu I 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 sS, 0 Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL I ili'V 9 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE <� (This section need not be completed if the permit is for one hundred dollars ($100) valuation moi; ,Kw��f �t �y{�1n1� w t n f3 �h+Trr3" x`' lgiol AW iA I ''�%ef? ; VY �i 1 Ve r 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 Date Owner NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you should become ZONE: BY: - `y subject to the Workers' Compensation provisions of the Labor Code, you ,must forthwithMinimum comply with such.provisions or this permit shall be deemed revoked. 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, Civil Code.) , " Side Setback from Property Line Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated; and is subject to. FINAL DATE 1 SPEC'IOR 1 • 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. 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- bove mentioned mentioned property for inspection purposes. Validated by: Signature of applicant Date / .: Zv ,,Mailing Address ` Validation:" City, State; Zip' WHITE - FINANCE PINK - APPLICANT, GREEN BUILDING. GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE ,. ...t .,-.'L' .- t -. `L '.. .��' - •I' .;L.`-_ . a< ... ., a. ..'l. _ . � ..Y:= .... n. .'rN... . _ . r. w.. .. ... v_ N� -. .. -.. ....1. t...a ,.., ! .. �h.w s w... ,. 3�9J ._ 'l....-...�7.. S . �� CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT rp $ UNITS SLAB GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. a FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FT. Qr GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. fa FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. @ - $ LUMBER GR. FINAL INSP. URINAL SO. FT. ra ROOFING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation IFLOOR DRAIN MECHANICAL FEES VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTONDISHI APPLIANCE DRYER FIREPLACE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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 SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT. B.T.U. SO. FT. RESID (a 11A c SEWAGE DISPOSAL SO.FT.GAR @ Y c 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 SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 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 INSULATION/SOUND FINISH GRADING I A CT2411�1 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS , GARDEN WALL FINAL