04455 (SATT)-44 4 _4.5.
P.O. BOX 1504 5 ; = rr .7 ,
Building78-105 CALLE ESTADO
Address 55-045 Tangl.feiOogd LA QUINTA., CALIFORNIA .92253
Owner.
Sunrise Companv BUILDING: TYPE CONST. OCC. GRP.
' Mailing ,
Address r. - � CoAmt % Club Drive A.P. Number Y Vlgst - Tho G3eOns
City,.' Zip Tel. - `
palm Do 922605b0�2 28 9 Description
Legal Desc�i
Contractor Project DescriptiNatidrml mortgage o' IDThase 4G Plan.;
Address
(Zip I Tel. a4
State Lia208130 ( City # 308 F }
& Classif. Lic. _
Arch.,,Engr.,
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
70 OO) of Division.3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
Thereby 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 rile 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 violation of Section 7031.5 by 'any applicant for a permit
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 of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
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 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
O Copy is filed with the city. O 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
Of less.)
I certify that in the performance of thg 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
Sq. Ft. , 1400'.
Size
No. - 2
Stories
No. Dw. '
Units '
New ❑ Add ❑
Alter O Repair'❑ Demolition ❑
Date Owner
NOTICE TO APPLICANT., If, after making this Certificate of Exemption you should become
ZONE:
BY: -
l!
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances: �I
Front Setback from Center Line
alis` .
Rear Setback from Rear Prop. Line
Estimated Valuation
CONSTRUCTION LENDING AGENCY
PERMIT
AMOUNT
Plan Chk: Dep.
I_
Plan Chk. Bal.
i
X79 5Y
Const.
Lender's Name
430
Mech.
49 r, VV
Electrical
try5 , Liu
Plumbing��7�
S.M.I.
expiration if work thereunder is suspended for 180 days.
8 r'
Grading
I certify that I have read this application and state that the above information is correct.
Driveway Enc.
Date Permit
Infrastructure
:Oz r,414 r . SAX
Miss Uealz
1,243r50
get-- Intrantimeture
I 44J 9b
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
'
TOTAL•tL��"�
f�
,
mat:' ,•r..�`
REMARKS
"
City, State, Zip'
I certify that in the performance of thg 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., If, 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 such provisions or this permit shall be deemed revoked.
Minimum Setback Distances: �I
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
I_
work for which this permit is issued. (Sec. 3097, Civil Code.)
i
Side Setback from Property Line. '
Lender's Name
Lender's Address '
FINAL DATEINSP-EfTO�Rg
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.
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
f�
,
Mailing"Address
Validation:
City, State, Zip'
!L,
WHITE = FINANCE, PINK - APPLICANT, GREEN - BUILDING,
GOLDENROD L ASSESSOR'S OFFICE; HARD COPY - FILE
CONSTRUCTION ESTIMATE
'NO. ELECTRICAL FEES
NO. PLUMBING FEES
ISI FL' SO FT W $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL SO FT. a
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILE HOME SVC.
BAR SINK
POR SO FT. a
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR SO. FT. Cl
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. 50 FT. f(1
GROUT
DRINKING FOUNTAIN
WALL SO. FT. C
FINAL INSP.
BOND BEAM
URINAL
SO. FT. rp
GRADING
cu. yd.
$ plus x$
= $
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOHDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
JILAUNDRYTRAY
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 1 I c
SEWAGE DISPOSAL
SO.FT.GAR rg 1i c
HOUSE SEWER
FI ISH GRADING
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 -SEP -IC 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
INSULATIONISOUND
FI ISH GRADING
L ION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATIURESIINITIALS
,
GARDEN WALL FINAL