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04350 (SATT)Building Address Owner Mailing Address City r .. P.O. BOX 1504 55-423 Tangl ood LA QUINTAC t'�CALIFORNIA 92253 , SunriseCompany Contractor �I Address its City BUILDING: TYPE CONST. OCC. GRP. :lluntry ClUb DriVIS , .. _ _ A.P.•Number _PGA, WOOL "' The GrOent Zip Tel. 92260 �6��►"�� Legal Description l Project Description - plain * U ^" Phase 70 r Zip Tel. r4 ' • State Lic. & Classif. 288130 Arch., Engr., Designer Address Cit Lic.# 90�.�� 2 ' • .. „ Sq. Ft... _ . � , No. No. Dw. Size Stories Units el. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION • I hereby affirm that qam 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. r' { . r r s" .SIGNATURE r DATE OWNER -BUILDER DECLARATION { 1 hereby affirm that I am exempt from the Contractor's License Law for the following ., 4;_.y."..reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a New ❑ Add ❑ Alter ❑ Repair ❑ ii Demolition ❑ Estimated Valuation $114o179 •; permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also #.. requires the applicant for such permit to life a signed statement that he is licensed pursuant to PERMIT AMOUNT provisions3 corn gwith Section License Law, Corrtthat. of the Businessland Professions Code.rator's f Division he is exempt therefrom, and the basis i'_;�+3lor the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. • . subjects the applicant to a civil penalty of not more than five hundred dollars (8500). Plan Chk. Bal. n a ,. ,` 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 Const. Professions Code: The Contractor's License Law does not apply to an owner: of property who .W builds or improves thereon and who does such work himself or through his own employees, Mech. a' a 0-0. 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 Electrical `10 0 415 of proving that he did not build or improve for the purpose of sale.) , 0 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 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.1. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Seca B. & P.C. for this reason Driveway Enc. Date Owner Infra�struc,.turekP. �$2,q��39.{i<`l3 1 Seri Credit 1♦2U4♦52 WORKERS' COMPENSATION DECLARATION io .iS 1 411fi1 TEf<f rii �s / 4s+a *i; 4A.: I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certifiep copy thereof. (Sec. 3800, Labor Code.)- " Policy No. Company O Copy is filed with the city. O Certified copy is hereby furnished. w TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE • (This section need not be completed if the permit is for one hundred dollars ($100) valuation`67'��iai'3'i� �s}f Y�, �,g ,Fi•� "w'wq�R'Q4i.. • or 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 i 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 _ Distances: comply with such provisions or this permit shall be deemed revoked. Minimum Setback 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 Lin_ e f .Lender's 'Name :+ Lender's Address FINAL DATE A- INSPECTOR This is a building filled out, validated, is to permit when properly signed and and subject ' " • expiration it 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.. t. Validated by: Signature of applicant w Date- ate Mailing Mailing Address Validation: ' City, State, Zip FILE '� f WHITE FINANCE, PINK APPLICANT GREEN ,BUILDING, GOLDENROD . ASSESSOR'S OFFICE, HARD COPY :� Myh-...,, �:..�•:�...,tr�.._....�.r.f.-.w �..,«»...+.�:,._,,. ...,,. .. ,.1,.._�,�...�:.i.«..,....,_ ._,.,�„�,x;�,,.,... .....mss. �.... .. _.....�w.._� CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO F1 N $ UNITS SLAB GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. M FORMS SEWER OR SEPTI: TANK ROUGH WIRING MOBILEHOME SVC. ' BAR SINK POR SO FT a GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. fpr TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. C FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. Q -$ LUMBER GR. FINAL INSP. URINAL SO. FT. 4Y ROOFING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTOKDISH) 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 g 1 V: c ISEWAGE DISPOSAL SO.FT.GAR 3/4c HOUSE SEWER CERT. OCC. 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 SEPTI: 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 FINISH GRADING YI I ON Zo- CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL