07037 (SFD)44a
P.O. BOX 1504 No. 07037
Building 54"195 Shoal Clreek LA QUINTACCALIFORNIA92253 "
• Address '
Owner
Sunrise Company
Mailing' BUILDING: TYPE CONST. - OCC: GRP..
Address 42-600 Cook St. Suite 200 PGA WEST Phase 26A
A.P. Number
City Zip ITel-
Palm
_Desert 92260 5-66-282€ Legal Description -Tract 24317-2
Contractor Project Description Plan 9i
National Mortgage b Land'
Address
Same
City Zip Tel.:
State Lic. City DNS e 9
& Classif.288130 Lic. # 328 Sq. Ft. GAR 420 No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ .
Address' Tel.
' City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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:Jr
. i -
SIGNATURE - DATE
OWNEWBUILDER DECLARATION Estimated Valuation -
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,6usiness and Professions Code: Any city or county which requires a
permit to construct, after, 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 AMOUNT
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 Plan Chk. Dep. • _
subjects the applicant to a civilpenally of not more than five hundred dollars ($500).- 6734. -
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan. Chk. Bal.
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
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 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.) Electrical 17U.29i
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing lob. W
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 contractors) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec_ R. 8 P.C. for this reason Grading
Driveway Enc.
Date Owner Infrastructure §64..
fM55 �i���t 9 •+�'i -
WORKERS' COMPENSATION DECLARATION Intra Due
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.
TOTAL • ~' M any`: , i'� /1
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the pemtit is for one hundred dollars ($100) valuation � .l r'.1 X r � }tom i rw' ;•* Y v jet 1 ") ` ct ti
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any pperson in any manner so as to become subject to the Workers' Compensation -
Laws of California
o t
a --Owner
NOTICE TO APPLICANT. if, after malmmg'this Certificate of Exemption you should become
ZONE:
BY: �f
subject to the workers' compensation provisions of the Labor Code, you must'forthwitn
comply with such Provisions or this permit shaft be deemed revoked. -
Minimum Setback Distances: ' -
4
Front Setback from Center Line
t
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
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and'is subject to
expiration if work thereunder is suspended for 1130 days.
I certify that I have this
9
�� 1219
read application and state that the above information is correct.
I
Issued by:
Date Permit
agree to comply with all city and county ordinances and state laws relating to building
construction, and herebyauthorize representatives -of this, city to enter the -above.
- mentionedpropertyforinspectionpurposes
•Validated by:
' Signature of applicant Date
Mailing Address
Validation:
City,. State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® E
UNITS
A.C. UNIT
COLL. AREA
�CSLAB GRADE 3 �l L
YARD SPKLR SYSTEM
2ND FL SQ. FT. ®
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. $p. FT. ®
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
AS (ROUG
METER LOOP
DRAINAGE PIPING
CAR P. SO. FT. ®
REINF. STEEL
GAS (FINAL)
TEMP. POLE
DRINKING FOUNTAIN.
WALL SQ. FT.
GROUT
WATER HEATER
URINAL
Sp. FT. @
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION E
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
$
FLOOR DRAIN
MECHANICAL FEES
LUMBER GR.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
$OOFING �� �n«<
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
MESH
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
GROUND PL8Q1
UNDERGROUND
A.C. UNIT
COLL. AREA
�CSLAB GRADE 3 �l L
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
WER OR
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
/FORMS
4e—FOUND. REINF. T—g�
✓
AS (ROUG
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$
=_
LUMBER GR.
FINAL INSP770'�
MING
FINAL INSP.
$OOFING �� �n«<
��� 7_6
�K -� L/ 2�-o
REMARKS:
VENTILATION
FIRE ZONE ROOFING :
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
OU6ATHING
MESH
INSULATION/SOUND /�
I
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL