06813 (SFD)Building
Address 54-291 Shoal Creek
Owner Sunrise CoMany
Tw�v 4 4 a"
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address 42-600 Cook St. Suite 200
City Zip Tel.
Pala Deset" 92260 1
568-2828
Contractor
natinrlal Land &
Tel.
State Lic. City
& Classif. 288130 Lic. # 328
Arch., Engr.,
Designer
Address Tel.
City IZip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
7000) baf ivsion 3 of the Business and Professions Code, and my license is in full force and
effect
SIGgATUM DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Brsiness and Professions Code: Any city or county which requires a
permit to corisnvct, alter, improve, demolish, or repair any structure, prior to 8s issuance also
nW*w the applicant for such pemul 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) or
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for Ore alleged excerption. Any violation of Section 7031.5 by any applicant for a permit
sub ects the applicant to a clivi penally of not more than five hundred dollars (E500).
❑ 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
Professims Code: The Contractor's License Law does not apply to an owner of property who
bukft or improves thereon and who does such work himself or through his own employees,
Provided Ghat such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion. the owner -budder will have the burden
of proving Mat he dol not build or Improve for the purpose of sale.)
❑ 1, 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 nag appy 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_ R. & P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No, Company
❑ Copy is filed with the city. ❑ Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(Ths section need not be completed if the pentut is for one hundred dollars ($100) valuation
of ideas)
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
Date Owner
N0710E TO APPLICANT. 8, after making this Certificate of Exemption you should become
SE bject b the Workers' Compensation provisiors of the Labor Code, you must forthwith
comply witit such provisions or this permit shat/ be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 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.)
Lenders Name
Lenders Address
This is abuilding permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
1 certify that 1 have read this application and state that the above information is correct.1
agree 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 Addrr'zs
City. State, Zip
ILDING: TYPECONST.,
No. 06813
_OCC: GRP.
Number P&A WEST - Phase 23A
Legal Description_
Project Description
Tract 20717-3, Platt 1CR
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 1/9Permit
Validated by:
Validation:
Sq. Ft. 1330
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$94,224
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
buv.4i
Const.
OIL/ .UU
Mech.
. UU
Electrical
".I99
Plumbing
96.Uo
S.M.I.
6. 65 -
Grading
Driveway Enc.
Infrastructure
*41 .4!?
I Vubu. Cb
MUSS UYVU-11.
116 .25
TOTAL
REMARKSr.r;x�
M01iu. 1 �4q_3. t'
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 1/9Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. @
TEMP. POLE
I
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. @
FINAL INSP.
WALL SQ. FT. @
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ plus x$
_$
URINAL
SQ. FT. @
4L INSP-
FRAMING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIRE ZONE ROOFING:
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRYTRAY
AIR HANDLING UNIT CFM
IKITCHEN 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
SQ. FT. @ c
IWATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 1% c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3Vac
HOUSE SEWER
FINAL INSPECTION
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 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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.IN
4L INSP-
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL
1