06812 (SFD)I QubA'
44 -
P.O. BOX 1504 No. 81
Building 7&105 CALLE ESTADO
Address54"299 S'hoal Creek LA QUINTA, CALIFORNIA 92253
Owner
Sunrise Company
Mailing BUILDING:. TYPE CONST. - OCC; GRP.
Address42-600 Cook St. SVite 200 A.P. Number PGA WEST Phase 23A
City Zip Tel.
Palm Desert .92260 1 568-2828 Legal Description
ContractorProject Description Tract' 20717-3s, Plan3CR
Va tional Land At Mortgage
Address
Sara
City'Tp Tel.:
State Lic. City .Y
& Classif..G8Bl3 Lic. # 328 Sq. Ft. 36.27 No. No..Dw.
Size Stories Units
-Arch., Engr.,'
Designer New ❑ Add ❑ Alter EIRepair ❑ -Demolition ❑ :.
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
7000) of Division 3 of the Business and Professions Code, and my license is in full force and `
" _SIGNATURE - DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirin that I am exempt from the Contractors License Law for the following $113,727
reason: (Sec. 7031.5,Lfusinness and Professions Code: Any city or county which requires a -
permit to constnict,. 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 aid 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 civril penafty of not more than five hundred dollars ($500). Plan Chk. Bal
❑ 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, Suisness and Const. owl. 40
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, theowner-builder will have the burden Electrical ♦V .a�
of proving that he did not build or improve for the purpose of sale.) -
❑ I, 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 - 1 •
does not apply to an owner of property who builds or improves thereon„and who contracts for S.M.I. •...
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
Grading
❑ 1 am exempt under Sec B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure.
Less Credit 1.0,G' .4J -
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 _:�:A
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL p23L[.fF� r' : j_•+' t
CERTIFICATE OF EXEMPTION FROM REMARKS • '
WORKERS' COMPENSATION INSURANCE r +� na11V-Zi
completed if the permit is for one hundred dollars ($100) valuation �y i^t� j
• (This section need riot 6e 1`,;t'` �;�;.DFi' I•'� `t'if i L'f�: t''” �. 7..4. ,':),,
• 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 `
Date Owner
NOTICE TO APPLICANT. H, after makhg. this Certificate of Exemption you should become ZONE: BY:
suh%ect to the Workers• Compensation provisions of the Labor Cede, you must forthwith Minimum Setback Distances: '
comply with such provisions or this permit shall be deemed revoked.' -
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
Lenders Name
Lenders Address
This is a building permit when properly filled out, signed and validated, and is subject to' FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180 days. - b/9 !9Q
I certify that I have read this application and state that the above information is correct. Issued by: Date f 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 '
Mailing Address Validation:
City,. State, Zip '
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SQ. 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. SQ. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CARP. SQ. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT.
=$
LUMBER GR.
FINAL INSP. —�
URINAL
SO. FT.
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
WASHER(AUTO)(DISH)
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Yi c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
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 FEETLUMB. 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 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 INSP. —�
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
1