06811 (SFD)P.O. BOX 1504 No. 06811
Building 78-105 CALLE ESTADO
Address W307 Shoat Creek LA QUINTA, CALIFORNIA 92253
Owner
•Sunrise Company BUILDING: TYPE CONST. OCC: GRP.-
Mw Ing '
Address42w600 Cook St. Suite 200 A.P. Number PGA WEST Phase 23A
City lZip Tel.
Pa
lm Desertl 92260 S68-2826 Legal Description
Contractor Project Description irarrt 20717-3, Plan, 4C
f#ation, al Land & Mortoane
Address
Sates
City Zip Tel.:
State Lic. City
& Classif- 285230 Lic. # 328Sq. Ft. � No. No, Dw. ,
• • Arch., Engr_, - -
Size - Stories - Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑.
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
700oaffirm that I am licensed under provisions of Chapter 9 (commencing with Section
f Division 3 of the Business and Professions Code, and my license is in full force and
effect :� ; •''_ L� '<.r r
SIGNATtME DATE
r OWNER -BUILDER DECLARATION
• I hereby affirm that 1 am exempt from the Contractors License Law for the following Estimated Valuation $ ra2,816
c.
reasor[.(Se. 7031.5,Busness and Professions Code: Any city or county which requires a ja7
peana to construct. after• reprove, dermorsh, 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 Contractors License Law, Chapter 9 (commencing with Section 7000) of
Qv -cion 3 of the Busness 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 civil penally of not more than rive hundred dolars ($500). - Plan Chk. Bal.
0 1, as owner of the property, or my employees with wages as their sole compensation, will e
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COrISt. 7 ri1rJ. it
Professions Code: The Contractors License Law does not apply to an owner of property who
Du,Tds or reproves thereon and who does such work himself or through his own employees, Mech. V" .
provided that such improvements are not Mended or offered for sale. B, however, the building ♦ _
or improvement is surd within one year of completion, the owner -builder will have the burden Electrical ��.
of proving that he did not build or improve for the purpose of sale.) •04 -
6 1, as owner of the property, am exclusively contracting with licensed contractors to com. Plumbing 1 1 fit)
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 reproves thereon, and who contracts for S.M.1. •.� `
such pro}ells with a contractor(s) licensed pursuant to the Contractors License Law.) ti
Grading
Q 1 am exempt under Sec_ a, g P.C- for this reason
Driveway Enc.
Dateowner Infrastructure • a�..i .
SS • � i 1 a.ri�ti.
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
6 Copy is filed with the city. O Certified copy is hereby fumished.
TOTAL : fit•. -" ;lt. w f
CERTIFICATE OF EXEMPTION FROM REMARKS '
WORKERS' COMPENSATION INSURANCE 3-• ••• - •--1" eta > ; n tit, e
(rho section need not be completed It the permit is for one hundred dollars (5100) valuation t3:ya it sas{h"I .0 ` '•�' ti.p f" .`'t.- ..6<5+ !: �y
or less.) -
I certify that in the performance of the work for which this permit is issued, I shall not
=California person in any manner so as to become subject to the Workers' Compensation
Laws of California
s -Date Owner .
NOTICE TO APPLICANT ff.' after making this Certificate of Exemption you should become .ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith -
Comitywith Such provisionsorthis pemirtshall bedeemed ncoked: Minimum Setback Distances: -
Front Setback from Center Line
coNSTRucnon LENDING AGENCY
Rear Setback from Rear Prop. LinE-
�
1 hereby Side Street Setback from Center Line
affirm that there is a construction lending agency for the performance of the . A
work rorwhicA this permit is issued. (Sec. 3097, Civil Code.) Side.Setback from Property Line
Lenders Name
Lenders Address FINAL DATE INSPECTOR
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
certify that 1 have read this application and state that the above information is correct. Issued by. Date a -Perm id
1 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
Wailing Address Validation:
City,. State, Zip
c
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. 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
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT.
=$
LUMBER GR.
ALINSP.
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
LAUNDRY TRAY
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
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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 & 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.
ALINSP.
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 SIGNATURE311NIT1ALS
GARDEN WALL FINAL
1