07399 (BLCK)Building 54-395 Shoal Creek
Owner
Sunrise Company
Addr� 4.2-6()0. Cook Street
City Palm Desert Zip 92253
Contafictor
` onal Mortgage & Land
city
State Lic.
& Class f. 288130
Arch., Engr.,
Designer
Address
T4ht 4 4 Q"
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Suite 200
City
Lic. # 328
Tel.
,ity Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
71of bnusion 3 of the Business and Professions,C06, and my license is in full torcetaf'd
effect /f
If OWNEWBUILDER DECLARATION J
1 hereby affirm that 1 am exempt from the Contractors License Law for the following
reason (Sec. 7031.5,Brrs4ess and Professions Code: Any city or county which requires a
pem* to construct, alter, irprove, dernoffsh, or repair any structure, prior to its Issuance also
requires Me applicant for such Permit to Fite a signed statement that he is licensed pursuant to
due provisions of the Contractor's License Law, Chapter 9 (commencing with, Section 7000) of
4vWod 3 of the mss and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exe mptim. Any violation of Section 7031.5 by any applicant for a permit
subjects the applwvrt to a civ? penally of not more than five hundred dollars ($500).
❑.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, Sulsness and
Professions Code: The Conbactors License Law does not apply to an owner of property who
builds or irproves thereon and who does such work himself or through his own employees,
provided that such iWovements are not intended or offered for sale. If, however, . the building
or improvement is sold within one year or completion, the owner -builder will have the burden
of provsmg that he lid not brad or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to corm
struct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner or property who bul 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 a, & P.C. for this reason
Date - Owner
WORKERS' COMPENSATION DECLARATION
hereby aftirrn that I have a certificate of consent to self -insure, or a certificate of
Worlds 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
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.) '
1 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 WorF:ers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: 9, after making this Certificate of Exemption you should become
subject to lips Mbrkers' Compensation provisions or the labor Code, you must forthwith
coney with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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.)
Lenders Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
certify that I have read this application and state. that the above information is correct.
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.
Signature of applicant Date
.Mailing Address
City,. State, Zip
No. 07399
BUILDING: TYPE -CONST. OCC: GRP.-
A.P. Number PGA VleSt
,Legal Description Phase 23A.
Project Description 354 linear feet 4f 6 -foot
block wall
Sq. Ft. No. No. Dw.
Size - Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation . tA_PW
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
108.000 sir`
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
$108.6.3
REMARKS
.....ia x-Y..t. _ ..f.*sh n
L.•.'
ft
i'wyyAASU
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 DATEINS�PECTORR0
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SQ. FT. @
GROUT
DRINKING FOUNTAIN
WALL SQ. FT. ®
FINAL INSP.
BOND BEAM
URINAL
SQ FT ®
GRADING
cu. yd.
$ plus x$
=$
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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,TEM/PERM
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® Vbc
HOUSE SEWER
FINISH GRADING
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.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSUTATIONISOUND
FINISH GRADING
/
INAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL