05985 (SFD)T4ht 4�Q�w
AAdddi
iress 55--071 Southern Rills
Owner
Sunrise Co.
Mailing
Address ?
City
F
Contractor
State Lie-
B�Classit-
N
Arch, Ene4,'
' Designer.
P.O. BOX 1504
78-105 CALLE ESTADO
LA,QUINTA, CALIFORNIA 92253
v Club
Tel. R y
92260 568
Tela
City
Lic. # 328
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
hereby afE¢rn tlhat 0 arm, feensed under provisions of Chapter 9 (commencing with Section
eif7 hof ""Isiorn 30 the Business and Professions Code, and my license is in full force and
SIGNATURE DATE
OWNER -WILDER DECLARATION
hereby affirm that 0 aan exempt from the Contractors License Law for the following
reasons (;See w3v.66Bosiness and Rntessiorrs code: Any city or county which requires a .
pemut to consirucA, alfer improve clamorah, or repair any structure, prior to its issuance also.
requires the applicant tar, such pemtit to file a sorted statement that he is licensed pursuant to
the provisions of the Commctor§ license Law, Chapter 9 (commencing with Section 7000) of
Division, 3 of the Business and Protessiorls Code, or that. he is exempt therefrom, and the basis
for the alleged) exemptFam. Any vialat-ran of Section 7031.5 by 'any applicant for a permit
sub{ects the applicant to) a civill penalty of not more than five hundred dollars (5500). .
El.4 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
Ptofessiorrs Cady Tihe Canmactor's License Law dues not appy to an owner of property who
6urrTds or improves therearn and who does such work himself or through his own employees,
provided that such improvements are not untended at offered for safe. If, however, .the building
or linprovement is: sold) within one year of completion, the owner -builder will have the burden
of proving "he didinof buildlor improve for the purpose of sale.)
El 1, as owner of the property, am exclusively, contracting with licensed contractors to con-
struct the project (;See 7a",. Business and Professions Code: The Contractor's License Law
does mut apply to, am owner, of property who builds or improves thereon, and who contracts for
sacs prajexs witch a conttacfar(sy licensed pursuant to the Contractor's License Law.)
m 1 am exempt under Ser; a & P.C- for this reason
Date Gwrier
WORKERS COMPENSATION DECLARATION
I hereby affimn that 0 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 110 -Company
. pit Copy is fifed with the city- Q Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE
(fhfs section reed not be completed if the penrld is for one hundred dollars ($100) valuation
orless:p
certify thn in the performance of the work for which this permit is issued, I shall not
ert00oirany person in any manner so as to become subject to the Workers' Compensation
Laws of Califord"m
Date ,Groner
NOTICE TO APRUCAAW: It after making this Certilicate of Exemption you should become
SuDlect to the Workers" C impensation provisions of the Labor Code, you must forthwith
comply with such pravisfar.Is or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of the
work for winch tins permit is issued_ (Sec. 3097, Civil Code.)
Lender's Uame
Lenders AddYess
This is a buifdingt permit when property filled out, signed and validated, and is subject fo
expiration it work tltennard'er is suspended for 180 days.
I certify that 0 have read this application and state that the above information is correct.
1 agree to c amptif with afl] city and county ordinances *and state laws relating to building
constructk ntq and hereby authar&e representatives .of this city to enter the above-.
mentioned property for drspection purposes
Signature of appfiicant Date
Ailing A
City, state zip
No. 05955
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number PGA West
Legal Description
Project Description Phase 19S. Plana
HtMAHKSs+rrcntasy;.t.=rrktxlKi+xx'..,^f...-
ive
ZONE:
BY:
Minimum Setback
Distances:
Sq. Ft.
Size 2826:
No. No. Dw.
Stories Units
Newer Add ❑
Alter ❑ Repair ❑ Demolition 0
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
6T19-8
2
Estimated Valuation
194,692.1
PERMIT
AMOUNT
Plan Chk. Dep.
.
Plan Chk. Bal.
602.41 •
Const.
•r3
Mech.
82.50
Electrical
142.41
Plumbing
20-4000
S.M.I.
Grading
Driveway Enc.
Infrastructure
•
mus cXe-d2M.29
rue
2190.2 '
TOTAL
HtMAHKSs+rrcntasy;.t.=rrktxlKi+xx'..,^f...-
ive
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
6T19-8
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
r
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL. Sp. FT. ®
DUCT WORK
ROCK STORAGE
UND. REINF.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
REINF. STEEL
GAS (FINAL) TEMP. POLE
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CAR P. SO. FT. ®
LUMBER GR.
g<FINAL INSP. ��
RAMING
FINAL INSP.
DRINKING FOUNTAIN.
WALL SO. FT.
REMARKS:
URINAL
SO FT ®
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
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
ME H
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
CERT. OCC.
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
INSPECTOR'S SIGNATURE311NITIALS
SO.FT.GAR ® 3/ac
HOUSE SEWER
GARDEN WALL FINAL
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
S ACK
ROUND PLUMBING UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE
r
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
F MS
EWER OR SEPT N ROUGH WIRING
DUCT WORK
ROCK STORAGE
UND. REINF.
�AS (ROUGH) METER LOOP
( /�-
HEATING (FINAL)
OTHER APPJEGUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
g<FINAL INSP. ��
RAMING
FINAL INSP.
OOFING r �`
_ l�f n !� ((L C�C�
C•t/�- 7t'2 _ `(_T /�
REMARKS:
If VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR, FIREWALL
PLLATHING
ME H
W—USULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURE311NITIALS
GARDEN WALL FINAL
1