05988 (SFD)P.O. BOX 1504 No. 05988*
Building ' 78-105 CALLE ESTADO
Address 54"633 Southern HMO MLA QUINTA.•CALIFORNIA 92253
Owner , .. ,
Sunrise co.
".- .
BUILDING:,TYPE•CONST. OCC: GRP.-
Address 75-005 Country ClubA.P,..Number, . PGA West �
City Zip Tel. .. �.,
P•D� ,. 922 568--2&28, Legal Description
Contractor Project Descriptionry'y Ph I9B P19M 10�
Address
City, Zip Tel.: '
State Lic. _ w City
&Classif: 2"8130 ^ Lic. # 328 _ y Sq. Ft., No, No. Dw.
'Size .2272 Stories Units'
:.,.Arch:,,gr
En, ,
Designer , ? , NeA Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address'. Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION u
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 '
effect.
+N
SIGNATURE DATE _ r
j• OWNER -BUILDER DECLARATION,
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for, the following 158,546•€30
reason: (Sec. 7031.5,Bustness and Professions Code: Any city or county which requires a '• •:
- permit to construct, after, hmprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to We 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 •. 's7}
Division 3 of the Business 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 five hundred dollars (8500). ,�� • d �� °;'
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. a
• do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and 'Const. •�%�
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,
provided that'such improvements are not intended or offered for sale. If, however, the building Mech. 'e. bZ*
or Improvement is sold within one-year of completion, the owner -builder will have the burden Electrical
••..•t �••
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 - G •
struct the project. (Sec. 7044; Business and Professions Code: They Contractor's License Law y;
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M,j, - •
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 cce t 1/84.77
WORKERS' COMPENSATION DECLARATION Infra DLit 17b4o 11
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. 3.800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. "
TOTAL 3743.69CERTIFICATE OF
RKERS'COMPE SATIONION FROM REMARKS.
a"';ry�eyM` ijt� .,,Q�� A.3 q k • _�jj�j�t -t'(� a(�'
• _ WORKERS' COMPENSATION INSURANCE .. _
. (rhis section need not be completed if the permit is for one hundred dollars ($100) valuation - �'. �� ... ^i•ri+.-s r y y a W
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 a'
Date ' Owner
NOTICE TO APPLICANT: ft, after making this Certificate of Exemption • you should become—.' ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such Provisions orthis permit shall bedeemed revoked. Minimum Setback Distances: • ^ -
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 fath performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line
Lender's Name -
Lender's 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. r 6-19
1, certify that 1 have read this application and state that the above information is correct.. Issued by: Date Permit
I agree to comply with all city and county ordinances and state laws relating to building Nbove-�
-construction, and hereby authorize representatives -of this city. to enter 1.hmentioned property for inspection purposes Validated by:Signature of applicant DateMailing Address ' Validation:
City,. State, Zip
' CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. ® $
UNITS
B GRADE (
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL Sp. FT. ®
FORMS
ER OR SEPTI K
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
AS (ROUGH) /�
G
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 Sp. FT.
=$
LUMBER GR.
VINALINSP./ . ZO
FRAMING / 2
URINAL
Sp. FT. @
l�
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
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
SPARK ARRESTOR
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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
FINISH GRADING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® VAc
HOUSE SEWER
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
R UND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE (
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ER OR SEPTI K
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
OUND. REINF.: %
l
AS (ROUGH) /�
G
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.
VINALINSP./ . ZO
FRAMING / 2
FINAL INSP.
ROOFING
l�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
ING l�
MESH
ULATION/SOUND /D
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUR£SIINRIALS
GARDEN WALL FINAL
'I
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7
r DAVE S'TEAVENS
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i�� :�.., r}{ ��s T p� < �, .Inspection Servlc5es
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PROJECTf,�� t ",LC�C� PROJECT
x� ADDRESS ��`�- � t11 Z f CLIENT ,P_.
S�� a t �/ t,���' _.c=� s d r� �►AJDATE' o c? rxb 3� ,
µ BLDG. PERMIT # ARCHITECT A' A /z C t4
'ENGINEER t t.-� Cra J c i'! � CONTRACTOR aC L rA 1A k �A e i � �
4
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INSPECTION TYPE ' X
INSPECTION REPORT
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CERTIFICATION OF�COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted,
substantially complle's wlth,appr&ed plans, specifications and applicable sections of the building codes. This'report covers :>
the•location 9�46fie^wd ,!O ispected'only and does not constitute engineering opinion or project control:
'£%P'1 r x• 't 'Ee?tEb'^'747 s. ,� - s .f ! L�
!
CERT.
NO.r��'' -r INSPECTOR NAME
(Print Clearly)
a DATE 0 19114t?e tt o��.>_� INSPECTOR SIGNATURES �`