059824.4
P.O. BOX 1504 N o , 05982
Building 78-105 CALLE ESTADO
Address 54-837 .Boutbern HIM LA QUINTA, CALIFORNIA 92253
Owner
Sunrise -Co.
Mailing - 4 j BUILDING: TYPE CONST. OCC: GRP.
Address 75-90§ Country Clam PGA West
.. A.P. Number.
City Zip Ti.
P.D. 92260 568-2R0:_Legal Description
Contractor Project Description raiii 19B Plan 30M
f!€ Age
Address
City Zip Tel.:
State Lic.-,t City
& Classif.'288,130 Lic.#328 328 _ , � Sq. Ft. No. No. Dw.
' "'.4Ao; , Size 2826 Stories Units
Arch., Engr.,
Designer Nevem ' Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address' Tel.
-------------
City Zip State
Lic. #
,+ • LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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.
SIGNATURE DATE '
OWNER-BUILOER DECLARATION Estimated Valuation q�
1 hereby affirm that I am exempt from the Contractors License Law for the following 194,692.00
reason: (Sec. 7031.5,13usiness- and Professions Code: Any city or county which requires a
-permit to construct, atter, knprove, 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
Division 3 of the Business and Professions Code, or- that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation Professions.
Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.
subjects the applicant to a civilpenalty of not more than rive hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
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, 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, the owner -builder will have the burden Electrical
of proving that. he did not build or improve for the purpose of sale.)
14Z 4t
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing •:tib
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 improves. thereon, and who contracts for S.M.I. 13.63
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date owner Infrastructure •
Leser it> 1Z 2190.29
WORKERS' COMPENSATION DECLARATION 77
�� :� K1a a
I 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
❑ Copy is filed with the city. ❑ Certified copy is hereby fumished.
TOTAL 4 W
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE ^., ' *x ;.ri ^ "' ^ A 14 fx�- x
(This section need not be completed ffthe pemtit is for one hundred dollars (8700) valuation atYi�;• %5., v • "J'et a>
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 Workers' Compensation
Laws of California
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 -
complywifhsuchprovisionsorthispemritshallbedeemedrevoked. 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 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.
I certify that I 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
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
. t
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
GRADE
RO H PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FO MS
ER OR SE
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. S0. FT. ®
(ROUGH) l`
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT.
LUMER GR.
Al
dV4LFINAL INSP. (f —C V
1/f
V
URINAL
SQ. FT.
Dt
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
G�R 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
I WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
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 GOND. SOLAR
SETBACK
ROUND PLUMBINGQ
UNDERGROUND
A.C. UNIT
COLL, AREA
GRADE
RO H PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FO MS
ER OR SE
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
OND. REINF. 7S
(ROUGH) l`
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
—Plus—x$—=$
LUMER GR.
Al
dV4LFINAL INSP. (f —C V
1/f
V
FINAL INSP.
FING
Dt
REMARKS:
VENTILATION
FIRE ZONE ROOFING,
FIREPLACE
SPARK ARRESTOR
G�R FIREWALL
�/
LAHING
MESH
SOLATION/SOUNDS 3 !�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATU RES/INITIALS
GARDEN WALL FINAL
M5— Zf