05980 (SFD)Building
194,632.00
PERMIT
Address
54-765
Southe= W, b
Owner
�•
Const.
•
Sunrise- Co.
Mailing
Electrical
t42.41
Address
75-005
Country Club
City
Grading
Validated by: am
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Zip
P.D.
•
' 92260
Contractor
e
AFL
Address
TOTAL
'IM0 1_16X9
City IZip
i
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mr
828
8 Classif. Zi$$Q Lic. #8
Arch., Engr.,
' --Designer
Address' Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
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.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busimess and Pmliessions Code: Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such Penn# to fie a signed statement that he is licensed pursuant to
the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) of
+ Division 3 of the Business and Professkms Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any ,vkNation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a ciw7 penally of not more than rive hundred dollars ($500).
O 1, 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, Buisness and
Professions Code: The Contractors 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
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or irprove, for the purpose of safe:)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
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
such projects with a contractor(s) ficensed pursuant to the Contractors License Law.)
O 1 am exempt under Sec- a. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
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. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the.city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need riot be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of ting 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
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
Comply with such provisions or this Permitshall 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.)
Lender's Name
Lender's Address
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. '
1 car ity that 1 have read this application and state that the above information is correct:
'1 agiee 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.
Signatureof applicant Date
Mailing Address
City, State, Zip
No. QS
11LDING: TYPE CONST. OCC: GRP
P. Number PG&'West
Igal Description
oject Description "e 19B Plan 3MIR
Sq. Ft. 2826 No.
Size Stories
No. Dw
Units
New1b Add ❑ Alter ❑ Repair. ❑ 'Demolition ❑
Estimated Valuation
194,632.00
PERMIT
- AMOUNT
Plan Chk. Dep
Front Setback from Center.Line
Plan Chk. Bal.
�•
Const.
•
Mech.
�% .•
Electrical
t42.41
Plumbing
4•.
S.M.I.
.t9
Grading
Validated by: am
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Driveway Enc.
Infrastructure
•
atsIRS
e
TOTAL
'IM0 1_16X9
REMARKS
:.�ti1i.4s�rx1:?'a#1,+!:rifitil ,sSs`�
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
6_19•-89
Issued by:
Date Permit
Validated by: am
IV/"
/
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
GRADE
R UGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT. ®
FORMS
W OR SEPTI
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
UGH) 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 Sp. FT.
=$
LUMBER GR.
FINAL INSP
FRAMING
a
URINAL
Sp. FT.
t �� ,7K/ o
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
G? FIREWALL
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.
SO. FT. ®c
BATH TUB
FINISH GRADING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3Vac
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
SqrBACK
UND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
GRADE
R UGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
W OR SEPTI
ROUGH WIRING
DUCT WORK
ROCK STORAGE
dllrU D. REINF
UGH) 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$
=$
LUMBER GR.
FINAL INSP
FRAMING
a
FINAL INSP.
OOFING L6 A
t �� ,7K/ o
l� `^/�/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
G? FIREWALL
THING ld
MESH
j SULATIONISOUND Iq
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUR£S/INITIALS
GARDEN WALL FINAL
l 1r- 3