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05979 (SFD)Ce P.O. BOX 1504 No. 05979 Building 78-105 CALLE ESTADO. . Address 5$-711 8outhe vi Hills LA QUINTA, CALIFORNIA 92253 Owner sunrise Co. Mailing BUILDING: TYPE.CONST: OCC: GRP. Address %'3- 005 Country Club PGA West . ' A.P. Number City Zip Tel. •� P.D. X68-2828 Legal Description / ContractorftElSe 19B Pl= 3MI SPA+r Project Description Address Zip I Tel.: •State Lic. City & Classif. 283130 Lic. # 328 Arch., Engr., Designer AddressTel. CityJZip State Lic. If 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 effecV • ! r s SIGNATURE - DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Business and Professions 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 permit to Re a signed statement that he is licensed pursuant to 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 .r for the alleged exemption. Any violation of Section 7031.5 by* *any applicant for a permit subjects the applicant to a civil penalty of not more than rive 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, Buisness and 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 safe. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden orproving that he did not build or improve for the purpose of sale.). O 1, 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) licensed pursuant to the Contractor's License Law.) - ❑ 1 am exempt under Sec B. & 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 Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No --Company 0 Copy is filed with the city. O Certified copy is hereby furnished. 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.) I 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: It, 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 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 properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days: I certity 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 ZONE: BY: ' Minimum Setback Distances: Front Setback from Center Line Sq. Ft. 2826 Size No. Stories No. Dw. Units New 1M Add ❑ Alter ❑ Repair ❑ Demolition ❑ FINAL DATE INSPECTOR Issued by;, o Date 6—f,9-89 Permit Validated by: Validation: - __ Estimated Valuation 194,692.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. G+� Const.. • Mech. 02-� 3Ct Electrical 142.41 Plumbing 204.00 S.M.I.. Grading Driveway Enc. Infrastructure+• Less 1=8 9 Dile 2190.Z9 TOTAL I.tlti!{ i:' /a REMARKS 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 Issued by;, o Date 6—f,9-89 Permit Validated by: Validation: - __ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE ROUH PLUMB. YARD SPKLR SYSTEM 2ND FL SQ. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE D F. POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® HEATING (FINAL) OTHER APPJEOUIP. EINF. STEEL GAS (FINAL) DRAINAGE PIPING CAR P. SQ. FT. ® GROUT WATER HEATER DRINKING FOUNTAIN. WALL SQ. FT. FINAL INSP. BOND BEAM WATER SYSTEM URINAL SO FT ® GRADING . cu. yd. $ plus x$ =$ ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP.-� WATER PIPING NOTE: Not to be used as property tax valuation ROOFING / VENTILATION 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 LAUNDRY TRAY 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER FINAL INSPECTION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE N.ECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK ROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTI A ROUGH WIRING DUCT WORK ROCK STORAGE D F. (ROUGH) / C METER LOOP HEATING (FINAL) OTHER APPJEOUIP. EINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING . cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP.-� AMING FINAL INSP. IINSS�P. ROOFING / VENTILATION e�� / 1O/�f REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR R. FIREWALL THING lQ MESH SULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL t