04650 (MFD5)/ 1 '
.0465
} r ' e1 P.O. BOX 1504 /
Buildjn 78-105 CALLE ESTADO+
Address 04- Firestone SLA QUINTA, CALIFORNIA 92253 9
Owner
Sunrise Cc epany
Mailin
Address' 75-005 Country Club Divilre
f<
BUILDING: TYPE CONST. _ OCC.�GRP.
. ' .. L.P. Number 0. PGA i1oitl`-,�- `he Greens
City I Zip Tel.
Palm Desiart 92260 : 09-:2828
Contractor ;".
National Mortgage J.,
Address
Name
City,-
Zip
Tel.
t�
Sq. Ft. 178£3
Size
No.
Stories
State Lic. 28$230
City
& Classif.
Lic. #
Arch., Eng r.,
Designer, tit
Address,.
Tel.
City �.
Zip i -if
State
i
Lic. #
v
A3 9.8
�s
LICENSED CONTRACTOR'S'DECLARATION
I hereby affirm that Lam 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
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,Buslness and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile assigned 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
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 five hundred dollars ($500).
O 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 or property who
builds. or improves thereon and who does such work himself or through his own'.employees.
Provided that such improvements are noVintended or offered for sale. If, however, the building
or Improvement Is sold within one year of completion, the owner-bullder will have the burden
of proving that he did not build or improve for the purpose of sale.)
O 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 i who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
t O' I 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
Worker's Compensation -Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No.., Company
O Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
v `• 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
=any parson in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT., If, after making this Certificate or Exemption you should become
subject . to the Workers' Compensation provisions of the Labor Code, you must forth=
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.)
Lender's Name
Lender's '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 certify 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
Description '-
t Description Phase SAG Plan E
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Sq. Ft. 178£3
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
FINAL DATE
INSP Cy�OR
10/B
zw
Date Permit
Validated by:
i
Estimated Valuation
$129:»769
Y PERMIT
AMOUNT
Plan Chk. Dep.
Plan,,Chk. Bal.
$ 481.27
Const. ,'
485.50
Mec.h.
39.00
Electrical
72.50
Plumbing
10S.00
8.44
Grading '
Driveway Enc. .
Infrastructure
$2017.314
L358,66
Loss Credit
1,358.66-
N.'
TOTAL
57
REMARKS
_.
xCt":�1it{iti!•Yti'' ��✓1tE�rtd.y-Y--r
'•:yt1:i.af x,1
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
INSP Cy�OR
10/B
Issued by:
Date Permit
Validated by:
Validation:
1 I
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDEMI100 - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
iST FL SO FT (a $
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. a
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC
BAR SINK
POR SO FT. a
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT.
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO FT. 0
FINAL INSP.
WALL SO. FT. r1
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus xE
= $
URINAL
SO. FT. 4t
FINAL INSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE, Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RE SID 0 1% c
SEWAGE DISPOSAL
SO.FT.GAR @ l c
HOUSE SEWER
INAL INSPECTION
CERT. OCC.
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 8 AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
S (FINAL) Z
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus xE
= $
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
!?SH GRADING
INAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL 7d