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04653 (MFD5){, 04653 P.O. BOX 1504 Building - 78-105 CALLE ESTADO �� Arfrirpcs Firestone , _LA QUINTA, CALIFORNIA 92253 Owner,, 1 Sunrise Compan Mailing., Address City Zip gait •rles'ert 92260 Contractor BUILDING:- TYPE CONST. OCC. GRP. t!` A.P. Number PGA West The Gzeqns Tel. 4 ^. 8``282 Legal Description y Project DescriptionPhats$ 'CAG Plan Au r Address t' IZip ITel. State Lic. City & Classif. 288130 Lic. # 39,8__ Arch., Engr., Designer Address Tel. City . Zip State K • • 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 effecv. ,_,y Z. SIGNATl1gE * DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Susiness 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 file 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 thathe 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 or not more than rive 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 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 improve for the purpose of sale.) ❑ 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) 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 Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No.' Company =t ❑ Copy is filed with the city. ❑ 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.) 1 certify that In the performance of th? work for which this permit is issued, I shall not =any person 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 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 Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the j work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address FINAL DATE INSPECTOR. This is a building permit when properly filled out, signed and validated, and is subject toU/ ?� 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: i City, State, Zip I � L WHITE - FINANCE PINK ^�APPLICANT,,GREEN - BUILDING, GOLDENROD • ASSESSOR'S OFFICE, HARD COPY - FILE tifi,W,.' .'a - ar �.-- •,_ ... ,...�'�i r_..._:a:x:,. ...' ._'A �. -.. .,. ,:.°._rs`^',. .. R..�k-.hew._ ,`i- .. .. ,...... i__.. f"�"t��#iF.:�i1r3 Sq. Ft.,, 1598 Size No.. NO. DW. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $114s179 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 4 Wbz) 6!31 Const. 4-tu r�U Mech. JV • UU Electrical i a - Plumbing !'b ,ou S.M.I.! • I:C Grading Driveway Enc. Infrastructure 569.03 Less c r"ealaxt I y X U 4 t. �L TOTAL V+? a 45. U4 , , -ZC-/ r . / ti4U REMARKS 1.4pai-*401.44 V.-10tV4 �J ZONE: BY: 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 j work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address FINAL DATE INSPECTOR. This is a building permit when properly filled out, signed and validated, and is subject toU/ ?� 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: i City, State, Zip I � L WHITE - FINANCE PINK ^�APPLICANT,,GREEN - BUILDING, GOLDENROD • ASSESSOR'S OFFICE, HARD COPY - FILE tifi,W,.' .'a - ar �.-- •,_ ... ,...�'�i r_..._:a:x:,. ...' ._'A �. -.. .,. ,:.°._rs`^',. .. R..�k-.hew._ ,`i- .. .. ,...... i__.. f"�"t��#iF.:�i1r3 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES ISI FL SO Fl y $ 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 GA (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. Cr TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. 4V FINAL INSP. WALL SO. F?. fd WATER SYSTEM DRINKING FOUNTAIN GRADING cu. yd. $ plu5 x$ = $ URINAL SO. FT. (a 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.COOL HOOD SIGN WASHER(AUTOt(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, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. a c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID fd 1'A c SEWAGE DISPOSAL SO.FT.GARr JVc HOUSE SEWER /' NAL INSPECTION/„ (C/ 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. GA (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL S (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plu5 x$ = $ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR - GAR. FIREWALL LATHING MESH INSULATION/SOUND FI ISH GRADING /' NAL INSPECTION/„ (C/ CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 7d