05058 (SFD)_ ;V
3'v
Cl/
P.O. BOX 1504 No. 05058
Building 78-105 CALLE ESTADO
Address 54-279 Inverness LA QUINTA, CALIFORNIA 92253
Owner y
Sunrise Ca o.an 4 BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 62-40110 C Iftlit Rt " n A Infl A.P. Number PGA West -• Phase 40A
City Zip J
el.
Palm Desert 9226t3 568-2828.. Legal Description
Contractor Project Description rias ICR
National mortgage -
Address .
Same
CityZip Tela
State Lic. City
BClassif. 288130- Lic.# 326 Sq. Ft. i33a No.. .. No.Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
Ihereby
affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
effect
700f1)of Division 3 of the Business and Professions Code, and my license is in full force and
� y
SIGNATURE DATE-�
OWNER -BUILDER DECLARATION
1 hereby affirm that I am_exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,8ushess and Rofessiortis Code: Any city or county which requires a
permit to construct. alter improve, demolish, or repair any structure, prior to its issuance also
therequires the
provisions Contrado s license Law, gChaptered statement
a
9 (commencing with licensed
ection 7000) of
Division 3 of the B chess and Protessbas 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 appicant to a clivi penalty of rat more than five hundred dollars ($500).
❑ 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 Contmdoes License Law does not apply to an owner of property who
builds or a prones thereon and who does such work himself or through his own employees,
provided drat such rrprovements are not ittended or offered for sale. If, however, the building
or improvements sold within one year of completion, the owner -budder will have the burden
of provimg that he did not brdd or iryuove for the purpose of sale.)
❑ 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 h proves thereon, and who contracts for
a such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec_ 11, & P.C. for this reason
Date owner
WORKED' COMPENSATION DECLARATION
lI affirm that I have a certificate of consent to self -insure, or a certificate of
w
pensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
❑ Copy is filed with the city. ❑ Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKED' COMPENSATION INSURANCE
(This section need not be completed i1 the permit is for one hundred dollars ($100) valuation
of fess.)
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 Califomia.
Date Owner
No tkE 7O APPLICANT: d after mal0mg'MIS"Certilicate of Exemption you should become
subject to the Nforkers' C.onpensation provisiorrs 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(wilding permit when property filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
1 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 authorise representatives .of this -city to enter the above-.
mentioned property for inspection purposes
Signature of applicant Date
Mailing Address
City, State, Zip
Estimated Valuation $94224
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. S 342.149
Const. 418.00
Mech. n
Electrical 54-94
Plumbing S.
S.M.I. _
Grading
Driveway Enc.
Infrastructure $2,120.49 1,060.25
,ess Credit 11060.25
TOTAL $2.008.85
REMARKS
a')h� r: �c'r' .t f? � I � °i t't•-'est)—its# �[ t't
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
12/27188
Issued by: Date Permit
Validated by: i
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
lT' FL. SO. FT. ® $
UNITS
• SLAB GRADE 1 f--� y—� '
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P. SQ. FT.
TE P. POLE
WALL SQ. FT.
GROUT
DRINKING FOUNTAIN
RVIC
FINAL INSP.
URINAL
SOFT ®
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
ING /
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, TEMIPERM
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
5GLATIONISOUND
SQ.FT.GAR ® 3/ic
HOUSE SEWER
ISH GRADING
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
SETBACK
OLIND PLUMBING3,27
UNDERGROUND
A.C. UNIT
COLL. AREA
• SLAB GRADE 1 f--� y—� '
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ER OR SE
ROUGH WIRING
DUCT WORK
ROCK STORAGE
Z5=. REINF.L �exg C
S (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
S (FINAL)
TE P. POLE
GROUT
WATER HEATER_!!
RVIC
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
FINAL INSP.
ING /
FINAL INSP.
ROOFING
/�$
�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
I d2
MESH
5GLATIONISOUND
ISH GRADING
AL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL