05079 (SFD)4
P.O. BOX 1504 N u . 05079
Building 4-551flV°x1e88 7&105 CALLE ESTADO
Address AQUINTA,
CALIFORNIA 92253
Y
Sunrise Company
BUILDING: TYPE CONST. OCC: GRP.-
Mailing
Address 42--600 'Nook St.. State 200
A.P. Number PGA Rest -- Pbase 39A
CityZip
Rear Setback from Rear Prop. Line "
Tel.
Palm Desert
192260
1 368-2828
Legal Description
Project Description Plan 124-1
Contractor
INSPECTOR
-
Address
Issued by:
O
C' er
City
Zip
Tela -
PERMIT
State Lic. City
& Classif. s, 288130 Lic. # 328
Arch., Engr.,
Size
Designer
Address Tel.
City I Zip I State
Lic. #
r LICENSED CONTRACTOR'S DECLARATION
hereby affirm that 1 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 -- - - ^a' 'DATE
OWNER -BUILDER DECLARATION
hereby affirm that I am ,exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
Penn to constrict, after, improve, demolish, or repair any structure, prior to its issuance also
requires the aPPWant for such permit to We 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
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
Subjects the appicant to a civil penalty of not more than five hundred dollars (5500).
❑ 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 Contractor's License Law does not apply to an owner of property who
builds or krproves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. N however, the building
or improvement is sold within one year of completion, the owner-bugder 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
1 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
(Tins section need not be completed if the permit is for one hundred dollars ($100) valuation
or fess.)
certify that in the performance of,thp.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 -f11-1 nner
11bT10E TO APPLICANT: If, after makingilhis»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
1hereby 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
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 100 days.
1 car lity that I have read this application and state that the above information is correct.
1 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
ate_Mailing Address
City, State, Zip
1330 No., No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
-Demolition ❑
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
12/291£8
Issued by:
Date Permit
Estimated Valuation
$94',224
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 342.49
Const.
418.00
Mech.
34.00
Electrical
59.99
Plumbing
87.50
S.M.I.
6.52
Grading
Driveway Enc.
Infrastructure
$2,120.49
1,060.25
Less Credit
1,060.25
TOTAL
$2,008.85
("/.0
REMARKS
+w tYi+. tY 4 •ytt Ytj.. r.y \e �i •'i.i �.
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
12/291£8
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
;ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. S0. FT. @
FORMS
ER O ; N
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS ( UGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
I ROOF DRAINS
(FINAL)
TEMP. POLE'
DRAINAGE PIPING
CARP. SO. FT. ®
GROUT
TER HEATER
WALL SO. FT. ®
FINAL INSP.
DRINKING FOUNTAIN,
BOND BEAM
WATER SYSTEM
URINAL
SQ FT ®
=$
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
RAMING i
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
REMARKS:
IWATERSOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
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
MSH
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11A c
SEWAGE DISPOSAL
FINISH GRADING
SQ.FT.GAR ® Vic
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ER O ; N
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS ( UGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
(FINAL)
TEMP. POLE'
GROUT
TER HEATER
VICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
RAMING i
FINAL INSP.
ROOFING
(.� g
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
G FIREWALL
H G
MSH
NSULATION/SOUND
FINISH GRADING
e/'F'1'NAL INSPECTION
71 CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL