003219 (SFD)P.O. BOX 1504 No,' 003219
Building 78-105 CALLE ESTADO
Address 54— . Inverness LA QUINTA, CALIFORNIA 92253
Owner
Sunrise comnAnv
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address 75-005 Courtry Club Driv A.P. Number PGA West
City Zip Tel.
Palm. ��sertj 92260' 568--"2,828 Legal Description
Contractor �Y��qk �►X'ki�. �fJt �cSF#ts�? �. Ian t�,-
� Y�:L826K., P
3i
Project DescriptionP�
Address..
City Zip Tel.
State Lic. City
& Classif. 288130 Lic. # 328 Sq. Ft. DWG 1627No. No. Dw.
.: Arch., Engr.; . _
Size -SYR 424Stories • -• - Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑' Demolition ❑
Address Tel.
City Zip State
_.. Lic.-#
•.j 'I' he eb affirm that I tam licensed under provisions of Chapter 910( (commencing with Section-
)
7000) of Division 3'of the Business and Professions Code, and my license is in full. force and
'effect !/,7-7
SIGNATURE: 1...- `- ♦ f r . vy v v DATE
"
OWNER -BUILDER DECLARATION
•1 hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation
reason: (Sec. 7031.5,Business and. Professions Code: Any city or. county -which requires 'a
permit to construct, alter, improve, derimolish, or repair any structure, prior to its issuance also AMOUNT
the requires the applicant for. such permit to file a signed statement that he is licensed. pursuant to PERMIT - - 'r
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
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 Plan Chk.'Dep.
subjects the applicant to a civil penalty or not more than five hundred dollars ($500). -
❑ I, as owner of the property, or my employees with wages as their sole compensation, will 'Plan Chk. Bal 9 IPA, AA
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. lla
Professions Code: The Contractor's License Law does,not apply to an owner ol,property, who, - .AAA A_
builds of improves thereon and who does such work himself or through hiVown.employees, Mech
.provided that such improvements are not intended or offered for sale: If, .. however, the'building -4A nn .
or improvement Is sold within one year or completion, the owner -builder' will have the, burden "Electrical '
of proving that he did not build or improve for the purpose. of sale.) _
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con. Plumbing .'
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 S. M. 1.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O I am exempt under. Sec. B. 8 P.C. for this reason Grading
Driveway Enc.
Date Owner Infrastructure 1 .7 115 441
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
❑ Copy is filed•with the city.. ❑ Certified copy is hereby furnished.
. ' TOTALCERTIFICATE OF xt t
WORKERS' OMPENSATION. NSURANCE PTION FROM REMARKS yi`J, J15%4 P. �"x+-�, :
• :1.'W LYYr.Y. a YCJ7YYL. .k .�. s..rs ar.a
(This section need not be completed it the permit is for one hundred dollars (S100) valuation
or less.) - - -
I certify that in the performance of the 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: Il, after making this Certificate of Exemption -you should become ZONE: BY:
subject to the Workers' Compensation provisions of, the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
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
work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180 days. _
I certify that I have read this applicationand state that the above information is correct, Issued by: Date 7 / 115 / R Permit
I agree to comply with all city and county ordiriances•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:
City, State, Zip
HARD COPY I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT. p
WALL SO.. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
1
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
I WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL 'HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
�UF7CW
�7
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/a c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
ROOFING/�
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
GROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE i 91
ROUGH PLUMB. 7v /�
G
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR P -Tl TSA K
J
ROUGH WIRINGORK /`/8
�UF7CW
�7
ROCK STORAGE
FOUND. REINF. /�
ROUGH) /� 1/�f�
/
® TER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-x$-=$
LUMBER GR.
FINAL INSP. If Z 9
FRAMING /Q//` 97
FINAL INSP.
ROOFING/�
a�
AV
/� �� /� �•
✓�/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING L�L [y /d
MESH
INSULATION/SOUND ID 1j(J
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE. FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL