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003812 (SATT)4 P.O. BOX 1504 BuildinAddrress 56'� 012 Pebble Deach LA QUINTACCALIFORNIA 92253 Owner Sunrise Com anv N0. 00812 Mailing BUILDING:'TYPE CONST. OCC:. GRP. Address '15-005 Country Club Drive A.P. Number PGA *:est. City Zip —FF --568-2928 Palm Depart... 92260 - Legal Description Project Description 1hafie 29B Plan 20M Contractor ]17Y4#" f e"ftRtx i DA R"A`117 aYla Zi'. � _ ... _ .Address " City"" _.. Zip Tel.. c. &tate Cla sl f. �$$�� City Lic. �,�� ... _ ., . DWG.2596 2596 Sq. Ft., No. No. Dw. Size A 577 Stories Units Arch., Engr., -- Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State 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 .effect. . SIGNATURE DATE OWNER -BUILDER DECLARATION I herebyaffirm 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 permit to construct, alter, 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 o/ the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation o/ Section 7031.5' by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). . 0 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner o/ property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, -however, the building • or improvement is sold within one year o/ completion, the owner-builder.will have the burden o/ proving that he did not build or improve for the purpose o/ sale.) ' Estimated Valuation d ptf qQ Y G sir -PERMIT - AMOUNT ' Plan Chk. Dep. _ Plan Chk. BBI. 525.10 10 COr1St..}�" yy • Mech. • �j> . Electrical -,$�.� Plumbing 132.50 O I, as owner of the property, am exclusively contracting with licensed contractors to con- strucl 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.) ❑ I am exempt under Sec. B. & P.C..for this reason S -M.1-' ' - .2.57 Grading Driveway Enc. Date Owner Infrastructure 4 045.90 WORKERS' COMPENSATION DECLARATION I hereby affirm that A have a'certificateof 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. ❑ Certified copy is hereby furnished. TOTAL REMARKS e + CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ,� rz,r ; nn ; 0,1:11-7 AA 4 ; _0C14 1 1'1 (This section need not be completed i/ the permit is /or one hundred dollars ($100) 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. .., _ ... +' R /1 i"t rtt T'nTIkI 4 1+4 i 7 4 1 Date Owner NOTICE TO APPLICANT: 1/, alter making this Certificate o/ Exemption you should become subject' to the Workers' Compensation provisions or the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. ZONE: BY: ' Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line 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. (Sea. 3097, Civil Code.) Side Street Setback from Center Line Side. Setback from Property Line Lender's Name FINAL DATE INSPECTOR A �� 88 Issued by: Date @ Permit Validated by: . Lender's Address • This is a building permit when properly filled out, signed and validated, and i's 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 Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SO. FT. p CAR P. SO. FT. WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE 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. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER REMARKS: 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 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./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. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL