4021 (SATT)P.O. BOX 1504
Building 79-786olyvipia Fields 78-105 CALLS ESTADO
Address LA QUINTA, CALIFORNIA 92253•• .
Owner "
Sunrise Company
Mailing .,
BUILDING: TYPE CONST. OCC. GRP.
Address 75-005 Country Club Drion, � W _. A.P. Number _PGA West "~' The Greens '
City Zip - Tel. ,
Palm Desert 92264 56 ,-t MQ Legal Description
Contractor Project Description --P an CR rte' • PpYase 3
National mortcraae
=Address
Zip
State Lic. 288130
& Classif. -
Arch.; Engr.,
Designer
Address
Tel. -
City F.t. 2
Lic. #$ Sq. . .. NoNo. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
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. F N<, ! �' L .t._• t`.
SIGNATURE ,DATE
OWNER -BUILDER DECLARATION
I 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
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Di—to 3 I th B' d P I I h
Estimated Valuation $1.10 514 ,
PERMIT AMOUNT,
on o e us ass an ro ess ons Code, or al. 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 applicant to a civil penalty or not more than five hundred dollars (8500).
' ❑ 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
orimprovement is sold within one year Or completion, the. owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
Plan Chk. Dep.
.. -
Plan Chk. Bal.
Const.
�%�
450450.
Mech.
�f
+ o 0
Electrical
F� t1
63 .v 6't. 0
Plumbing
99..00 ,
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struet the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner o1 property who builds or improves thereon, and who contracts for
S,M,I•
,� +
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O I am exempt under Sec. B. & P.C. for this reason
Grading
_
Driveway Eno.
Date Owner
Infrastructure
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."
TOTAL
::# • • ,
CERTIFICATE OF EXEMPTION FROM
" WORKERS' COMPENSATION INSURANCE
REMARKS
•,},•tg�;,`F--�6R.,,y,w."'
(This section need not be completed if the permit is for one hundred dollars ($100) valuationle'.bK..7'tt:;A;,
Or less.) •. -
.I certify that in the performance of tho work for which this permit is issued, 1 shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California..., -
Date i
Owner:
NOTICE ,TO APPLICANT: lf, alter 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. - - ' - +
p''�A'r • "Y{'SY{rY7'i X14" 'YK.l9!H.' .:h -
ZONE:
-''
ZONE: BY:
Setback Distances: ,
Front Setback from Center Line
• r�` CONSTRUCTION LENDING AGENCY
I hereby, affirm that there is a construction lending agency for the performance of,the
"work
work for which this permits issued. (Sec. Civil Code.) '•,"
Rear Setback frac Rear Prop. Line
Side Street Setback from Center Line '
Side Setback Jrotn. Property Line• S `-
�3097,
Name ' t
Lender's. Address ..
_ `This1s a building permit when properly filled out,'signed and validated and is subject to
expiration it work thereunder is suspended for 180 days. :•
.I certify that 1 have read this application and state that the above information is correct
r.- 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 r r r
FINAL DATE I VSPECTOR
���
' Issued by:°' ' Date Permit '
`
Validated by:
r Validation:
_ .
GOO4_EFILEL- R q `
r. QASSESSORS OFFICE HARD COPY FILE
}}
eYa •_ � } , R - tC ...G. - +� aie... .' � i . _ ,. F ZX H '
-L City,, State; Zip_,?
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C4,. PI.N.:�K,. AP)kPCWHITE FINANLIANT, GREEN �:.B..U4 ILDIM.:G;>,+
�a. F ._ .�a . _ i5.....i . 4 1 a +n . 4 ... l
CONSTRUCTION ESTIMAIL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
ISI FL SO F1 ip $
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2N0 FL SO FT. qt
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
GAS (ROUGH)
METER LOOP
GAR SO. FT. *
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO FT. 4V
GROUT
WATER HEATER
WALL SO. FT. a
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. d
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
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
VENTILATION
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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.
SO. FT. ® c
BATH TUB
LATHING
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID 1 1i c
SEWAGE DISPOSAL
SO.FT.GAR 1:c
HOUSE SEWER
FINISH 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 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.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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
SIN L N
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL