4471 (SATT)•4 ��
14
P.O. BOX 1504 `
Buildin
Addressg 79,73) Olympia Fielda LA QUINTA, CALIFORNIA 92253
Owner
Sunrise Company BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address 75-005 Coon Club Drive A.P. Number PGA West -" Tho Groea s
City Zip Tel. ,
Paint Desert 9 260 _568-2828 Legal Description
Contractor����� �� "' ���� ��
National Mortgage Project Description
Address
Sates
City - Zip Tel.
State Lic. 288130 City 398 172
& Classif. Lic. # Sq. Ft. 00 No. No. Dw.
Arch., Engr., Size Stories Units
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
7DO0) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following 4;'
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a 'r'
69
permit to construct,_ atter,;improve, demolish, or repair any structure, prior to its issuance also
requires the applicant /or.�%such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions o/. thea Coiitiactor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 o/ the-Business`an_ d Professions Code, or that. he is exempt therefrom, and the basis
/or 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 of not more than five hundred dollars ($500).
O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. qci ♦ �%
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 4 .500
Professions Code: The Contractor's License Law does not apply to an owner of property who 39400
builds or improves thereon and who does such work himself or through his own employees, Mech.
provided that such improvements are not intended or offered for sale. If,. however, the building «�
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical (2 � 50
or proving that he did not build or improve for the purpose of sale.) i� fn
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 105 0 00
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law ,t
does not apply to an owner o/ property who builds or improves thereon, and who contracts for S.M.I. 8 o 1»4
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
(] I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure $2017.31
Less Credit 1, 3 5'a 'be
WORKERS' COMPENSATION DECLARATION Not Infra stru >tu 1,358.66
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. A "�+• ^ p
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 the permit Is for 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.
Date Owner
NOTICE TO APPLICANT: If, after 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. .
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.)
Lender's 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 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
City, State, Zip
REMARKS
1
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 .IIVSPEGT.OR
u ILf0+
Issued by: Date . Permit
Validated by:
Validation:
1
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY- FILE
CONSTRUCTION ESTIMATE
.4"
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT (a s
2ND FL SO FT. g
POR SO FT at
GARSO. FT. Q'!
CAR P. SO FT. ra
WALL SO. FT. (d
SO. FT. td
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.IEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT. B.T.U.
SO. FT. RESID 1 v: c
SEWAGE DISPOSAL
SO.FT.GAR tic
HOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE:d
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
INSULATIONISOUND
FINISH GRADING
'F ON
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL