SBA 1995-289FE B 0 2 1995
CITY OF LR'' U-INTA'___r
PLANNING & DEVELOPMENT DEPARTMENT
APPLICATION FOR SETBACK ADJUSTMENT
CASE NO: Z__,,-2S>2
FEE: $100.00
APPLICANT: Submit this form with two copies of a scaled site plan,
drawn to adequately depict the nature of the request. A nonrefundable
fee of $100 is required when the Application is submitted. Check must be
make payable to the "City of La Quinta".
If the Applicant is not the owner of the property, a letter must be
submitted by the owner authorizing the Applicant to execute this document
in his behalf.
PLEASE PRINT OR TYPE
ILv6 L-! vD -�`'3; - A3Scc. �irc•/
APPLICANT/CONTRACTOR: �•z_ p Kt :tee, DATE
CONTACT PERSON ( I F DIFFERENT) 1�z ,e� otA-2t `w PHONE C1, tq� '777-7-7 & (o
MAILING ADDRESS: 9 i S 1J6f�f2
(Address
City
OWNER'S NAME:
MAILING ADDRESS: y )g(oS
ress
City
State) (Zi
PHONE t'!or,) Z`1Z-7i(06
State) (Z
STREET ADDRESS OF PROPERTY: 7c3'7 Zo _-T- Is ��t R:T- : LA- Qtr n.
LEGAL DESCRIPTION OF PROPERTY: LOT #
ASSESSOR'S PARCEL NUMBER:
TRACT
ADJUSTMENT REQUESTED: To iLj-�WW C `V77>1S i/V Gb II
REASON FOR REQUEST: `4-E�7 OJ10c :5S A" S285-F- R E30 tl I RZ--b 7n ►�pp�� V
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JUSTIFICATION: No request for a Setback Adjustment shall be granted
unless it is determined that it is consistent with the intend and purpose
of this Ordinance; that there are special circumstances applicable to the
property, including such factors as size, shape, topography, location or
surroundings that justify the approval of the adjustment of the setback
requirement, and that the adjustment will not be detrimental to the
health, safety, and general welfare of the community or be detrimental to
property in the area of the parcel for which the adjustment is requested.
FORM.013/CS
RECEIPT City of L?"''iinta, 78-495 Calle Tampico, P. O. Box 4, La Ouinta CA 92253
C
D E 19 NO.9079
RECEIVED FROM
ADDRESS
DOLLARS $ _�dy
.FOR
ACCOUNT HOW PAID -
AMT. OF CAS
ACCOUNT
AMT. PAIDVALANUt CHEC ®i
DUE ORDER BY x
- s .--..-..ram-.�-. ._ - _. - . _ .. .. _ s..., .-. -,- _•. _ r. __ _ _..-v-.—
ROGER SNELLENBERGER & ASSOC., INC. Palm Desert, CA 92211 006589
2/1/95 SETBACK APPLICATION $100.00
Z49
:S, r
a�w
MEMORANDUM
CASE: 9,5=de'� Locations)
Request (s) : Qd UC41E�2A�.� �a,-r ho�� 79
Your setback adjustment application is hereby approved, subject to
the following conditions:
Conditions:
1. Obtain a' building permit from the Building and Safety
Department.
2. The other Zoning Code provisions shall be met.
3. If ground excavation is required, please contact Underground
Service Alert (USA) at 1-800-422-4133.,The service is free of
charge provided USA is given .at least two working days'
notice.
4. Additional Conditions:
After review it was determined that:
1. This adjustment is consistent with the intent and purpose of
the Zoning Ordinance.
2. There are special circumstances applicable to the property,
including such factors as size, shape, topography, location or
surroundings that justify approval of the adjustment. These
circumstances are: 6,xa7l,S
ThaM yoW-f-gr your cooperation.
Si"relJ,.
opment Departme
Attachments
c: Building and Safety.Department
interoffice
M E M O R A N D U M
to: Mayor Pro Tern Bangerter
from: Greg Trousdell, Associate Planner
subject: Detached Garage at Cactus Flower
date: August 21, 1995
Jerry Herman stated that you wanted to receive information on Mr. Norris Bernard's complaint
regarding the detached garage structure that Mr. Jim Snellenberger built at 79-720 Iris Court.
Enclosed is the material you have requested. If you need any additional information in Jerry's
absence, please call me at 777-7067.
T4ht 4 4a
78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 -. (619) 777-7000
FAX (619) 777-7101
May 16, 1995
Mr. Norris Bernard
44-550 Marguerite Court
La Quinta, CA 92253-4830
SUBJECT: DETACHED GARAGE
Dear Norris:
Your letter was brought to the attention of the Planning Commission at their meeting of April 25,
1995. At that meeting, the Commission asked staff to conduct a survey of the other cities in the
Valley -to determine whether or not an applicant/developer would be required to process an
application for a detached garage in any special manner. The results of that survey were taken back
to the Planning Commission at their meeting of May 9th. The Commission determined that there
was no action that could be taken by the Commission accept to revise the Zoning Code during their
update process.
Attached for your review is the information obtained from other cities in the desert. If you have any
further questions or would like us to look into any other options, please contact this Department.
Very truly yours,,,
JERRY/HERMAN
Community Development Director
JH:bjs
Enclosure
LTRJH.449 MAILING ADDRESS - P.O. BOX 1504 LA OUINTA, CALIFORNIA 92253
0
MINUTES
PLANNING COMMISSION MEETING
A regular meeting held at the La Quinta City Hall
78.495 Calle Tampico, La Quinta, CA
MAY 9, 1995 3:00 P.M.
I: CALL TO ORDER
A. This meeting of the Planning Commission was called to order at 3:08 P.M. by Chairman Adolph.
Commissioner Barrows led the flag salute.
II. ROLL CALL:
A. Chairman Adolph requested the roll call: Present: Commissioners Abels, Anderson, Barrows, Butler,
Gardner, Newkirk, and Chairman Adolph.
B. Staff Present: Community Development Director Jerry Herman, City Attorney Dawn Honeywell,
Senior Engineer Steve Speer, Principal Planner Stan Sawa, Associate Planner Leslie Mouriquand,
and Department Secretary Betty Sawyer.
III. PUBLIC COMMENT: None
IV. WORKSHOP: `
A. Continued - Zoning Code Update: a request of the City for adoption of Notice of Intention to.hold_
a public hearing on Old 52nd Avenue to Francis Hack Lane.
1. Principal Planner Stan Sawa presented.the information contained in the staff report and
reviewed what had been covered to date.
2. Chairman Adolph asked if staff would like to address- Mr. Norris Bernard's letter. Aaff
stated the problem arises with basic compatibility issues where CC & R's.do not exist.
City Attorney Dawn Honeywell stated that in a Zoning Ordinancejunless there is'a specific
area of the town, cities do not typically get into real architectural detail or style unless
they are trying to create a historical district or feel in town. Discussion followed.
Members reviewed the proposed update to the Zoning Code. Those areas addressed were:
PC5.9
1
Planning Commission Minutes
May 9,1995
3.
Section 9.60.030
Page 004 • c.4.a.1) change the footage to 20•feet
Page 004 • D.1. Gates • Materials. ....Section and provided any wood used is of
"no less than a grade of ........ of construction heart
D.2. Width. "Pedestrian". gates ........ except that "other" gates
may...
E.2.b. All wood fencing "no less than a grade of", shall be put it
wherever it appears.
Page 005 • E.2.c. Add shall be a minimum of "nominal" 4" X 4" . .
E.4. Change cinder block to "precision concrete, block or cinder
block" and "...are covered with stucco, texture coating, "paint" .
or other....".
4.
Section 9.60.040
Page 00.7 B.6. "...shall be of minimum "nominal" 2" X 2" material...."
5.
Section 9.60.050:
Page 007 Table 9 change Interior side yard . to 3.5' for 0.100 square feet
structures
6.
Section 9.60.060. Commissioners asked that the wording for Garages and Carports
be changed.
7.
Community Development Director Jerry Herman relayed information that had been obtained
from the other cities in the Valley relating to detached garages. The garage referred to in
Norris' lettevis the same height as the house and under the height requirement for the
area. Staff will send this information to Mr. Norris. Discussion followed concerning
garage heights as they related to compatibility.
8.
Section 9.60.060
Page 008 A: Heights. Change "maximum structure height shall be 17•feet". Staff
to look into designing a table that makes the determination for height
based on lot sizes.
9.
Section 9.60.080
Page 009 C.2.. Height and Diameter. "...shall be no more than ten feet..."
8.
Section 9.60.140
Page 017 B.4. Change "properties" to "features".
PC5.9
3
.Planning Commission Minutes
May 9,1995
9.
Section 9.60.150
Page 018
B.3.
Add shall riot exceed 18 feet "from court surface" and delete
or as approved by the Planning Commission."
10.
Section 9.60.160
Page 019
2.
Height.. Pole or fence -mounted, "decorative or landscape type.
lighting shall be....
11:
Section 9.100.030
Page 052
B.
shall be measured from, "the finished grade at the" base of the
fence.
Page 053
3.a.
Change to 30-inches
4.
Change to 30-inches
12.
Section 9.100.040
`
Page 054
B.l.a.
Change to.15%
B-1.b.
Change to 15% staff to address drought -tolerant and water
efficient landscaping
.Add B.6 Majority of "landscape plants shall be water efficient."
Page 056
3.
Change to 30"
7.c.
Change language regarding wood to agree with language from
Residential Standards.
Page 057
7.d. Staff to check on wording.
13.
Section 9.100.060
Page 057
A.3.
On page 058 add sentence "Planting to be maintained and
replanted in perpetuity."
Page 058
B.1..
Change to 30-inches.
14.
Section 9.100.070
Page 058
A.2.
Height to be same as residential requirements..
15.
Section 9.100.080
Page 059
1.
Change December 1 to "Monday following Thanksgiving."
PC5.9
3
Planning Commission Minutes .
May 9,1995
16. Section 9.100.120
Page 061 A. Remove the word "permanent"
C.3.a Change four inches thick to six inches.
Page 062 C.3.b. Add language from Residential Standards.
D. & D.1. Remove the word "permanent".
17. Section 9.100.130
Page 063 C.6.
Change Fire Chief to Fire Marshal in both places
18.
Section 9.100.140
Page 063 1..
Change to read "..gatherings of 50 to 300 people." Staff to
create two temporary use permits. One will only require staff
approval. ,
Page 064 e.
Change Fire Chief to Fire Marshal.
19.
Section 9.100.150
Staff to update to current products and address according to
foot candles and limitation to the number allowed. Add this to
the Residential requirements as well if necessary.
Page 065 A.3.
Add "or safety hazard".
A: Purpose. Add something about using the most energy efficient lighting
Page 068 1.a.
Change Planning and Development to Building and Safety
Department.
Page 069 H.1.
Add the original adoption date instead of "date of". Add to the
last sentence "...no change other than bulb replacement.
20.
Section 9.100.170
Page 071 2.
Add language regarding once the building is removed the
property must be restored to the original condition which might
include dust or weed abatement.
21.
Section 9.100.180
Page 073 3.
Add cash bond "to guarantee removal and restoration of site"
22.
Section 9.100.200
Page 076 D.2.
On a concrete pad "sloped to drain to the gate per disposal
company..."and City"
PC5.9
4
•
•
Planning Commission Minutes
May 9,1995
23.
Section 9.100.220
Page 078 7
24. Section 9.100.240
Eliminate the words "when practical".
Page 08.1 C. Add "product line and dispensing equipment".
E.1. Add "...major repair and rebuilding, transmission . and engine
repair, autobody..."
25. Section 9.100.270
Page 083 Staff to be sure this is the same as the Uniform Plumbing Code.
26. Section 9.100.230
Page 079. B.1. "...the applicant shall provide plans ""and"" identify.... approved
by ""all".
Chairman Adolph recessed the meeting at 5:25 P.M. and reconvened at 7:03 P.M.
V. PUBLIC COMMENT: None
VI. PUBLIC HEARINGS:
A. Continued - Street Name Change 95.006: a request of the La Quinta Volunteer Fire Department for
a change of the name of a portion of Old 52nd Avenue to Frances Hack Lane.
I. Community Development Director Jerry Herman presented the information contained in the
staff report, a copy of which is on file in the Community Development Department and
explained that staff had not received the information requested of the Coachella Valley
Recreation and Parks.Department regarding renaming the Community Park.
2. Based on this information, it was moved and seconded by Commissioners AbelslAnderson
to continue the item to the Planning Commission meeting of May 23, 1995.
3. Commissioner Butler clarified that there currently were only two parks available in La
Quinta that could be named after anyone. Commissioner Abels stated he felt they should
wait the two weeks to see what the Coachella Valley Recreation and Parks District would
do.
4. Commissioner Barrows asked what the Volunteer Fire Department wanted. Community
Development Director Jerry Herman stated that they are still requesting the street name
be changed.
PC5.9
Planning. Commission Minutes
May 9, 1995
5. There being no further discussion, the Planning Commission voted unanimously to continue
the public hearing to May 23, 1995.
B. Conditional Use Permit 95.019: a request of Airtouch Cellular for approval to install a 100-foot high
monopole with three cellular antenna arrays, three microwave antenna dishes, and reinstall the
.sports lighting.
PC5.9
1. Associate Planner Leslie Mouriquand presented. the information contained in the staff
report, a copy of which is on file in the Community.Development Department.
2. Chairman Adolph asked what was immediately behind the proposed pole location.
Community Development Director Jerry Herman stated the pole was is in the middle of the
two ball fields and backed up to the Evacuation Channel. Discussion followed regarding
the location of the pole on the site plan.
3. Commissioner Butler clarified that the light standard that is on the pole will remain as it
is now: Staff replied that the conditions state that the light must be replaced exactly as
it is now.
4. Commissioner Butler stated that with the additional pole this will give La Quinta additional
cellular coverage and increase emergency services. Staff stated that was true.
5. Commissioner Newkirk clarified that the pole would not appear to be any different than it
is now to the property owners to the south, what about the properties to the north. Staff
stated that due to the distance to the properties to the north, it should not be any
different.
6. Community Development Director Jerry Herman clarified that the. lights were not the issue,
but the monopole. The City Council will be addressing the issue of.the lights shortly during.
the Capital Improvements budget review.
7. Commissioner Anderson asked what the span of the array would be on the pole. The
applicant clarified it would-be a 13-foot radius and a 26-foot diameter. The applicant
clarified that it was a diameter or 13-13-foot apex.
a. Commissioner Anderson asked if there were any photographs of actual installations. Staff
stated they did not have but, reminded the Commissioners of the pole that was installed
at the Imperial Irrigation District property.
6
interoffice
M E M O R A N D U M
to: Jerry Herman, Community Development Director
from: Greg Trousdell, Associate Planner '
subject: Detached Garage Survey
date: May 3, 1995
Per your request of April 26, *I have called a few cities in the area to determine whether or not
there is a special process an applicant/developer must go through to have a large detached garage.
My findings on this topic are:
1. Cathedral City - A CUP is required if more than a four -car garage is proposed on a single
lot:
2. Palm Springs - Architectural review is only required if the home is on a major
thoroughfare.
3. Palm Desert - Detached garages shall be located in the rear yard area. Special
approval is not required.
4. Coachella - Did not respond to survey.
5. D. S. Springs - Special approval is .not required.
6. Indian Wells - They do not permit detached structures on lots less than 22,000 sq. ft.
However, they have permitted attached multiple car garages.
T Indio- Special approval is not required, but the garage shall be architecturally
compatible with the single family home.
8. Rancho Mirage - Special approval is not required.
mmsur2
J
FILE COPY
78-495 CALLE TAMPICO - LA OUINTA, CALIFORNIA 92253 - (619) 777-7000
FAX (619) '777-7101
1995
Mr. Norris S. Bernard
44-550 Marguerite Court
La Quinta, CA 92253
SUBJECT: DETACHED GARAGE (CACTUS FLOWER)
Dear Mr. Bernard:
We have reviewed your letter concerning the recently constructed detached garage at 79-720
Iris Court. A building permit for this structure was issued in February after completion of
the existing home. The garage structure met the general requirements of the City's existing
Zoning Code when it was issued. The only. exception to the above statement was the City
allowed a setback adjustment for the application request because the distance from the
garage to the home was less that 10-feet. The construction of the garage was designed to
be. architecturally. compatible with the existing home. The City's Compatibility Ordinance
did not apply to this application because the garage was built by the home owner after the
home` was completed.
Your project, although not a gated community, should have a set of governing rules that can
exceed our Zoning Code provisions. ' The governing rules are called Conditions, Covenants
and Restrictions (CC and R's) and should have been part of property title policy when you
purchased your home. If your existing CC and R's do not allow this type of accessory
structure, you as a homeowner (along with your Association) could seek legal counsel -to
' correct this problem.
If you have any. questions, please contact our office at 619-777-7067.
J
Very truly yours,
DEVELOPMENT DIRECTOR'
Planner
GT:kaf
MAILING ADDRESS - P.O. BOX 1504 LA OUINTA, CALIFORNIA 92253
LTRGT39S
interoffice
M E M 0 R A N D U M
to: Jerry Herman, Director of Community Development
cc: Tom Hartung, Building and Safety Director
from: Greg Trousdell, Associate Planner.
re: Detached Garage Structure
date: April 6, 1995
At the March 28 Planning' Commission meeting, Mr. Norris Bernard complained
about an under construction detached garage being built by Snellenberger and
Associates at 79-720 Iris Court (Cactus Flower II). The following information.has
been obtained concerning this site.
The existing single family home was completed in December 1994. 'Mr. Jim
Snellenberger owns the existing home. A building permit was issued to construct the
+ 666 sq. ft. detached structure on February. 16, 1995. However, before the permit
was issued for the garage structure, a setback adjustment was approved. The
adjustment allowed the new garage to be placed less than 10-feet (e.g., 7.5-feet) from
the existing home. The garage is ten feet from the rear yard and five feet from the
side yard, and meets all other R-1 requirements.
Mr. Snellenberger has said that he'is building the garage to store his. boat and other
related vehicles (i.e., company truck). The floor plan describes these uses on the
building plans. The building will be architecturally compatible with the existing
house (frame and stucco with tile roof).
:If you need further information on this topic, please let me know.
Attachment
interoffice
M E M O RA N DU M"
to: Jerry Herman, Director of Community Development
cc: . Tom Hartung, Building and Safety Director
from: Greg Trousdell, Associate Planner
re: Detached Garage Structure
date: March 29, 1995
At the March 28 Planning Commission meeting, Mr.. Norris Bernard complained
about an under construction detached garage being built by Snellenberger and
Associates at 79-720 Iris Court (Cactus Flower II). The following information has
been obtained concerning this site..
The subject property is owned by Mr. Jim Snellenberger. A building permit was
issued to construct the + 666 sq. ft. detached structure on February 16, 1995.
However, before the permit was issued for the garage structure, a setback adjustment
was approved.. The adjustment allowed the new garage to be placed less .than 10-feet
(e.g.,. 7.5-feet) from the existing home. The.garage is ten feet from the rear yard and
five feet from the side yard, and meets all other R-1 requirements: Lastly, the. height
of the garage is the same as the existing home (i.e., 17-feet) based on approved
construction plans.
Mr. Jim Snellenberger has said that he is building the garage to store his boat and
other related vehicles (i.e.; company truck). The floor plan describes these uses on
the building plans. The building will be architecturally compatible with the existing
house (frame and stucco- with tile roof).
If you need further information on this topic, please let me know.
Attachments
NORRIS S. BERNARD
44-550 MARGUERITE CT. GEnnq0
THE DESERT
LA QUINTA, CA 92253
TELEPHONE (619) 360-1841
TO: Mr. Donald Adolph, Chairman DATE: March 28, 1995
La Quinta Planning Commission , ,
. Cactus Flower South
.. .... . ..... . .... .. . . .. .... .. .. .. . ...... . SUB . JECT: . .....Roger Snell-enbe.rg.e.r. & As.soc.
Tract # 24208, lot # 4
Planni.ng Dep-artmen.t....perm.i.t.s. ..? ..............
Dear Chairman and Members of the Commission*:
My wife -and. I live in Cactus Flower., ..a. -d-evelopment.. within ..the ... . ...... . ... ..
City of La Quinta, however, our home was built by Williams
Develotment Company -and and -not. by ..the .. -c-ur-re.nt.....builder....(Sn.ell.en . .. .... ... .. . ....... .... .
FDLD berger). During the four years we have lived here we have F."
enjoyed our home, our neighbors.., ....the .. community - which
Highway 111, but still in to Quinta.
It has - been brought to my attention ' that a recent iit ...... 1s6'fd1 ... has.. . . . . ..... ...
been, or is near the completion stage of construction in this
area'. I'ciffi_speaking of_. a' home in _Cactus Flower; P'lA'ft 4", - - eX_'
panded 'bonus room', with the remaining two -car garage and
located on Lot # 4, Tract # 24208, *address'i' '79'-'720- Ifi-s' "Court
.(nearest cross -street: Blazing Star Trail, the current home
of Jim Shel*lenb(§rger" son of Roger S*h'6l1bhb6rget, the deweTop
er.
The 'sore' that the people of Cactus..Flower are complaining to
me about is the current project, still under construction of
. .. .. .. ... ......... ....... ... ...1 . that
...... I . ... .. ...... can
.... ................ .
a BARN, located on the south side of the home that can be seen
from the street. As a matter of fact it can be.seen from
.. ......... . I ..... . ......
Blazing Star Trail and Miles Avenue. We can only assume the
proper building permits were issued for this construction
A picture, taken from the street of the project d'u*ringcon-
struction is attach6d.
....... ..... ... .. . . ..... .. ......... ...... .
No matter where you live, PGA -West, the Cove, Westward-Ho,etc.
would you want a 'barn, going up across from your home ? We
the citizens of Cactus Flower invite each and every member of
the Planning Commission to view this structure, call it what-
ever you like, then determine if it blends with the surround-
ing area. Now is the time to put an end to this blight, we
need to kill the cancer before it spreads to other areas
Should you, the planning commission, feel that a Public Hear-
ing on this subject is in order, I'm sure we will be able to
fill the Council Chamber on the evening you select.
A reply is requested so the citizens of North La Quinta will
know if its o.k. to construct barns, pig pens, chicken coops
and/or hi -bay sheds for 'construction equipment. Our C.C.& R's.
mean nothing anymore
�Sin e 1 y , . . . . . .
r
Norris S. Bernard, a La Quinta citizen LMAR2 8 1995
CITY OF J.A QUI MA
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PLAMIING DEPAR;
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44
P.O. BOX 1504No. 13990
Building ., 78-105 CALLE ESTADO
Address t 9-720 Iris Court LA QUINTA, CALIFORNIA 92253
xoaer 5neiiwnaeraer ana ASSOC.
Mailing r _
Address 7._.rn�-
City J Zip Tel.
La Quin-ta 92253 777-7767
Contractor
Jame
State Lic. City
& Classif. 3 488234 Lic. # 1858
Arch., Engr.,
Designer Carlos Elias -Engineer
Address Tel.
38 -825 Charlesworth Rd 328-7271
Cr ty State
• at:hed: al Cit:,Zip 92234 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 ln,full
effect. force and
( L
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 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 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 applicant to a civil penalty of 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
or improvement is sold within one year of completion, the owner -builder will have the burden
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-
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
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. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need. not be completed if the permit is for one hundred dollars (8100) valuation
or less.)
I certify that in the performance of tho 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, alter making this Certificate of 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.
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.
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 604--251-004
Legal Description T.nt A TX ACC 7 4 7, Q q Cyk Ctyj r- 1Sht ar
Project Description S=
Sq. Ft.
Size 2025
No.
Stories
No. Dw.
Units
New C�[ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$122 345.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
504.31
Const.
120.00
Mech.
4 9.0 0
Electrical
147.03
Plumbing
162.00
S.M.I.
12.23
Grading
21 on
Driveway Enc.
Infrastructure
2 7 5 2 .:' 6
KFEs in Public
!laces
55.86
TOTAL
4523.19
REMARKS
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
Issued by: Date Permit
Validated by:
Signature of applicant Date
Mailing Address
City, State, Zip
Validation:
CONSTRUCTION ESTIMATE
z-
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL. SO. FT. ®
2ND FL. SO. FT. ®
POP. SO. FT. ®
GAR. SO. FT. ®
CAR P. I SO. FT.
WALL SO. FT.
SO FT ®
ESTIMATED CONSTRUCTION VALUATION
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
$
WATER PIPING
NOTE: Not to be used as property tax valuation
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
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DEL
TOTAL FEES
MICRO FEE
MECH.FEE
PL.CK.FEE
CONST. FEE
ELECT. FEE
SMI FEE
PLUMB. FEE
STRUCTURE PLUMBING D 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
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
111
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. / L 9
FRAMING ��,✓✓✓
FINAL INSP.
ROOFING 2
REMARKS!
VENTILATION
FIRE ZONE ROOFING
FIREPLACE .
SPARK ARRESTOR
GAR. -FIREWAL
LATHING
MESH
INSULATIONISOUND `l Ito Q �6
FINISH GRADING
FINAL INSPECTION ) R
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESANITIALS
GARDEN WALL FINAL
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