07-2523 (AR)79115 Arbola Circle
IIIIIIIIVIIIIIIVIIIIIII 54
IE 4
--— - — P.O.BOX 1504 No. 15676
78-495 CALLE TAMPICO
Addrress 79-115 Arbola circle LA QUINTA,CALIFORNIA 92253
Owner Sinellenberger & Associates
BUILDING: TYPE CONST. OCC:GRP.
AddreMailinss 41--865 Boardwalk* Ste. 21.2 A.P.Number 604--271 .009
Ci atm eserto h 92231. ( 19).777r-7' 68 Legal Description Lot.'78 Tract 239313 Phage
Contractor Project Description WD Plan 2
Sime
Addressll .Aterxa't
City Zip Tel.:
State Lica City
&Classif.. B 488234 Lic.# 1858 Sq.Ft. No. No. Dw.
Arch., Engr., -. Size 2132 Stories Units
Designer Charles D. Garland New ❑ Add O Alter O Repair O Demolition(I
AdlSs163 Cathedra"' Cyn Dr.ip Te,<C19) 774--7t 2S
C'ea.thedral Cit r; CA 9223 t#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am.Iic—sed' provisions of Chapter 9(commencing with Section
7000)of Div is'ion 3 of°the Business,efid Professions Code,and my license is in full fo cea d
effect. ,.r
GNAT a..r DATE
OWNER-BUILDER DECLARATION Estimated Valuation 129
/I he eby affirm that I am exempt from the Contractor's License Law for the following Xo 559•00
reasoJy.'-`(Sec. 7031.5,Busi7ess 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 PERMIT AMOUNT
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 plan Chk. De
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan
subjects the applicant to a civil penalty of not more than five hundred dollars($500). plan Chk. Bal. 618.71
❑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 Const. .
Professions Code: The Contractor's.License Law does not apply to an owner of property who
00
builds or improves thereon and who does such work himself or through his own employees, rbcs a S1
provided that such improvements are not intended or offered for sale. If, however, the building Mech. 0
or improvement is sold within one year or completion, the owner-builder will have the burden Electrical "50'06
of proving that he did not build or improve for the purpose of sale.)
❑ I,as owner of the property,am exclusively contracting with licensed contractors to con- Plumbing 150.00
struct the project. (Sec. 7044, Business and.Professions Code: The Contractor's License Law 9 Q (-
does not apply to an,owner of property who builds or improves thereon, and who contracts for S.M.I. 1 .8
such projects with a contractors)Licensed pursuant to the Contractor's License Law.)
Grading 20.00
❑1 am exempt under Sec B.&P.C.for this reason
Driveway Enc. 00
Date owner Infrastructure 2,868.05
_Arts in Public Places 71..40
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.00py`ihereof.(Sec.3800,Labor Code.)
Policy No. Company f
O Copy is filed with the city. O Certiflid'copy is hereby furnished.
TOTAL 4,687.58
CERTIFICATE OF FROM REMARKS
WORKERS'dOMPENSATIONINSURANCE
(This section need not be completed if 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 r
employ any personnia in any manner so as to become subject to the Workers'Compensation
Laws of Califor
Date Owner
NOTICE TO APPLICANT: d, 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 C r Line
Rear Setback fro P Line
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND Side Street Set om Ce r Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE -
HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION.. . Side Setbac m Propel'{
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEYS FEES. FINAL DATE INSPF.( fnOR
This is a building w
permit hen'properly filled out,signed and validated,and is subject to 1 f!
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. Issued by. Dat P, rml
I agree to comply with all city and county ordinances-and state laws relating to building 199
construction, and hereby authorize representatives -of this city to enter the above-. t7
mentioned property for inspection purposes. Vdlldated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
i
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINv FEES
IST FL. SQ.FT.a $ UNITS
2ND FL. SO.FT.@ YARD SPKLR SYSTEM
POR. SO.FT.a MOBILEHOME SVC. BAR SINK
GAR. SO.FT.a POWER OUTLET ROOF DRAINS
CAR P. I SO.FT.a DRAINAGE PIPING
WALL SQ.Ff.
DRINKING FOUNTAIN
SO.FT.a URINAL
ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING
NOTE:Not to be used as property tax valuation FLOOR DRAIN
MECHANICAL FEES WATER SOFTENER
VENT SYSTEM FAN EVAP.0OOL HOOD SIGN WASH ER(AUTO)(DISH)
APPLIANCE DRYER GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY
AIR HANDLING UNIT CFM 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.a c BATH TUB
SO.FT.a c WATER HEATER
MAX.HEATER OUTPUT,B.T.U. SO.FT.RESID a 11/4 C SEWAGE DISPOSAL
SQ.Ff.GAR a 3/4c HOUSE SEWER
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 PLUMVPfffly UNDERGROUND A.C.UNIT COLL.AREA
SLAB GRADE ROUGH PLUMB. BONDING HEATING(ROUGH) STORAGE TANK
FORMS v SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE
FOUND.REINF. V GAS(ROUGH) METER LOOP HEATING(FINAL) OTHER APPJEQUIP.
REINF.STEEL GAS(FINAL) TEMP.POLE
GROUT WATER HEATER SERVICE FINAL INSP.
BOND BEAM WATER SYSTEM
ADING
LUMBER GR. FINAL INSP. l?/ cu.yd.
FRAMING ) FINAL INSP. $ plus x$ =$
ROOFING / REMARKS:
VENTILATION 01l/ I
FIRE ZONE ROOFING I 1 Ih
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND ' 13
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIaNATURESIINITIALS
GARDEN WALL FINAL