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SFD (9602-034)44715 Los Manos Dr 9602-034 ALC # LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with DATE Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. 48&234 13 5 — ->211 0- JOB Sm License # Lia Class—.E:xp.(Date_ y OWNER Date Signatureof Contractor /„fi ,_J.,,,r /-7 ,,., _Ow I hereby affirm that I am exempt horn 0 Contractor's License Law for the. following reason: '1_ ( ) 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, Business & Professionals Code). () I, as owner of the property, am exclusively c6ntracting with licensed contractors to construct the project (Sec. 70444, Business & Professionals Code). ( ) I am exempt under Section B&P.C. for this reason Date Signature of Owner F •' WORKER'S COMPENSATION DECLARATION I hereby.affirm under penalty of perjury one of the following declarations: have'and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ( ) I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. (This secttao d Jai completed if the permit valuatio+n ;i sy4rIl00.00 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, and agree that if I should become subject to the workers' compensation p ovisions of ectio 3700 of the Labor Code, I shall forthwith comply with v!i`ns. / / 7 .Date: —Applicant -7/25 " Warning: Failure to secure I er Compensation coverage is unlawful and shall subject an employer to cnm n penalties, and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 -of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of Is p plica on agrees to, & shall, indemnify & hold harmless the City of I 1ie'jLs, rl officars, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives -o this City to enter upon the above-mentioned property for inspection purposes - j BUILDII ,Si.a ai.1Kl LOT 44-715 LOS MANOS DRIVE ROGER STNELLDMITHERGER tit ASSOC .41$65 'BOARDIVALK 6212 PALM UE5E RT CA 922.11 (6119)777-7766 USE OF QUINt'.ERRA PLAN 1w FEE PERMIT PERMIT 0602-034 APN 6604.265 -005 ROGER SN1y'L ENBERGER &'. ASSOC 41865 BOARDWALK #212 P:ALiv[ DESERT CA 922.11 (619)777,-7766 CB1.9 1858 DESIGNER/ENG[NEER CHARLES 1D. GARLAND 33-163> CA1I1WRAL CANYON DR. TRACT CONSTRUCTION 2,015,00 5F GARAO&CARPORT 625.00 SF ESTIMATED COST OF CONSTRUCTION ERAfff FELE SUNVI"Rv Pi AN C31BC9 'FFE 101-1300-439-318 $597 CONS'i RQTMON FE6 101-000-41 s-000 $716 '64ECHWCAL PPE 101-000-421-000 $53 E1YR.-VRICAT.F1-7 101-000-420-000 $131 PTFt;IM BIGHT. 1014W-419-00.0 $154 S IPOING MOTION FEE - .RE` M 101-000-241-000 $12. GRAD1'NO FIRE 101.-000-423-000 $20 tW1Z`t1S!'RUCi'UR1 FFA .225-0(30-443-342 $2,137 , ART 1N PUBLIC; PLACI±S - R1,5I1a 701-000-255-000 $54 06 50 io 55 M 00 89 2> 1Z9,s 'a.it7 SUB -TOTAL CONST'RUCi ONAND PLAN CHECK $4.476.88 ,LESS PRE—PAID FESS $0.00 TOTAL P ERNOT F.E .S DUE NOW $4,476 S ,.Signature (Owner/Agent) Date I RECEIPT I DATE IBY (DATE FINALED I INSPECTOR INSPECTION RECORD -` " OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs I Underground Ducts Forms & Footings Ducts Slab Grade Z ZOO IVA Return Air Steel H Combustion Air Roof Deck Exhaust Fans O.K. to Wrap . F.A.U. Framing L7 A Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL A ROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APP OVAL Gas Test Electric Final Waste Lines if Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Poo! Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: Notice: Document Cannot Be Duplicated Date 2/2/96 No. 14112 Desert Sands Unified School District 82-879 Highway 111 Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Owner Name Roger Snellenberger & Associates No. 44715 Street Los Manos Dr. Cit, La Quinta Tract # 23913 Lot # 111 Type of Development Single Family Residence Comments APN # 604-265-005 Jurisdiction La Quinta zip 92253 Permit # Log # Study Area 233 Square Footage 2015 No. of Units 1 At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.72 x 2,015 or $ 3,465.80 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. . \ , :: ►z' Fees Paid By Roger Snellenberger & Associates Teleplione `,7.77-7756, Name on the check By Dolores A. Ballesteros Superintendent Fee collected /exempted by Pauline Pearson Payment Received Signature a A , Q ani o P.M A 11.6XYZ — Check No. NI $3,465.80 11027 Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting