SFD (9602-024)44805 Los Manos Dr
9602-024
u) V LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with
W Section 7000) of Division 3 of the Business and Professionals Code, and my
O
r, License is in full force and effect. 498234 a , - 30
License # Lia Class _...Exp. Date ./
Z YDate Signatureof Contractor —//I,_ ..'
cTo OWNER -BUILDER D CLARATION
J W I hereby affirm that I am exempt fro a Contractor's License Law for the
LLJ 0_ following reason:
to ( ) I, as owner of the property, or my employees with wages as their sole
Z 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' contracting with licensed
contractors to constructtthe p6ject (Sec. 7044, Business & Professionals Code).
( ) I am exempt under Section B&P.C.Jor this reason
NDate Signature of Owner
N
rn WORKEJi'S COMPENSATION DECLARATION
d Q 1 hereby affirm under penalty of perjury one of the following declarations:
C) g Z ( ) I have and will maintain a certificate of consent to self -insure for workers'
F< MO compensation, as provided for by Section 3700 of the Labor Code, for the
X W LL, performance of the work for which this permit is issued.
p J J ( ) I have and will maintain workers' compensation insurance, as required by
M JU Section 3700 of the Labor Code, for the performance of the work for which this
O U permit is issued. My workers' compensation insurance carrier & policy no. are:
d rn H Carrier Policy No.
,It Z (This section of b completed if the permit valuationis,49 $, 00.00 or less).
,x linuevs dbv.•..55-d
n co
( ) 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 7r visions of-Sectio—n--3700 • f the Labor
Code, I shall forthwith comply with 700! ro sions. :P
Date: Applicant f
Warning: Failure to secure Workers Compensation coverage is nlawful and shall,
subject an employer to crmirf'al 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 resuq fty isrli on agrees to, &shall, indemnity
& hold harmless the City of IiidiArr►►t slits officers, 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.
kr%rtify that I have read this application and state that the above information is
cect. I agree to comply with all City, and State laws relating to the building
cstruction, and hereby authorize representatives of this Cityt enter upon the
ve-mentioned property for inspection purposes. /
0
\'Signature (Owner/Agent) Data
A"'
BUILDING PERMIT
PERM'T'
9all'2,-f9.24
DATE 21 W96
VALUATION ,4x't2j,"4.16 LOT 114 TRACT 23913
JOB SITE ADDRESSAPN
44-905 LOS A°iANOS'iiWE
04-27.2-010
OWNER
CONTRACTOR
ROOMR SNEl,1. ENBERC)ER &A SOC.
RCKI' :R SI'jE LENB 1'..l:iER & ASSOC
41,X65 BOARDWALK 92112
41865 BCti.it%rWALK ft2i2
PALM DESERT CA 92211
RAI.M DESERT CA 922.11
(619)777-7766 011110 181%
X619)777-7766
DESIGNER/ENGINEER
r.HARLI,S D, OAR LAND
33-10 CAT T—DR L CANYON DR-
USE OF PERWa1d`iGL.I 6"' 1LY111. i irr L.LIN'U'
QLJ11VT1rRRA
PL XN 1
FEE DESCRIPTION
FEES
TkA'CC CONSTRUCTION 2,015.00 SF
GAR,40 ICARPOR.T 626.00 SF
ESIMIATED COST OF WNST.RiiMOtN
112.1,6".10
PERMIT FEE SUMMARY
MAN CIIEC► FITS 101-000-439,315 $59".06
—
COWfRUC` ION F'Erl 101-000-4.18.000 $718.50
A CHANICAI- Fa- 101-000-421-000 $53.517
CO
ELECTRJ.CAL (-EE 101.000-420-000 $131..55
PLUMB[NO FES 1.01-000-419-000 $141.00
rn
`—
STONGi IMOTION PEE - RESID 101-000-241-000 $12.17
C a
O1 ADING K'E 101-1100-4.23.000 $20.00
rl
itdl•MA,S'1`RUCTUREFRk 22.5-000-443-342 $2737.89
Q(
ART IN P1.IBLIC PLACES • REM 701-000-255-000 SS4.21
LL -
SUB -TOTAL CONETMUM ION AND PLAN CHECK
$4.476 883
LESS PRS -PAID FEES
$0.00
TOTAL 1I'ERM1T FEES 1D"U1J'lvOW
S4,476.88
RECEIPT
DATE
By
DATE FINALED
INSPECTOR 7771
INSPECTION RECORD
OPERATION
DATE
I INSPECTOR
OPERATION
I DATE
I IN9PeC R
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel V
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
warty Wall Insulation
Condensate Lines
Party Wall Firewall _
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL ROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I
Gas Piping
PLUMBING APPRO ALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping 1. 9,9
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection A I
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICA 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)
I
Notice:
Document Cannot Be Duplicated
Date 2/2/96
No. 14100 .
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Owner Name Roger Snellenberger & Associates
No 44805
City La Quinta
Tract # 23913
APN # 604-272-010
Jurisdiction La Quinta
Permit #
Street Los Manos Dr. Log #
Zip 92253 Study Area 233
Lot # 114 Square Footage 2015
Type of Development Single Family Residence
Comments
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. , + -
Fees Paid BTelephone": `
Y Roger Snellenberger &Associates
, 777_7766
:
Name on the check 7
By Dolores A. Ballesteros
Superintendent
Fee collected /exempted by Pauline Pearson Payment Received $3,465.80
Check No. 11027
Signature P, it A p
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
44805 Los Manos Dr
15273
4
P.O. BOX 1504 N o . 15 2 ( 3
Building 44 Q45 i1oS ManszB Dr. 78-495CALLETAMPICO
Address LA QUINTA, CALIFORNIA 92253
Owner Snellenberger & ASSOCiates
Mailing
BUILDING: TYPE CONST. OCC. GRP.
Address 41-865 Boardwalk
A.P. Number
Cityip Tel.
Para Desert, Cif 92211 777-7766 Legal Description
Contractor Project Description Temporary Power Pole
Poorer Plus
Address .
2724 E. Regal Park
City ZiD
Raincho Mirage, CA 92270 16011863-2525
State Lic. City
& Classif. 523596 Lic. # 1881 Sq. Ft. 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 herebyy of 'rm that 1 am.lfcensedu der,piovl`siops'of Chapter (commencing with Section
7000) of Di on•3"of the Businessrnd.Professions Code and my lice a is in full force d
.effect.
N TU -Y .,ry ` DATE
I tL /r OWNER-BUILDE ECLARATION Estimated Valuation35 44
rea9orF by affirm that I am exempt from the Contractor•s License Law for the following
(Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after. 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
for 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 rive hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
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, Mech.
provided that such improvements are not intended or offered for sale. If, however, the building 1
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 3
of proving that he did not build or improve for the purpose of sale.) J
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
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 S.M.I.
such projects with a contractor(sl Pcensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec. B. ✓£ P.C. for this reason
Driveway Enc.
Date owner Infrastructure
WORKERS' COMPENSATION DECLARATION
I herebyaffirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policyy Company
(pCopy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 33.50
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(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
employ any pparson in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: ft, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shah be deemed revoked. Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE _
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side=Sefback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This Is a building permit when properly filled out, signed and validated, and is subject to FINAL DAT n INSPECTOR
expiration if work thereunder is suspended for 160 days. 1 I
I certify that I have read this application and state that the above Information is correct. Is$'ii d by: lei date Permit
I agree to comply with all city and county ordinances and state laws relating to building U
construction, and hereby authorize representatives of this city to enter the above-. S ll CJ J 1'V' I
mentioned property for inspection purposes. Validated by:-
Signature of applicant -Date-
Mailing
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING; FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
I
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. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID a 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
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 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 APPJEOUIP.
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
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL