14931 (AR)V t. P.O. BOX 1504 N o . 14 931
Building 'a 78-495 CALLS TAMPICO
Address 44-615 B -Lazing Star Trail LA QUINTA, CALIFORNIA 92253
Owner Joni i3.:CUyles
Mailing BUILDING: TYPE CONST.
Address C/o 43865 Boardwalk #212
A.P. Number
City Zip Tel.
Palm Desert, CA 92228 777-1161 Legal Description
Contractor Project Description Bonus; ROM
Rocrer Snellenber er & ASSoc. , inc.
Address .
ILS 41865 Boardwalk, #212
'f
v Palm Desert, CA 92223. .y,. 777- 7766
State Lic. City
& Classif. B 488234 Lic. # 2.858
Arch., Engr.,
Designer
Address Tel.
City I
Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I�hereby affirm that I an) licensed underfprovisj9r s of Chapter 9 (commencing with Section
, 7 of Division,3 oft the Business and Professfio. Codey';�and my license is in full force and
,effect. tex-allt-117
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from' the Contractor's License Law for the following
reason: (Sec. 7031.5,11tsiness 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 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
Divlslon 3 0/ 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 cl0penalty of not more than five hundred dollars ($500).
❑ 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 inprove for the purpose of sale.) -
b I, 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 contractors) ()tensed pursuant to the Contractor's License Law.)
O 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 mpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy o. Company
Copy is filed with the city. O Certified copy is hereby furnished:
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed !1 the permit is for one hundred dollars ($100) valuation
'or less.)
I certify that in the performance of lhV work for which this permit is issued,.l shall not.
employ any parson in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date --!--Owner'
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 deemedrevoked: ,p
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIESAND CIVIL FINES UP. TO ONE
HUNDRED THOUSAND DOLLARS ($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.
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.
1 certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinancesand 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
OCC. GRP.
I
Sq. Ft. X88 No. No. Dw.
Size - Stories Units
New ❑ Add ❑. Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $6r524.-00
I
PERMIT AMOUNT
Plan Chk. Dep.
BY: f
Plan Chk. Bal.
59.50
Const.
90.00
Mech. '
4 -Am"
Electrical
2-1 SR
Plumbing
.00
S.M.L.
I PECT
Grading
Driveway Enc.
�r
Infrastructure
1
t IN
TOTAL
3 --
REMARKS
ZONE:
BY: f
Minimum Setback
Distances:
front Setback from Center Line
Rear Setback from Rear Pf L' e
Side Street Setback from ter LI
Side Setback from Pr Lin.
FINALDATE
I PECT
Issued by:
Validated by:
Date y \ Pei i ,
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING. FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK >
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT.
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/<c
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 S 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 SIGNATURES/INITIALS
GARDEN WALL FINAL
Wt=D 1 ,_j3 LA QUINTA HDLG & SAFETY 6195648487
5 F'
Certificate of Compliance: Resideniiai (Page 1 of 2) CF -1 R
Project We I®
L .{ 14 Lo I S
Project Addrew Bullring Permit
�-�►2=1� TiE��M41�-7-7-7 -_1_1 Plan Check I ai;
Oocornentatlorr Author Tefepteone
1 S Field Check I Dare
Compliance Method (Package. Point Sysm or Cor pular) Climate 2or►o EnlorcementAgency se only
te
GENERAL INFORMATION
Total Conditioned Floor Aroa: _ 18 8 It
Building Type: ✓ Single Family ✓ Addition
(check one or more) Multi -F ExWing-Plus-Addtlon
Front Orientation: North East South /West / All QrlerttationS
(Input o on in degrees and circle ono.)
Plumber of Dwelling Units:
Floor Construction Type: Sla Raisod Floor (cirde one or bath)
BUILDING SHELF INSULATION
Construction
Component Insulation Assembly Location/Comments
Type _ R -Valve U -Value (attic, to garage, typical, etc.)
2
Walt .............. t .�_
Wall.............. _
Roos .......... -
Root ............. 4
Floor .............
Floor. ............ y
Slab Edge .... N lA —
FENESTRATION Shading Devices
Fenestration Area Fenestration Interior Exterior Overhang Framing Type
Orientation (so U -Value (roller blind, etc-) (sharlescreen, etc.) (yes/no) Cmeta ktood/vinylj
Front.... (A -2-457 • 7S PrILLM
Front...-. ( )
Left ...... ( )
Left.......
Rear.....
Rear.._ ( )
Right..... ( )
Right..... { )
Skylight ....... r
Skylight ....... ----
THE>F MAL PgASS
Type/Covering Area Thickness
(slabrexposed, file, etc.) (si) (inches) LocatioWDescrlptlon (kitchen, bash, etc.)
RevL. d Jeauary ttf{rd
NO+1-23-94 WED 15:54 LA QUINTA BDLG & SAFETY 6195648487 F-02
n
ificete of Compliance: Residential (Page 2 of 2) CF -1 R
�P'"
Oal®
HVAC SYSTEMS
Nota: Input hydronic or combined hydronic data under Water Heating Systems, exoept Design HeaSng Load.
Distribution
Heating Equipment Minimum Type and Duct or
Type (furnace, heat Efficiency Location Piping Thermostat
pump, eta.) (AFUFMSPF) (ductslattic, etc.) R -Value Type
t ST7 is e.
Cooling Equipment Minimum Duct
Type (airoonditioner. Efficiency Location Duct Thermostat Corrfiguration
heal pump, evap. 000ling) (SEER) (attic etc.) R -Value Type (spit or package)
_X 1 5 Tl �l G
WATER HEATING SYSTEMS
Energy External
Rated' Tank Factor or Tank
Water Heater Distribution Number Input (kW Capacity Recovery StandbyInsulation
Type Type _ ___ _ in System or Btulhr) AallonsyEfficiency Loss (%) R -Value
C—K t ST► Aa &-
1.
1. For amen gas slorage (rated input 5 75,000 Btulhr), electric aealsatanee and Met pump water hastare list Enneerrggyy Factor.
For terga gaa storage water hostors (rated input 2 75,OOD etuhr), list Rated Input, Reoovery Ef6dency and Stanciby Loas.
For in$aiotaneous 1- waW hemists. Ise( Rated IrWLA and Recovery E-Tw ienc y.
SPECIAL. FEATURESIREMARKS (Add extra sheets if necessary)
GOMPLIANCE STATEMENT
This certificate of compliance fists the building features and pejormarwe specifications needed to compty Wth Title 24, Parts t and 6, of
the California Code of Regulations, and the administraM regulations to implement them. This certificate has been signed by tf)e
individual with overall design responsibility. When this certireate of c ntpliarm is submitted for a 'sngle bulldinp plan to be butt in muliple
orientations, any shading t9ature that Is varied is Indicated in the Spotaal Foatures/Remarks section_
Designer or Owner (Far euslneaa & Profa.alona Cade)
warns: 2� 6> S �r��u E,2� &ao c_
Tina/F`rn:
Address: A&DwR1-1d 2� Z
S rLJ� ES E0z: 44 9Z2r t
Tetephone: lot 4 ? —%1 tb Co
Lir,. R:
(cignaturo)
Enforcement
Agency
g
Name: Mihzlt- .
(data)
Rovlucd Janlu,ry 1992
Documentation Author
Name: L 'o6 1 Goz�t A -#J
Ti"JFirm: 4 AM
Addrw 9d►
Telephone:
(slgnahrre) (da5o)
Z
FIT i
1r
K(TQ I-1 r
k�MH�f� + IDP�,(FK POCH 7
�_., :_.—, —�-C� �TIT�c�N ►�J1�L.L TD ��-�J1l�► r�
I n o t)o►J u6 Rco..~1
_ _t I
W. H . d/P L,�u,)fl PLATr-OR
U NOT��L���. o�l
y ��N O�C40
�1��
F�� P WrJENO� P ���8
coM'10 F- 1:0,ZA 14 C-4 L,-%/ I" I
� ! I��1 ENT PtR�4t�1�kc�?oF
TSP F LY'-'1D� �W�QI— I�I
a �'�T�N-(olr-oc�7oP����c�-,
OM IT C-4, pR,ADD wPl.l. } Cehnv
HAI
� L�") ��, (1-1; 1 � � F T
5/(Y,P9-(t�LL (2CLC- PF P\ Fx, PIAN N(T7-;*