13987 (SFD)Tdif "
�-
P.O. BOX 1504 No. 13997
78-105 CALLE ESTADO
Address 44'--640 Blazing Star 'gall LA QUINTA, CALIFORNIA 92253
Owner
Roser Snellenbe>rger and As.Rgc BUILDING: TYPE CONST. OCC. GRP.-
Address SS -695 Pebble Beach� 601--251-013
A.P. Number
City zip Tel. Lot 13 Tract 24208 Cactus Plower
La Quinta 92253 777-7767 Legal Description
Contractor Project Description SFD
same
Address
City Zip Tela
State Lic. ' City
& Classif. -B 488234 Lic. # 7 858 Sq. Ft. No. No. DIN.
Size 2025. Stories Units
Arch., Engr.,- �.. - _- - - - - - -
Designer Carlos Elias -Engineer New Add ❑ Alter ❑ Repair ❑ Demolition ❑
Ad Tel. Charlesworth tar. Te1.328-7271
City Zip State
Cat iedral City 92234 Lic. # F
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that"I am licensed under provisions of Chapter 9 (commencing ,with Section
7000) of Divispioh•3 of the Business>and Professions Code, and my license is in full force and
/
effect r f ' t"�+-,.._.a,- A731 /r"r
SIGNATURE v/ J DATE
OWNER•BUILDERDECLARATION Estimated Valuation 122 345 Q4
I hereby affirm that I am exempt from the Contractors License Law for the following r .
reason: (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 fife 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 p.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). L i! Y A j -
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. ii
31
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 720.00
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 Mech. 49.00
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 147.03
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- Plumbing 162.00
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law . D+
does not apply to an owner of property who builds or improves thereon, and who contracts for .S.M.I. 12.23
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading 20.00
❑ 1 am exempt under Sec. B. & P.C. for this reason
• Driveway Enc.
Date Owner Infrastructure 2752.76
Arts in Public Places 55.96
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 1 '
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. I I I r 1
TOTAL I 4523.19 I !'
CERTIFICATE OF EXEMPTION FROM REMARKS / r.1 tel ,
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation I 1 m
or less.) 1
I certify that in the performance of thg work for which this permit is issued, I shall not 1
employ any person in any manner so as to become subject to the Workers' Compensation S J
Laws of California. �r V
Date Owner
NOTICE TO APPLICANT. If, alter 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 Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) Side Setback from Property Line ,
Lender's Name
Lender's Address FINAL DATE INSPECTOR
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. Issued by: Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the above-.
mentioned property for inspection purposes. Validated by:
Signature of applicant —Date—
Mailing
ateMailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ROUGH WIRING
DUCT WORK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (ROUGH) ( Z` G�
l
METER LOOP
DRAINAGE PIPING
CAR P. SQ. FT.
REINF. STEEL
WALL SO. FT.
TEMP. POLE
DRINKING FOUNTAIN
GROUT
URINAL
SQ. FT. ®
SERVICE
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
BOND BEAM
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
LUMBER GR.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
INSU TI NIS UND
i 11N,
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 I JA
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. 0� lay
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) ( Z` G�
l
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) W1
Z
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. I
FRAMING / P
FINAL INSP.
ROOFING
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSU TI NIS UND
i 11N,
FINISH t DI
FINAL INS E ION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
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