14539 (RPL)4
of P.O. BOX 1504
Building 44,645 Blazing Star Trail 78-495 CALLE TAMPICO
Address LA QUINTA; CALIFORNIA 92253
Owner
Roger Snellenberger a Asso.
Address 41-865. Boardwalk #212
City Zip Tel. _
�a1m.Beer,. CX 922.1 `Ii7�-?766
Contractor
qT, irA Gilbert Inc.
Pal€ Desert, i ZIp 92211 Tel.360-6512
State Lic. City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
City Zip State
_. Lic. #
`..�� LICENSED,CONTRACTOR'S DECLARATION
I hereby'affj'rm that I am licensed.under provisions of� Chapter9 (commencing with Section
7000),0( D�ivtsion_.3 of the'Business ar1d Prof ss ons Code�nd my license is in full force and
No. 14539
BUILDING: -TYPE CONST.- OCC. GRP.
A.P. Number
Legal Description
Project Description Poral' and Spa
Sq. Ft. No.
Size Stories
New ❑ Add ❑ Alter ❑
t _,-N%1_- __'r * _'. '""
Estimated Valuation
I hereby•affirm that I am exempt from--the.Contracto' s License Law for the following
-reason: (Sec. 7031.5,Busfness' and Professions Code: Any city or county which requires a
permft,to'construct, after, impiove, 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
PERMIT.
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 five hundred dollars ($500). -
Plan' Chk. -Bal.
❑ 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
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
or improvement is sold within one year of completion, the owner -builder will have the burden
Electrical '
of proving.that he did not build or unprove for the purpose of sale.)
❑ 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. .
such projects with a contractor(s) (caned pursuant to the Contractor's License Law.) -
Grading
0 I am exempt under Sec. B. 8 P.C. for this reason -
Driveway Enc.
Infrastructure
Date Owner
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.)
PalkcY q0-11 .Company
JWCopy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM"
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 person in any manner so as to become subject to the Workers' Compensation
Laws ofCalif0 me.
Date _ Owner
NOTICE TO APPLICANT: N, 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 deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND'
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,
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE; INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when property filled out, signed and validated, and is subjectto
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.'.
I agree to comply with all city and county ordinances and 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
TOTAL
No. Dw.
Units
Repair.❑
Demolition ❑
►0,000.00
AMOUNT • ,
64.35
19.00"
24.00
A5.
{� 0
27.00
259.35
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line'
Rear Setback from Rear Pr / Lin
P�
Side Street Setback from<G nter Li . e,
Side Setback from Pry erty Line Q
FINAL DATE tN&P VAI
Issued by: Date t Permifg
Validated bv:
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 TA
ROUGH WIRIN
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SQ. FT.
GROUT
WATER HEATER
WALL SQ. 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
LAUNDRYTRAY
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
ERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
VPL.CK.FEE
MECH.Fi
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING 41-1
ECTRICAL p 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 TA
ROUGH WIRIN
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
,/J
/ _ _/j �/ !J✓/`/
r�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
/
FINAL INSPECTION r� `
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL
F?,