14549 (SFD)4
P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 48-615 Paseo Tarazo LA QUINTA, CALIFORNIA 92253
Roger.Snellenberger & Associates
MailinAddress 41. 865 Boardwalk #212
City Zip TTel-
(5]_'a31Ef Detert, C[ 9223.1 9) 777--7766
Contractor
Sale
Address
State Lic. City
& ClassifB. 48 $.234 Lic. # 1858
Arcn:, tngr.
Designer Carlds. "Elias — Engineer
, 38 213s Charles'Worth Dr. (,i9) 328-7271
Ci y 1'&
State
C� edra1-Ci ty,92234 Lic. #
LICENSED CONTRACTOR'S DECLARATION _
I hereby affirm that I am licensed undekprovisions of Chapter 9 (commencing with Section
7000) of yyDiw��sion 3 Pthe Busi ess an/drProt�essMo-ris Cod and my license is in full force and
effect.
SIGNATURE DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
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 rile a signed statement that he is licensed pursuant to
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
subjects the applicant to a civil penalty of not more than fire 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 I improvement is sold within one year of completion, the owner -builder will have the burden
. .of provingthat he did not build or improve for the purpose of sale.)
b 1, 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 contractor(s) #caned pursuant to the Contractor's License Law.)
O I am exempt under: Sec. a, & 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 Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy o• Company
Copy 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 thg work for which this permit is issued, 1 shall -not,
employ anyperson in any manner so'. to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT. ff, 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 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 160 days.
I certify that 1 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
N0. 14549
BUILDING: TYPE CONST. VP OCC: GRP. R3
A.P. Number �i4q�882--d8g
Legal Description Lot ` 34 . Tract 20052-4
Project Description` Fl? Pan
. Laguna &fie iia . Pw z
Sq. Ft.38r�8 No. No. Dw.
Size Stories Units
New ❑ Add ❑ . Alter ❑ Repair ❑ Demolition ❑
Estimated ValuationU
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
-
Const:
.v .
Mech.
Electrical
Plumbing
150.. 0
S.M.I.
U
Grading
t?. U0
Driveway Enc.
.Ott
Infrastructure
Z,369.34
krt - ill Public Vlaces
25.
TOTAL
t ii •
REMARKS
ZONE: BY:
Minimum Setback, Distances:
Front Setback from Center Line "
Rear Setback from Rear Prop: Line
Side Street Setback from Center Line
Side Setback from Property Line,
FINAL DATE INSPECTOR':��<6
Issued by:- DateC Permit
Validated by:
validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
PORE SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ. FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
A.C. UNIT
FLOOR DRAIN
MECHANICAL FEES
ot
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
HEATING (ROUGH)
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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
REINF. STEEL
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GROUT -
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
ot
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
.401
SEWER OR SEPTIC T
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. t
l
GAS (ROUGH)
ef
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT -
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
yd.
$ plus
LUMBER GR.
FINAL INSP.cu.
FRAMING
FINAL INSP.
ROOFINGl/ I
S
y Q
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING �1Tv
MESH
All I
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION U
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL