14551 (SFD)%i��f!IACt/
P.O. BOX 1504 No. 1.4551
Building48-{329 Paseo "i°arazo LA OU NTA, CALIFORNIA 92253
Address -
Owner
Roger Snellenberger. A .Associates vkq R3
MailinBUILDING: TYPE -CONST. • .00C: GRP.
Address 411-'855 Boardwalk 4212 646'-082--015
A.P. Number
City Zip Tel. Lot 41 Tract 2005.2--4"
Pal. Desert,92211 (519),777-77,55 Legal Description
Contractor Project Description SFD Plan 1
Sada Laguna De La Paz
Address - .. -
City Zip Tel.'' -
State Lic. City
& Classif..B. 488234. Lic. # 1858 Sq. Ft. ', No. No. Dw.
- Arch., Engr.;
Size I854 Stories Units
Designer caklos ` , lids _ Engineer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Z3 tharlesworth Dr. ff 19) 328-7271
CityZip State
. Cat�ledra$ •Cite h 92234 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provision of Chapter 9 (commencing with Section
7000) of Division 3 oLtfle BusineJs� and/P fessions�stl/C�dd�e, and fiy license is in full force and
effect.
tend
is11%t Cir
_$LGNATURE "� DATE ,.
OWNER -BUILDER DECLARATION Estimated Valuation $107,272.00
:
I hereby affirm
'that I am exempt from the Contractor's License Law for the following
reason: .(Sec. 7031.5,8usiness and Professions Code: Any city or county which. requires -a ••
permit to construct, atter, improve, demoltsh, 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 - l
Plan Cil(. Dep.
for the alleged exemption. Any violation of section 7031.5. by 'any applicant for a permit 566. j1 r:
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). - - -
❑ l,.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.1� 7 r
.. 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 ^f
.
or improvement is sold within one year of completion, the owner -builder. will have the burden Electrical - '�3 f
of proving that he did not build or Fnprove for the purpose of sale.) - _ _
04
O'l, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing • 15 0 c 010
struct the project. (Sec. 7044, Business and .Professions Coder The Contractor's License Law q
- does not apply to an owner of property who builds or improves thereon, and who contracts for S.M•1• - 1V ..80
- such projects with a contractors) pcensed pursuant to the Contractor's License Law.) -
0 I am exempt under Sec. B. 8 P.C. for this reason Grading 2,0. 00
0
Driveway Enc. , 00
Date Owner Infrastructure 2,369.34
Arta In Fubl1> Places, Z5.01U
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
opy is filed with the city, ❑ Certified copy is hereby furnished.
TOTAL 4,UT4.34
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed• if the permit is for one hundred dollars ($100) valuation .
or less.)
I certify that in the performance of thg work for which -this permit is issued, I shall not
employ any person in any,manner so as to become subject to the Workers' Compensation
Laws of California
Date � - Owner
NOTICE TO APPLICANT: ft, after making 'this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you. must forthwith
comply with such provisions or this permit shall be deemed revoked. -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, -AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($I00,000), 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 it 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 abov�
mentioned property for inspection purposes. '
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS
ZONE:
BY:
Minimum Setback
Distances:
Front Setback.from Center
Rear Setback from Rear Pr
Side Street Setback from,E
Propert)
Side Setback from
FINAL DATE
I N�SPECTO
Issued by:
Date
Validated by:�
Validation:
Titer Line
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT. ®
POR. SO_ FT. ®
GAR. SO. FT. ®
CARP. SO. FT.
WALL SO. FT. ®
SO. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/a c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
ROOFING
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-
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) I
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
le �� w
_n
3 s sf p�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND �3
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL