14444 (SATT)P.O. BOX 1504
Building78-495 CALLE TAMPICO
Address 48-642 11,aseo TZlXazo LA QUINTA, CALIFORNIA 92253
Ownktiger Snellenberger a Associates
Mailing "
B
Address 55-695 Pebble Beach A
City Zip Tel.
La . Qauinta. f CA 92253 (619)777-7767 L
Contractor Pr
Same
Addracc . .
City
p
State Lic. City
& Classif. B 488234 Lic. # 1858 '
Arch., Engr:, - ,
Designer i -s r 05 .Ell ia's Engineer,
Ad s 5 Charlesworth Dr. T 1619) 328r7L7I.
City Zip State
..Catknediral.• iitl zro -CA- 92234, Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that IAm licensed under provisions of Chapter 9 (commencing whit Section
7000) of Division,,3 of the Business atid'Professions Code, and my lice)nseeiis inn full force and
- effect.- i.ro S...s�..L-,M� �'^•�...►,._..� �J .f �T! �•Eri
SIGNATURE ' DATE
'OWNER -BUILDER DECLARATION - iv
I hereby affirm that I am exempt from the Contractor's License Law for the following
- reason: (Sec. 7031.5,Busless 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
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 penally -of not more than five hundred dollars ($500).
O 1, 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, they owner -builder will have the - burden
of proving that he did not build or Improve for the purpose of sale.) -
❑ 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) Pcensed pursuant to the Contractor's License Law.)
❑ I 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.)
Poli o. Company1
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 (S 100)• valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, 1• shall not
=any pperson in any manner ad as 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
OMPENSATION,
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• above-:
mentioned property for inspection purposes.
Signature of applicant Date'
Mailing Address
City, State, Zip
No. 1.4444
UILDING: TYPE CONST: VN •OCC: GRP. R3_
P. Number 646-082-041
Le Description Lot 67 Tract 20052-4
oject Description Sid Plan
Laguna De . r a Paz
Sq. Ft. No. No. Dw.
Size 2001 Stories " Units
New ❑ Add.❑ Alter ❑ Repair ❑ . -Demolition ❑
Estimated Valuation X115, 33 .2L'
PERMIT -
-AMOUNT
Plan Chk. Dep.
Plan Chk. Bal
5B5. 9z
Const. = ..
695.50
Mech.
6... 00
Electrical`
142, 52
Plumbing
1S.0.0V
S.M.I..
ill. 60
Grading
20.00.
Driveway Enc.
.00
Infrastructure
2,452.58
Arts In F,55 ,. y :Laces
38.32
TOTAL
4,158.44
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 Pr9pg5t i Line•
FINAL DATE /[NSPEC�OR �(
Issued by: Date'p_ </ Per. it
Validated by:
`-mo ILValidation: `
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT. ®
FOR. SO. FT. ®
GAR. SO. FT. ®
CAR P. 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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SO. FT. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 V. c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/<c
HOUSE SEWER
FINAL INSP.
ROOFING
GAS PIPING
PERMIT FEE
REMARKS:
MIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE rPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING t ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND
-UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR
ROUGH WIRING'
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
ETER 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.
/
/1 FINAL INSP. 5
FRAMING
FINAL INSP.
ROOFING
� /A / � / � Z ��s J �
•
REMARKS:
VENTILATIO
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/
LATHING (/ L
MESH
INSULATION/SOUND
FINISH GRADING /J7�
FINAL INSPECTION HV
CERT. OCC. /
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL