13464 (SFD).r A'
4
P.O. BOX 1504 N o .
Building 48-643 Paseo 'iiarazo 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Roger 8nellenberger & Associates VN
Mailing BUILDING: TYPE CONST. OCC. GRP.;
Address 55-695 Pebble Beach 646-082-'022
A.P. Number
City Zip Tel. Lot 48 Tract 20052.4
La Quinta, CA 92253 (619) 777-7767 Legal Description
Contractor Project Description SFD Plan 3
8a
A(1[1rP.CC Laguna De La Paz
13464
R3
City lZip I Tela
State Ljc.B 488234 (City 1858
& Classif. Lic. #
Designer
Carlos as g
Engr.,
Designer lEli- Engineer
"195US25 Charlesworth Dr. Tq619)328-72T
City Zip State
Cathedral. City 92234 Lic.# 6839
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am censed under provisions of Chapter 9 (commencing with Se tion
7000) of Division 3/`of.the Business an/d'Professions Code, and my license is in SII 1 and
effect. 1,7S1
SIGNATURE "t -DATE
OWNER -BUILDER 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, alter, 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 o/ Section 7031.5 by 'any applicant /or a permit
subjects the applicant to a civil penalty o/ not more than five 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 o/ 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 o/ completion, the owner -builder will have the burden
o/ proving that he did not build or improve for the purpose o/ 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 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 Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. 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, I shall not
employ any person in any manner so as t0 become subject to the Workers' Compensation
Laws of California.
Date owner
NOTICE TO APPLICANT: I/, 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.
CONSTRUCTION LENDING AGENCY
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.)
Lender's Name
Lender's Address
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.
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
REMARKS
ti.
t
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 L-ine—
,r /,\ 1I
FINAL DATE �� U INSPECTOR I
Re.)
Issued by: I EWA ,n'�,. Rermlt
Validated by:
Validati
! Biys
Sq. Ft. 1980
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$112,799.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
582.92
Const.
685.00
Mech.
68..50
Electrical
142.04
Plumbing
162.00
.S.M.I.
11.3
Grading
20.00
Driveway Enc.
.00
Infrastructure
2g523.31
Arts in PublIc
Places.ti�
TOTAL
4,227.0-7
REMARKS
ti.
t
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 L-ine—
,r /,\ 1I
FINAL DATE �� U INSPECTOR I
Re.)
Issued by: I EWA ,n'�,. Rermlt
Validated by:
Validati
! Biys
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
Y
2ND FL. SQ. FT.
POR. 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
ROUGH PLUMB. BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS i
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAS (FINAL) 1/ 7l �p TEMP. POLE
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
FRAMING Y
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
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 / NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
10
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS i
SEWER ' ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) 1 METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) 1/ 7l �p TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INS 6
FINAL INSP.
GRADING
cu. yd.
$ -Plus-x$-=$
LUMBER GR.
FRAMING Y
ROOFING /S
�
� ,l �
, 7/5 Y
{O
,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
rp
INSULATION/SOUND yl L qj
FINISH GRADING c�
FINAL INSPECTION g
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL