13466 (SFD)Building
Address
Owner
4
48-911 Paseo Tarazo P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Roger Snellenberger 5 Associates
Mailing
Address 55..695 Pebble Beach
City Zip T
La Quintal CA 92253
Contractor
Same
Address
ty
No.
11LDING: TYPE CONST. VN OCC: GRP.:
P. Number 646-062--424
13466
R3
'1. Lot 50 Tract 20052-4
{613} 777-7767 Legal Description
Project Description SPD' Plan 3
Lagena De La ' Paz
State Ljc.B .488.234 (City
&1858
Classif. Lic. #
Desi 'neryl '
9 Carlos Elias -- Engineer
,es
Aa3dass25 Cha riesworth Dr. 1 Te( 619) 328-7271
City Zip 'State
Cathedral Citif 32234 Lic. # 6839
LICEN$ED.CONTRACTOR'S DECLARATION
1 hereby affirm that Pam licensed under provisions of Chapter 9 (commencing with Section
700 0) of Division 3 of the BJsiness and Professions Code, and my license is 1'h full for a nd
effect._f^ �l / }}��`
a
_SIGNATURE -J _ M �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 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 or 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 or not more than rive hundred dollars (5500).
❑ 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
orimprovement is sold within one year or completion, the owner -builder will have the burden
or proving that he did not build or improve for the purpose or 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, 1 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. If, after making this Certificate or 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
Sq. Ft. 1980
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation
$112r799.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
582. 92
Const.
635.00
Mech.
8.50.
Electrical
142.04
Plumbing
162.00
S.M.I.
11.30
Grading
20.00
Driveway Enc.
' -00
Infrastructure
2,573.3-1
Arts in FEUrle
Places
r•.
TOTAL
4v221.07
REMARKS
ZONE: BY: �..
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from -Rear Prop. -Line
Side Street Setback from Center Line
I it ZJ—v_N I. M I,`)
Side Setback from Property Line
J
FINAL DATE I I E g64
e
Issued by: I Date -- Permit
nil l
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. Q. 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
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH) METER LOOP
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
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
FINAL IN
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/, c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
----[
MECH.FEEC
[PL.K.FEE
ONST, 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 ROUGH WIRING
DUCTWORK
ROCKSTORAGE
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 IN
g
FRAMING 2 1
FINAL INSP.
ROOFING
�/z—
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING (�
MESH
INSULATIONISOUND
FINISH GRADING t 3M
FINAL INSPECTION
R
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL