13468 (SFD)Tw�t 4 4 a"
P.O. BOX 1504
Building 48--651 Paseo Tarazo, 78-105 CALLE ESTADO
Arft'frP"CS LA QUINTA, CALIFORNIA 92253
Owner Roger Snellenberger & Assnciates
Mailin
Address 55-695 Pebble Search
City Zip Tel.
La Quinta, CA 92253 1(619)77'7-7767
Contractor
Same
Address
ty jZip
State Lic. S 488234 (City 1858
& Classif. Lic. #
Arch., Engr.,
Designer Carlos Elias v Engineer
AU1 CharlesWorth Dr, T��ilg) 32$-7271
Cit Zip State
thedral Cite 92234 Lic. # 5839
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed nu dbr-provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Buisines{i°ss�and Professions Code, and my license is in fulllrforc 'and
effect. 1A,, I? L"
SIGNATURE `� / 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 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).
❑ 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 improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
O 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
0 Copy is filed with the city. O 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 the 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. If, 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 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. 33488
BUILDING: TYPE CONST. VN OCC. GRP. R3
A.P. Number 646x-082-026
Legal Description Lot rad Tract 20052-4
Project Description SFV Plan 2
Laguna De La Paz
$111,392.00
Sq. Ft.
Size . 71950
No. No. Dw.
Stories Units
'~
New ❑ Add ❑ Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation $111,392.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
i 2
Const.
s 5
Mech.
6Z.00
Electrical
140.95
Plumbing
150.00
S.M.I.
11,20
Grading
20.00
Driveway Enc.
.00
Infrastructure
2,482.9-9
Arts in VU
-511c Places
zu.
TOTAL
4l
15 Ts"6 4
REMARKS
------
ZONE: BY:
Minimum Setback Distances:
Front Setback -from Center Lin —
Rear Setback from Rear Prop. Line 1 j
Side Street Setback from Center Line
Side Settiack„f AT Zo4eriArte
FINAL DATE INSPECTOR L
Issued by: �l`D e. / ��i Permit 1
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
`
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
2ND FL. SO. FT. 0
FORMS
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
OTHER APPJEOUIP.
DRAINAGE PIPING
WALL SO. FT.
TEMP. POLE
DRINKING FOUNTAIN
SO. FT. ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING '
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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
SO. FT. ®c
I WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
I I
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
OUGH WIRING
DUCTWORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
LUMBER GR.
FRAMING til
ROOFING 19
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
1/
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
vvI
CERT. OCC.
FENCE FINAL
GARDEN WALL FINAL
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
cu. yd.
$ plus x$
REMARKS: