9606-120 (SFD)LICENSED CONTRACTOR UECLAHA7lUN
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License�234Bc. Class Exp. D 17/30/97
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to'construct the project (Sec. 7644, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one. of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700'of the Labor Code, for the
performance of the work for which this permit is issued. '
. ( ) I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit isATx@& Rirkers' compensation insurance c%crMA9Tlicy no. are:
tamer Policy No.
(This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
.addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject* to the conditions and restrictions set- forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnity
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void.if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent)
Date
DATE
JOB SITE
ADDRESS
PUILDIN$%f R�VIIT6/ VALUATION oT PERMIT40&120 TRAM9 13 PH63 6 7
OWNER
ROGER SNELLENBERGER & ASSOC
.41-865 BOARDWALK, SUITE 212
PALM DESERT CA 92211
(619)777-7766
USE OF PERMIT
SINGLE FAMILY DWELLING
QUINTERRA
PLAN 1R
TRACT CONSTRUCTION
.GARAMCARPORT
APN
CONTRACTOR / DESIGNER / ENGINEER
ROGER SNELLENBERGER & ASSOC..
41-865 BOARDWALK, SUITE 212'
PALM DESERT CA 92211
(619)777-7766 .CBL# ...1858,:.
5
CHARLES D. GARLAND
33-163 CATHWRAL CANYON DR
2,015.00 SF
626.00 SF
ESTIMATED COST OF CONSTRUCTION
PERMIT FEE SUMMARY
PLAN CHECK FEE
101-000-439-318
5597.06
CONSTRUCTION FEE
1017000-418400
$716.50
MECHANICAL FEE
101-000-421-M
$53.50
ELECTRICAL FEE
101-000-420-000
$131.55
PLUMBING FEE
101-000-419-000
$154.00
STONG MOTION FIE - RESID
101-000-241-000
$12.17
GRADING FEE
101-000-423-000
$20.00
INFRASTRUCTURE FEE
225-000-443-342
$2,737.89
ART IN PUBLIC PLACES - RESIC 701 -OW -255-000
$54.21'
SUB -TOTAL CONSTRUCTION AND PLAN CHECK.
LESS PRE -PAID FEES
TOTAL PERMIT FEES DUE NOW
RECEIPT I DATE I BY I DATE FINALED
INSPECTOR
12104.10 I
$4,476.88
$0.00
$4,476.38.1'.f.
Notice:
Document Cannot Be Duplicated
Date 7/19/96
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
No. 14664 Jurisdiction
Owner Name
Roger Snellengerger
No. 79045. Street Ocotillo Dr.
City La Quinta zip, 92253
APN # '604-264-001
La Quinta;
Permit # .
Log' #
Study Area 233
Tract # 23913 Lot # 63 Square Footage 2015
Type of Development Single Family Residence
Comments
No. of Units 1
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports,
covered patios/walkways, residential additions under 500 .square feet, detached accessory structures or
replacement mobilehomes. It has been determined the above-named owner is exempt from paying
school fees at thi's time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Codi 53080
in the amount of, 1.84 x 2,015 or $ 3,707.60
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
f�
Fees Paid By Roger Snellenberger ; Telephone 777-7766
Name on the check
By Dr. Carol McGrew s`
' i r
Administrator in Charge `
Fee collected /exempted by • Pauline Pearson
Signature puaa_Qtn, e'�`OO �► n1Diir�-
Payment Received $3,707.60
Check No. 12957
Collector: Attach a copy of county or city plan check application form to district copy for all waivers:
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
LICENSED CONTRACTOR DECLARATION
U) I hereby affirm under penalty of perjury that I am licensed under provisions of
)— ,Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
C'i 6j Professionals Code, and my License is in full force and effect.
O Z) M License # Lic. Class Exp. Date
r` QLO
LU C
Z r` Date Signature of Contractor r,..
Or
U °) OWNER -BUILDER DECLARATION
LU LLJ CD I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ D_
U)License Law for the following reason:
Z_ ( ) 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, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
C•') () I am exempt under Section , B&P.C. for this reason
to
N Date Signature of Owner
ON
C)
Q WORKER'S COMPENSATION DECLARATION
C) CC I hereby affirm under penalty of perjury one of the following declarations:
U-) O () 1 have and will maintain a certificate of consent to self -insure for workers'
X w �= compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q U ( ) I have and will maintain workers' compensation insurance, as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
tl
U-) f— permit is issued. M workers' compensation insurance carrier & policy no. are:
It Z Carrier _-A °0 f t k:141 r Policy No. _;:'"f V.Yf ,
co =)
C'J
J
(This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions.
Date: 7� t.'' k- Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
• correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned, property for inspection purposes.
Signature Owner/A
gent), %-- Date°
BUILDINGPERMIT PERM T# °°NTR°`#
607
DATE izy (496, VALUATION LOT
SITE
ADDRESSJOB
OWNER
CONTRACTOR/DESIGNER/ENGINEER
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I IAItI-F,<i I4iAit1.AMD
USE OF PERMIT
lylt�4-i��l;I'e'1�11f},1 11�wt'.I,Ie1fVtT
3t Iti'1f":y i��IS'�I`t,Fit,C.'/�Iv1113f�i.1(t
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tat AN f'Ilt' '1} 1.•Ir4' Iffi 4VIIZ J it A; IN
lilt
lum .ilei '?JJ
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10'A,l1AAI1 At. Hqs $111 fltfU �� i Utlri �;yb,vlt
If i1,1HP'AL 114-1• lilt AXIIIAMY NN) `31: 1 SS
PI IIN110 Ns. 1+'1" 1,01 .011111 1110 01133 Gi�f 1}11
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.If 1^) IY✓ if IN e e ee R4K°11 t'oi to "Tit 1A7 •11.1f 41 ii A At ; .11
-- VJ. 9141"11' j11 I$I81 : 10 - t/i.0 Al
co
f,,7 it e••!
I a VIA# PFIRVIT VVFN 01 IF NOW,
%-O,, 7t( fu �
JUL 19 1996
By -.._
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans t
OX to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath 09
Drywall - Int. Lath
Final
Final
POOLS - SPAS
' BLOCKWALL AP ROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
-Equipment Enclosure
Shower Pans 170,
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
,.:Final
:COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL PPROVALS`
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power '
Final
Utility Notice (Perm)