13989 (SFD)•
TA
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 79-71.0 Star liowe LA QUINTA, CALIFORNIA 92253
Owner
Rouen Snel.lenberaer and Assoc.
Address 55-695 Pebble Beach
City Zip Tel.
La Quinta 92253 777--7767
Contractor
ress '
Zip I Tel.
State Lic. City
& Classif. D 488234 Lic. # 1858
Arch., Engr.,—
Designer Carlos. Elias -Engineer
Address Tel.
3£3-825 Charlesworth Dr. 3.28-7273
CityZip State
Cat teciral. Cit 7 92234 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed°uf —der provisions of Chapter 9 (commencing with Section
7000) of Division 316f,//the((rB�ness and(,Pryofessions Code, and my license isjo.full forcye•and
SLGNATURE A R ',FDATE
OWNER -BUILDER DECLARATION I
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 or Section 7031.5 Dy 'any applicant for a permit
subjects the applicant to a civil penalty 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 or completion, the 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 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
O 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 (8100) 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 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 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
ateMailing Address
City, State, Zip
No. 13939
)
f! t
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 604-251-007
Legal Description Lot 7 Tract 2420$" Cactus Flrver
Project Description SFD
n l�
t
�I, hiUU ZD 1 iyy I
ZONE: BY:
Minimum Setback Distances:';°
Front Setback from Center?L• ine
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
Sq. Ft.
Size 1 Rf;7
No.
Stories •
No. Dw.
Units
New IX Add ❑
Alter ❑
Repair ❑ Demolitiori ❑ +i
Estimated Valuation
$1-14 706.00
PERMIT
AMOUNT, Sy
Plan Chk. Dep.
Plan Chk. Bal.
,An 1A
Const.
607_ tit)
Mech.
A
Electrical
JA7 'At%
'Plumbing
AA t
.S.M.I.
11 A7
Grading
7 nn
Driveway Enc.
Infrastructure5p�f3.
g
AT -4-9 n MADI i. -21 mm-eim-ei
1.9 77
TOTAL
REMARKS
n l�
t
�I, hiUU ZD 1 iyy I
ZONE: BY:
Minimum Setback Distances:';°
Front Setback from Center?L• ine
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. g $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
Y
ARD SPKLR SYSTEM
2ND FL. SQ. FT..9
FORMS
SEWER OR SEPTIC T NK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
FOR. SQ. FT.
GAS (ROUGH) / �►
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. 9
TEMP. POLE
GROUT
DRAINAGE PIPING
CARP. SQ. FT. &
FINAL INSP.
WALL SQ. FT. :0
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus x$
=$
URINAL
SO FT ®
FRAMING
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
�% /
WATER PIPING
NOTE: Not to be used as property tax valuation
REMARKS:
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
SPARK ARRESTOR
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.
SQ. FT. ® c
BATH TUB
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
FENCE FINAL
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 4 ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBINIATY
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC T NK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) / �►
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HE TER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.% (
FRAMING
FINAL INSP.
ROOFING lb2 ('
�% /
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
HICN G 7 14
MESH
INSULATIONISOUND 7
FINISH GRADING / I
FINAL INSPECTION 1
CERT. OCC. 1
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
fit
Tt1� 9�
TiN 11f '141d j lttlitcl
iN
ltt�1tli1 ctli� -SctL'titt.tblli
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS 79-710 Star Flower Trail
. J.
Use Classification Single Family Dwelling Bldg. Permit No. 13989,
Group R3 Type Construction VN Fire Zone Use Zone SR
Owner of Building- Snellenberger _& Associate 55-695. Pebble Beach _
City La Quinta, CA 92253 By; Bruce Pelletier
Dote: December 19, 1994
Building Official
POST IN A CONSPICUOUS PLACE