15002Tit, f4
"
1 ' P.O. BOX 1504
B&Wding 78-495 CALLE TAMPICO
Addressr 79-665 Starflower Tr. LA QUINTA, CALIFORNIA 92253
Owner r Walter Likina
Address Santa
City Zip Tel.
.La Quinta, CA 92253 1 777-11.61
Contractor
Roger Sneilenberger & Assoc., Inc.
Addres
4.L d5 Bda.rdwalk, Suite 212
Desert, Xr 92216
State Lic. City
& Classif.. g 4882.34 Lic. # 1858
Arch., Engr.,'
Designer A3 chard Dulleck
Address Tel.
«`is�IQE3
City Zip State
Lic. #
,. LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisionspf Chapter 9 (Commencing with Section
000) of Division 3 of�he Busines/sand /P fessions//CCode, and my license is in full force and
effect: E /1 ' E1 r _.,Citi:
SIGNATURE -' DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,ausiness 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 civilpenally 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 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) (kensed 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.)
Polic IP'tcompany
Wr 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 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: 11, 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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES -UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,00D), IN ADDITION TO THE COST OF COMPENSATION;
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
Thls 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 1 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, Zlp
No. 15002
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description
T�Oi>u Rboia
Sq. Ft.
Size ISO
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
�,C� , 205.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
52.65
Const.
81.00.
Mech.
15.00.
Electrical
20.25.
Plumbing
S.M.I.
o 52
Grading
Driveway Enc.
Infrastructure
TOTAL
169.42
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear P ine'
Side Street Setback from,er ine
Side Setback from Pro'e L-11
FINAL DATE '�SPECTOQR_
L
Issued by: Date ern
e
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. S0. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. g0, FT, ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. @
GROUT
WATER HEATER
WALL SO. Ff.
FINAL INSP.
DRINKING FOUNTAIN.
SO. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
SO.FT.GAR ® 3/ac
HOUSE SEWER
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
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
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 INSP.
FRAMINGWall
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING y ,
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIG NATURES/INITIALS
GARDEN WALL FINAL
.
��_iUINTA BDLG & SAFETY 6195648487
' IAV V' -<::J-'7 '� WtL 1;��.5 Lr'1 .
Certificate of COmPliance: Residential (Page 1 of 2) CF -1 R
t f'tJ S J I t om_ r RA t `—
Project Aactteaa
y CD i� Nlr4,t 9 Teleptoone
;CUmsntatjon Author
5
Cotnplfance. 111 !'111-04 (Padcape, Paint System a Computer) Climate Zone
GENERAL INFORMATION
Total Conditioned Floor Area: j 57� ' tt2
Building Type: Single Family Addition
(check one or more) Muttl-Famity AlExisting-P.kus-Addtion
..Front Orientation: 27 �° onpui own /S �� es c�dej Irl'stations
Number of Dwelling Units:
Floor Construction Type. Slab i Raised Floor (circle one or bath)
BUILDING SHELL INSULATION
to
Bullring Permit it
Plan check / ale
Field Check/ Data
Enforcement Aqency Use Only
Construction
Component Insulation Assembly Location/Comments
T R -Value 1 -1 -Value (attic to garage, typical, etc.)
Wall .............
Wall ..:........... —
Roos ............ — — ---���
�� ► r S —
Root ............. —
Floor .............
Floor-.: ..........
loor..:.......... _
Slab Edge
FENESTRATION Shading Devices
Fenestration Area Fenestration Interior Exterior
rlriPnlnlinn fsfi U -Value (roller blind, etc.) (shadescreen.
Front.... (✓j ::VS S
Front..... ( )
Lett ....... (✓) 25 • '1 5
Rear--
Rear
ear— -Rear ( )
Rigrti..... ( }
Right.....
Skylight ....... —
Skylight .......
Overhang Framing
THERMAL MASS
Type/Covering Area Thickness
(slab/exposed, tile, etc..) (Si} (inches) Local ionlOescrlptIon (kitchen, bath, etc.) _—
�Lv_S-�---
na'ir A January 007 Q 1 "�/ COO/,l Ak
o' ql� Iq �
WED 15:54 LA bUINTA FDLG & SAFETY 5195548487 F-(32
Certificate of Compliance: Resldentlal (Page 2 of 2) CF -1 R
Nrajetl iltle Dele
HVAC SYSTEMS
Nola: Input hydronir or combined hydraric data under Water Heating Systarns, exoept Design Heating Load.
Distribution.
Heating Equipment Minimum Type and Duct or
Type ournaco, heat Etficlency Location Piping Therlostat _.
pump, etc.) (AFUl1HSPF) (ductsrattic, etc.) R -Value Type
f✓xt ST1uG u �A
Cooling Equipment Minimum Duct
Type (air conditioner, Efficiency Location Duct Thermostat Configuration
heal pump, evap. cooling) (SEER) (attic etc.) R -Value Type (spt3t or package)
r --x 1 5-1-7 &j NI /A
WATER HEATING SYSTEMS
Energy Extemal
Rated' Tank Factor or Tank
Water Heater Disiribution Number input (kW Capacity Recovery Standby Insulation
Type Type In System or Btu/hr) (gallons) - ' Efficiency Loss (%) R -Value
�)c r ST IN 6 to IA
1. For slash gas storage (rated input S 75,000 Btu/hr), e6ettrlc maislance and beet pump water tr¢atam, list Energy Factor.
For targe gas storage waLwf hosters (rated Input 2 75,OOo 8tultrr) Ilst Ratod Input, Recovery Efficiency end Stancby Losa.
wou
For Inatantare gas waw be* lore , list Rebed Input and Recovery Efficiency.
SPECIAL. FEATURESIREMARIKS (Add extra sheets if necessary)
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and performance specifications =ded to compty vAh Tina 24, Parts t and 6, of
Ute California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the
inclMdual with overall design responsibility. When this certificate of mripliam is s txnitted for a sNe building plan to be buil in mulliple
orientations, any shading feature that Is varied is Indicated in the Special Features/Remarks section.
Designeror Owner (pr ausina" a Professions code) Documentation Author
Name: RV [o ,�L =c $;✓fQ S[ OC.�Z/�cNama:
TidelFim:cyJ?lMt� TiterFirm:
Address: 4 19 to Dw 1- AddrpsA:
aQ -, 221 t
Tehphona: C (n l 4 -7-7 -7 - -71 Lo (o Telephone:
Lir,. R:
5�
(signature) (dam} (signature) datxr)
Enforcement Agency
-Name:
Tido:
Agency:
Telofrf.one:
(sigma W ru/stamp)
R,ovlead January 1992
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