12165 (SFD)Building
Address
Owner
4 04zil aba
P.O. BOX 1504
78-105 CALLE ESTADO
48-525 Via Amistad LA QUINTA, CALIFORNIA 92253
Snellenberrger & Associates
maning
Address 55-695 pebble Beach
City Zip Tel.
La Qui.nta, Cid 92253 777-7767
C49ntmraeotor
Address
Tela
State Lic. City
& Classif. S 58551$ 1 Lic. # 2866
Arch., Engr.,
Designer Carlos Elias - Engineer
Address Tel.
38825 CharieSWortb Drive 328-7271
CityZip State
Cathedral Cit 92234 Lic. # 16639
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
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 fife 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 penalty of not more than five hundred dollars (8500).
O 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.)
❑ 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.)
O 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. 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 Address
City, State, Zip
No. 12165 ✓j
11LDING: TYPE CONST.
P. Number 617-672`822
OCC: GRP.
Legal Description Lot 22 Tract 20052.--3
Project Description 8M Plan 1
Sq. Ft.
Size 1850
New
No.
Stories
No. Dw.
Units
7
L
Add ❑ Alter ❑ Repair ❑ Demolition ❑
3timated Valuation
$107p272.80
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal
566 _ 6
Const.
667 _ 5n
Mech.
69 50
Electrical
1 1%7 0A
Plumbing
I Sn _
.S.M.I.
I n. Att1
Grading
7 n
Driveway Enc.
ti
Infrastructure
2.369.34
Artst in
"n r_.f;4_i1li
Y,
TOTAL
4,014_
14
REMARKS
# r
ZONE: BY: I J:l an I
Minimum Setback Distances:, VA
Front Setback from enter Line
Rear Setback from ' OOVProp. Line {
Side Street Setback from Center Line '
Side Setback from Property Line
FINAL DATE INSPECTOR
i
Issued by: Date Permit
Validated by:
Validation:
= CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. a?LUMBING FEES
1ST FL.-; SQ. FT. ® $
UNITS
SLAB GRADE
— r CA r
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
FOR. SO. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CARP. SQ. FT. @
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT.
=$
LUMBER GR.
FINAL INSP.
URINAL
SQ. FT.
ROOFING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ILAUNDRYTRAY
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.
SQ. FT. @ c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
HOUSE SEWER
CERT. OCC.
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
I---
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
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE -,F INAI
~
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL' ----
?
s
a
CITY OF u �UINFk
_ IiY Elf uulW4
o. ^ `� DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING D
.64-224sIVIS G 1 ll lye
24-HOUR NOTICE FORFI(V Pj ZION
Owe Roger Snellenberger & Associates
Contractor S ame
Permit Number 12165
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOBADDRESS 48-525 Via Amistad
SFD
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING L
PRE-GUNITE _
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS 6EEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECT,RIL GROUND WORK
DO NOT POUR CON RETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT - A/C
FIREPLACE
ROOF G'
BOND BEAM
O.K. TO WRAP U !�
GROUT ❑ 4' ❑ 8'
FRAMING 3 L
INSULATION
PRE -ROOF.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR 2[_
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK _
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4!88 u
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: - Indio, CA`92201
Document Cannot Be Duplicated 619-775-3500
Date -18/11/93 I Type of Permit La -Quinta
No. 12370 Permit #
Log
Owner Name Laguna De La Paz
No. Street See Below
City La Quinta. Zip 92253 Study Area 109
APN # Tract # J Lot #0 Square Footage 7
Type of Development Single Family Residence No. of units Q .
Comments 48-531 Via Amistad 1,980 sq. feet, 48-529 Via'Amistad 1,852 sq. feet, 48-527 Via
Amistad 1,95(1T, 4R-525Via AmiStacl 1.852 sTPt, 48-523 Amistad 1,85 sa
fPPt49-c,21 Via Amirf;; l c;2S faPt' 4R-519 Via Amictari 1Rli7 cn faPt
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 this time'due to the
following reason:
Under Mitigation Agreement
This certifies that school facility fees imposed pursuant to Government Code 53080
in.the amount of 628.00 x70 or $ 4,396.00 have been paid to D.S.U.S.D, for
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.
Fees Paid By Roger Snellenberger Telephone 777-7767
Name on the check
By Tames E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Vickie J. 'Durrett
� Payment Received,
Signature G�/ l .c k' U-� —,IQkt lute 'Check No. 055467
Collector: Attach a copy of county or city plan check application form to district copy for all wavers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounti.ng