12971 (SFD)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Addross 48-507 Via Amistad LA QUINTA, CALIFORNIA 92253
Roger Snellenberger & Associa
Mailing
Address 48--117 Via Hermosa
City Zip Tel.
La Quanta, CI 92253 1 564--6136
Contractor
The Trider Corporation
Address
48-360 Vista De Nopal
City Zip
Eel:La Qui,nt&, �9225364-6136
State Lic. & Classif. 585819 # 2865
Arch., Engr.,
Designer Robert Earl & Associates
Address I Tel.
City( Zip ( State
Lic. #
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. r _
SIGNATURE DATE
OWNER -BUILDER DECLARATION
a 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
t 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 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
orimprovement is sold within one year of completion, the owner -builder will have the burden
1 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. ❑ 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 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 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 sof this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 12971 4- "
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 617-672-031
Legal Description Lot 31 Tract 20052--3
Project Description SFD Man 1
Sq. Ft. 185() No. No. Dw.
Size Stories Units '
New ( Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated valuation
$107,272.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
566.16
Const.
667.50
Mech.
68.50
Electrical
137.04
Plumbing
150.00
S.M.I.
10.80
Grading
20.00
Driveway Enc.
.0_
Infrastructure
2,369.34
A -M in
I: kc Places 15. Ufa
TOTAL
4,014.34
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
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
1ST F', SQ. FT. ® $
UNITS
SLAB GRADE
t
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SD. 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
r
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
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
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 APPJEQUIP.
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
r
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
.GARDEN; WALL FINAL
6�,
6
CITY OF L-A OUINTA
C4 Ut WwNT OF PLANNING4 DEVELOPMENT
BUILDING DIVISION
2246
MAY 2 ll",?UR NOTICE564-FOR -INSPECTIONS
ap
Aar
owrw-Roger'Snellenberger & Associates
Contractor The TriA__ p
Permit Number 12971
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOBADDRESS 48-507 Via Amistad
SFD
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING ;F7
PRE-_G0NIT_E_'
DO NOT POUR CONCRETE UNTIL ALL ABOVE HASBEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDER
S
ELECTRICAL GROUND
ND WORK,
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLU—MBING.
ROUGH GAS & GAS TEST
HEATING &VEN-T-Alc
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
GROUT 0 4' 0 8'
FRAMING
INSULATION.
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS,—BEEN SIGNED
T
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK I �l -I I eOW-7-1
FINALS
ELECTRICAL
7
PLUMBING
FINAL GAS TEST.
HEATING - A/C
HOUSE NUMBERS.
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT
TO
TURN ON UTILITIES Of?OCCUPYBUILDING.
Alga
ESERT SANDS UNIFIED SCHOC DISTRICT
82-879 Highway 111
NOTICE: Indio,
Document Cannot Be Duplicated CA -92201
(619) 347-8631
Date 5/20/93 Type of Permit I La Quinta
No. 12222 Permit #
f%usn r KI RogerC 11 1k 2- A Log
69111W CIL Sauk. MIUD
N o. street See Below
City, La Quinta,_ Zip 92253 Study Area 109
APN # Tract #. Lot #= 'Square Footage 13
Type of Development Single Family Residence No. of, units
Comments, Laguna De La Paz; 48-535 Via Amistad, 48-505 Via Amistad-4-8 - 507 Via Amista
WMIMUMM 0:
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:
EXEMPTION NOT APPLICABLE
This.certifies that school facility fees imposed pursuant to Mitigation Agreement
..in the amount of 628.00 X 0or $ 1,884.00 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 S ellenberger & Assoc., Inc. Telephone 777-7767
Name on the check
By James E. -IJvP11z
Assistant Superintendent, Business Services
Fee collected /exempted by Tomi'Doebereiner
Payment Received
Signature U C UA 0 LKI, A' Check No. 1235
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
t