12159 (SFD)Building
Address
Owner
r •4 "oi
�
4 0
P.O. BOX 1504
78-105 CALLE ESTADO
4£--534 Via lMaistad LA QUINTA, CALIFORNIA 92253
:nal
& Associates
Address 55-695 Pebble Beach
City Zip Tel.
L Quinta, CA 92253 777--7767
Contractor
Same
Address
Tel.
State Lic. City
& Classif. $ 5955I9 Lic. # 2866
Arch., Engr.,
Designer Carlos Elias -- Engineer
Address Tel.
38825 Charle.swflx i Dr. 328-7271
"eathedra! Cit Zip - 92234 State
1639
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 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
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) 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
❑ 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 ($100) valuation
or less.)
I certify that in the performance of tha 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 or 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
n
No. 12159 '
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 617-672--047
Legal Description Lot 47 Tract 20052-3
Project Description SFD Attached Pial 4
Sq. Ft. No. No.
Size Stories
No. Dw.
Units
New Ll AddP.. Alter ❑ Repair ❑ Demolition ❑
,t
Q
Estimated Valuation,
$90,137.00
4
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
`, 3.lU
Const.
Wf • U0
Mech.
bw. U
Electrical
T227. 25
Plumbing
150.00
.S.M.I.
Ur.:LU
Grading
2U.00
Driveway Enc.
.00
Infrastructure
L f7
l�
TOTAL
l •
REMARKS
t
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:
•S
4:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
e�
1ST (.?' SQ. FT. ® $
s _ UNITS
SLAB GRADE
ROUGH PLUMB.
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.
WALL SQ. FT.
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ plus x$
=$
URINAL
SQ FT ®
FINAL INSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
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/ac
HOUSE SEWER
FINAL INSPECTION
GAS PIPING
PERMIT FEE f.
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 APP.IEOUIP.
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
a ERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
`GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT -
82-879 Highway 111 -
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
Date 8/9/93 1 Type of Permit La Quinta
No. 12368 Permit #
Log
Owner Name Laguna De La Paz
No. Street See Below
city La Quinta Zip 92253 Study Area 109
APN # Tract # Lot # 0 Square Footage 17
Type of Development I Single Family Residence No. of units
Comments 48533 Via Amistad 1980 sq. feet, 48536 Amistad 2001 sq. feet, 48534 Via Amist d,
48532 Via Arnktad" 48530 Via Amistad, 48528 Via Amistad 1562.-,Q, fept- 49526
Vin Amictarl ?QQ1 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 & Associates Telephone 777-7767
Name on the check
By jams F. Lively.
Assistant Superintendent, Business Services
Fee collected /exempted by Vickie J. Durrett
� Payment Received
Signature E,L C_iC : /CC l L -Lctt check No. 15725
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
_ 0-r
a
CITY , ',LA QUINTA
e
Of ~ DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
owner Roger Snellenberger & Associates
Contractor Same
Permit Number 12153
POST ON JOB IN COQ`-' ' ` Ar'F
INSPECTOR MUST SIGN Al_L ; .F i �1,i ABLE SPACES
JOBADDRESS 48-534 Via Amistad
SFD Attached
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
.FOOTING STEEL Gl'
MAIN GROUND SYSTEM
GROUND PLUMBING -C/7
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS 6EEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
n9 -n1 nw Im
FIREPLACE
ftr .^�
U.M. 1 v vvnP%r
FRAMING
1.11
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGN D
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK - _
FI
ABOVE APPROVALS DO NOT INCLUDE RIGHT Tu
TURN ON UTILITIES OR OCCUPY BUILDING
4!,38 —