14163 (SFD)i P.O. BOX 1504 No. 24163
Building 78-105 CALLE ESTADO
Address 79-690 iris Court LA QUINTA, CALIFORNIA 92253
Owne
Zoger 5nelienberger & Associates
Mailing ►-� _ i
Address
City Zip Tel.
1 (
` Contractor
Sate
Address
ty lZip ITel.
State Lic. City
& Classif. g 488234 Lic. # 1858
Designergr; ' Carlos Alis �- Engin6ar
Act,dWg,,, Charlesworth1?z. Te1.619) 328.7271
City 11 Zip State
Catheftal Citif F CA 92231 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm -,that I Sm•licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 33,of re Business a andyProfessions Code, and my license is in full
fuforcefend
effect
i ellj
./ '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, after, 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
lhe'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).
❑ 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 ownemployees,
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 buildslor improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 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, o~ Company
in 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 (8100) 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: 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
BUILDING: TYPE CONST. VN OCC: GRP. R3
A.P. Number 604-251-001
Legal Description Lot'. 1 Tract 24890
Project Description SFD Plan 8
Cactus Flower I1
3
'
Sq. Ft. 2025 No.
Size Stories
r i
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $122,349.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
604 • i
Const.
72v.00
Mech.
` v
Electrical
x
Plumbing
3. v
S.M.I.
12.23
Grading
•-U.v
Driveway Enc.
. UV
Infrastructure _
• �
4,732.76
Ill #' 1'. C: Y" .LtYzC.: SCA
� � • t3 t3
TOTAL
4 , 5 ^
REMARKS
x_
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 LiAe
FINAL DATE —INSPECTOR-
41
NSPEC ORAl
/!fin
Issued by: Date � y � Perpt `
Validated
Validation
CONSTRUCTION ESTIMATE
NO:, ELECTRICAL FEES
x
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
W
ROUGH PLUMB.
2ND FL. SQ. FT. @
HEATING (ROUGH)
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
'
DRAINAGE PIPING
WALL SQ. FT..®
HEATING (FINAL)
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER -
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GRADING
cu. yd.
$ plus x$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP. -
LAUNDRYTRAY
AIR HANDLING UNIT CFM
ROOFING D'
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 ® 11/4 c
SEWAGE DISPOSAL
SPARK ARRESTOR
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAR. FIRE LL ~
LAT NU /O
MESH
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 o ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWERROUGH
WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF. 1
'
GAS (ROUGH
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATE
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
i
FINAL INSP. -
FRAMING*
FINAL INSP.
ROOFING D'
r
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIRE LL ~
LAT NU /O
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIG NATURESJINITIALS
- GARDEN WALL FINAL
` INSULATION CERTIFICATION
This is to certify that insulation has been installed in conformance with the
current energy regulation, California Administrative Code, Title 21 State of
/ California, in the building bated at:
SITE AMR= _hist gR SSE 4 IOTA / 1A QtJOM CA
CEILINGS
Batts.• Tyree FnERGEAS Manufacturer /00RUM Thickness 12" R -Volas R-38
Blown; 'Type Man facturer Thickness R -Value
EXTERIOR WALLS
. ITYPe juBmqks Marmiacturer 2RE(ONIVIMThickness. 35/8 R -Value R-13
FLOORS 1yw btinufacturer Thickness R -Value
General Contractor License #
BY Title Date
Schmid Insulation Contractors, Inc. License 0 121S17 C-2
_
Title Vice president Date 12-21-94
INSULATION CBRTIFICATICN
i
This is- to certify that insulation has been installed int conformum with the
current energy regulation, California Administrative Code, Title 21 State of
California, in the building located at:
SITE ArMRss Fr cSE 4 Ylri'4
[ �uJ� CP.
CEILINGS
Batts: Type Manufacturer
Thickness
12" R -value R-38
Blom: Type Manufacturer
Thickness
R -Value
F.X7MIOR WALIS
5/8
'Ijw F`I ASMmnfacturer
S/� Thickness
3 R -Value R-13
FIOORS Type Manufacturer
Thickness'
R -Value
General Contractor AIM License #
BY Title Date
Schnid Insulatim Contactors, Inc.
• 1 Y
BY
,0
- License # 221517 C-2
Title Vice Presid}t— Date __1.2;-21-94