14740 (SFD)A.
4
P.O. BOX 1504 No. 14740
Building 78-495 CALLE TAMPICO
Address 48--601 Calle Esperanza LA OUINTA, CALIFORNIA 92253
Owner
Roger Snellentier er & Associates BUILDING: TYPE CONST. • 6'N OCC. GRP. R3
Mailin
Address 41-865 Boardwalk #212 646-121--001
A.P. Number
CityZip Tel.
Part Desert, C:! 52211 11619)777-776
Contractor
Sante
Address.
City jZip . I Tel.:
State Lic. City
& Classif.g • 488234 Lic. # 1858
Arch., Engr., '
Designer Carl.es' Elias — Engineer
3l�9 •,I Charierworth Dr. i01,91)328-7271 .
City Zip State
Cathedral City,. to 92234 Lic. #
- LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of gpaptel,9 (commencing with Section
1000) of Division ,3.ofllhe Business}— d Professiions Code, aand.my licen a is in full force and
�ieffecl ��.c-u y f i i� 7 77,
SIGNATURE - DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors 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 or 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 rive hundred dollars ($500).
O I, as owner of the property, or my employees with wages as their sole compensation, will
do,ltie 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 knproves 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
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 contractors) 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
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy o. Company
ly 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., 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. - -
{ WARNING: FAILURE TO SECURE WORKERS'. COMPENSATION COVERAGE IS UNLAWFUL, AND -
lI SHALL SLIEUECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE.
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
iThis Is a building peimit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 160 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
i
Mailing Address
City, State, Zip
Legal Description Lot 1 Tract 20052-4
SFD
Project Description Plan 3
.Laguna..De La Paz
Sq. Ft. 1980 No. No. Dw.
Size Stories Units
New ❑ Add O Alter O Repair ❑ Demolition ❑
Estimated Valuation $117,221.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. �_
592.43
Const.
702,.50
Mech.
68.50
Electrical
142.04
Plumbing
150.00
S.M.I.
11.72
Grading
20.00
Driveway Enc.
00
Infrastructure
2,622.81
Arts in Pub! -. c Places
43.05
TOTAL
4,353.05
REMARKS
ZONE: BY: }
Minimum Setback Distances:
Front Setback from Center
Rear Setback from Rear P in
Side Street Setback fr ter Lin
Side Setback from P e y Line
FINAL DATE NWECTOR� X.)
Issued by: Date Perm
Validated by:
Validation: N� `"
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING; FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT. p
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SE I
n
9
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CAR P. I SO. FT. ®
METER LOOP
HEATING (FINAL)
WALL SO. FT.
REINF. STEEL
DRINKING FOUNTAIN
SO. FT. ®
URINAL
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
WATER SYSTEM
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FRAMING
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 % c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAR. FIREWALL
LATHING
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 w /ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBIN97
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
S
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SE I
n
9
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
j I
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL
TEMP. POLE
GROUT
WATER HEATEF
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
i
.17
FINAL INSP.
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
ROOFING
VENTILATION
0 ��
01
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION U
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIQNATURESJINITIALS
GARDEN WALL FINAL
r'�
't�, f �� ',:
"ems ��/ �� •�= ��� _ � )�'%��[s',+
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t
x 4 as: Q'Cy` an r
M0p,9
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(t of a 1 ututa
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
s
t
Code certifying that at the time of issuance this structure was in compliance with the various'
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESSg_6gl
I
i
Use Classification SFD Bldg. Permit No. 14 7 4 0
l
i.i
I
Group R-3 Type Construction VN Fire Zone Use Zone R-1
i I
Owner of Building Rear Sna11anherqar CcCICAddress 41-865 Bar-dwal j$932
'
City Palm rnAgert rA Q2260 eyl Bruce Pelletier
1
i.
Date: 6-2-95
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Bui.ldinq Officio
POST IN A CONSPICUOUS PLACE
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