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15098 (CP)Twit 4 P.O. BOX 1504 Building 78-495 CALLE TAMPICO Address 48-602 Calla nnnpran7a LA OUINTA, CALIFORNIA 92253 Owner Roger Snellenberger Mailing B Address 41-855 Boardwalk 021.2 A City Zip Tel. Contractor Master Piddle &.Spas Address 73-555 EVY 111 City lZiD Tel.: Pa3Lra Desert I 92 State Lic. & Classif. 238947 C--53 Arch., Engr., Designer Address City Lic. # 1 t I Tel. City (Zip (State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that ham licensed oder Drovlsions of Chapter 9 (commenci g with Section 7000) of Division,3bfa'the Busines ani! Professions Code, and my license is n f I to .and effect. ,# �J !� A t ,�( 5 r� r SIGNATURE t! ,COLA ( 7 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 rite 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). 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, eulsness 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 bulld or improve for the purpose of sale.) O 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 IDate Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker'smpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Poli``cy//N- Company Sd;Gopy 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. N, 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 SHALL SUBJECT 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. This is a building permit when property filled out, 'signed and validated, and is subject to expiration if work thereunder is suspended for 160 days. I certify that I have read this application and state that the above information is correct. I agree to comply with allcity 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— a Date Mailing Address City, State, Zip No. x.5©98 UILDING: TYPE CONST. OCC. GRP. .P. Number egal Description roject Description COW -01n A?" etat I S' X _161 1?nrli l. Sq. Ft. No. No. Dw. Size. Stories Units New ❑ Add O Alter 0 Repair. O Demolition ❑ Estimated Valuation $15,000 PERMIT AMOUNT Plan Chk. Dep. 4105.30 Plan Chk. Bal. Const. $162.00 Mech. *24.Ua Electrical $45.00 Plumbing $27.00 S. M.I. Grading Driveway Enc. Infrastructure $.353.30 TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Rear Setback from I Side Street Setback Side Setback fromO, FINAL DATE Issued by: Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA SLAB GRADE ROUGH PLUMB ` YARD SPKLR SYSTEM 2ND FL. SQ. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CAR P. SQ. FT. GAS (FINAL) TEMP. POLE WALL SQ. FT. DRINKING FOUNTAIN SO. FT. ® WATER.HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSI. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED I I l (1 I LAUNDRY TRAY 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. SO. FT. ® c BATH TUB SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL LATHING SQ.FT.GAR ® 3/ac HOUSE SEWER MESH GAS PIPING PERMIT FEE INSULATION/SOUND PERMIT FEE I PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING'��I & I ELECTRICAL /1 HEATING & AIR COND. SOLAR SETBACK GROUND PLLOV UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB ` BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTI TANt le 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 INSI. ROOFING I I l (1 I REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL