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14752 (SFD)Buildin Address 48-A604 Calle Owner Tlihf 4 4 Q" P.O. BOX 1504 78-495 CALLE TAMPICO ar za LA QUINTA, CALIFORNIA 92253 No. 14752 Roger Snellenber er & Associates BUILDING: TYPE CONST. VN OCC. GRP. R3 646-123-019 Mailin Address 41-865 Boardwalk #212 A.P. Number Legal Description Lot 19 Tract 20052-4 CityZip Palm Desert, A. 92211 Tel. (639) 777 -7766 Mech. 62.00 Electrical Project Description SFD Plan 4 Contractor Sante Laguna De La Pax 9.37 Address 20.00 City Zip Tela 2,108.59 State Lic. & Classif. g 4188234 Lic. # . 1858 Designer Carlos $3ias - Engineer IdWft Charlesworth Dr. TP1619)328-7271 City Zip State Cathedral. Citi , CA 32234 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am 1'eensed under�rovisi0 sof Ch��te.g"(comrgencing with Section 4000) of D1)sion 3 of the u"siness and rofes,is'o Cod , a%�jm�y lice e 's in full force and p ect. j � t � if Vim0 7a�sc f./ � SIGNATURE l 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, atter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Divlslon 3 o! 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 Wild 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 Wilds 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 here��b,,,,,,YYYYYY/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.) Policy Company 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 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. ti, 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 properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 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 Mailing Address City, State, Zip Sq- Ft. 1562 Size New ❑ Add ❑ No. No. Dw Stories Units Alter ❑- Repair ❑ Demolition ❑ Estimated Valuation $93,715.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 518,.25 Const. 612.54 Mech. 62.00 Electrical 127.25 Plumbing 150.00 S.M.I. 9.37 Grading 20.00 Driveway Enc. 00 Infrastructure 2,108.59 TOTAL 3,607.96 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Rear Setback from Rear Pr Side Street Setback fro Side Setback from Promei FINAL DATE I Issued by. Date_ Validated by: Validation: . i r L — R."4. rmit CONSTRUCTION ESTIMATE NO. ' ELECTRICAL FEES NO. PLUMBIW FEES 1ST FL. SO. FT. @ $ UNITS COLL. AREA SLAB GRADE .D YARD SPKLR SYSTEM ' 2 ND FL. SO. FT. @ HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SO. FT. @ DUCT WORK ROCK STORAGE GAR. SO. FT. @ POWER OUTLET ROOF DRAINS METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. SO. FT. @ GAS (FINAL) WALL SO. FT. @ DRINKING FOUNTAIN. SO. FT. @ URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES GRADING CU. yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER ROOFING 6 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY 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. SO. FT. @ c BATH TUB SPARK ARRESTOR 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 MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION 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-F�tJECTRICAL HEATING & AIR COND. SOLAR � wy SETBACK GROUND PLUMBINGUNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE .D ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SE41oq�fr ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) f METER LOOP HEATING (FINAL) OTHER APPJEOUIP. 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. v FRAMING Z FINAL INSP. ROOFING 6 U �Q REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL