14749 (SFD)T4'ht 4 4 Qum&
P.O. BOX 1504
Address 48619 Calle Bsperanza LA OUINTA, CALIFORNIA 92253
Roger Snellenberger & Associates
Address 41--865 Boardwalk 0212
Palm Desert, zip 92211 (619)777-7766
Contractor
Same
Address
el.
State Lic. City
& Classif. B 488234 Lic. # 1858
Arch., Engr.,
Designer Carlos Elias - Engineer
°3dtd10'213 Charlesworth Dr. D-19} 328-7271
C Cityl; IpCA 9223Q �LLiidt#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm -that I am licensed under proy)slons gj.Chapter 9 (copfinencing with Section
7000 of Division 3 oft Business d Prof sions Cod A'nd my f55ense is in full force and
effect. K f r'/� 7G ;t '-e'�
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 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 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
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 rive 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 rnprove 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 contractor(s) pcensed 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�efflrm that I have a certificate of consent to self -insure, or a certificate of
Worker's mpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy Company
opy 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.)
1 certify that in the performance of thg work for which this permit is issued, I shall not
employ anyperson in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT: M, after making this Certificate or 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 ($100,00(3), 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 car Illy 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-.
mentloned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 14749
BUILDING: TYPE CONST. V14 OCC. GRP. R3
,A.P. Number 646-121-010
,Legal Description Lot 10 Tract 20052-4
Project Description SFD plan 2
Laguna Fie La Pax
Sq. Ft. 1950 No.
Size Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $115,938.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
585.53
Const.
695.50
Mech.
62.00
Electrical '
140.95
Plumbing
150.00
S.M.I.
11.59
Grading
20.00
Driveway Enc.
.00
Infrastructure
2„585.27
Arts in Public Places
39.85
TOTAL
4,296.69
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback fromiepa.
Rear Setback from Side Street Setback
Side Setback frortyi'roperty OAe
FINAL DATE
Issued by: Date_
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING; FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE I
YARD SPKLR SYSTEM
2ND 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
GROUT
URINAL
SO. FT. ®
+FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
GRADING
cu. yd.
$ plus x$
FLOOR DRAIN
MECHANICAL FEES
r I
FRAMING�7
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING '
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1'/a c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
FINAL INSPECTION
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 ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUM BIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE I
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR
ROUGH WIRING
`DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL) '
TEMP. POLE
GROUT
WATER HEATER
SERVICE
+FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
r I
FRAMING�7
ROOFING r �
VENTILATION
�i�
/�
REMARKS:
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
,{
INSULATION/SOUND L �q
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL