14750 (SFD)4
P.O. BOX 1504 No. 14750
Building 78-495 CALLE TAMPICO
Address 48-621 Calle Rsperanza LA OUINTA, CALIFORNIA 92253
Owner
Roger Snel'?enberger & Associates, VN R3
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address 41-$65 Huardw *l.k 9212 546--121-011
A.P. Number
City Zip ITel-19,„-" 11 't=art 2QQ52�-4
Palm Desert, 9x211 {6fi7i--fifi66 Legal Description
i Contractor Project Description SFd • Plan 1
SF.;tme ..Laguna De La Paz
Address
i
City Zip Tel.:
State Lic. City
& Classif. B 488234 Lic. # 1858 - Sq. Ft. No. No. Dw.
Arch., Engr., ._ . ...
Size 1852 _ . . "�•- Stories• Units
Designer Chills . Rlias Engineer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
! 348' ; Charlesworth Dr. 18'19) 3`8-.7271
It State
*kthedral CityZip CA 92234 Lic. #
LICENSED CONTRACTOR'S ECLARATION
I hereby affirm that I am licensed under p[siorp:rChapt€r 9 commen��'ng with Section
I' x 000) of Division 3rof the B fsiness and,P fessiorfs Cdde, and" y licennseLis�in full force and
1 effect- 1�`'.-lk-A-4 r`
i SIGNATURE DATE
OWNER -BUILDER DECLARATION
Estimated Valuation $111,430.00
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec.. 7031.5,Buslness 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 •t"1PERMIT AMOUNT
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 theiefrom, and the basis.
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. 576.17
subjects the applicant to a civil penalty of not more than firive hundred dollars (5500). Plan Chk. Bal.
❑ 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 681.50
Professions Code: The Contractor's. License Law does not apply to an owner of property who Const.c
builds or improves thereon and who does such work himself or through his own employees, Mech. 6 • 5 Q
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 Electrical 137.04
of proving that he dM not build or knprove for the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 150.00
struct the project. (Sec. 7044, Business and .Professions Code: The Contractor's License Law 1 S
1
does not apply to an owner or property who builds or improves thereon, and who contracts for S.M.I. 1 . 14
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading 20.00
O I am exempt under Sec.- B. & P.C. for this reason
Driveway Enc. .00
Date Owner Infrastructure 2,462.89
Arts in Public Places
WORKERS' COMPENSATION DECLARATION
I herebyraffirm that I have'a certificate of consent to self -insure, or a certificate of
Worker's Cgmpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Polis� �'e Company
g opy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
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: H, after making this Certificate of Exemption you should.become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from C in
Rear Setback from ro ine
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setb m Cen ine
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, Side Setback ProlDerty
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEYS FEES. FINAL DATE INSP&6
This is a building permit when properly filled out, signed and validated, and is subject to
i 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. Issued by: Date Yeit
I I agreeto comply with all city and county ordinances and state laws relating to building
I construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for Inspection purposes. Validated by:
I Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING. FEES
IST FL. SO. FT. @ $
UNITS
SLAB GRADE
ROUGH PLU
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
FORMS
[^
SEWER FI 7
!
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
GAS (ROUGH)
METER LOOP
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. @
GROUT
WALL SO. FT. @
SERVICE
DRINKING FOUNTAIN
BOND BEAM
URINAL
SO. FT. @
GRADING _
cu. yd.
$ plus x$
_$
ESTIMATED CONSTRUCTION VALUATION $
FRAMING l
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRYTRAY
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
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1 Va c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
r
FINAL INSPECTION41
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 ECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLU
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
[^
SEWER FI 7
!
ROUGH WIRING
DUCTWORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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.
FRAMING l
ROOFING
� � r ^
1
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWAL
LATHING CR7 jqj
MESH V
INSULATIONISOUN
FINISH GRADING
r
FINAL INSPECTION41
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL