14877 (SFD)Building
Address
Owner
uu�,tc�
P.O. BOX 1504 No. 14877
78-495 CALLE TAMPICO
4-8.-633, Calle 113speranza LA QUINTA, CALIFORNIA 92253
Snellenberger: & Assoc.latbs
B
Address 41-,86,5 Boardwalk #212
.City Zip ]Tel- y ' '
Palm Desert, 92211 161911777-766
Contractor
Sant'' ;
Address
UILDING: TYPE CONST.. -. OCC: GRP.'
A.P. Number
Legal Description Lot,, .i7 ✓ Tract 20052•-4
Project Description,..SFD Plan 3 � -
State Lic. City
& Classif.. B 488234 Lic. # 1058 Sq. Ft. - No.
Size• 1980 -'Stories
Arch.; Engr.,
Designer neerNew ❑ Add ❑ : _ 'Alter. ❑
A�d 25 arleiworth Dr, Tfa19) 328-7271
City Zip State _.
... Gathedral -, CitF , CA 92234 Lic. # .
LICENSED CONTRACTOR'S DECLARATION. r
I hereby affirm that I am licensed under prdvisionsgdf Chapter 9 commencing with Section
7000) of Div sign 3 of tJfP B3usiiness dnd Profession C e, and Jfiy license is in full force nd
effect. iJc/— ildC z l f' ��P1di „'3..,,. q"�.a.R
SIGNATURE DATE' '
OWNER -BUILDER DECLARATION
d I hereby affirm that 1 am exempt from the Contractors License law for the following
Estimated Valuation '
reason: (Sec. 7031.5,Business and Professions Code: Any city or, county which requires a.:'.
'
...PERMIT
permit to construct, atter, 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 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
-
Plan Chk..Dep. .
'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
-
Plan. Chk. Bal.
Const.
do the work, and the structure isnot intended or offered for sale. (Sec..7044;-Buisness arid-
Professions Code: The ContraUor's. License Law does not apply to an owner of property who
j
_ Mech.
builds or Improves thereon and who does such work himself or through hfs .own employees,
- provided that such improvements are not Intended or offered for sale. If, however, the bu7lding.
Electrical
or improvement 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.) . .. .
Plumbing'
O"1, 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 contfactor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec.. B. S P.C. for this reason
S.W.-
Grading
,
Driveway Enc.
Date Owner
Infrastructure
Arts in ftbl
'
WORKERS' COMPENSATION DECLARATION
. I hereby affirm that I Have a certificate of consent to self -insure, or a certificate of
Worke?s Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy No.lff_ Company
.
Q;eo'py 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
No. Dw.
Units
Repair ❑ ' -Demolition ❑
4117'221.00
AMOUNT
592.43
702.50
V2, 50
68.5.0
142.04
150.00
11.72
20.00
.00.
2,622.81
c Places 43. ®5
TOTAL r 4,353.05,
.REMARKS .
or less.) ..
I certify that in the performance of lhF work for which this permit is issued, I shall not
employ any pperson in any. manner so as to become subject to the Workers" Com pensation
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
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 8706 OF THE LABOR CODE, INTEREST; AND
ATTORNEY'S FEES.
This is a building permit when propedy'filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that,l have read this application and state that the above information is�correct.
I agree to comply with '411 city -and county ordinances and state laws. relating°.to building
construction,. and . hereby authorize representatives. .of thisl city to enter the' above-:
mentioned property for inspection purposes.'
Signature of applicant Date'
I Mailing Address
City, State, Zip
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center -Line• '
Rear. Setback frorti:Rear, Prop.,
Side'Street'Setback from Ce ine '
Side SetbacksfiomPrope e
.'FINAL DATE dSFINSPE R *4
Issued by: ,' Date •,' Permit
Validated by:
Validation:
5K ..
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
2ND FL. SO. FT. p
SLAB GRADE
YARD SPKLR SYSTEM
ROUGH PLUMB.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
STORAGE TANK
FORMS
a
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®'
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
DRINKING FOUNTAIN
SO. FT. ®
METER LOOP
URINAL
ESTIMATED CONSTRUCTION VALUATION $
REINF. STEEL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
REMARKS:
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
FIRE ZONE ROOFING
SO.FT.GAR ® 3/.c
HOUSE SEWER
FIREPLACE
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 A PLUMBING / ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
Ay
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
a
SEWER O
ROUGH WIRING
DUCT WORK
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
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING "H
MESH
INSULATION/SOUND 9J
FINISH GRADING
FINAL INSPECTION I
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL