14755 (SFD)P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 48-818 Calle Esperanza LA OUINTA, CALIFORNIA 92253
Roger Snellenberger a MaocialCes
Address 4l'-865 Boardwalk #212
City Zip TelPalm Desert, C32211 613j777-7766
Contractor
Same
Address
�► r �[af#
& Classif. g 4882-34- I Lic. # 1858
Arch., Engr.,
Designer Carlon Elias —Engineer
i Charlesworth Dr. 1 ?9)328-7271
CityState
-Cathedral -CityZip CAr 92234 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affir tm hMthe
icense I underpprovision of Chapter (commencS g with Section
7000) of Diviysion`3usiiness an/d^Professlo Code, and license ie i full force and
`effecto
. ✓`C-G�4��•�i'��
SIGNATURE 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, alter, 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
I 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
t subjects the applicant to a civil penally of not more than Ove 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, Butsness 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 improve for the purpose of sale.)
t 0 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 contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION .
I hereb /affirm that 1'have a certificate of consent to self -insure, or a certificate of
Workers mpensation Insurance, or a certified copy thereof. (Sec. 3800. Labor Code.)
Polic o. 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 thg 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: d, 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 if 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
No. 14755
BUILDING: TYPE CONST. OCC. GRP.
A.R._ Number 646'-121-022
Legal Description Lot 22 Tract 20052-4
Project Description SFD Malt
Laguna De La Paz
Sq. Ft. No. No. Dw.
Size 2001- Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. '
Side Street Setback from Ine
Side Setback from Proj
Li
FINAL DA
Issued by:
Validated by:
Validation:
Estimated Valuation $119,915.00
PERMIT
AMOUNT,
Plan Chk. Dep. '
Plan Chk. Bal.
595.93
Const. J
7019.50
Mech..."
62. 00
Electrical
142.52.
Plumbing ,'
138.00
S.M.I.
12.99
Grading
20.00
Driveway Enc.
.00
Infrastructure
2,642.73
-Arts in Public -Places
49.79
TOTAL
4,372.46
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. '
Side Street Setback from Ine
Side Setback from Proj
Li
FINAL DA
Issued by:
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL. SO. FT. p
DUCT WORK
ROCK STORAGE
FOUND. REINF.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
REINF. STEEL
GAS (FINAL) TEMP. POLE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. SO. FT. ®
WATER SYSTEM
-GRADING
cu. yd.
$ plus x$
WALL SO. FT.
LUMBER GR.
DRINKING FOUNTAIN.
SO. FT. ®
IF
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
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
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SPARK ARRESTOR
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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
FINISH GRADING
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
FENCE FINAL
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 n ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMB UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR -4 ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) qMETER 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.
W+
FRAMING
IF
FINAL INSP.
ROOFING
VENTILATION
L�
J
/)
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REMARKS:
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