15673 (SFD)T -i -ht 4 4 Qum, &
P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 44-860 z``>~onterra Dr • LA QUINTA, CALIFORNIA 92253
Owner Snel? enberger fi Associates
ilii
Mailin
Address 41-855 Boar&walk, Ste. 212
City 1ZIp Tel.
Palm Desert,'. t 922.1 (619)777-7768
Contractor
Same
Address
State Lic. City
& Classif. B 488234 Lic. # 1858
Arch., Engr.,
Designer Charles D. Garland
A c�=S163 Cathedral Cyn Dr. Tf'61.9) 778-7025
city Zip State
Athedral Cit, , CA 922.3# Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Dividiton of the Busines zany Profe8 ions Code, and my Iicer @ is in full force, and
effect. _7
GN TU - �+ " r DATE
I 9;f{ OWNER -BUILDER DECLARATION
?eby affirm that 1 am exempt from the Contractor's License Law for the following
ret son. (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 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
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, Buisnessand
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 thatsuch 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 bulk! or Inprove 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) licensed pursuant to the Contractor's License Law.)
I
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of'cons'ent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company /_:
D Copy is filed with the city.O Certifico
py is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff 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 pperson in any manner so as to become subject to the Workers' Compensation
Laws of Caldornia.
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
i 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 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-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
N0. 15673
11LDING: TYPE CONST. OCC. GRP.;
N 664-272--004
R-3
M.P. umber
,Legal Description
Project Description
Quintarr.a
LOt 102 Tract 23913
S?D Plan 4 Model
Minimum Setback
Distances:
Front Setback from Center Line
Sq. Ft.
Size 2593
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Side Setback from; roperty Line
I
FINAL DATE
INSPECTOR?
1
'��f� Permit << \r
Issued by:
Dai
Estimated Valuation
$153y652.00
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
452.88
Const.
828.50
Mech.
89.50
Electrical
166 As
Plumbing
1,,.00
S.M.I.
15.37
Grading
20.00
Driveway Enc.
08
Infrastructure
3,430.83
Arts in Publ c Places 134.13
TOTAL
5.567 14 S, 317.39
REMARKS
ZONE:
BY.
Minimum Setback
Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from; roperty Line
I
FINAL DATE
INSPECTOR?
1
'��f� Permit << \r
Issued by:
Dai
Validated by:
ti
"J
Validation:
• � r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
fy
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. 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 SD. 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATIO
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1'A c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3Yac
HOUSE SEWER
MESH%�/
INSULATION/SOUND
FINISH GRADING
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 PLU
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
fy
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
A
SEWE IJIEi
i
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (RO GH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. /
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
RAMING/5,
FRAMING/0')
vv
FINAL INSP.
ROOFING
^/ n
r ,.� ✓ p' F''// �-/J �[/
•j -J (�- lO vim'/ o
/ 7l
V 777
((
REMARKS:
VENTILATIO
r
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH%�/
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL