12571 (SFD)Building
Address
Owner
mailing
Address
BOX 15_04-"�*'_'.A` NO. IZO 1-i
78,105 CALLE'ESTADO
48-637 Vista -Tierra I/,, LAQUINTA,'C.ALIFORNIA92253
r Snellenberger & Associate, -S* BUILDING: TYPE CONST. OCC. GRP..
.55 -695 -Pebble Beaph A.P. Number 617-661-019,
City Zip ITel.
4619) 777-7767 scription
La QuintA. 92253 CA I Legal De Lot 19 Trac,,- 20052�-6
Contractor, , .•Spb. Plan 2
Project Description
&emtr . Mayd Develbpmeent
ru:
BOX 7 yy
7
City Zip Tt�
RancWo i r Age 92270. 19)340-3792
State Lic. City
& Classif.' T'620453 Lic. #
Arch.; Engr.,;--`
Designer ,j,,-_-- CArio',s" -E, lia-s' --Engineer
Addr 9§ '2`_":
s-5dhir1b-5W0rth Drive A19) 3 A19)328-7271
City Zip State
Cathedral 'Cit 1l, CA 92234 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that r am licensed under provisions of Chapter 9 (commencing with Section
7000) of Dif '
n oh a
Business and Professions Code, and my license is in fullforceand
effect
.
SIGNATURE DATE
'OWNERIBUILDER DECLARATION
I herebyaffirm ihai I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busines-all'and Professions Code: Any city ori 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
the provisions
. ons of'the Contractor't 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).
0 1, 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
11 builor..,,' roves thereon and who does such work himself or through his own employees,
e_ ",',t,ha!f' such improvements are not intended or offered for�'§ale. If, however, the building
liioW* ent,i 0 sold within one year I completion, the owner -builder will have the burden
0 Vin"thathe did not build or improve for the purpose of sale.)
as owner 0 the
I h property, am exclusively contracting with licensed contractors to con-
st ' ru ( the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
oes not apply to an owner of property who builds or improves thereon, and who contracts for
s
uch projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 1 am exempt under Sec B. & P.C. for this reason
ii
Date _�'-Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
it Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
cLcrpy is filed with the city,. 0 Certified copy is hereby furnished.
71 -
CERTIFICATE OF EXEMPTION FROM
WO.RKERS'COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
Icertify that in'the,pbrformance of,thp work for which this permit is issued, I shall not
employ any person iin'any manner so as to become subject to the Workers' Compensation
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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction -lending agency for the performance of the
work for which this.permit is issued. (Sec. 3097, Civil Code.)
Lender's Nam
Lender's Address
This is a building permit when properly filled out, signed and validated, ind 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 sof this city to enter the •above=.
mentioned properly for inspection purposes.
Signature of applicant -Date
Mailing Address
City, State, Zip
Sq. Ft. AINo, No. Dw.
Size .1950
Units i
New 0 Add Ei, "y' Alter 0' Repair 0 -Demo*liti8n'b'
4
Estimated Valuation. 4111 392.00
PERMIT AMOUNT,
.,4Plan Chk. Dep. 250.00
'Plan
.Chk., Bal.25. 52
Const.
Mech.
Electrical.
Plumbing
.S. M. 1.
Grading
Driveway Enc.
Infrastructure
- 62, A G',
140 95'.'�
15 0 0 _0
2 4 0 2
TOTAL 4,152.64 *1.902.64:-,
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setba ck from -Center Lin
RearSetback from Rear.Prop. Line
Side -Street Setback from Center Line
;,_�SiJe Setbac.-k from Property Line
FINAL DATE INS I TOR /A
/
Issued by: Date Permit
Validated by: V 0
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINGc-EES
1ST FL. SO. FT. $
UNITS
v
n r
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
FORMS
SEWER OR SEPTIC TANK
/
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
GAS (ROUGH)
METER LOOP
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. @
GROUT
WATER HEATER
WALL SO. FT. @
FINAL INSP.
DRINKING FOUNTAIN.
SO FT @
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET' r
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
LATHING
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
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE LPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
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
REMARKS:
VENTILATION
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
CD , -17
Building
Address LAGUNA DE LA PAZ
Owner
ling
P.O. BOX 1504 APPLICATION ONLY
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City
Zip
Tel.
LA QUINTA
92253
1777-7767
Contractor
ROGER SNELLENBERGER
Address
- ':SAME
-City
Zip
Tel..
State Lic.
City
& Class if' 488234
Lic. #
Arch., Engr.,
Designer TERRA -DEL SOL DESIGN
GROUP
Address I Tel
CityZip State
PALM DESERT 92261 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the usiness an Professions Code, and my license is in full force and
effect. ✓C��C�(
1GNATIIRE V 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, 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
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).
1-; 1, 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 improve for the purpose of sale.)
1.-1 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.)
17 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 consent to self -insure, or a certificate of
Woiker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it 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: 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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's. Name
Lender's Address
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
BUILDING DIVISION
BUILDING: TYPE CONST.
A.P. Number
Legal Description
Project Description
S
PLAN 2
1 9 So
Sq. Ftp No.
Size Stories
New ❑ Add ❑ Alter ❑
Estimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
OCC. GRP:
Lor I?
No. Dw.
Units
Repair ❑ Demolition ❑
AMOUNT
nC(l f1 Q 1QQ1/11
ZONE: BY:
Minimum Setback Distances: ,
Front Setback from Cerj Line
Rear Setback flaom RehT-Prine_
Side Street Setoack from Center Line
Side Setback frim Property Line_
FINAL DATE INSPECTOR
Issued by: Date Permit_
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING BEES
IST FL. SO. FT, g $
2ND FL. SQ, FT.
POR. SO. FT. @
GAR. SO, FT.
CAR P. SO. FT. to
WALL SO. FT. frq
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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, p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1'/. c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEEELECT, FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER 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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATI ONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL