12610 (SFD)f
P.O. BOX 1504 N o .
Building 48--638 Vista 'Tierra 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Roger 8nellenberger & Associates
Mailing BUILDING: TYPE CONST. OCC: GRP.:
Address 55-6195 Pebble Beach 611-661-033
A.P. Number
City zip Tel. Lot 31 Tract 20052-6
La Quinta, CA 92253 (619)777 7767 Legal Description
ContractorSYD Plan 5
r�St+E3»tf� same Project Description
126.0
—1 -5 -7 --
State Lic.I City
$
& Classif. —dp
Lic. # 3
Arch., Engr.,
Designer Carlos Miss a Engineer
A,TWg52 5 Charlesworth Driv Te(619)328-7271
Cit . Zip State
athedral fit I, -C,� 92234 L��,.t#'
Ie
LICENSED CONTRACTOR'S DECLARATION ,
I hereby affiAlhat I am licensed under provl"sIons of�Chapterm
9 (comenci.g,wi ht Section
67000) of Divivsiog) 3;of'fho�,.Pusiness ang;professionsCode and my license is in full force and
OWNER -BUILDER DECLARATION/
I heregy affirm that I am exempt from the Contractgs License Law for the following
reason: pec. 7031.5,Business and Professions Code: Any city or county which requires a
perrkt,to construct, alter, 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, 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 buitding
orimprovement 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.)
❑ 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.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Sq. Ft. 2001 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $115,331.2€
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc
Date Owner I Infrastructure
tR in Publi
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poli�cy i
�No'_ Company
C1 dopy is filed with the city. O 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 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: If, after making this Certificate of Exemption you should be;ome
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
ateMailing Address
City, State, Zip
AMOUNT
250.00
335.922
695.50
62.00
142.52
150.0{
31.60
20.00
.00
2,452.59
aces 38.32
TOTAL 4,158.44. 3,903.44
REMARKS r
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
I
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
FINAL DA
Issued by:
Validated
Validation
Y
7
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING PEES
1ST FL. SQ. FT. ® $
UNITS
/
( 1 �y
BONDING
YARD SPKLR SYSTEM
2ND FL. ` SQ. FT. ®
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING,
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. Q. FT. ®
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ 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.COOL 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'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
LATHING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PER FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE FPL.CK.F1EE
CONST. FEE ELECT. FEE
SMI FEE ITLUMB . 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 APP./EQUIP.
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 SIGNATURES/INITIALS
GARDEN WALL FINAL
•
P.O. BOX 1504 APPLICATION ONLY
Building 78-105 CALLE ESTADO
Address 46-6 3VIM TIEIM LA QUINTA, CALIFORNIA 92253
Mailing
Address 55-695 PEBBLE BEACH
City Zip Tel
LA QUIM 92253 619 777-7767
Contractol=
Aaaress I
P.O. BOX 157
RANCHO MIRAGE 92270 619
State Lic. City
& Classif. B620453 Lic: #
Arch., Engr.,
Designer CARLOS E IM — ENGINM
Address _ I Tel.
Cit&THMRAL CITY Fil"92234 Dict#
I hereb firm that I am lid@nsed u der p (v�idns of CKapter 9
7000) of iv siora 3 of the BusiA ss nd PJ�f a"s ons Cod"e, and m
effect. ♦ I // /
OWNER -BUILDER DECLARATION
h reby affirm that I am exempt from Yie Contractor's License Law for the following
ears (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
to construct, alter, 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 or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
(J 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
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.)
" 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 I 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
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. O 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: 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 sof 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. SM OCC, GRP.
A.P. Number 617-661-031-9.
Legal Description TRACT 20052-6
Project Description IDT 31 — PIAN 5
Sq. Ft. 2001 No.- No. Dw.
Size Stories Units .
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
(Estimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL _
REMARKS
AMOUNT
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback frcm Property Line
FINAL DATE_
Issued by:—
Validated by:—
Validation:—
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES i
,1ST FL SO. FT. $
UNITS
TOTAL FEES
2ND FL. SO, FT, @
CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE
YARD SPKLR SYSTEM
POR. SQ. FT.
MOBILEHOME SVC.
BAR SINK
GAR. S0. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. @
GAS (ROUGH)
DRAINAGE PIPING
`WALL SO. FT. a
OTHER APPJEQUIP.
DRINKING FOUNTAIN
SO. FT. @
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER HEATER
SERVICE
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
FRAMING
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
REMARKS:
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
..SPARK ARRESTOR
LAUNDRY TRAY
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
-INSULATION/SOUND
BOILER B.T.U.
SO. FT. @ c
SO. FT. @ c
ATER
WSE
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 1 V. c
ISPOSAL
SQ.FT.GAR a 3/4c
mc.
STRUCTURE
PLUMBING ELECTRICAL
HEATING & AIR COND. SOLAR
' SETBACK
GAS PIPING
PERMIT FEE
PERMIT FEE PERMIT FEE
DBL
TOTAL FEES
MICRIFEE MECH.FEE jPL.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 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
-INSULATION/SOUND
-FINISH GRADING
.FINAL INSPECTION
CERT. OCC.
FENCE FINAL
GARDEN WALL FINAL
)
1SPECTOR'S SIGNATURESANITIALS