14048 (SFD)• 4 4 "
P.O. BOX 1504
ilding 78-105 CALLE ESTADO
dress 48-209 Vista De Nopal LA QUINTA, CALIFORNIA 92253
uw mkoger Snellenberger & Associates
Mailing
Address 55-595 Pebble Beach
City Zip Tel.
La Quinta, CAI. 92253 1(619)777-7767
Contractor
Same
City Izip
State Lic. City
& Classif. B 488234 Lic. # 1858
Arch:,
Designer Carlos
ri •' g~ ' Elias - Engineer
9
A _ dress . T I.
I1a15 Charlesworth Dr. 1619)328.7271
Cit Zip State
&, tbedral Cit= , CA 9223 I..ic. #
LICENSED" CONTRACTOR1I DECLARATION
6 hereby affirm that I am licensed udder pro`vislons of,Chipter 9 (commencing with Section
7000) of Div))isi�og,3 of the Business and Prroleessi ris wide, andel my license is in full force and
effect. f,• ., __..o fi -!'" 5, %>'� "a k
SIGNATURE~ 0' -V— "�"' 4" - .% DATE
OWNER -BUILDER DECLARATION
I here affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buslness 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
Division 3 or 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 rive hundred dollars ($500).
oil,
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. It, however, the building
orlimprovement is sold within one year of completion, the owner -builder will have the burden
or proving that he did not build or improve for the purpose of sale.)
❑ I, asowner 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.)
[A am am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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. ❑ 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.)
0 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, alter 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.
II
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-.
meI ntioned propertyfor inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No.
JILDING: TYPE CONST. VN OCC: GRP.
P. Number 646-1.1:0-079
14048
R3
Legal Description ..Lot 5 Tract 20052-7
Project Description 5FD Plan 2
Isaguna De La Paz
TOTAL 4 t 5 41
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 Property Line
FINAL DATE
INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
Sq. Ft. 1950 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation $111092.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
5755.52
Const..
681.50
Mech. '
62.00
Electrical
140.9.5
Plumbing
150.00
.S.M.I.
11..20
Grading
2G.00
Driveway Enc.
.00
Infrastructure .
2,482.99.
Arts In Public Places
28.48
TOTAL 4 t 5 41
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 Property Line
FINAL DATE
INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
t+
2ND FL. SQ. FT. @
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT. ®
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN
SQ. FT. ®
HEATING (FINAL)
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.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
CU. yd.
$ plus x$
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINAL INSP. 1
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
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 PLUMBING
NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPT AN
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.LV
GAS (ROUGH)/
1
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATEIF R If
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
CU. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. 1
FRAMING Q
FINAL INSP.
ROOFING /
viv-4v
'
b
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA ING S ��
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION j rp
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL