14054 (SFD)I
4
P.O. BOX 1504
No. 14454
Bu Iding 78,105 CALLE ESTADO
Address 48-210 Vista Del Nopal LA QUINTA, CALIFORNIA 92253
own
ekoger Snellenberger a Associates VH
R _ BUILDING: TYPE CONST. OCC: GRP.. --R3
Ad� A.P. Number jreMa0inss 55-695 Pebble Beach 646-110-0115
CitJ Tel. Lot 19 Tract 20052-7
4a Quinta, CAT92253 (619)777-7767 Legal Description
Contractor ID t D r' tion SFd Plan 4
Zip
to Lic.
City
& Classif. B 688234 I Lic. # 1858
ArchDesigner Carlos Elias � Engineer
g
A��ess25 Charlesworth Dr.. Te{619) 325-927f
Ci i9 Zip State
6thedra2 Cit i C€1 9223$ Lic. #
LICENSED CONTRACTOR'S DECLARATION
I.nereby affirT that I am licensed'under provisions.off.Chapter 9 (commencing with Section
70x0) of Division 3 of the Business and Prdfessions'Code, and my license is in full force and
eflzct. ,r` (. .� i� -_0- . C:i Df ✓.;:rF,
�/ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
rea.:on`($ec. 7031.S,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
req,7ire.s 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
su'llects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ !, as owner of the property, or my employees with wages as their sole compensation, will
do She work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Processions Code: The Contractor's License Law does not apply to an owner of property who
bulids or improves thereon and who does such work himself or through his own employees,
proWded that such improvements are not intended or offered for sale. If, however, the building
or;vnprovement 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, 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
dors 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
Da!i owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
rker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
icy No. Company
❑ Copy is filed with the city. El Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(TWs section need not be completed if the permit is for one hundred dollars ($100) valuation
orless.)
J 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.
DIte Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
su' jecl 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
wCrk for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
j This is a building permit when properly filled out, signed and validated, and is subject to
exoiration if work thereunder is suspended for 180 days.
1 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
cchstruction, and hereby authorize representatives sof this city to enter the above-.
mkntioned property for inspection purposes.
Sl'lnature of applicant —Date—
.-j.,
ate
rojec ... Ip I
Lacuna De L4 Paz
Sq. Ft. No. No. Dw.
Size 1562 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $90o137.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal
513.11
Const.
599.00 .
Mech.
62.00
Electrical
127.25
Plumbing \ ,
150.00
S.M.I.
9.10
Grading
20.00
Driveway Enc.
.00
Infrastructure
21028.08
TOTAL
, X18. 3
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 Pe
Validated by:
Milling Address Validation:
Ci}y, State, Zip
CONSTRUCTION ESTIMATE
NO. q ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SETBACK
GROUND PLUMBIN
2ND FL. SO. FT.
A.C. UNIT
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SD. FT.
DRAINAGE PIPING
WALL SO. FT. ®
-
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
HEATING (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GRADING
cu. yd.
$ plus x$
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.
SO. FT. ® c
BATH TUB
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 PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBIN
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) 1 t�
/ /
�IAETER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINA
TEMP. POLE
GROUT
WATER HEAT
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.•
FRAMING I1 9
FINAL INSP.
dq
ROOFING f'
VENTILATION
o
� / / � Q� ��
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREW LL
LATHIN �/ (D
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL