14051 (SFD)T4hf 4 4 Q"
I3ullcing 48-216 Vista De Ho aI.
Ad'dr=ss
O w ger
M ilii
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Snellenberget & Associates
Addr-Iss 55~695 Pebble Beach
Quinta,, CA Izip 92.253 I(619) 777-7767
Addr--ss
I
City Zip Tela
State Lia City
& ciEssif. B 488234 Lic. # 1858. .
Arch_; Engr:,C+arltlS
Designer' -
_,rs Charlesworth Dr. C611911328 -727F
Uythedral Citi z'PeA 92234 State
I LICENSED" CONTRACTOR'S'DECLARATION
f�
I!hereby affirm that I am licensed under provisions of Chaipter 9 (commencing with Section
7000) of Division,3.of the Susine`ss,af�id Prrofesdions Crodde?and m ieense is in full force d
9IGNAZJ130i * - - ll `DATE
62,!e/I(eMb�y
OWNER-BUILDER DECLARATION
affirm that I am exempt from the Contractor's License Law for the following
reac. 7031.5,Business and Professions Code: Any city or county which requires a
permit go 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'prrvisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Divisioe 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for ;the alleged exemption. Any violation o/ 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 11, 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
Profes�IOns Code: The Contractor's License Law does not apply to an owner o/ 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 /or sale. I/, however, the building
or Improvement is sold within one year o/ completion, the owner -builder will have the burden
o/ 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 rot apply to an owner of property who builds or improves thereon, and who contracts for
such p ojects with a contractors) licensed pursuant to the Contractor's License Law.)
I
❑ I1 are exempt under Sec. B. & P.C. for this reason
Datjjje Owner
j 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 rection need not be completed if the permit is for one hundred dollars ($100) valuation
or less)
I I certify that in the performance of lhp 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 :)f 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
compN with such provisions or this permit shall be deemed revoked.
I
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work fir which this permit is issued. (Sec. 3097, Civil Code.)
Lende:"s Name
LencleP's Address
'Ths is a building permit when properly filled out, signed and validated, and is subject to
expira�ion if work thereunder is suspended for 180 days.
I cedify that 1 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
copstruction, and hereby authorize representatives ,of this city to enter the above-,
menti.med property for inspection purposes.
I
Signature of applicant Date
Mailing Address
Citi, State, Zip
i
No. 14051
BUILDING: TYPE CONST. WIN OCC: GRP. R3
A.P. Number 646-110-090
Lot 16 Tract 20052.7
Legal Description ,
Project Description BPS Plan 4
Laguna.. De La Paz
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Se erty Line
FINAL—D E INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
Sq. Ft.
Size 3562
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$90,137.00
PERMIT
AMOUNT
Plan Chk.'Dep.
'
Plan Chk. Bal.
513.10
Const.
599..00
Mech.
62.00
Electrical
127.25 -
Plumbing
150.04
S.M.I.
9.10
Grading
20.00
Driveway Enc.
00
Infrastructure
2,028.08
TOTAL
3,508.53
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Se erty Line
FINAL—D E INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
r
ROUGH PLUMB. 111
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ROCKSTORAGE
FOUND. REINF.
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
OTHER APP.IEOUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. I SO. FT. ®
WALL SO. FT.
WATER HEATER
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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 ^,JECTRICAL HEATING & AIR COND. SOLAR
rnc�
SETBACK
ROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADEIMW
ROUGH PLUMB. 111
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC NK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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 (� '4
FINAL INSP.
ROOFING
VENTILATION
i &-r
'
! 1. tl r 7 /f
(�
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
ff
LATHING
MESH I
)
INSULATION/SOUND /
FINISH GRADING j
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL