14303 (RPL)`414
- P.O. BOX 1504 No. 14301:-'..,"`
Building , 78-495 CALLE TAMPICO s
Address
515-695 .Pebble Beach LA QUINTA, CALIFORNIA 92253
Owner Roger Snelle erger ;' k
BUILDING TYPE CONST: OCC: GRP,
Mailing San6". ' r
Addresst
s A:P. Number
City. Zip Tel. r
La at1int. a i' GA. ��2�3 ������fi.�.. Legal Description
Contractor.. ' Project Description �00�
.Address .
638-so A-Pereiz Rd. E-9
Cit Z` Tel
Cabledrai_ di-iv-j 'h 9*22i4i
State Lic. 5�� City j4.,;
& Classif. ; •. Lic. # Sq. Ft. No No. Dw:
Size Stories , Units
Arch:, Engr., i
DesignerNew.❑ Add ❑ "' "`. Alter Repair'❑.. Demolition:❑
Address Tel. }
City Zip State •
Lic. #
LICENSED CONTRACTOR'S DECLARATION.
1I hereby affirm that-l'am licensed under provisions of Chapter.9 (commericing with Section
of Division 3 of the Business and Professions Code, and my license is in full force and
ffect. .
. SIGNATURE-' DATE -
OWNER-BUILDER DECLARATION
Estimated Valuation 4°n
I hereby affirm that I am* exempt from the Contractors. License Law for -the following. b 316"00('a V '
reason: (Sec. 7031.5,Susfness. 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 ' AMOUNT
requires the applicarit./or such:. permit-to.file a-signed statement, that. he is licensed 'pursuant tog -PERMIT -
the provisions o/ the Contractor's License.,Law, Chapter 9 (commencing ,with Section 7000) of -
'-Division 30/ the Business and Professions Code• or that. he is exempt th�erefrorn,, and -the basis
for the alleged' exemption: Any. violation -o/ 'Section 7031.5. by 'any applicant for. a permit. Plan Chk. Dep.:
.subjects the applicant to a civil penalty o/ not more than rove hundred dollars ($500).
0. 1, as owner of ;the property„or my. employees with wages as their sole compensation, will Plan Chk. Bal. ' gg3'V
do the work, and the structure is not intended or offered for sale. (Sec. 7044; Buisness and
Const. -J.!_.2
Professions. Code:The,Contractor's. License. Law'does.not'app/y to anyowner o/ property who -
builds or Improves •thereon and .who -does such work himsel/ or •through his 'own •employees,
provltled tha(sbch fmprovementsare. not intended. or ;ollered for sale. ll, however, the building - Mech.,:,
or lmprovement.issold, w/thfn one year oYcomplefion; the owner•bullder wlll.have the burden.
Electrical -'4,. 00'!.'
. of proving.thaf hedid not DuiW or frnprove !or the purpose of sale.)
p'1, as owner of'the property; am.exclusively contracting with licensed contractors to con-- Plumbing- ..'27. 00 .
strucl the project. (Seca 7044, Business and Prolessfons Codes ThelContrscfor's License Law -
does not apply to an. owner o/ property •who•6uilds or-improves thereon, and who contracts for - S.M.I.
' ' such projects wtth'a co"ntractor(s) Licensed pursuant to the Contractor's License Law.) -.. '
Grading
❑•I am exam t under,Sec. B..& P.C. for this reason
Driveway Enc.
Date owner Infrastructure
-323
WORKERS' COMPENSATION OECLARATION--------. r: .
I hereby affirm'ttiat I have acertificate' of: consent to self-insure, or.a -certificate of tt" 9'78
g 3�
Worker's Compensation Insurance,.or a certified copy thereof (Sec. 3800, Labor Code.)' - f��7,a 7gy
Policy .. rl,,,'.- - .Company /....:. .. _ .
Copy is filed with the city, . ❑ Certified copy is hereby furnished..
TOTAL
CERTIFICATE OF EXEMPTION FROM • . REMARKS
�— —WORKERS' COMPENSATION INSURANCE •
(This section need not be • completed If the permit is for one huhdred dollars ($100). valuation - � r•G2���°Yi:®S�"!' '”' a �"t3C'�� =�j ,: ��. •
or less.) ..
I.certify that in the performance of thg work for which this permit is issued, I shall not :�"Qisv$♦�$:9�i . X51 C3bCS'"� �'^.'Y
"employ any e.rson.in any-manner so as to become subject to. the Workers' Compensation
Laws of California '
.. bale Owner'
NOT/CE.TO APPLICANT: lt..a/ter -making this 'Certificate .o/ Exemption• you. should- become.. ZONE: " $Y
.'sbbject to the :Workers'' Compensation provisions o/ the Labor Code, you must 'forthwith2.
comply with such' provisions or this permit shall be deemed revoked.e - M lnimum•SetbaCk -'F
l stances. ,r ., - •.`
Front Setback from Center Line
Rear: Setback. from Rear. Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND., Side S,tfeet;Setback from Center Line
SHALL SOBJECT'AN� EMPLOYER TO CRIMINAL PENALTIES'mAND CIVIL FINES-UP TO. ONE
- - '
HUNDRED THOUSAND DOLLARS ($100,000), IN.ADDITION TQTHE COST OF COMPENSATION, Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE IABOR.'COOE,'.INTEREST, AND
ATTORNEY'S FEES. f
This is a building permit when properly filled out, signedfand•validated, and is subject.to • FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180-days. i , . ' - . I . •
I certify that I have read this application and state that the above information,is correct. :Issued by Date P, —m. 1.
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-. ' 1,
mentioned. property for inspection purposes. S V311dated by:
Signature of applicant k Date'
Malling.Address V.alidatioh: `
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT, ®
CARP. SO. FT.
WALL SO. FT.
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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
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. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Ya 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. 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 SIGNATURES/INITIALS
GARDEN WALL FINAL