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9603-0030 (AR) IIIIIIIIIIIIIIIIIIIIIIIII 374 IE t P.O.BOX 1504 N o• 15 831 Building 78-495 CALLE TAMPICO Address 79-080 Arbola Circle-' LA OUINTA,CALIFORNIA 92253 Owner Snellenberger & ASSOCiates Mailing BUILDING: TYPE CONST. OCC.GRP. Address 41-'865 Boardwalk, Ste. 212 A.P. Number 604--271-005 City Tzip Tel. Lot 74 Tract 2392.3 phase I Pa IA Desert, 92211 1(619)777-7766 Legal Description Contractor Project Description Master bedroom extension Sarre Supplemental to permit #15680 Address Quinterra City Zip Tela State Lic. City &Classif. B 488234 Lic.# 1858 Sq.Ft. No. No. Dw. Arch., Engr., Size 109 Stories Units Designer New ❑ Add ❑ Alter ❑ Repair❑ Demolition ❑ Address Tel. City Zip State Lic.# LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am,licensed undef provisions of Chapter 9(commencing with Section x{.7000)of Division 3 of thef Business an Profess/ions Code ann my lice is in full force and r effect. SIGNATURE r' DATE OWNER-BUILDER DECLARATION Estimated valuation $5,919.00 I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, after, 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 PERMIT AMOUNT 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 .plan Chk. De for the alleged exemption. Any violation of Section 7031.5 by'any applicant for a permit p subjects the applicant to a ctvil penally of not more than rive hundred dollars($500). plan Chk. Bal. 52.65 ❑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 Const. 81.00 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, Mech. �� provided that such Improvements are not intended or offered for sale. If, however, the building orimprovement is sold within one year of completion, the owner-builder will have the burden Electrical 3.82 of proving that he did not build or Improve for the purpose of sale.) O I,as owner of the property,am exclusively contracting with licensed contractors to con- Plumbing +04 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 S.M.I. 59 such projects with a contractor(s)(tcensed pursuant to the Contractor's License Law.) Grading .0{} ❑ I am exempt under Sec. B.&P.C.for this reason Driveway Enc. 100 Date Owner Infrastructure 133. 18 .Arts in Pubi3., Places 14.80 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 O'Copy is filed with the city. ❑Certified copy is hereby furnished. TOTAL 286.04 CERTIFICATE OF EXEMPTION FROM REMARKS 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: ff. after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rea Pop.Line WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND Side Street Setback,, Ce ter Line SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE _ HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION, Side Setback fro erty Li DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS is a FEES. FINAL DATE INS OR� This is a building permit when properly filled out,signed and validated,and is subject to rn ^ 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. Issued by: DaPermit 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. Validated by: n Signature of applicant Date Mailing Address Validation: \ City, State, ZIp \ / CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES IST FL. SQ.FT.® $ UNITS 2ND FL. SO.FT.p YARD SPKLR SYSTEM POR. SO.FT.® MOBILEHOME SVC. BAR SINK GAR. SO.FT.® POWER OUTLET ROOF DRAINS CAR P. SQ.FT.® DRAINAGE PIPING WALL SO.FT. DRINKING FOUNTAIN SO.FT.® 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.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. SQ.FT.®c BATH TUB SQ.FT.®c WATER HEATER MAX.HEATER OUTPUT,B.T.U. SO.FT.RESID®1+/.c SEWAGE DISPOSAL SQ.FT.GAR®3/.c 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 PLUMBING UNDERGROUND A.C.UNIT COLL.AREA SLAB GRADE LS 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 LUMBER GR. F FINAL INSP. cu.yd. FRAMING O �,(p �f/ FINAL INSP. $- plus x$ =$ ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL