001880 (SATT)P.O. BOX 1504
Building O
54--172 Oak Tree LA QUINTAC
Address CALIFORNIA 92253
Owner
sunzufe COMPM7
Mailin
Address 75-005 Country Club Drive
CityZip Tel.
WrA rt.. . 92260 3rrtir?�—Z�2�
Contractor
Hationai Laud and ftrtgage
r y
City Zip Tela
sae Sam same
State Lic. City
& Classif. Lic. # 328
Arch., Engr.;
Designer Robert A1.teVere Assm.
Address 2915 Reed x.0 Ave. (714)54€3-5117
CityZip State
• Costs Hesay 1 9252.5 Lia #
LICENSED
I hereby affirm that,l'am licensed
7000) of Divis7,3`of the Business
effect. / . . . �:,•
i DECLARATION .
of Chapter 9 (commencing with Sect
Code, and my license is in,full forcei
/ OWNER -BUILDER DECLARATION
I -hereby affirm that I am exempt from the Contractor's License law for the following
reason: (Sec. 703 1.5, 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.
requires 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
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ 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. (Secr•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. If, however, the building
or improvement 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.) -
❑ 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 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
Date Owner
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.
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.)
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, atter 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.
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 it 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 :aZi_
mentioned property for insp Ilion purposes.
.r y1 ` Signature of applicant •-Y N/ ! . l Date' /
Mailing Address ` rx
City, State, Zip
f
HARD COPY
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
,Legal Description
Project Description WEST PLAN 1QR
Sq. Ft. No.
Size ' • - Stories
No. Dw.
Units
New;;] Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
324.94
Const.
391. UU
Mech.'
j�t.0Y1
Electrical
59.99
Plumbing
87.50
S.M.I.
5.99
Grading
Driveway Enc.
Infrastructure
1,276.00
TOTAL
Z, 119.42
REMARKS
OWL AD SPA E PART OF THIS PEWT
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 11-12-83Permit
Validated by:
Validation:_
A3251
11 13 2 9;42 CK
CONSTRUCTION ESTIMATE
IST FL. SQ. FT. ® $
2ND FL. SO. FT.
POR. SQ. FT. ®
GAR. SO, FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SQ FJ ®
ESTIMATED CONSTRUCTION VALUATION $
NO. ELECTRICAL F
UNITS '
MOBILEHOME SVC.
POWER OUTLET
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRYTRAY
AIR HANDLING UNIT CFM
OTHER APP.IEOUIP.
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
GRADING
cu. yd.
$ plus x$
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
ROOFING
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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 �3
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ER OR C N
OUGH WIRING
DUCT WORK
ROCK STORAGE
L/
T/ FOUND. REINF. 2 r
J
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
�'+ AS (FINAL) l� /_
C/
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
G/Q(JAL INSP. �• -
1
/ FRAMING ?
FINAL INSP.
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