11984 (RER)Building
Address 44-890 See1e
Owner ' ,
Acacia 96m,es
TA 4I
P.O. BOX 1504 0 , 11984'
•78-105 CALLE ESTADO
V Drive LA QUINTA, CALIFORNIA 92253'
mailing -
Address Same
City, , , Zip Tel.
L4:-Qui,nta., CA 9225.E
Contractor .
Patrick J. BUgcry
Addle s,87 'Schafer dace
City Zip Tela
92260 772-39891,
State;Lic City
& Classif. BI• -6142953 Lic. # 2569
Arch:;•Engr.,
Designer
Addiress - - Tel:
City:., ,` , Zip State
LIC. #
LICENSED CONTRACTOR'S DECLARATION
I h;ieby affirm that I am_Ucensed under provisions of Chapter 9 (commencing,with Section
7000 "of Division 3 ofrth�`Bu iness and'Professions Code, and my license is ifl/full forree,and�
•
effect;-
SIGNATURE,
ffect. SIGNATURE•
;.,O" OWNER•BUILDERDECLARATION
I`hereby affirm.that I am exempt frpm the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city orJcounty which requires a
1
., 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'fGr a permit
subjects the applicant to a civil penalty of not more than five hundred dollars .(S500)!
❑ I, as owner of the property, or my employees with wages as their, ole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 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 igfenbed or --offered for sale. If, however, the building
or Improvement is sold within one year of com`pletion, thelg`wner•builder will have the burden
of proving that he did not build or improve for thalFurpose of s�alptn
0 I, as owner of the property, am exclusively contraetmg7with 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 contractoy(aj licensed pursuant to the Contractor's License Law.)
O I am exempt unclSec B. & P.C. for this reason
Date + owner,
WORKERS' COMPENSATION DECLABAXION
'I hereby affirm that I have a certificat pf co'nspn to self -insure, or a certificate of
Worker's Compensation Insurance, or a cV,tl�edropy ther€ fe(Sec. 3800, labor Code.)
Policy No. Compa y/� VEX
❑ Copy is filed with the city. Certified copy is hereby furnished.
CERTIFICATE OF-.•EXEMP.VON,FROM i
WORKERS' COMPENSATION INSURANCE
(This section need'not be completed if the permit is for one hundred dollars,(S100) valuation
or less.) -
I certify that in the performance of the work for which this permit is issued, I shall not
employ any persdjl!in any manner so as
Laws ofCeto•becdme subject to the Workers' Compensation
.;ajl forr)ie�O'
•Date/� Owner sib
NOTICE 'TO. APPLICANT: If, after,0making thls Certificate of Exemption you should become
subject to the Workers' Compensatiorin Pr visioris of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoke
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency,.fot'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.fllled out, gnand validated, and is subject to
expiration it work thereunder is suspended for 180 da '
I certify that I have read this applicatiori;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�uthorize representatives of this city to enter the -above,mentioned property for'iiispection purposes.
Signature of applicant
Mailing Address
City, State, Zip
BUILDING: TYPE CONST. OCC: GRP
A.P. Number
Legal Description
Project Description - Sales of f "ice ba:6k +to czar- acte
Sq. Ft.
Size .
New ❑
No.
Stories
Add ❑ Alter ❑
N'o. Dw.
Units
Demolition ❑
1.
Repair ❑
S
;timated Valuation $1,000.00
PERMIT AMOUNTi
Plan Chk. Dep.
Plan Chk. Bal.
Const. 30.00
Mech.
Electrical
Plumbing
S.M.I. '
Grading + >
Driveway Enc. nn,
Infrastruc „ -
TOTAL- � • Ju,. iiia,
REMARKS x
4 1ti.a A/V
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
ROCK STORAGE
FOUND. REINF.
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP.IEQUIP.
DRAINAGE PIPING
CARP. SQ. FT.
TEMP. POLE
WALL SQ. FT. ®
DRINKING FOUNTAIN
SQ. 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
/1� `/ ✓/
!(•/�
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/A c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
MESH
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 APP.IEQUIP.
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
�Aa
Fm,
I �J11�V/ N
G
/1� `/ ✓/
!(•/�
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
5c -c - U-1
NOOK
FAMILY .ROOM
J `
C.
w
C:
LL
O
SINK
WET
BAR
1A LAUNDRY
POWDER
WINDOW
3
KITCHEN I
DRY WASH Q
(SPACJ LPACE ( U v,
WIN FAU
nx:w 3o F Rr Do oil, .
a
— — — — — — — — E4TE
ALA-
TYPC,-
C- vnovv h
WSuD►��cc% (Zll 1 ,
3C R s
fTY OF LA O U I N
BUILDING & SAFETY DEPAR MENT
CONDITIONALLY
ACCEPTED FOR,CONSTRUCT I�
New 30 SUBJECT TO INSTALLATION AS P R
\ANDAL APPLICABLE CODES
�Y �3
-s-WSTALL- ClA(LOALF JUo2R�
FIRST FLOOR .
7
0 1 (P -Tr"
�Z�_aer �tz—
F
T4 of 14a (0lzinta
�lii��tn� �tn� �'����t �t.lti�ilzn
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the -City regulating building construction or use. For the following,:
BUILDING -ADDRESS. 44-890 Seeley Drive
Usi,clas-sification Single Family Dwelling Bldj. Permit No. F 11984
Group R3 Type 'Construction VN Fire Zone Use Zone -SR
Owner of Building Acacia Homfi s Address 4 R 1 e V Dri ve
city La 01ii ntaf -CA 92253 BY: Mark Harold
Date; April.14, 1993
Building Officiial
IN A
III