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07826 (SFD)- Ir- Buildin Address 78-595 Alder Circle P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing I Address 1"i W_ ilac�p i►�rrw City lZip ITel. Contractor I 5 Address ' City Zip Tel.: State Lic. City & Classif. �^� Lic. # Arch., Engr.4 ' Designer Address Tel. City (Zip ( State I Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm lha�am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisionr3 of the Busij)&srand ProfessionsICode, and my license is in full force and effect. 'y/t'' ' SIGNATURE ,-F '" - f 7 'OWNER -BUILDER DECLARATION IIreliy.'affirm that I am exempt from the Contractor's License Law for the following reason:' (Sec.' 7031.5,Susiness 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 provisionsofthe 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. (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 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.) O 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 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 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 thg 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. DateOwner NOTICE TO APPLICANT: If, after making this Certificate of 'Exemption you should become subject to the Workers' Compensation provisions or 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 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 construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for Inspection purposes. Signature of applicant Date - Mailing Address City, State, Zip No. 07826 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Acacia Homes Legal Description Tract 23268 Plan 8-3 Project Description Lot 104 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 DATEINSPECTOR Issued by: Date 5/4/90 Permit Validated by: Validati ... :'" I IIIIIII VIII III VIII (III 46 IE Sq. Ft. 1722 Size. No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $93,555 PERMIT, 1 _ T E _ AMOUNT Plan Chk: Dep. Plan Chk. Bal. 507 36 Const. MAW Mech. M 50 Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure Q5 TOTAL REMARKS r 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 DATEINSPECTOR Issued by: Date 5/4/90 Permit Validated by: Validati ... :'" I IIIIIII VIII III VIII (III 46 IE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS A.C. UNIT 2ND FL. SQ. FT. SLAB GRADE YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. SEWER OR SEPTI?*Vf,-/ DRAINAGE PIPING WALL SO. FT. DUCT WORK DRINKING FOUNTAIN SO FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation REINF. STEEL FLOOR DRAIN MECHANICAL FEES TEMP. POLE WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER HEATER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRYTRAY 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 ® 1% c SEWAGE DISPOSAL SO.FT.GAR ® 3/ic HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES��EE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR f Y SETBACK GROUND PLL BI G G UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTI?*Vf,-/ ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. �j /7 GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPIEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING ?:xcu, yd. $ plus x$ =$ LUMBER GR. FINAL INSP.Lo 844RAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH IN ULATIONISOUND O. FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 111.11111 I1III I III 47 Building 780595 ALDEN &tyl 4 QuIbElk P.O. BOX 1504 N0. 9502 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Owner ACACIA CONSTRUCTION Mailing Address 1021 W. BASTENCHURY City Zip Tel. FULLERTON,CA 92633 — Contractor RICHARD G. PAG CONSTRUCTION Address 54-991 LEIT110AVE. CityZip Tela D.H.S. 92260 329-6817 State Lic. City & Classif. 538171 Lic. # Arch., Engr., Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 am licen ed Y at provisions of,Chapter 9 (commencing with Section 7000) of Division 3 of a sI ss Professigns-Code, and my license is n ful fotce an'd effect. "f V r t —, `,/' 1 1 SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for -the following reason: (Sec. 7031.5,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). O 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 Professfons 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thior ssection need not be completed if the permit is for one hundred ndrr\ed dollars ($100) valuation I certify that in the performance of lhp work fp4 which this pe Tnit is issued, I shall not employ ani pperso t a y manner so as,to becor`fie' sub' ct_to�-tthhe Workers' Compensation (•'DLam of tJalifo��I . � v� �r ��F �7 ate 7— / nen NOTICE TO APPLICANT: I/, after making his -Certificate of ExempDb4yo0uld_become subject to the Workers' Compensation provisions o/ 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 above. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING: TYPE CONST. PATIO OCC. GRP. A.P.'Number Legal Description Project Description PkTIO COVER ONLY COVER — 13' X 14' Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $1,750.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. �29 . Z 5 Const. 45 .0) Mech. Electrical Plumbing S.M.I. • 14 Grading Driveway Enc. Infrastructure TOTAL $74.39 REMARKS QQ!)11$4 J.0,1 �V f`11-'11.r.i To Llt 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 1ST FL. SO. FT. ® $ UNITS COLL. AREA 2ND FL SQ. FT. Ct YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. DUCT WORK DRAINAGE PIPING WALL SQ. FT. DRINKING FOUNTAIN. SQ FT ® HEATING (FINAL) 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 GRADING cu. yd. $ plus x$ LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEWPERM 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 ® 1 Vi c SEWAGE DISPOSAL FIREPLACE SQ.FT.GAR ® V4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE TOTAL FEEST7EE LATHING MECH.FEEEPLCK.FEICN ELECT. FEE SMIFEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE Ct 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 �e -(� Ci FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION 9 �l CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 1111111111111111111111111 48' -44 IE No. ©932.8 � P.O. BOX 1504 Building 78-105 CALLE ESTADO Address. 78-595 Alden Circle LA QUINTA, CALIFORNIA 92253 V \•1 Owner Uv` AnaeiA ROMPS BUILDING: TYPE CONST. OCC: GRP. Mailing Address A.P. Number City Zip Tel. Legal Description Contractor Project Description ' swan Fo'ois Address S13a City Zip TeL er—�. x443.4 Q 1� ..AA CA State`Llc. My _r City & Classif. '; 421014 Lic. # 249 Sq. Ft. No. No. Dw. Size - Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION ' I hereby affirmlthat I am licensed under provisions of Chapter 9 (commencing with Section " 7000)o1 Division3 of the Business and Professions Code, and my license is in full force and effect. - ..,SGNATU LbATE ' - OWNER -BUILDER DECLARATION Estimated Valuation I ere y affirm that I am exempt from the Contractor's License Law for the following , 7500.00 ,+reason: (Sec. 7031.5,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 . -_requlres 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 for the Any Section 7031.5 any for plan Chk. De p alleged exemption. violation of by applicant a permit. subjects the applicant to a civil penalty of not more than five hundred dollars ($500). . . . plan ChkBal C 64 •� S ❑ 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. 99• 80 .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. 24.00 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 Electrical 45.00of 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- Plumbing 27.00 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 $.M.I. • 55 - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. 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. 3900, Labor Code.) Policy No. ompany - - opy is sled with the city. O Certified copy is hereby furnishedf - 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 thg 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: It, after making this Certificate of Exemption you :should become subjectto 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 if 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 above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip Infrastructure ., TOTAL 259.41 REMARKS ' AU FV59.9i TO 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: '. . •rte. . �T .. -t � • « r. . � � .r « . �1 .AAI' -r :i. .t. � .. CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS ' SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOB]LEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® GAS (ROUGH) VzVar (,(/) DRAINAGE PIPING WALL SO. FT. ®' OTHER APPJEOUIP. DRINKING FOUNTAIN. SO FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. s'ellf' 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, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SPARK ARRESTOR SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Vi c SEWAGE DISPOSAL SO.FT.GAR ® 3/4c 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 -"01(Q:- UNDERGROUND 3 Q[ (,YJ 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) VzVar (,(/) 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. s'ellf' FRAMING r FINAL INSP./ 3 hC irCL L ' l/ ROOFINGREMARKS: {Pcy ��r 2��a� c ►� �'�j G ala A��� VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION g(Vl( CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL