BLCK (9746)it, a
P.O. BOX 1504 N O . '974.;6
Building Miles .�VS:nue 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
�-
- Owner
Acacia Constlkrction
Mailing BUILDING: TYPE CONST. OCC: GRP.-
Address 1021 W. Bastanchury #100
A.P. Number r"rA^4- IlUg
City - Zip - JTe7Lr all.ert,On 92623 14/992-0880 Legal Description Acacia :loves 2-nd Phase
Contractor
�:lc toil Masonry Project Description
Addres 304 1f of 6' block -wall
. a. DOX 3771
'• Plan Chk. Bal.
City
Zip
92?53
Tel.
:5679La.Quinta
a�
S.M.I. -
Grading
Driveway Enc.
,`" _c_.
State Lic.
City
��/� " " / f?".
�
& Classif. , 591684 C29
Lic. # 1631
Sq. Ft. No:. , � " No. Dw.
Size • 8,00 If Stories., Units �a
Arch
'.; Engr., -
❑ �'<�Add ❑ Alter ❑ -" Repair ' ❑ ,.• 'Demolition ❑
' DesignerNew
Address
Tel.
'"�.✓"� +
City
Zip
State
J
Lic. #
/r LICENSED CONTRACTOR'S DECLARATION
SI herebt ffirm that Cam licensedAnder provisions of Chapter 9 (commencing with Section
>� 000) of • ivisl in 3 of therBusines and Pro�selon�Eode, and my license is in full force and
1GNATURE 7 T' - DATE � - •
OWNER -BUILDER DECLARATION Estimated Valuation '
I hereby -affirm that I am exempt from the Contractor's License Law for the following
20,06b"
reason: (Sec.,'703t5,Bustness and' Professions Code: ;Any city or county wAlch requires a t
perrntt to consWct, atter, fmprove, tlemolish, or repafr, any structure, pdon to its Issuance also
,�;-requires the appllcanf (orsuch permtt'to Ble a slgnedstatement that he is licensed pursuant to • ,PERMIT
:`,-.:':; the provlslons o/ the Contractor's,LIi:ense Law, Chapter'9 (commencing with Section 7000) of ' `
-'�?Dlvfslon 3'0l the Business and Pro/essfons Code, or.thaLhe !s exempt therefrom, and the basis
SkT.'/or the alleged,exemption.Any vrolatlon •o/ -Section 7031.5 •Dy 'any' applicant for a permit .Plan Chk. Dep. . ' ..
; ~;'sub/acts the applicant to a clvlLpenaf(y o/not more than five hundred dollars,($500). • ' ' '• - '
,.' p 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 or 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 onetyear of completion, the owner•bugder 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 withJlcensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does notapply to an owner of property who builds or improves thereon, and whocontracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. & P.C. for this reason
'• Plan Chk. Bal.
Const.
Mech. -
Electrical -
Plumbing
S.M.I. -
Grading
Driveway Enc.
Date owner
Infrastructure
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
Policy
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 'permlt is for one hundred dollars .($700) valuation
or less.) � . .
I certify that in the performance of thg work for which this permit is issued, I shall notes
employ any parson In any manner so as to become subject -to the Workers' Compensation
Laws
of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Cert�cate • of Exemption you should become
.NOTICE
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
Ihereby 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
TOTAL
HEMARKS.
191
• s.
AMOUNT-
L
2.0u.
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 f Permit-
_ I
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL SQ. FT.
FOR. SO. FT. ®
GAR. SO, FT. ®
CAR P. SQ. FT.
WALL SQ. 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
vl
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM ' FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/iC
HOUSE SEWER
FRAMING
FINAL INSP.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.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
vl
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
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 G
4
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL