9617 (SFD)Building
Address 78-670 Carnes -Circle
Owner
Acacia
Mailing
Address 1021 Bastanchu_�v Ron
City lZip ITel.
Contractor
Address
t
Zip I Tel.:
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST
A.P. Number
State Lic. City
& Classif. B 2923954 1 Lic. # 1612
Address Tel.
City Zip State
I I Lic. #
LICENSED.CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed'under provisions of Chapter 9 (commencing with Secti n
7000) of Division 3 of the Busines's and Professions Code, and my license it in full force aond
effect.
SIGNATURE- DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reasop: (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 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).
0 1, 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 hl ' a own employees,
provided that such improvements are not intended or offered for sale. - If, however, the, building
or improveme!ntlis 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.) . .
b 1, as owner o6he property, am exclusively'contracting with licensed contractors to con-
struct the projec ' I . (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.)
0 1 am ex��pt under Sec.—B: & P.C. for this reason
Date __�.—Owner
WORKERS' COMPENSATION DECLARATION
I hereby aiffirm.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
0 Copy is filed with the city. .0 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 thp work for which this permit is issued, I shall not
employ any person in any manner so as Ao become subject to the Workers' Compensation
ma.
Dal, /. - I ' '. �_Iowner
Laws of Califor
NOTICE TO APPLICANT. If, after maWijn 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 Nam — -_
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 i s correct.
I agree to comply with all city and county ordinances and state laws relating to building
con st ruction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant —Date
Maili ' ng Address
City, State, Zip
Legal Description Lot 55
Project Description Plan. A-3
No.
OCC*. GRP.
9617
Sq. Ft. No. No. Dw.
Size 1362 Stories Units
New 0 Add El Alter 0 Repair 0 -Demolition 0
5timated Valuation
74,631
PERMIT
� I . .
I I
AMOUNT
Plan tlik.., b6p. -
Plan Chk. Bal.
446.34
Const.
527.00
Mech.
47.00
Eledrical
�90.61
Plumbing
'A20. 50
S.M.I.
5.25
Grading
Driveway Enc.
Infrastructure
1679.19
G 71 Q 114– 14
TOTAL
2915"'89
REMARKS
ZONE: BY:—
Minimum Setback Distances:
—Front Setback from Center Line
RearSetback from RearProp. 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
I ST FL. SQ. FT. @ $
UNITS
SLAB GRADE
1�z
2ND FL. SQ. FT. @
BONDING
YARD SPKLR SYSTEM
FOR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. @
GAS(ROUGH) &(X&?/
DRAINAGE PIPING
WALL SO. Fr. @
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
SQ. FT. @
TEMP.PCLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
I FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.)OlAe
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 SYST�M- FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. @ c
BATH TUB
SO. FT. @ c
I WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR @ V4c
IHOUSE SEWER
F
1.7UTHWING 1,40
IGAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBIL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT.FEE
SMIFEE PLUMB. FEE
STRUCTURE /-PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR -
SETBACK
'?
/GROUND PLUMBING -7(/, (qt,
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
1�z
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
V
FORMS
ZIOSEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE.
FOUND. REINF./? V
GAS(ROUGH) &(X&?/
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
z
GAS (FINAL)
TEMP.PCLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
_c.. yd -
$_plus_x$_=$
LUMBER GR.
FINAL INSP.)OlAe
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
F
1.7UTHWING 1,40
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION-
6
-
CERT. OCC.
FENCE FINAL
INSPECTORS SIGNATURESIINITIALS
GARDEN WALL FINAL