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14924 (SFD)44 P.O. BOX 1504 N o . 14924 Building 78-495 CALLE TAMPICO Address 78-805 b6tolan Circle LA QUINTA, CALIFORNIA 92253 Owner ALc'XG1a ConBti`2iC$3.dII BUILDING: TYPE CONST. VN OCC. GRP. R3 Mailin Address 8141 E. Kaiser Blvd. #310 604-233•-426 A.P. Number City Zip Tel. Anaheim, CA 92808 I(TIM282-5800 Contractor Same Address - State Lic. City & Classif. B -i, 293954 Lic. # 1612. Arch., Engr., Designer ��'sign 4i � i Irvine Ave.. 1114) 641-3:505 CityZip State Santa .anal l3©i9- A, CA 927 ZR. # . LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divi ion,3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNEWBUILDER 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, after, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rife a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or 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 penally 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 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 one year of completion, the owner -builder will have the burden or 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 LicenswLaw.) O 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, ora 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 (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 parson In any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: d, after making this Certificate or 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. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 egal Description %?t l35 Tract 23268 roject Description 'SFD plan D Acacia Sq. Ft. No. No. Dw. Size. 1835 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback.fiom Center Line Side Setback from Property Line FINAL DATE INSPECTOW- I I Issued by:- Date ✓�i.' • Perm it �\ Validated by: Estimated Valuation $112066.90 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 573.26 Const. 685.00 Mech. 55.54 Electrical 140.41 -Plumbing 138.00 S.M.I. 11.21 Grading 20.'00 Driveway Enc. 00 Infrastructure 2,521.51 Arts in Public Places 30.17 TOTAL 4,175.06 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback.fiom Center Line Side Setback from Property Line FINAL DATE INSPECTOW- I I Issued by:- Date ✓�i.' • Perm it �\ Validated by: CONSTRUCTION ESTIMATE NO.' ELECTRICAL FEES NO. PLUMBIW3 FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA 2ND FL. SQ. FT. YARD SPKLR SYSTEM POR SQ FT ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS ROUGH WIRING DUCT WORK DRAINAGE PIPING CAR P. SQ. FT. GAS (ROUGH) WALL SQ. FT. HEATING (FINAL) DRINKING FOUNTAIN SQ. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GRADING cu. yd. $ plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FRAMING "� fj LAUNDRY TRAY AIR HANDLING UNIT CFM � P OVENTILATION ,40 vi y/ /Sf (� 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ IA c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac 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 GOND. SOLAR SETBACK GROUND PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR ROUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH) ER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. FINAL INSP V GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING "� fj ROOFING� � P OVENTILATION ,40 vi y/ /Sf (� / REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING16 f MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURESIINITIALS GARDEN WALL FINAL