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14923 (SFD)Buildin Address 78-795 Nolan Circle Owner Acacia Construction P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Mailin Address 8141 E.. raiser Blvd. #310 City T ip Tel.. Anaheim, CA 92808101411282-5800 Contractor Same ity - )Zip I Tel.: State Lic. City & Classif. E-1 233954 Lic. # 1G1«1 Arch., Engr., DC nesi3 Designer - Will irvin'e A,ve. 1114) 641-1505 City Zip J&tate Santa ,eta Heig its, -CA 927# LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9.(commencing with Section . 7000) of DTII" Vol the Business and Professions Code, and my license is in full force andannd effect. B.v..._ FIA �t9 )'u. �/1�z �' Tri $1GNATURE """ttL F DATE OWNER-BU,ILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any .city or county,' whlch requires a permit to construct, atter, 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 basts for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a cMl penalty of not more than rive 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 knprove 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) (lcensed 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.) Poll 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 pparson in any manner so as to become subject to the Workers' Compensation Laws of Calmfomia. Date Owner NOTICE TO APPLICANT. N, - after making this Certificate o1 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. 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 160 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 No. 14923 BUILDING: TYPE CONST. YN OCC. GRP. B3 A.P. Number 604-233-025 Legal Description Lot 194 Tract 23268 an C Project Description B' ��' ACncia Sq. Ft. No. No. Dw. Size 1.691 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Estimated Valuation $98, X45.00 PERMIT AMOUNT Plan Chk. Dep. sued by: Plan Chk. Bal. 536.78 Const. 636.0€3 Mech.65.50 Validation: Electrical x,33.49 Plumbing 144.00 S.M.I. 9.84 Grading 20.00 Driveway Enc. .tai! Infrastructure 2,215.02 TOTAL 3,747.63 REMARKS 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 /;1 /SPECTOR­ FINAL DATE ate sued by: PermiO V Validated by: / 'y% X• Validation: 1 �J - CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. 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 FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(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. SQ. FT. RESID @ 11/4 c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® 3/.c HOUSE SEWER FINAL INSP. ROOFING Z GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL =EES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING n� ELECTRICAL HEATING & AIR COND. SOLAR . cin SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRAD (� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER S A ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) / / METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL mv GAS (FINAL) TEMP. POLE GROUT WATER HEAT R SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ -Plus-X$-=$ LUMBER GR. FINAL INSP. FRAMING / FINAL INSP. ROOFING Z 1 J � ©��'• / (^� l/{ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LAT ING T MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION' CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL