13384 (SFD)T44t 4 4 Q"
Building
Address 78-805 Irwin Circle
Owner Acacia Construction
Mailing
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No.
BUILDING: TYPE CONST. Vs OCC. GRP
13384
Address 8141 E'. Kaiser Blvd. #310A.P. Number 604-232-027
City Zip Tel. %t 156 Tract 23.268 Phase 2
Anaheim, CA 92808 (714)x82-5804 Legal Description
Contractor Project Description Siam Plan
Same
_ Address
City lZip
State Lic. g.,.1 293954
& Classif.
Arch., Engr.;, Design
Designer g
A 2.0is-1 Irvine Ave.
City 1612
Lic. #
TeJJ.710 641--1505
CityIp State
Santa Ana Hei'hts, CA 9 ria.7f
. LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I arWlicensed under provisions'of Chapter 9 (commencing with Section
i 7000) of Division 3 of the'Business and Professions Code, and my license is in fu11`fioor6e a♦♦n'dd
effect.
r
_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).
01,
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.)
❑ 1, 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 'enpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policl 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 i1 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 person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making 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 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
Acacia Homes
Sq. Ft. .
Size '2358
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
'$135692.00 92.V0
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
643.05
Const.
765.58
Mech.
_
55.50
Electrical
159.33
Plumbing
168.00
.S.M.I.
13.60.
Grading
20.00
Driveway Eno.
40
Infrastructure
3,053.07
Arts in PubTic
Places 89.23
c
TOTAL'__77 4;967.28
REMARKS i
lip r r r
ZONE:—BY:—
Minimum
ONE: 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
SLAB GRADE L� f
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. p
FORMS
.10
SEWER,
9
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH) /
ETER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) /
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
WATER HEAT�R
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ. FT. ®
WATER SYSTEM
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
VENTILATION
FLOOR DRAIN
MECHANICAL FEES
_
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FENCE FINAL
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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. p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/a 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 COND. SOLAR
SETBACK
GROUND PLUMBING
t y DERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE L� f
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
.10
SEWER,
9
ROUGH WIRING
DUCTWORK
ROCK STORAGE
FOUND. REINF.ACAV
GAS (ROUGH) /
ETER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) /
TEMP. POLE
GROUT
WATER HEAT�R
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP. 7
>
GRADING
cu. yd.
$ plus x$
REMARKS:
=$
LUMBER GR.
FRAMING 5 7�
ROOFING
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL /117
LATHING
MESH
INSULATIONISOUN
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL