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13374 (SFD)T4hf 4 4 a" Building 78-800 Irwin Circle P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. 13374 Owner AC8Ci8 Construction BUILDING: TYPE CONST. VN OCC: GRP. R3 Address 8141 g.. Kaiser Blvd. 4310 604-232 -415 A.P. Number City Zip Tel. Lot 144 Tract 23269 Phase 2 Anatheim, CA 92808 014) 282-5800 Legal Description Contractor SFD Plan C SaltProject Description Address Acacia $Gums City Zip Tela State Lic. B-1 X93954 _ & Classif. City Lic. # ��� Sq. Ft. 1591 No. No. Dw. Size Stories Units Arch., En' Designer DC Design New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Add . La%s 1 Irvine Ave. T i�I4) 642-1.505 . Cit Banta Ana Ilei Ip ter CA 91 State Lic..# I LICENSED CONTRACTOR'S DECLARATION I hereby affirm that l,am licensed under provisions of Chapter 9 (commencing w'th Section 7000) of Division 3 of the Business and Professions Code, and my license is in fy11 force and effect f V i 1/ 1 -7 fl7 %,— - SIGNATURE t A' 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). ❑ 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 improve for the purpose of sale.) Estimated Valuation $94,648.00 PERMIT, AMOUNT - 1 - Plan Chk. Dep. g ►(} n _ Plan Chk. Bal: 1 _] �,�0 Const. 0 5 Mech. t 2 x35.5 - Electrical �. 49 Plumbing - _ 144.00 ❑ 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 License Law.) ❑ I am exempt under Sec. B. ti P.C. for this reason S.M.I..9.50 Grading 20.00 Driveway Enc. h 00 Date owner Infrastructure l., ]129.59 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, - Polic,y� Nolte Company Co is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS (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 thg 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. ) fN— � f 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. v ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line 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.) Side Street Setback from Center Line Side Setback from Property Line Lender's Name �- FINAL DATE INSPECTOR 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. Issued by: Date Permit Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS 2ND FL. SO. FT. DUCTWORK YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CARP. SO. FT. DRAINAGE PIPING WALL SO. FT. WATER HEATEIA DRINKING FOUNTAIN. SO. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ GRADING cu. yd. $ -Plus-x$-=$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP.(/ �0`i" FLOOR DRAIN MECHANICAL FEES ROOFING 0 WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM IKITCHEN 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.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 / / NDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER ROUGH WIRING DUCTWORK ROCK STORAGE FOUND. REINF. C.�� GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEGUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATEIA I SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ -Plus-x$-=$ LUMBER GR. FINAL INSP.(/ �0`i" FRAMING FINAL INSP. ROOFING 0 VIJ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL