13375 (SFD)4 4 a"
P.O. BOX 1504 N o . 133T5.
BuildinALLE
Address 78-790 Irwin Circle LA QUINOTACCAL FORNpIA 92253
Owner ACdCx,r1 Construction
BUILDING: TYPE CONST. VN OCC: GRP. R3
Address 8141 E. Kaiser Blvd. #311 604-232-016
A.P. Number
City ZipTel. Lot 145 Tract 2.3268 Phase 2
Anahein? CA 92808 (7141282-5800 Legal Description
Contractor SFD Plan $
$ ame
Address
Tel.
State Lic.City
9 Classif. 293 54 Lic. # 3.632
Arch., Engr., Design
Designer
A��0151 Trvine ,Ave. 71714)641-15051
Cit i Zip St (e
BYanta ,Ana Fief pI&S. CA 92 c.#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Se
7000) of Division 3 bf the Businels and Professions Code, and my license is in�f01Vorce
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) 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 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 or 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 or 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. & 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.)
POlicy. 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 thg 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: 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 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-.
1 mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Project Description
Acacia Homes
Sq. Ft. No.
Size 23x'38 Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation cc 0p0A
$135 rr v92y V4�
PERMIT
AMOUNT
Plan Chk. Dep. .
Plan Chk. Bal.
643.05
Const.
765.50
Mech.
55.50
Electrical
159.13
Plumbing
168„00 .
S.M.I.
13.60
Grading
20.00
Driveway Enc.
.00
Infrastructure
3,053.07 --
,053.07 --
Arts
Arts n Public Places
89.23
TOTAL
4,967.28
REMARKS a
ZONE: --BY:-
Minimum
Y: 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:
Validati
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
*
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
ROUGH PLUMB.
BONDING
POR. SQ. FT.
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SD. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT. @
DRINKING FOUNTAIN.
SQ FT ®
METER LOOP
URINAL
ESTIMATED CONSTRUCTION VALUATION $
REINF. STEEL
WATER PIPING
NOTE: Not to be used as property tax valuation
GAS (FINAL) 4
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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.
SQ. FT. ® c
BATH TUB
VENTILATION
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE LPL.CCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
4 i 99
SETBACK
GROUND PLUMBING,S
J NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
Q L
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
AV
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
/
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) 4
TEMP. POLE
111
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL IN 01$
ROOFING -2..o,6,we
?
,
"t
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING C
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTIONLl
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL