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12842 (SFD)T4 UW CV P.O. BOX 1504 No. 12,842 Building 78-105 CALLE ESTADO Address 78-77V Irwin Circle LA QUINTA, CALIFORNIA 92253 Owner Acacia Construction I MailinBUILDING: TYPE CONST. OCC: GRP. Address 8141 9. `raiser Blvd. 0310 604-232-018 A.P. Number City Zip Tel. Anaheimil. CA, 928€38 Contractor Same Address ity lZip (714)'282"-580 egalDescription Lot 147 Tract. 23268 Project Description SFD Plan A Acacia Homes State Ljc. & Classif. B_;1 2'93954 Front Setback from Ce r t Mine X I ' Arch., Engr., Designer �� Design r Side Street Setback from Center Line Add�ee351 IrVirle AVC. Estimated Valuation $75,314.00 City Santa Arta He Zip Lghts, CA f State Lic,f#7 City Lic. # 61 Sq. Ft. 1280 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Tel.t714) 641-150 I hereby affirm that I am licensed under provisions .cT ChapteA (commencing with Section 000) of Division 3 of the Busine�sss and ProfessionnsrCode, and my license is in lull force and effect. %ax f/ 1/i.a _..:; e far... /- g ./ ,� 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). O 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.) p 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 contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner i 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.) Poli�Y N�� Company f,Copy is filed with the city. O 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 (3100) valuation or less.) I certify that inthe performance of the work for which this permit is issued, I shall not =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 Nam e 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-. mentioned property for inspection purposes. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip 3 Front Setback from Ce r t Mine X _t Rear Setback from Rear Prop. Line r Side Street Setback from Center Line Side Setback from Property Line Estimated Valuation $75,314.00 INSPECTOR PERMIT AMOUNT Plan Chk. Dep. c , Plan Chk. Bal. \ , ,57,6 Const. 531.50 Mech. - `. 49.00 Electrical: = 117.30 Plumbing ` 144.00 S.M.I. 7»60 Grading 0 20.00 Driveway Enc. .00 Infrastructure 1,694.57 r"• TOTAL_ REMARKS �I ZONE: BY Minimum Setback Distances: t" f Front Setback from Ce r t Mine X _t Rear Setback from Rear Prop. Line r 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. SQ. FT. ® $ UNITS COLL. AREA �• H r w � . Y ARD SPKLR SYSTEM 2ND FL. SQ. FT. p HEATING (ROUGH) STORAGE TANK POR. SQ. FT. Q MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. DRAINAGE PIPING CAR P. SD. FT. HEATING (FINAL) OTHER APPJEOUIP. - -WALL SQ. FT. DRINKING FOUNTAIN SQ. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP.g 1i5 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROOFING �� LAUNDRYTRAY AIR HANDLING UNIT CFM 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. SQ. FT. ® c BATH TUB SQ. FT. ®c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL LATHING 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 a SETBACK GROUND PLUMBING ERGROUND A.C. UNIT COLL. AREA SLAB GRADE � . ROUGH PLUMB. op BONDING HEATING (ROUGH) STORAGE TANK FORMS 4 SEWER ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS, (ROUGH q METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL 10"GAS (FINAL) TEMP. POLE GROUT WATER HEATER _ SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP.g 1i5 FRAMING FINAL INSP. ROOFING �� / b REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. 1 WTI FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL