13378 (SFD)T44t 4 4 a"
Building 78-760 Irvin Circle
Address
Owner Acacia Construction
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Address 8141 E. Kaiser Blvd. #310
CityZip Tel.
Axtaheim, CA 92801 1010282-5800
Contractor
Same
Address
City lZip
State Lia B-1 - 293954( City 1512
& Classif. Lic. #
Arch., Engr., DC Des,,�
Designer
ttl851 irvinef Ave. 1114) 541-1505
Siinta Ana. Heig.Iffs, CA 927I�Li��#
LICENSED CONTRACTOR'S DECLARATION.
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3,of the
/Business /and,Professions Code, and my license is in full force and
effect. f !! #i� ✓ : �' ?r .
SIGNATURE t ✓ DATE
OWNER -BUILDER DECLARATION
No. 13378
BUILDING: TYPE CONST. VN OCC: GRP.a Pa
A.P. Number 604-232--029
Legal Description Lot 148 Tract 23268 Phase' 2,
Project Description SFD Plan E
Acacia Mamas
Sq. Ft. No. No. Dw.
Size 2358 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
I hereby affirm that I am exempt from the Contractor's License Law for the following
g p when
tstimateo valuation 4 rt
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b
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
-
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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
PERMIT AMOUNT
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 Section 7031.5 by 'any for
-
Plan Chk. Dep.
of applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
,
Plan Chk. Bal. b43. !)
❑ 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
Const./b5.:T
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,
Mech. - 5`3.
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
Electrical .-159..3
of proving that he did not build or improve for the purpose of sale.) ..
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
'
Plumbing 1613 . U0
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
S. M. 1. 1 . blu
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec. B. & P.C. for this reason
Driveway Enc. . U
Date Owner
Infrastructure / UPJ •
Artb
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 No® Company
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6py
,
❑ is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL t b • d
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS'COMPENSATIONINSURANCE `
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
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or less.)
I certify that in the performance of thip work for which this permit is issued, I shall not
' —7
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
/ 1
Date Owner
J
NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become
V
ZONE: V BY: -�'
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
Ihereby 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 Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE INSPECTOR
This is a buildin ermit h I fill d t d d I'
proIper y e ou , signe an va Idated, 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. Issued by: Date Permit
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL -FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE Z
t 1 *
YARD SPKLR SYSTEM
2ND FL. SQ. FT. p
FORMS
SEWER ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. Sp. FT. ®
GAS (ROUGH) ' METER LOOP
of
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
GROUT
DRAINAGE PIPING
CARP. SQ. FT. ®
FINAL INSP.
WALL S0. FT. ®
—
DRINKING FOUNTAIN.
GRADING
cu. yd.
plus x$
_$
URINAL
SO. FT. ®
FRAMING
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
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0 0 n % .
v '
j2
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES ""
.
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTQ)(DISH)
APPLIANCE DRYER
FIREPLACE
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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
--.-.._SQ. F.T.-@-c. • •
BATH _.TUB ._
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FENCE FINAL
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 PLUMBIN / UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE Z
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) ' METER LOOP
of
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
/
FINAL INSP. �j�j
FRAMING
FINAL INSP.
ROOFING' y
I
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0 0 n % .
v '
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REMARKS:
REMARKS:
.
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL