13379 (SFD)6 .44 0 .
' P.O. BOX 1504
Building 78.-750 Irwin Circle 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Acacia Construction
mauing
Address 8141-E. Kaiser Blvd. #310
City Zip Tel.
Anaheim, CA 92808 101411282-5800
Contractor
ramd
Zip
Statesi f. B-1 293954
& Classif. .
-Arch., Engr.,
Designer DC Design
• Add ess
X 3$1 IrVIZe, Ave.
Cizip
SaY3'�A Ana St�''•i1. lhts,
I hereby affirm that I am)licen'sed unc
7000) of Division 3.of the"Business and
effect. j7::
%,Ixy
Lic. # 1612
'J'714)
714) 04 —1.505
State
92 UPW . .
DECLARATION -
of Chapter 9 (commencingwith Section
.ode; and my license is in Iull.force°and
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).
❑ 1, 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.)
❑ 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.)
0 1 am exempt under Sec. B. ti. 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 N� .Company
GkCopy 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 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
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.)
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-.
mentioned property for inspection purposes.
Signature of applicant -Date-
Mailing
ateMailing Address
City, State, Zip
No. 13379
BUILDING: TYPE CONST. VX OCC: GRP. R3
A.P. Number 604`232--020
,Legal Description Lot 1.49 Tract 232618 Phase 2
Project Description SPD. Plan D
Acacia Homes
Sq. Ft. 1835No. No. Dw.
Size - Stories Units .
New ❑ Add ❑ . Alter ❑ Repair ❑ Demolition ❑
=stimatea valuation
$107,,763.00
PERMIT..
AMOUNT '
Plan Chk. Dep.
Plan Chk. Bal.
" _
Const.
�560.75
6:67.50
Mech.
_
55.50
Electrical"" '• j 240.42
Plumbing
138.00
.S.M.I.
10.80
Grading
20.00
Driveway Enc.
00-'
Infrastructure
2F-424.6,7 '
Arts 3n Public Places 25.00
TOTAL
4.042.63
REMARKS
( 1r7
p
ZONE:
BY:
Minimum Setback
Distances: f
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:
16
Date Permit. -- ^-'
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT.® $
t UNITS
COLL. AREA
h
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CARP. SO. FT. ®
WALL SO. FT.
WATER HEAT
DRINKING FOUNTAIN.
FINAL INSP.
URINAL
SO. FT.
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ plus x$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
—�4'1,
FLOOR DRAIN
MECHANICAL FEES
ROOFING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
"'
GARBAGE DISPOSAL
!FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
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. ® 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
7 71
SETBACK
GROUND PLUMBING
NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE rl
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)% !/
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEAT
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR.
FINAL INSP.
—�4'1,
FRAMING 7j
FINAL INSP.
ROOFING
�.-� q /
/
/yn
�+
'V
%���//�j
l
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL