13997 (SFD)ng
4
P.O. BOX 1504
44-•630 N. Harland Dr LA QUINTACCALIFORNIA 92253
Acacia Construction
Address 8141 S. Raiser Blvd. # 310
City Zip Tel.
Anaheim 1 92808 1(714) 282-5000
:lame
Address
State Lic.
AMOUNT
City
& Classif. B-1 293954
486. 6
Lic. #
1612
Arch:, Engr,, -
49.OU
Electrical
Designer jC Design
Plumbing
144.0101
Addie s0351 Irvine Ave
614)
641-150
CityZi
State
-0-
Santa Ana. . Tghts;
92700C.#
. . LICENSED CONTRACTOR'S DECLARATION
I' hereto Iirm that I am.licensed under provisions of.Chapter 9 (commencing with Section
000) of v�Q n� 3 of the Businessr–a7nd Professions Code, and my license is in f1'�I'7fprce nd
ffect: "X�Aii a .� S-� A � � .F.
0.0,^—
OWNER-MILDER DECLARATION
I hereby affirm that Lam exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,13usiness.and Professions Code: Any city or county which requires a
permit to construct, atter; Improve, 'demotish, or repair any structure,, prior to Its issuance also
requires the applicant for Such permit to 0fe a signedstatementthat he Is licensed pursuant to
the provisions o1 the Contraofor'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 ekemptlon. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to. a cW penalty of not more than five hundred dollars (5500).
O 1, as owner of the propertyor my employees with wages as their sole compensation, will
do the work, and,the structure, is not intended or offered for sale. (Sec. 7044, Bulaness 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 hedid not bulli or rrriprove 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.)
❑ 1 am exempt under See. 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_.Qompdnsation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy o. 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 th0 work for which this permit. is issued, I shall not
employ any:pparson in any'manner so as to become subject to the Workers' Compensation
laws of Calitornia.
Date owner
NOTICE TO APPLICANT: n after making this Certificate of Exemption you should become
sub)ect 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. 3087, Civil Code.)
Lender's Name
Lender's Address
This Is a bullding permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that 1 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 Address
City, State, Zip
No.
JILDING: TYPE CONST. 1, H OCC: GRP.
P. Number 604@231-015
1.3997
A3f
,Legal Description Lot 17 Tract 23268 Phase 3
Project Description SPD Plan A
Acacia
Sq. Ft. No. No. Dw.
Size- 1400 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $84.84U.80
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
486. 6
Const.
572.00
Mech.
49.OU
Electrical
I 7. 3
Plumbing
144.0101
S.M.I.
8.48
Grading
2.0.00
Driveway Enc.
-0-
Infrastructure
1 13 0 8•
TOTAL j j 33up.6�
REMARKS
ZONE: BY:
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
Issued by:
Validated
Validation:
�9,95r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. a $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2 ND FL. SO. FT. a
ROUGH PLUMB.
O
BONDING
MOBILEHOME SVC.
BAR'SINK
POR. SO. FT. a
`
GAR. SO. FT. a
POWER OUTLET
ROOF DRAINS
ROCK STORAGE
FOUND. REINF.
DRAINAGE PIPING
CAR P. i SO. FT. a
GAS (ROUGH)
ETER LOOP
WALL SO. FT. a
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SO. FT. a
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
SERVICE
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
=a
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FRAMING Ca
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. a c
BATH TUB
SO., FT. a c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID a 1 Vi c
SEWAGE DISPOSAL
SO.FT:GAR a 34c
HOUSE SEWER
SPARK ARRESTOR
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 GOND. SOLAR
SETBACK
GROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
WAI
ROUGH PLUMB.
O
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
`
SEWER
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
ETER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
E plus xa
=a
LUMBER GR.
FINAL INSP. ,
FRAMING Ca
FINAL INSP.
ROOFING D
S
/'j
%Z
V
g /�
ZT/ / �Y
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHI G
MESH
INSULATIOWSOUND' 9
FINISH GRADING +�
FINAL INSPECTION 7
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL