13998 (SFD)Building
4
P.O. BOX 1504.
78-105 CALLE ESTADO
44-650 N. Harland Dr LA QUINTA, CALIFORNIA 92253
Acacia Construction
Address $141 E. Kaisex Blvd. # 310
City Zip Tel.
Anaheim. 9288$ 014) 282-580
Contractor
Sallie
Zip
& Classif. B-1 29395$ I Lic. # 1612
Arch., Engr.;- -
Designer DC Design
Address Tel.
20351 Irvine Ave. (710-641-1505
CityState
Beata ` Ana nZip his 9270Lic. #
LICENSED CONTRACTOR'S DECLARATION
I herebyy affirt��rrth�at I am licensed under provisions of Chapter 9 (commencing with Section
000)t f Dlvls of the Business and-f?ratesslons Code, and my IicenseA In fl �orce� d_
SIGNATURE _ DATE
OWNER -BUILD R DECLARATION
1 hereby affirm that I am exempt from the. Contractor's License Law' for the following
-resson: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after, Improve, demolish, or repair any structure, prior to its Issuance also
requires the applicant' for such permit to 10a a signed statement that he is licensed pursuant to
rip
of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 8 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis
for the alleged exemption.- Any violet:, of Section 7031.5 by 'any applicant for a permit
subjects the applicant. to a -civil penalty of not more than rive hundred dollars ($500).
O I, as owner ofrthe 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 taw does not apply to an owner of property who
builds or bnproves. thereon and who ;does such work himself or through his own employees,
provided that such Improvements are not Intended or offered for sale, fl 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.)
❑ 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. proiectswith a'contractor(s) licensed pursuant to the Contractor's License. Law.)
❑ l am exempt under Sec. B. 8. P.C. for this reason
IDate owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent, to self -insure, or a certificate of
Worker's Co ensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Pol icy N Company
CW'Opy 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 the 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 tabor Code, you must forthwith
comply with such provisions or this perm, 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, CIO Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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 Address
City, State, Zip
No. 13998
JILDING: TYPE CONST.OCC: GRP.
P. Number 604-231-016
Igal Description Lo.t 16 Tract 23268 Phase 3
oject Description SFD Plan D
Acacia
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from. Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Cen er 'ne
Side Setback from Property,
FINAL DATE
Issued by:
Validated.by:
Sq. Ft.183tt
Size
'No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$112 p.006.90
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal
Const.
Mech.
55.50
Electrical
1
Plumbing
38. 00
S.M.I.
11.21
Grading
20.00
Driveway Enc.
—0—
Infrastructure
2521.51
'Arts in Public
Places
30017
TOTAL
•
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from. Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Cen er 'ne
Side Setback from Property,
FINAL DATE
Issued by:
Validated.by:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
FORMS
SEWER
ROUGH WIRING
MOBILEHOME.SVC.
BAR SINK
POR. SO. FT. ®
GAS (R UGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) I
TEMP. POLE
DRAINAGE PIPING
CARP. SO. FT. a
GROUTWATER
Tf
HEATER
SERVICE
FINAL INSP.
DRINKING FOUNTAIN
WALL SO. FT. ®
WATER SYSTEM
SO FT ®
_
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FRAMING
WATER PIPING
NOTE: Not to be used as property tax valuation
/llzz
FLOOR DRAIN
MECHANICAL FEES
REMARKS:
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.
t SO. FT. ® c
BATH TUB
MESH
INSULATIONISOUND 7
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 114c
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
L
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (R UGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) I
TEMP. POLE
GROUTWATER
Tf
HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu: yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING a F
/llzz
_ /ep
C/1
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK.ARRESTOR
GAR. FIREWALL
ANG 63 y
MESH
INSULATIONISOUND 7
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESJINITUILS
GARDEN WALL FINAL