14002 (SFD)P.O. BOX 1504 No. 14002
Building 78-105 CALLS ESTADO
Address 44-7304. Harland Dr LA QUINTA, CALIFORNIA 92253
Owner
Acacia Construction
Mailing
AddressS141 E. Kaiser Blvd. 0 310
VIN
BUILDING: TYPE CONST: OCC: GRP.—.�3
A.P. Number604-23i-020
CityZip Tel.
Anaheim I92808 1014) 282-580C
Legal Description Lot 12 Tract 23260
Phase 3_ '
Contractor'
Project Description SPD Plan A
Same
Address
Acacia
City Zip Tela
State tic.
&'Classif. "B-1 293954
City
Lic. # 1512
Sq. Ft. No., No. Dw.
Size 1400 Stories Units
Arch:, Engr:,
New ❑ Add ❑ Alter ❑ Repair ❑
-
-Demolition ❑
Designer DC Design
Address
Tel.
20351 Irvine Avis
(714) 641-150
City Zip
State
Santa Ana Ilei hts 9270-1
uc. #
LICENSED CONTRACTOR'S DECLARATION
I hereb affirm that I am licensed under provisions of Chapter 9 (commencing with Section
aQ 170f i n 3 of the Business,and Professions Code, and my license is in full force and
etfect.. � 2 q - 1,
•SIGNATURE - GATE
OWNER• ILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec: 7031.5,13usiness 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 purmwd to
the provisions of the Contractors License Law, Chapter 9 (conunenccng with. Section 7000) of
Division 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis
lot the alleged exemption. ,Any violation of Section 7031.5 by 'any applicant for a pend
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, as. owner of the property, or my employees with wages as their. sole compensation, willp
do,the ,work, and the'structure is not intended or offered for sale. (Sec. 7044, stasness and
.Professions Code: Me Contractor's License Law does not apply to an owner o1 property who
builds or improves thereon and who does such work himself or .through 1& 01 ernpoyees,
provided that such Improvements are
d . not intended or offered for sale. N, however, the budLirng
of Improvement is sowithin one year of completion, the ownerbmlder w® have the burden
of proving that he -did not build or Improve for the purpose of safe)
❑ 1, as owner of the property, am exclusively. contracting with licensed contractors to con-
struct ths'project: (Sec. 7041; Business and Professions Code: The Contractors 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 Sec- B. & P.C. for this reason
Estimated Valuation $84r040.00
- PERMIT
- -
AMOUNT "
Plan Chk. Dep. -
Plan Chk. Bal.
!1 r
Yi 8 V .56.
Const.
572 i Q®
Mesh•
49.00
Electrical
9
11.! „3Q
Plumbing
144.00
S.M.I.
8.48
Grading
-
20.00
Driveway Enc.
—0—
Date Owner
Infrastructure
1908.90
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's,Obmpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
POlic o. Company
EfrCopy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
3306.24.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed N the permit is for one hundred dollars ($100) vahration
or less.)
I certify that in the performance of the 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 ofCahfornia.
Date Owner
NOTICE TO APPLICANT: n, after making this Certlf sfe of Exemption, you should became
subject to the Workers' Compensation .provisions or the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked..
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from R op. Line
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.)
Side Street Setback Ce n ine
Side Setback from erty
Lenders Name
Le i's Address
Th
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.
FINAL DATE PE(�1e�R
vC /�
Issued by: Dat
r
%/
Validated by
,94
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
i
•
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
f
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
DRAINAGE PIPING
CAR P. SO. FT. ®
WALL SO. FT.
DRINKING FOUNTAIN.
SERVICE
FINAL INSP.
URINAL
SO FT ®
WATER SYSTEM
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
y plus x$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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,TEMJPERM
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.@ 1+/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
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
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 (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP. �%
GRADING
cu. yd.
y plus x$
=E
LUMBER GR.
FRAMING
ROOFING rift,"
z�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA HING /
MESH
INSULATION/SOUND/ 9
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL