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12515 (SFD)P.O. BOX 1504 No. 12515 Building 78-105 CALLE ESTADO Address 79-755 West Karlantl LA QUINTA, CALIFORNIA 92253 Owner Acacia Confstsuctia�s Mailing BUILDING: TYPE CONST. OCC. GRP. Address 0141 E. 'Kaiser -Blvd. 031060$^232 -gilt A.P. Number City Zip Tel. Anaheim, Ctrl 92503 1010282-5800 Legal Description Uot 131 Tract 23265 Phase -1 Contractor Project Description S17D Pian B Acacia Construction ty State sic. B-1 293954 I Licy & Classif. If 1612 Arcn., tngr., Designer i)C Design Address Tel. 20351 Irvine Ave. (714)641-1505 City lZip State -Santa-Ana Hei hts, CA 92 TWIN LICENSED'CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70(10) of Division 3 of the Business and Professions'Code, and my license Is In full force and effect. 1 { ! " r SIGNATURE LL- DATE OWNER -BUILDER DECLARATION I heretij..affirm that I am exempt from the Contractor's License Law for the -following reason: ;(Sec':'7031,:,5'puslnesa and Professions. Code: Any city or county which requires a peis"o Construct,. alter, improve, demolish, or repair eny structure, prtor to Its Issuance also req alres,fhe:eppJcant fors permit to fth a signed statement that he is licensed pursuant ro =the'provlslons ol'the Contractor's License Lew, Chapter 8 (commencing with Section 7000) of OMsion 3 0/ the Business end Professions Code, or that he Ls exempt therelrom, and tha basis for the alleged. exemption. Any violation of Section .7031.5 Dy 'any applicant ror a permk subjects: the'applk:ant to a civil penally of not more than five hundred dollars ($500). 0 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, Bulsness and Professions Code: fie 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 buildor knprove 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 projects with a contractor(s) licensed pursuantto the Contractor's License Law.) ❑ 1 am exempt under Sec. 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. Compensation Insurance, ora,certified copy thereof. (Sec. 3800, Labor Code.) Policy No. -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 orless.) 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 Coda, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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.) 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. 1 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 Sq. Ft. 1596 No. No. Dw. Size - Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑. Estimated Valuation $96,547.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 532.32 Const. 626.00 Mech. 55.50 Electrical 1.33.42 Plumbing 150.00 S.M.I. 9.70 Grading 20.00 Driveway Enc: .00 Infrastructure 2,172.30 TOTAL 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 DA Issued by Validated Validatior CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST 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(ROUGH)71?/14 METER LOOP GAR. SO. Fr. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGEPIPING CAR P. SO. FT. ® GROUT WATER HEATER WALL SO. FT. FINAL INSP. DRINKING FOUNTAIN. SO FT a WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ =$ 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(AUTOXDISH) 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, TEM/PERM 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 ® 1Vi c SEWAGE DISPOSAL SO.FT.GAR Q Vic 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 C Z �3 /� �- Y �—' GROUND PLUMBING` DERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER, ROUGH WIRING DUCTWORK ROCKSTORAGE FOUND. REINF. GAS(ROUGH)71?/14 METER LOOP HEATING (FINAL) OTHER APP./EOUIP. 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. 3 7 FRAMING FINAL INSP. ROOFING l / / 9 / REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING Z)A�Al I d MESH INSULATION/SOUND / FINISH GRADING FINAL INSPECTION 3 �� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL 7% C tit 41 at Vu*nta UttOb ton t tint This. CertiflGote issued pursuant to the requirements of Section 306 of the Uniform Building ': - Codecertifying that at the time of, issuance this structure was In compliance with the various. ordinances, of the City regulating building construction or use. For he following: BUILDING ADDRESS 78-755 Wiest Harland User.gotsifiootionS ingle Family -Dwelling -Dwellinq, 12515 Bldjj. Permit No on VN - -up 3 Type Constructi .Mrs Zone Use zons, SR Acacia Construction 814:1 R. Kaiser Blvd'. #310 ,-Owner of Budding.Addriss CifyAnaheim, CA 92808 -Mark Harold Byl, Dcft:,March 25,,. 1994 Off a Iff Sul 'd'rn§ Off'ols' us POST IN A Q0VV*14V0" - PLAN