12464 (SFD)Buildi
C&tyl 4 4 9
P.O. BOX 1504
78-105 CALLE ESTADO
78-805 West Harland LA QUINTA, CALIFORNIA 92253
'".. Acacia Construction
mailin
Address 8141 B. wiser Blvd. #310
City I Zip Tel.
Anaheim, CA 1 92808 {71411282-5800
Contractor
Acacia Construction -
Address
p
state LiC. B-1 293954 (City 1612
& Classif. Lic. #
Designer
DC Design
Deesigner �
A�%!r&1 1rvirke Ave.
Santa Ana Heid
LICENSED
I hereby affirm that I am licensed
7000) of Division 3 of the Business
effect.
411641-1505
, CA 92 17#
ACTOR'S DECLARATION
"ng with Section
in full 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, after, 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
=visions of?the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Dlvlsidn.3'otahe'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 applklerir to a civil Penalty of not more than rive hundred dollars ($500).
O' I, as owtier_of,ttie 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•bullder will have the burden
of proving that he did not build or improve. for the purpose, of sale.)
O 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 contractors) licensed pursuant to the Contractor's License Law:)
❑ 1 a 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, or a certified copy thereof. (Sec. 3800, Labor Code.)
PolicyNoi Company
O,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
Of 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 CertNicate of Exemption you should become
subject to the Workers' Compensation provisions of -the LaborCode, you must forthwith
comply with such provisions or this permit shall, be deemed revoked.
CONSTRUCTION LENDING, AGENCY
I hereby affirm thatr 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.
.1 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 inspectlon;purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
AJ
No. 12464
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 604-'232-007
Legal Description Lot 136' Tract 23268 Prase I
Project Description SFD Plan D
TOTAL 4,042.63
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
Issued
Validat
Validat
Sq. Ft. 1835
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter O Repair ❑ Demolition 0
Estimated Valuation
$107,753.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
560.75
Const.
567.50
Mech.
55.50
Electrical
140.41
Plumbing
138.00
S.M.I.
- 10.80 .
Grading
20.00
Driveway Enc.
iyQ
Infrastructure
2,424.67
Arts in Public
Places 25.00
TOTAL 4,042.63
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
Issued
Validat
Validat
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE6
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
BONDING
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR.SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
DUCT WORK
DRAINAGE PIPING
CAR P. SQ. FT.
GAS (ROUGH).`//,/9,I
-WALL $Q. FT.
DRINKING FOUNTAIN
SQ FT ®
REINF. STEEL
URINAL
ESTIMATED CONSTRUCTION VALUATION $
TEMP. POLE
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
IWATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE. UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
LUMBER GR.
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.
SQ -FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ®'3/ic
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 Z Z
C/
GROUND PLUMBING
(UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE6
3 l LG1
ROUGH PLU B.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER O42
K
ROUGH WIRING:
DUCT WORK
ROCK'STORAGE
FOUND. REINF.
GAS (ROUGH).`//,/9,I
METER LOOP
HEATING (FINAL)
OTHER APPJEGUIP.
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. :/
FRAMING
FINAL INSP.
ROOFING (/ /y
/6
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING MkV/✓ t4
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION 3 �✓
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
41
OP
(fit#Uinta :a,f;
',. f'. Ute tit an'b 'afetnt tt �t ��Y�7,1
This-, C"cdte issued pursuant to the requirements of Section 306 of the Uniform 8ulldlhO,-.',r,,
..Code -certifying that at the time of issuance this structure was In compliance with the varioits.
ordinances of the City regulating building construction or use., For the following:
BUILDING ADDRESS 781-805 West Harland
Single Family welling
S FDBid
g. Nrmlt No. 12464
droop''VN Type Construction Fire Zone use zdn* SR
j4
4—,_ ns
Acacia Construction 8.141 R. Kaiser Bl'vd. #316,
Ow"Or *VBWldIh9. Address
hbim, CA 92808
Mark Harold
BY1.
Dots. March 25, 1994
Building Official
.I
-.00Tm i-ONIVICUOUB PLAN
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