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12455 (SFD)T 'ty� 4,4 a" P.O. BOX 1504 No. 12455 Building78-810 vilest Harland LA QUINTA, CALIFORNIA92253 Address _ Owner Acacia Construction BUILDING: TYPE CONST. OCC. GRP. Mailin Address 8141 3. Kaiser Blvd. #310 A.P. Number 604-23i- 008 Wheim, CA ZIP 912808 F714) 282-5800 Legal Description Lot 24 Tract 23268 Pt'�a�� 1 C ntract r Project Description �cac'F�i Plan B ia eo>gistruction Address City Zip Tela State Lic: X3--1 293954 City 1612 & Classif. Lic. # Sq. Ft. 1596 No. No. Dw. Arch., Engr., Size Stories Units Designer �ES1G�II New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ `%d -M1 Irvine Ave. 7h4) 641--1505 C'�'ydnta dna H04% ICA 92 # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am Iicensed"under4tovislons of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and,Professions Code, and my license is In full force and effect: �� PL : �,- SIGNATURE DATE OWNER -BUILDER DECLARATION Estimated Valuation 7 I hereby affirm that I am exempt from the Contractor$9& Contractors License Law for the following ,'54 • e 00 , reason: (Sec. 7031,5,Business and Professions Code: Any city or county which requiresa perm# to construct, .after, Improve, demolish, or repair any structure„prior to Its issuance also 1 requires the, appikant for such permit to /rIs a signed statement that he is licensed pursuant to PERMIT AMOUNT the proWsions of the Contractor's License taw, Chapter 9 (commencing with Section 7000) of Dlvisfoo;.3•.of the 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 Plan Chk. Dep. subjectsatia applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 1,,as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 532.32 do the, work,..and'the structure is not Intended or offered for sale. (Sec. 70.44, euisness and Const. 626.00 Professions Code The Contractor's License Law does not a . 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 Mech. 55. 50 of improvement Is sold within one year of completion, the owner -builder will have the burdenEIBCtrICa1 3 42 '1 . of proving that did not build or improve for the purpose of sale.) O I, as owner of"the property, am exclusively contracting with licensed contractors to con- Plumbing 150 . 00 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 improvesthereon, and who contracts for S. M.I. i . 7© such projects with a eontractor(s) licensed pursuant. to the Contractor'sLicense Law.) . 13I am exempt under Sec. B. 8 P.C. for this reason Grading 20.06 Driveway Enc. .00 Date owner Infrastructure 2,172.30 WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy,No__f Company O Copy Is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS 3, 6 9 9. 2 4 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 pparson in, any manner so as to become subject to the Workers' Compensation Laws of California. Date owner NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become ZONE: -BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions of this permit shall be deemed revoked, Minimum Setback. Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Ihereby 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. Setback from Property Line Lenders Name Lenders Address FINAL DATE I PECT This is a building permitwhen properly filled out; signed and validated, and Is subject to expiration if work thereunder is suspended for 160 days. I certify that I have read this application and state that the above information is correct. ISSued'by:Date ermit 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. Validated by: ' ` 2) z . r N19Q Signature of applicant Date 1 LJ Mailing Address Validation: \ f City, State, Z1. CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO FT ® $ UNITS COLL. AREA SLAB GRADE OUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SO. FT. ® HEATING (ROUGH) STORAGE TANK FORMS SVC. BARSINK FOR. SO: FT. (itMOBILEHOME DUCTWORK ROCKSTORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGEPIPING CAR P. SO. FT. 0 GAS (FINAL) TEMP. POLE WALL SO. FT. @ DRINKING FOUNTAIN. $O FT ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used,as property tax .valuation WATER SYSTEM FINAL INSP. FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. plus x$ 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER'' HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ®'1Ya.c SEWAGE DISPOSAL SO.FT.GAR ® i4c HOUSE SEWER MESH 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 S AIR COND. SOLAR SETBACK I GROUND PLUMBING ROUND A.C. UNIT COLL. AREA SLAB GRADE OUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER ROUGH WIRING DUCTWORK ROCKSTORAGE FOUND. REINF. y ` GAS (ROUGH) �71?Y tv 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. it $ GRADING cu. yd. plus x$ =$ LUMBER GR. / FRAMING ` / (((REMARKS: ROOFING lt—//] VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND 1 FINISH GRADING FINAL INSPECTION a g CERT. OCC. G FENCE FINAL INSPECTOR'S SIONATURESIINITIALS GARDEN WALL FINAL