13994 (SFD)Building
4
P.O. BOX 1504
8-105 CALLE-ESTADO
78-850 West Harland Dr' LA gUINTA CALIFORNIA 92253
Owner
Acacia Construction
Mailin-
Address 8141 E. Raiser Blvd. 0 310
CityZip Tel.
. An€theirn 9280$ 1(714) 2$2-580
Address
State Ljc.. &-1 293954
& Classif.
Arch.-, Engr.;-
Designer DC DesigA
Addre s
10351 Irvin Ave.
Lic. # 161.2
4) 641-1505
City L4P tate
Santa Ana I lghts 4276 iC. #
LICENSED CONTRACTOR'S DECLARATION
I hereb affirm that I am.11censed under provisions of Chapter 9 (commencing with Section
000) of on 3 of the Businea� id Professions Code, and my license is in full f e and
effect. + t , '` _ 2-1 ..11
A. n.. c 1 t -
SIGNATUREDATE
OWNE -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's 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 at nod statement that he is licensed pursuant to
the provisions of the Contractor's License law, Chapter 8 (commencing with Section 7000) o/
Division 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
subjects the 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
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 bnproves thereon and who does such work himself or through his own employees,
provided Mat such improvements -are not intended or offered for sale. It, 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 safe.)
p I, as-6wner 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 pursuant to the Contractor's License. Law.)
0 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -Insure, or a certificate of
Worker's CompensationInsurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy N, ' Company
dopy is filed with the:city. O Certified copy is hereby furnished.
'CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed 8 the permit is lot, one hundred dollars (5100) valuation
or less.)
I certify that In the performance of the work for which this permit is issued, I -shall not
employany person in any manner'so as to become subject to the,Workers' Compensation
Laws of Callfornia.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation Provisions of the Labor Code, 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' a' 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.
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. 13,994
BUILDING: TYPE CONST. VN: OCC. GRP. R3
A.P. Number 604-231-012.
Legal Description Lot 20 Tract 2326$ Phase'" 3
Project Description SFD Plan D
Acacia
Sq. Ft. 1'$35 No.
Size Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation $112,066.90
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
573.26
Const.
685.00.
Mech.
55.60
Electrical
1.4� 0.41
Plumbing
138.00
S.M.I.
11.21
Grading
20.00
Driveway Enc.
—0—
Infrastructure
2521.51
Arts In PUblia Places
n.17
TOTAL
$ •
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Pron. Line
Side Street Setback fro Line
Side Setback from Pro Line
FINAL DATE I
Issued by:_
Validated by:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
ROUGH PLUMB. V
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. 0
SEWER A
GAR. SO. FT. 0
POWER OUTLET'
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CAR P. I SQ. FT. 0
METER LOOP
HEATING (FINAL)
WALL SO. FT,
REINF. STEEL
DRINKING FOUNTAIN.
SO. FT ®
GAS (FINAL) 7 1 1
URINAL
ESTIMATED CONSTRUCTION VALUATION $ _
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
SERVICE
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO(DISH)
APPLIANCE DRYER
WATER SYSTEM
FINAL jINSP.
�
��fivy
I
/►/
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
=$
LAUNDRYTRAY
AIR HANDLING UNIT CFM
VENTILATION
KITCHEN SINK
ABSORPTION.SYSTEM B,TM.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3Ac
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 PLUMBIN/G��16
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. V
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER A
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH). -f ly,
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) 7 1 1
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL jINSP.
�
��fivy
I
/►/
FINAL INSP.
y�
/ q�
GRADING
cu. yd.
$ plus x$
REMARKS:.
=$
LUMBER GR.
FRAMING zlt Appf
ROOFING l
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING / fr
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION `
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL