Loading...
9903-0236 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date iil�a3�1 13 _ A,, 121 i99 Date C/�7Signature of Contractor f� � \yf' OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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, Business & Professionals Code). (. ) I, as, owner of the property, am exclusively contracting with licensed contractors to construct the 'project (Sec. 7044, Business & Professionals Code). ( ). I am exempt under Section B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: (z ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ( rI I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. STA:TI W.;�`1 42ti 35.9`:1 (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the work for which this permit is issued, I shalt not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor C6de,.0 shall forthwitb comply with thos e�provisions. iD20 Applicant -L-, t OWarning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for' a permit subject, to the conditions and restrictions set forth on his application. . 1. Each person upon whose � behalf this application is made & each person at whose request and for wh6se benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the aabove-mentioned property for inspection puur�pooses! ySignature (Owner/Agent] G'1?t! %�f -- Date2'� PERMIT # BUILDING PERMIT�;�.3 DATE � KI VALUATION q511%25 3 50 LOT �14 TRACT 1.t JOB SIj E ADDRESS 3; 6155 A RA COURT APN OWNER CONTRACTOR/DESIGNER/ENGINEER '47V'r-4J.%1,(,-r 0.0nTle, v ()/SiYld9J CAY'!.i'p ):11IGAP17C°�'i" {b AVQn." �£-013 "ivFlli`ir � -;M 3 NAPLES DRIVE I,A. QUIN EA CA. 92253 LA t.: UI(MI'A CA 92353 USE OF PERMIT SlNOLF .1"AMILY DWE.LU-NO. LOT $4, PLAN Mkt SI'D - Fi tti`vJI' DOES NOT I;vCLMIZ A:VAX «W%LL$ ()k KKDUL Nlt+1.•f'i1ILE 1S3VAN0i cif^ SAME "N TYPH. iMaiti i Cr"9NTRUl i1 N Z025.00 3F 1k.YRC7.VPATJ0 52>30 SIF d3titKtl P£tild,`AStk'C22CP 439AJU Sly 'XiTIMATIN) COSIt'OF MP1ST UCTIt3N PEIi�il,,ffT FEV, SUMta;M V CYDt+1,vrRU+C> no,&N f+'1E 101-000-418-M) IN.AI+ic; MM' FrUFF. NICI ANIC'AL:E 1d}j �lG -+} 'a -00t9 S�►3.SU GLI. -CSI IUCAL FEC 10140)420 -OW 3128.16 PLUMB+NO FEE 1.£11-0004,19-M $.f9U.75 NOTION t # Ftiro 01-000-241.000 Cflt.ADINTO 171M 101�OOD-4234M %x oo iNFRA:S`.t12LiCTUI72I"s1! 225.: O-443.342 SZ667.64 A.Wr T.N PUBLIC, PLt`a.1.7„,$ - RESIV 701-000-25-5.000 $18.13 1..1<SS PRI -PAID ]FEES $01M `!'OTAt'..I'Elttt IrF Ff RN 011-x. NOW 111111111111111111111 IN 62 I E R�FCEIPT /►,/ D1ATf- j ,j7�� �1 1 BY% jr D/jbl`l AL INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS ' Set Backs Underground Ducts Forms & Footings Ducts. Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap / F.A.U. Framing Compressor Insulation Vents Fireplace .L. Grills Fireplace T.O. Fans & Controls Party Wali Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath/ Final Final BLOCKWALL APPROVALS POOLS -SPAS steel - Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping 7 Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G. F.1. Smoke Detectors Temp. Use of Power /Z Final Utility Notice (Perm) COMMENTS: cx U I— N_ to W O � M r` u7 W C Z f` �0o I— C) J F -a 0) Z C11) L0 N ON (.5 °) CL Q Z `rQcc 0 J Q mVU O a a) 144,.Z co5 r, C) LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 488234 B 12/31/99 Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec: 7044, Business & Professionals Code). () I am exempt under Section , B&P.C. for this reason Date Sianature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ( ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ( ) I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. STATE FUND 626355-98 (This section need not be completed if the permit valuation is for $100.00 or 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, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnity & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) Date BUILDING PERMIT PERMrT"M 03- 23 DATE , r VALUATION 5119,253.50 LOT 54 TRACT 28458-1 - Uv -0� JOB SITE ADDRESS 43-615 ALBA COURT APN 6119-070-038 OWNERCONTRACTOR / DESIGNER / ENGINEER LAER,UVVXCiXTf--vp0Ln DOJiD SIK. L.&IB RCHR & ASSOC i , 78-615 NAPLES DR 78615 NAPLES DRIVE LA QUINTA CA 92253 LA QUINTA CA 92253 (760)772-0222 CBL# 1858 USE OF PERMIT SINGLE FAMILY DWELLING. LOT 54, PLAN 3AR; SFD - PERMIT DOES NOT INCLUDE BLOCK WALLS QR POOL. PLAN CHECK FEE REDUCED 75% FOR MULTIPLE ISSUANCE OF SAME PLAN TYPE. TRACT CONSTRUCTION 2.025.00 SF PORCH/PATIO 52.00 SF GARAGE/CARPORT 439.00 SF ESTIMATED COST OF CONSTRUCTION PERMIT FEE SUMMARY CONSTRUCTION FEE 101-000-418-000 $709.50 PLAN CHECK FEE 1014000-439-318 $146.98 MECHANICAL FEE 101-000-421-000 $53.50 ELECTRICAL FEE 1014000-420-000 $128.16 PLUMBING FEE 101-000-419-000 $140.75 STRONG MOTION FEE - RESID 101-000-241-000 S11.93 GRADING FEE 101-000-423-000 520.00 INFRASTRUCTURE FEE 225-000-443-342 52.667.64 ART IN PUBLIC PLACES - RESIC 7014000-255-000 $48.13 119,253.50 SUB -TOTAL CONSTRUCTION AND PLAN CHECK $3,926.59 LESS PRE -PAID FEES $0.00 TOTAL PERMIT FEES DUE NOW I 53,926.59 IIIIIII VIII III VIII IIII 64 _ IE RECEIPT DATE BY DATE FINALED I INSPECTOR SEP -22-99 WED 08:31 WESTERN INSULATION RX NC. 9096868786 P.09 I III�III VIII III VIII IIII 65 IE WESTERN INSUL,,ATION . INC. 4211 Latham Street, River�sidc, ;aUomia 92501 ' TeL (909) 686-8760 Fax (9C-9) 686.8786 INSULATION CERTIFICATE THIS IS TO CERTFY THAT INSULATION HAS BEEN 'NSTALLED IN CONFORNtANCE WITH, THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: TRACT! PHASE: BELLA VISTA — TRACT #28458-1 LOT # -54 SITE ADDRESS: 43615 ALBA COURT, LA QUINTA, CA EXTERIOR WALLS:: MANUFACTURER: John an ' HICKNESS: 3 55// " �R-VALUE: R-13 \ /' 1 CEILINGS: BATTS gLpW MANUFACTURER: Johns- anville THICKNESS. 11 R -VALUE: R-30 - - GENERAL CONTRACTOR: TRADITIONAL BUILDN IG CO. LICENSE NUMBER: BY: TITLE: DATE: INSULATION C-ONTRACTOR: WESTERN INSULATION, INC. LICENSE NUMBER: 481278 BY: TITLE: P UCfIONNAGER DATE: SEPTEMBER 22, 1999 1— ROGER SNELLENBERGER DEVELOPMENT 78615 NAPLES DRIVE LA QUINTA, CA 92253 (760)772-0222 (760) 772-0257 FAX TO: Apex Interior Source 79-553 Country Club Drive Bermuda Dunes, CA Fax: 360-3167 Aftention: Denise Lot & Phase: Lot 54, Phase 5 Date Required ASAP Requested by: J. Donald Olson Vice President PURCHASE ORDER # 2233 September 29, 1999 PROJECT: Bella Vista, Phase 5 Ship to: 43615 Alba Court La Quinta, CA Qnty Ord'd Material / Work Required Unit Price Total Furnish the following upgraded window covering: 1 Premier verticals w/soft flow valence $1,379.36 $1,379.36 Fresno White (pricing the same as La Jolla White) Horizontals with Privacey 7) Verticals 6) Horizontals 5 TOTAL $1,379.36 spectai•conaitionsnnstructions: Roger Snellenberger Develop ,nt v , CC: Design AUKNUVVLtUUt: ANU Kt I UKN Apex Interior Source By: Sep 29 99 11:19a F!ita Pursley 760-G74-1660 P.1 ... .. ... .. IIIIIIIIIIIIIIIIIIIIIIIII 66 Traditional Design 1E .5 White Sun Way. Rancho Mirage, CA 9,2270 (760) 674-1188 Fax (760) 674-1668 J & S Floors, Inc. 16872 Hale Avenue, Suite A Irvine, CA 492606 (949) 442-71390 Fax (949) 442.7891 Pager (949) 733-4681 PROJECT LOT/ PH... PLAN BELLA VISTA 54/5 101 AREA DESCRIPTION. Per Diagram Tile-B-IMO-Magiara Beige 14x14 Per Diagram .;Carpet -Bayview -Satin Pearl Pad -3/8" 51b Purchase Order I DATE P.O. NO. 9/27,199 i 2614 CLIENT NAME C.O.E. P-CANVOICE NO. fV.1C ILNITOSH 9127/99 C-BV54/5-01 QTY UNIT RATE AMOUNT 854 S/f 6.37 1 5,439.98 1.42.33 'S/y 6.00 I 853.98 IATTACH A"*COPY 'dF"THIS Pljk(:HAStORDER tdTHE dbRkE61�Ok-Dikb' INVOICE AND SEND TO: TRADITIONAL DESIGN CENTER 5 WHITE SUN WAY, RANCHO MIRAGE, CA, 92270 1411C1111UN: KIIAru EY y i ;SIGNATURE DATE % Total $6,293.96! F AXED LOXM Sep 29 99 11:19a Rita Pursle!j ?60-G?4-lGGO p.2 E L L'A I S TA 2 0 .2 .5 2,025 SquareFeet, 3 Bedrooms & 2 baths. Great I?owl:, Formal Dining Room, Sunny Morning Room, Interior LaundiTy Room., Wood-Bvrning Fireplace. With Gas Roger Snef I im I) cvj:,:r ;.nd Associates reserves '11;: rig. )t tv ch"'vgv prnduct I es g t. niter ('lsitI:,cI, ..:'hour AIIVcam.ru,zwt% arappr min!.Iaiw. I P131" JOIi projeG tv-.,uerin I z %-r^ prt!i in innry andb� suw ic) change i"i If, ow notice. 4;k4;ksales ol%insclor for detaili.