9903-0231 (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
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 Signature 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, 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 above-mentioned property for inspection purposes.
Signature (Owner/Agent) Date
'AIr
BUILDING PERMIT PERMIT 9"3-231
DATE VALUATION 5162,948.70 LOT 59 TRACT 28458-1
3
JOB SPtE
ADDSS 43.676 ALBA COURT
AP"
609-070-038
OWNER
CONTRACTOR/DESIGNER/ENGINEER
THE EXCHANGE GROUP
ROGER SNELLENBERGER & ASSOC.
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 59, PLAN 6A; SFD - PERMIT DOES NOT INCLUDE BLOCK WALLS
OR POOL.
TRACT CONSTRUCTION 2,763.00 SF
PORCH/PATIO 90.00 SF
GARAGE/CARPORT 598.00 SF
ESTIMATED COST OF CONSTRUCTION
162,948.70
PERMIT FEE SUMMARY
CONSTRUCTION FEE 101-000418-000 5860.00
PLAN CHECK FEE 1014000439-318 5718.69
MECHANICAL FEE 1014000-421-000 $92.00
ELECTRICAL FEE 1014000-420-000 $157.17
PLUMBING FEE 1014000-419-000 $166.00
STRONG MOTION FEE - RESID 1014000-241-000 $16.29
GRADING FEE 1014000-423-000 $20.00
INFRASTRUCTURE FEE 2254000-443.342 53,639.41
PRECISE PLAN 101-000-441-345 $25.00
ART IN PUBLIC PLACES - RESIC 7014000-255-000 $157.37
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$5,851.93
. LESS PRE -PAID FEES
$0.00
TOTAL PERMIT FEES DUE NOW
55,85193
IIIIIIIIIIIIIIIIIIIII1 05
IE
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE.
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
A
Underground Ducts
Forts & Footings
Slab Grade
bw
,rfp
Ducts
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
ZL
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
1.4.4
Pool Cover -
Sewer Connection
Encapsulation
Gas Piping
Gas Test
_ (�
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:J�
s.'o� yam )r;�7* 0 +0 /'S 99 Be -
Aug 17 99 02:22P Tradition Design Center 760-772-0673
BELLA VISTA
RELEASE OF RESPONSIBILITY
FLOORING
1, Ir.: purchaser of Lot ff Pliase$-'/at Bella Vista
Homes, herebycLmowl edge that by not purc•hasirrg nay flooring through the
Roger Snellerrberger and Associates, Inc. Desip-i Center.......
1. The flooring allowance I will be credited in escrow is s
2. Roger Snellenberger & Associates is only sanding the st ndnrd tile areas
(kitchen, entry, laundry). Any other floor prep is the responsibility of the
btryer or their -subcontractor.
3. Roger SneIlenberger & Associates has no responsibility to buyer as to any
cracked floor tiles, any leaks from toilets removed for flooring installation,
or any other damage caused by flooring iiistallation.
4. Roger Snellenberger & Associates leas no responsibility to buyer as to any
paint, baseboard or wall damage not noted at orientation.
5. This is considered a "bare Floor' closing and the flooring will not be
installed until after title has transferred.
Date: r?a3 °' 9 Buyer: "�
P.1
SEP -22-99 WED 08;33 WESTERN INSULATION FAX NO. 9096868786
WESTERN INSULAT'IONt INC.
4211 Latham Street, Rlverfkd1,'-alifoz.La 92501
Tel. (909) 686-8760 Fax (9C9) 686-8786
INSULATION CE.RTIFICATS
THIS IS TO CERTIFY THAT INSULATION HAS BEEN NSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORN1A ADMINISTRATIVE CODE, TITLE 24,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACT/ PHASE: BELLA VISTA — TRACT #28458-1
LOT # : 59
SITE ADDRESS: 43676 ALBA COURT, LA QL:INTA, CA
EXTERIOR WALLS:
MANUFACTURER: Johns -Manville THICKNESS: 3 5/8" R -VALUE: R-13
CEILINGS: BATTS BLOW
MANUFACTURER: Johns -Manville THICKNESS: 11" R -VALUE: R-30
CEILINGS: BATTS BLOW
MANUFACTURER: Crccnstone THICKNESS: 8.1" R -VALUE: R-30
GENERAL CONTRACTOR: - -
TRADITIONAL BUILDIN0 CO.
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICEN5E NUMBER: 481278
BY:
TITLE: PRO0VJcrION GER
DATE—' SEPTEMBER 22, 1999
a
P. 14
ROGER SNELLENBERGER DEVELOPMENT
78615 NAPLES DRIVE
LA QUINTA, CA 92253
(760)772-0222
(760) 772-0257 FAX
TO: Apex Interior Source
79533 Country Club Dr
Bermuda Dunes, CA 92201
Fax: 760/360-3167
Attention:
Lot & Phase: Lot 59, Ph 5
Date Required ASAP
Requested by: Don Olson
Vice President
PURCHASE ORDER #
2227
August 23, 1999
PROJECT: Bella Vista
Ship to: 43676 Alba Court
La Quinta, CA
l'—f rnde• 94 on
Qnty Ord'd
Material / Work Required
Unit Price Total
Furnish and install window coverings as follows:
Furnish entire interior of home with window coverings.
$1,700.00
$1,700.00
TOTAL
$1,700.00
Roger Snellenberger evelopment
cc: Pro tion
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Apex Interior Source
By: