SFD (9902-163)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 ? i Exp. Date
Date Signature of Contractor
�. r
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
1, 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 Sianafure of Owner
WORKER'S COMPENSATION DECLARATION
I hereby, affirm under penalty of *perjury one of the following declarations:
have - and will maintain a certificate of' ' consent to self -insure for workers'
cornpensation;.as'provided for by Section 700 of the Labor Code, for the
performance of the work for which this permit is issued.
(�' I have and.will maintairi workers';compensation insurance, as required by
Se tion 3700 of the Labor Code, for the,performance of the work for which this
peimit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier Policy No. -
..'01.41'TED P ACIEt1 .i'NS NWA21'17fi��64)
(This section need not be completed if the permit valuation is for $100.00 orless).
O 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 jar]d agree that if I should become
subject to the workers' compensation pro isirons�of Section 3700 of the Labor
Code, I•shall forthwith'comply with, ose provisions
Da e. " A -1 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 theIabor 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),+
r e '
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 1 TRACT
JOB SITE
ADDRESS
OWNER _ CONTRACTOR/DESIGNER/ENGINEER
S'TEV'EN WALKER HOMES SUVEN WALKER HOMES
7161.114D ANA.AVE. 7161 INDIANA AVT.
kIVERS4DE CA 92504 11.1Vi RS1.DE CA 92504
(909)7844 0840 CBL# 5357
USE OF PERMIT
LCAT 9; .PLAN 1A-80FD- P-ERIV.1 rt DOES NOT fkVG :UDE'BLoc-R V<P a8 OR.
P00L..
CUSTOM CONS RU" C.i'4i W 7,10. 100 Sr.
PORCWPATIO
284.011 sr,
t3ARA130CARPORT
5801.00 ,SI
�:.�a'.RAIA,fte' D Cmf OFCt�NS'if'�i.11;G"TI(DN
178,813.10
PE RAIll PPE S'dJ•MMARW
CONSTPLUCTI%ON'f"Ei'L
101-000-418-000
PLAN CHECK f'EE,
101-0004.39-3J8
$%S2,G11
MECHANICAL M
i ul-Utl0421-000
$85.54
UECT ICAL f1:S
10.1-000.420-000
3142.64
PLUNIS1NG VFW
1Q1. O(10-+119-0{!{)
$163.30
s'i'.tZomsmonoN.rn.•RES.i1:i
,t01-0000 24a-000
GRADING F"FF
10 1 -OOD-423-000
$20,00
i'IdFRA'.a'�1`RUCT WE FEES'
225.0i:Q-�i a-� 4;2
$3,91831
ART IN PlaraLIC PLACTS - RE:511; 701
$197,03
StJB, .Cf Y,t' U,.CONSTRUC,T.ION ,A ,IL) PLAN CRECKI $x,,2321, 46
LES.ti f�l'.G-}�At:u VE111, ISO.00
REOE�`,\; I DATE � �I ��` y4".' / DATE FINALED INSPECTOR
All'
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
3
Return Air
Steel
Combustion Air
Roof Deck
s
Exhaust Fans
O.K to Wrap
Z./4
F.A.U.
Framing 190V
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
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
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Z3
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
r
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 44 44 44 4
Utility Notice (Perm)
COMMENTS:
WESTERN INSULATION, INC.
4211 Latham Street, Riverside, California 92501
(909) 686-8760
(909) 686-8786 Fax
INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE
CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24, STATE OF
CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACT/ PHASE: PGA WEST -PHASE 2 TRACT #:28340-3
LOT#: 9
SITE ADDRESS: 80-125 MERION, LA QUINTA, CA.
EXTERIOR WALLS:
MANUFACTURER: JOHNS -MANVILLE THICKNESS: 31/.2 R -VALUE: R-15
CEILINGS: BATTS BLOW
MANUFACTURER: GREENSTONE THICKNESS: 10.3 R -VALUE: R-38
GENERAL CONTRACTOR: STEVEN WALKER HOMES.
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NU BER: 481278-
, 1
BY:
TITLE: Prod uctio Manager ,
DATE: OCTOBER 27,1999
COrtificate.of 0ccup*ancy* 0j,
C y of La
Building and Safety Depprtment �£M of�°
This Certificate issued pursuant to the requirements of Section. 109 of the Uniform Building Code,
certifying that, at the .time. of issuance, this structure was in compliance with the various' ordinances
A
of the City regulating building, construction or use. For the following.-
BUILDING ADDRESS: 80=1:26 MERION
Use Classification': SINGLE FAMILY. DWELLING Bldg. Permit No:: 9902-163 -
.Occupancy Group: R-3 Type of Construction: VN Land.Use Zone: RL
Owner of Building: STEVEN WALKER HOMES. Address:. 7161 INDIANA AVE
City: RIVERSIDE, CA 92504 ,
r By: 'DANIEL P. CRAWFORD JR.
Date: 11 /22/99
Building Official
�O POST IN A CONSPICUOUS PLACE ,