Loading...
SFD (9902-167)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of e;P'hapter 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. Clas1�.1 E p. Date ,.Date rf+ Yif{ji/ViJ Signature of Contxr7actor 1-- OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( )' 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, Business & Professionals Code). ( ) ; I, as owrier. of the property, am exclusively contracting with licensed contractors to.. construct the project (Sec. 7044, Business & Professionals Code)' ; O)am'exempt'under Section' B&P.C. for this reason I N Date ' = Signature. of Owner WORKER'S COMPENSATION DECLARATION Ir hereby, affirm under penalty 'of perjury'one of the. following declarations: ( 11 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.- �C) 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: Cartier Policy No. MATO-) P C,1}� IC INS N WA' 017896-0Q (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' compensatiq prfovislons bf, Seclion 3700 of the Labor Code; I shall foithwith comply with'th se!provisjons/ Date �% I l % 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, darriages 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' 66ove-mentioned property for inspection purposes. j ,�r,, Y� moi• vli�� '1 J .•��' /Signature (Owner/Agent] Date BUILDING PERMIT PERMIT" DATE VALUATION LOT 99®°e♦ �6i TRACT S20a.6?l.'3t1 ,I3 4 f 213340.3 JOB SITE ADDRESS �;+�_ APN �} -804 SOMEIt, ON' +6X-48©-099 OWNER ` : CONTRACTOR / DESIGNER / ENGINEER STEVEN WALKER HOMES S'I'SVIN wAI,IEP, .tom Es 7161 fNDIANA•AVE, 7161 INDIANIA AVF. RiV•E.RS:I:C3'E CA 075011 R WiRSIDE CA. 92504 ' (909)784-0&10 CRU 53-57 USE OF PERMIT LOT 13 KAN 3A -SFDL PM- MiT DOES NOT INCLUDE 3L(.)rK WALLS 0-9. POOL. PL AN CkTF&C BFE REDOCO) 7.5.V J^ OR IULTIPLE4 ISSUANCE Cif SANIF PLAN TYPR. CUSTOM CON.a 17 C: ON 11450.00 sp 'PORCIVPATIO 145,00 SF GiVIZ.AGPVC-ARPOR.T 539.00 S)' r„ST'IMAI,gin COST Or CONSFRUC110N 204,177.313 PE,RRMI1T EE SI1 t�MA Y CONSTRUCTION FEE. 101-000-11IR-000 $ I,007ko PLAN CHECK FEE 101-000-43:-315 $211$.13 MECHANICAL M ' 1.03-:000421-000 $85.50 JEME(YfRICAI. FE17 10.1 600.420-000 $154103 4PL'U&18I4G FBH ..101-000-419.000 $162.,50 STRONG MC2ucw kE - n-slo 101000 0641-000 $20.47 CrR��I3ifi1G E'1E 10L=000.43-(KJ0 $20:00 INI &NSTR.UCI t'f,711l FEFI. 2.5-000-443-:342. $4,531.94 ART IN PU91AC PLACES -:iL1~ W, 701-000-245.000 $261,69 • 81, -TOM CONNSTRUC'FION AM) PLAN CHECK. $6,1148.26 LESS PRE -PAID F US $0.00 TOTAL P.EILMIT FEES DUE NOW $6,448.26 RECEIPT ` k , DAT.,- ( BY.' �.. * - DATE FINALED INSPECTOR INSPECTION RECORD ' " OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade /TZReturn Air Steel Combustion Air Roof Deck S 7 Exhaust Fans O.K 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 Final Final POOLS - SPAS BLOCKWALL APPROVALS 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 Z Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral a 4 44aPool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: 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) n k` WES'T'ERN 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#: 13 SITE ADDRESS: 80-108 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: F TITLE: DATE: ' INSULATION CONTRACTOR: WESTERN, INSULATION, INC. LICENSE NUMBER: 481278 BY: TITLE: P oduction Onager U. DATE: O TOBER 27,1999 •._.r-e�•.�'tS- .r.="i+..�. ^"....fir+.r--.�.. .r. _.• . - •as.'+- .. ' i v W Mfg Ot;cupancyL,a. �T 6. City of1. a Quinta- U; Build ng. and ScifetyDepartmen't 't OF This Certificate issued pursuant to the requirements of Section 709 of the Uniform Building Code, certifying that, at the time of issuance,.. this structure was in compliance with the various ordinances of, the City regulating building construction or use. For the follo wing: BUILDING ADDRESS: : 80-180 MERION Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9902-167 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 Building By: DANIEL P. CRAWFORD JR Date,: 11/24/99 POST IN A CONSPICUOUS PLACE