0001-189 (SFD)t' LICENSED CONTRACTOR DECLARATION
'I hereby affirm under penalty of perjury that I am licensed under provisions of
Ii— _ Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 W Professionals Code, and my License is in full force and effect. '
:D ch License # Lic. Class Exp., Date
0 7438157 B 12)3001
Z r Date� Signature of Contractor
U 0 OWNER -BUILDER DECLARATION
HLU � I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) . License Law for the following reason:
Z ( ) t 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
r sale (Sec. 7044, Business & Professionals Code).
( ) 1', as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
O I am exempt under Section B&P.C, for this reason
LO
N Date )Signature, of .Owner.
N
Z WORKER^S^ COMPENSATION DECLARATIONIt ,
C cr: I hereby affirm under penalty of perjury one of ,the following declarations:
Lo H O O I have and will maintain a certificate of consent to self -insure for workers'
X LU�, compensation, as provided for by Section 3700 of the Labor Code, for the
Ocn J Q performance of the work for which this permit is issued:
QU (�l)�'I have and will maintain workers' compensation insurance, as required by
O Q Section 3700 of the Labor Code, for the performance of the work for which this
�•rn permit is issued. My workers' compensation insurance'carrier & policy no. are:
Z Carrier Policy No'.
d
J . (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' conipensation.laws of California, and agree that if I should become
3 subject to the workers' compensation provisions oPSection 3700 of the Labor
Code, I shall forthwith comply with those provisional
Date: h Applicant t .'
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.
ignature (Owner/Agent) Date
BUILDING PERMIT PERMIT#
DATE VALUATION '126,241{dLOT'
TRACT 2569Io
JOB SITE
ADDRESS 79-724 LORNiNG, LLG tCOYkX
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER '
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PALM 1aESE 1' Cts. 92260
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y
USE OF PERMIT
81NuiX11.FAt ILYM'i.,.LING
3fl)-LOT3G'1 LAN 2-11.s;,PLW T D06S NOT .!WCLt,Mi;i R.i.17Ci;.'WALLS t::'CR
1-100L.75" 8 PLMN CREGK FIEE t2B17L1C:110Pt ON NiU1,TIPt h 185(1ANICH CJY
SANW. kL.Ata .1-21PE
'.i�tl,'i'1",i;}'i��yri��i�',i(3;i3 . �,�"aS,Gi3 �i •
aAi2AO i.•sG".P+i2PCtRT 684.00 S
441.4" a' e�m ml) con c ov Coms ar:�'aurme"eq
12e�s3o-4.1<.4c0
CONS-IRUCTION'a k.63s 1.41=G(M_i184XX) $%334:070
pt; IN (IMECN 91c, t 1►t,.t1()i1--�3�)-3? a g� a;7
U. 1CrIbCikL ±t Ti 10R-000-420-000
1111.UMBIN F'E6ii►t.-clt7t)-d!!?-U{3ci 1 �i4 t �
_
13 T`iu-tl Q MOT! ON �i�, - HCZ5!D i (bi-(!(3(! ,?A! •t�} l
L%1`s V%i:tsN�id.:d1LiP A,�:: [' F"kiFs ,41,9t)T.ih?
`.
A 41' Ctrt:a'U13J C PLkVCHS - i 1L' 701. -OW -255-000
,Si;Ti:S_'!Q,D t, CO- Nf_Z!' CT(; !0N ND P.(;,AN CNT"I;f,;v4��
- T
$3,235—V
LESS
FE]ES ME,NOW
$3,235,10
RECEIPT
DATE
BY ;Z "',ATE
FINALED "'
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
_ �pp
F.A.U.
Framing
. X41
Compressor
Insulation
_0
Vents
Fireplace P.L.
Grills
Fireplace T.Q.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Q•'a "go
Drywall - Int. Lath
q-7 q-60
Final
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
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
7- — —gyp
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
4.7.0
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
0
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Law Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm) (R
WESTERN INSULATION INC.
.4211 Latham Street, Riverside, California 92501
Tel. (909) 686-8760 Fax (909) 686-8786
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: WILD FLOWER - TRACT # 25691'
LOT# 30
SITE ADDRESS: 79724 MORNING GLORY COURT:
EXTERIOR -WALLS:
MANUFACTURER: Johns -Manville THICKNESS: 3 5/8" R -VALUE: R-13
CEILINGS: BATTS BLOW
MANUFACTURER: Johns-Manvi e. THICKNESS: 13" R -VALUE: R-38
CEILINGS: BATTS BLOW
MANUFACTURER:. Greenstone THICKNESS: 1.0:3 R -VALUE: R-38.'
GENERAL CONTRACTOR: WORLD DEVELOPMENT
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACTOR:, WESTERN INSULATION, INC.
LICENSE NUMBER: 481278 "
BY:
TITLE: PROtUr-irION MANAGER
DATE May 23, 2000
Certificate of'.10ccup'ancy
City of La Quinta
Building and Safety Department
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
of the City'regu/ating building.construction or use. For the following:
BUILDING ADDRESS: 79-724 MORNING GLORY COURT
Use Classification: SFD Bldg. Permit No.: 0001=189
Occupancy Group: R-3 Type of Construction: V N Land Use Zone: R L
Owner of Building: WORLD DEVELOPMENT, INC
Building Official
Address: 74-333 HWY 111 STE 103
City: PALM DESERT, CA 92260
By: KEVIN M. HIGGINS
Date: 07-05-00
POST IN A CONSPICUOUS PLACE