9906-251 (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 .,#`911 Lemic. Class ' Exp. Dugvnnof
)Dat" e� Signature of Con tractorf
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 ; O;L'1� jLP iCt� a."ti a. Policy No. a, WC 470": tr
(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
worker compensation laws of California, -and agree that if I should become
SUN ¢t to the workers' compen sation•p�oyislon� of Sectiont3700 of the Labor
Co e, I shall forthwith comply with .tho'se'provlsions_/
ate: / l Applicant. %'"
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorin'representatives of this City to enter upon
the above-mentioned property for ins`pect_ion purposes/
�Sig'nature (Owner/Ag t� t Date --%
BUILDING PERMIT PERMIT#
DATE VALUATION ,17i.%rJ9'LOT TRACT
j 41
JOB SITE 56-580 NVOIii. 0 V11. lVGk;
APN %fy�, ^ i14 iiliJ
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
RIELLY 1-1O.W. "S, INC.
t ELL.'Y F:[ONIFS, TNTC.
23 CORFORAi'L PLAZA, #245
2.3 CORPOPLK1`i: lyUVA,11245
NEWPORTBEACH CA, 97660
NE'li PO t.'1' K'At :4 CA. 92660
(949)719-4975 C:.1# 5337
USE OF PERMIT
SINGLE. FAMILY DWEL ;.fNG
utiv-1..01 rE t. r v�t�-.t^t�t vaat .iy+.�x ttvs,.uu rsA.tJ�:t�
WALL 01t POOL. 7_19 PLAN CHECK.. FEE 1i:[s UC"1'I N tv'0A.,M'U1A` IP1,I1
ISSUANCE OR SAME PLAtd 1lh"F.
CUSTf3;irT CON13iT UCIiON "4483.00 SF
POiiM[PATIO 1,344.00 SF'
GARA.CRYCARPO)' Y 737.110 S ,
/�y q�t� ry.
p p ry� g� COS
ill 1414'114.$ 1!'COS 0 a %'N'36.6140 C 1�.t0N
nnyy�q.{{��.yyp ry G.��rp� q,g yl�i
CONSTRUCTION FEE, 01 -000 -4116 -OW $1,080.50
r�r,nNCKCI r:F1, 1t?tAXI-439-31
M1 0VANICAL MMi 101.000_421-000
FLiC`TRIC,Af, FM -3. 101-01110-410-000 15 ,15
f1Lihi BfN01-:EE 1014)0-419-000 S18tf.Sf)
N101�"�10N FE s - ,RF stT� 741-()/1N)
,�4vq+°��i�tq��-'ayll(`0 1101-�0W.
1120.00
fNFRAST.R.UC:"1`ZJl E,M— 225-000443x342 S ,67'7.10
ART .1N t USIA( :PLACE'S - lU;SIL 70.14)00-255.000 5314.37
i3 )iTAT, C:C3itIS"I'lidCttC)i`S t�.`dl?I_,AN C1diiC;1C.
$6,793,40
LESS PRE -PAID HES
$0.00
TO*fi .t, PF,RM 'C FEE.' OUl,Nt-)W
x6,7,93.40
Le
RECEIPT
DATE
BYf
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade/ _
// 3
Return Air
Steel
Combustion Air
Roof Deck
y drp
Exhaust Fans
O.K to Wrap
Up
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROV LS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PI . Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
/
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
NOU�08-2000 15:05 WESTERN INSULATION 909 686 8786 P.17i20
y
WESTEI.N' IN'SU]LATION, INC.
4211 iathAM Stl=t, lUverside, California 92501
Tkl. (909) 68$-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: PGA WEST - PHASE 18
LOT # 72
SITE ADDRESS: 56-580 MUIRFIELD VILLAGE, WEST COVINA, CA
EXTERIOR WALLS:
MANUFACTURER:
CEILINGS:
MANUFACTURER:
CEILINGS.-
MANUFACTURER:
EILINGS:MANUFACTURER:
JOHNS MANVILLE
BATT
JOHNS ANVILLE
BATT$
JOHN VILLE
THICKNESS: 3 5/8 " R -VALUE: R-13
BLOW
THICKNESS: 6 3/4" R -VALUE: R-19
BLOW
THICKNESS: 11" R -VALUE: R-30
GENERAL CONTRACTOR' RIELLY HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODUCTION MA
DATE NOVEMBER 8, 2000
1 z
08/17/:2000 •13 07 : P -949 ;852 8732 `#,r,,' DAVEY ROOFING:' INC$,!: ` + 'n �� (P.d 'ej`3�,
7
?, „F`t�Y},'„ do-•- yj7F,.
i +•.•l�tl 3§''.a Y3 s {�'i4, t Irl-�' 'A C �, a d •'L �',.`'
All
a4VEY
ROOFING INC.
August 17, 2000
Mr. Steve Gibson
Rielly Homes
81-120 Legeods Way
L.a Quinta, CA 92253
Re: Legends @ PGA West, La Quinta, California
Dear Steve:
Below is a listing by lot number of O'Hagen vents installed per your roof plan specifications:
3:133::3 3
..`s', 'Q��i3:i.,al?:'•`.s:.f.t;:::.1'.:Rl M=
, ;2tiJyC�is>13?.: e'?3
....
48
3RA
25
49
4B
26
50
2RC
23
51
3B
24
52
4RA
26
53
6C
27
58
5RA
26
59
3 C
24
60
6RB
27
61
4C
26
62
6RA
27
63
5B
26
70
5A
26
71
4RB
26
72
2A
23
73
5C
26
74
2RB
23
75
3A
25
If you have any questions; please feel free to contact me at 949-260-7925.
ou, .
P ick y
Vice President, Operations
17182 ARMSMRVEME
IRVWE. G4 92614
949/260-79M
949/852-1160 FAx
Certificate of Occupancy
City of La Qu'inta
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 regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification:
Occupancy Group:
SINGLE FAMILY DWELLING
R-3
56-580 MUIRFIELD VILLAGE
Type of Construction: VN
Owner of Building: RIELLY HOMES, INC
Building Official
Bldg. Permit No.: 9906-251
Land Use Zone: RL
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: DANIEL P. CRAWFORD JR.
Date: 11/13/2000
POST IN A CONSPICUOUS PLACE