9905-127 (SFD)U)
I_
04 to
W
O =) M
I,- CY u7
t,�W�
r-_ W
I,-
6 Z
cc)00
H cD
J
w w r
H d
Z
M
LO
N
ON
U °)
o 2 Z
r1 - CEO
XW !�
O -'Q
mUU
O
n 0�
It Z_
ob 5
�O
Q
J
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
1684 13 I' / ,/ i4t
yDate h� G Signature of Contractor a
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that'l 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.
()A I have and will maintain workers' compensation insurance, as required by
SLkNon 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.
(This section ii H hoMe completed if the permit valuation i1i'01 ,91000 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�:ompensation �provisions of Section 3700 of the Labor
Code, I shall forthwith comply with tho a provisions.
Date:Applicant 4 , - __ — 40& —
1
twarning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer fo 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 d
& 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 pllrpos s.
Ignature (Owner/Agent) AlDate'
BUILDING PERMIT PERMIT#
b•
DATE VALUATION LOT 9"AS-127 TRACT
06/10/191 S120.647.441 21" 23995-4
JOB SITE
APN
ADDRESS %
604111-040-021
OWNER CONTRACTOR/DESIGNER/ENGINEER
1NCO HOMES CORP. ;NCO HOMES CORP.
1292 W. ARROW HWY 1282 W. ARROW HWS'
UPLAND CA 91785 UPLAND CA 91785
(909)981.8989 CBL# 3318
USE OF PERMIT
SFD - PLAN 4J0R-'_% LOT 2L PERMIT 1 &S NOT INCLUDE BLOCK
WALLS OR POOL. PLAN tWiC PORTI'ON OF FEF. RUDUCEID 739, a FOR
AT TF r. r r to nV C!A h jr, Ili ass 2MMU
TRACT CONS'i'I2iI TURN Z,t)0fiA) :SF
P0RC%PA,T10 14.00 SF
(3ARA.Cs'rVcARPaP, T 583.00 SF
ESTOKATED COST OF CONSTV1 1CT I N
120,64-0.40
PERN11T FEV, SUMMARY
CONSTRUCTION FEE 10.1-830-418-044 $713.M
FLAN CHEC is FEES 101 -OW -439-318 $117.79
Mf ECHANICAL F£E 101-400-421-000 547.00
E1: EC 1'PJC.A1..FRE 101-000-420-000 $1330.44
PLUX(BING F'E.0 101-000.419-000 S 08.00
STRONG N40TION FEE -AESID 101-000-24t-000 srk.%
GRADING FEE 101-000-413•-000 $20.00
I*'R.A.5 T RUC:TME Fa 225-000-443-3142 $2,710.38
Am- TN !'UBwc nAi;ES - R mlo,- 7701-000=255.000
y
r
4A
SUB TcYrA.L CCYNS'I'RuctioN AND PLAN CHECK
$3,980.V
LESS P EU3 Pt1. D VC ES
1+4.1110
JUN, 10 -1999TOTAL rmiIT FEES DUE NOW
$3,980.29
RECEIPT '" °
DATE -t 114 ti
DATE F ALED
INSPECTOR
[BY
. �s
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
_
F.A.U.
Framing
_
Compressor
Insulation
j —
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
o �—
Final
Final Z Z
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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
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 77-10
Utility Notice (Perm)
COMMENTS:
Nov -A-99 FRI 11:54 WESTERN INSULATION FAX NO. 9096868786
P. 25
WESTERN. INSULA TIONv INC9
4311 Latham suet, FAveraide, California 93501 .
(909) 6a8.8760
(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: DESERT PRIDE -PHASE 4 B TRACT #:23995-4
LOT#: 21 PLAN 4
SITE ADDRESS: 45-150 BIRCHCREST CIRCLE, LA QUINTA, CA.
EXTERIOR WALLS:
MANUFACTURER: JOHNS -MANVILLE THICKNESS: 3 5/8 R -VALUE: R-13
CEILINGS: BATI'S LU
MANUFACTURER: GREENSTONE THICKNESS: 8.1" R -VALUE: R-30
GENERAL CONTRACTOR:
LICENSE NUMBER:
BY;
TITLE:
DATE:
AMERICAN COMPANY
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: oductio Manager
DATE: NOVEMBER 19,1999