0007-142 (SFD)LICENSED CONTRACTOR DECLARATION
111 hereby,effirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
N w Professionals Code, and my License is in full force and effect.
O f7 License # Lic. Class Exp. Date
tR LU '7141 is . B 10/31/2(
ZO r, -Date 1 1 Signature of Contractor '�; �• ,t / - K'
fl- ~0 OWNER -BUILDER DECLARATION
W W r- I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ � . , License Law for the following reason:
Z_ ( ) 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).
ce) () I am exempt under Section B&P.C. for this reason
LO
I N Date Signature of Owner
rn
Z WORKER'S COMPENSATION DECLARATION
o Z I hereby affirm -under penalty of perjury one of the following declarations:
Lo O () 1 have and will maintain a certificate of consent to self -insure for workers'
X w LIL compensation, as provided for by Section 3700 of'the Labor Code, for the
O � Q performance of the work for which this permit is issued.
ED Q U ( ) I have and will maintain workers' compensation insurance, as required by
OU Q Section 3700 of the Labor Code, for the performance of the work for which this
a L Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier c �1rLa% S
co OLE Sk1�. Policy No. NWC414063-02
�O
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' compensation laws of California, and agree that if I should become
ubject to the workers' compensation provisions of Section 3700 of the Labor
ode, I shall,forthwith comply with those provisions_.
�Date:`' /%' %.- Applicant " ~ ✓ "?-1 �c^�r �"7 / >�
.0 491
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 inspp-emiction purposes. f f
Signature (Owner/Agent) 0J - % Date
BUILDING PERMIT PERMIIT#���i'��
DATE VALUATIONLOT TRACT
100,460,to 7,5 273 J 9
JOB SITE
APN
ADDRESS (,j J t3 . a~AML1N[1 Vd"'rA
604 -W1 -OW
OWNER
CONTRACTOR / DESIGNER / ENGINEER
C'1:,�47URY CROWUL COivtiat UN311` 9S
C•ENTURY CR.OWTt7•.- (°O:2dIk11;1N1T°
1535 e30. `D" 9TItUT"r, UM 0200
1535 00> "1?• 'h;w7PJMq, MM -0200
8.4.N BY NARDI1O CA 92108
SA URARDW' CA92408
-
(909)381-6007 413 21.20
USE OF PERMIT
31901Y, FA1v112 Y MM -MG
SFD- LOT 25 PLAN 3RC PER 1171' VOK'S NOT INCLUDY, YS1..(?CK WALLS OR
POOL, 75% PIAN CHCC9 RF UC1:10N Fair; NIt LTIPLE 1S9URNa'.`•F
TRACT CONSTRUCTION 1,67%00 3I'
PORCH/PATIO 84.00 SF
GA.RAr3MA.RPQ'atT (W) x,173.50 , .
ESX:Ml1.M COSTA' F CONSTR1;rf31011
CONSTRUCTION FEE 101,,000-4-18-000 S64100
PLAN CNWK ME 101-000-435153£ $133.55
MECHANICAL "Y' 101.000.4.2.1.000 S151so
'EL1-(::TIUC.,AL ME 101.000-420..000 $115.61
PLUMB1NO FR'1 101.000-419.000 $123.73
3TRONO Ma: FION FEE • R&SID 101-000-241-000 $10.05
GRADING FFE 101.000-4.23.000 $20.00
IDLV ELOPPR.1MPACT ME 9i],971.D0
SUB TOTAL CO; i MY117101T AND PL/1N Ck11,C.W
$3,011 A6
S .SS PR.E^1'A%) FIMS
$0.00
/ t z
, - ;
ToTAY, rnArr. Yn s DuE mow
$3,011.46
RECEIPT
DATE
Y
DATE FINALED
INSPECTOR
�
r
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
Framing
a
#,(%-2--
Zas Lt }1 _
cat--
F.A.U.
Compressor
Insulation
t L ce�--ET
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 2� p� (��
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
_
Waste Lines t��/ V:_
Gas Test
Electric Final
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
'� LpG�b,��/
Pool Cover
Sewer Connection
l� �rv�—
Encapsulation
Gas Piping
Gas Test
IAO QI��
Appliances
Final
FinalA'`
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 2
Utility Notice (Perm) C(
COMMENTS:
i
01/22/01 09:08 FAX 760 346 7276 PARAGON INSUL.
INSULATION CERTIFICATE
45-666 CAMINO VISTA
Number and Street
Riverside
County
LAQI
27519
Tract No
Description of Installation
1 ROOF
Material
Brand Name
Thickness (inches)
Termal Resistance (R Value'
2 CEILING
Batt or Blanket Type BATT
Brand Name CERT
Thickness (inches) 12
Thermal Resistance (R -Valu
Loose Fill Type BLOWN IN
Brand CERTAINTEED
Contractors min installed weight square ft 0.615 Ib
Minimum thickness 1
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -Value)
3 EXTERIOR WALL
Frame Tyke
A. Cavity Insulation
Material
Thickness (inches)
S. Exterior Foam Sheathing
Material
Thickness (Inches)
4 FLOOR OVER GARAGE AREA
Material
Thickness (inches)
5 SLAB FLOORIPERIMETER
Material
Thickness (inches)
IC -1
City
IM 12
Brand Name
6 FOUNDATION WALL
Material Brand Name
Thickness (inches) Thermal Resistance(R-Value)
Declaratlon
I hereby certify that the above insulation was installed in the building and the above /oration in conformsnce with the current
Energy EfBaency Standerds for residential buildings (Title 24, part 6, Califronia Code of Regulationsindicated on the
Certificate of Complian , where applicable.
2 1/19:01 PARAGON INSULATION
Item #s ignature, to Installing Subcon ctor ( . Name) OR
General Contractl(Co. Name) OR Owner
Item Pis Signature, Date Installing Subcontractor (Co. Name) OR
General Contract (Co. Name) OR Owner
Item #s Signature, Date Installing Subcontractor (Co. Name) OR
General Contractl(Co. Name) OR Owner
'T
Peptembet 27; 1999
Mr. Tom Hartung
Building and Safety Director
City of La Quinta
78-495 Calle Tampico
La Quinta; CA 92253
RE: Tract 27519, Aliso I
Dear Tom:
r .
ca_�'�Cy- /-.� �-
CENTURY HOMES
Century Crowell Communities r. t
BLW
HAND DELIVERED
As per your request.. we will notify the prospective buyers of lots 22-26 of the above
referenced tract that they have a rear yard drainage area that they must leave free and
clear at all times. This notification will be in writing and the buyer(s) will sign at the
time of purchase. We can send the City a copy of the notification if you request, otherwise
consider this letter as our intent to comply with the above referenced condition.
Sincerehv,
CENTURY CROWELL COMMUNITIES
Y)U4� 4-10.
MARTY W. BUTLER
cc. Gary Weintraub, Vice President Operations
Tony Scimia, Vice President Marketing .
1535 South "D" Street, Suite 200 • San Bernardino, CA 92408
(909) 381-6007 • FAX (909) 381-0041