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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
714286 B .1 Oi31 C
ate _ _C Signature of Contractor—
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 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
perfo mance of the work for which this permit is issued.
'(K 1 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 OOLDEN EAGLE this Policy No. WWC.-544063-62
(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' compensation provisions of Section 3700 of,the Labor
Code, I all fgrthwith comply with th o 'sio s.
,pie: 010 10 Applicant �� _I ` r
Warning: Failure to secure Workers' Compensation cov a is unlawful and
shall subject an employer to criminal penalties and civil fie 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 i pection purposes.
�tSignature (Owner/Agent) ✓, Date 0
RA l
BUILDING PERMIT PERMIT#
DATE '1 „ VALUATION LOT 00"189 TRACT
00 $130,1m.10 24 2115 19
JOB SITE
APN
ADDRESS 451-7" CAM140 WMA
W44*11-W9
OWNER
CONTRACTOR/DESIGNER/ENGINEER
CENTURY CROWELL COMMI WITI3
CHR U1 Y CROWEZ.1'.. C:02v1M(JN1=-
1535 so, gX X31 wr. 017- 0200
1535 gO, 'a)" STREIT, a,„ #t20o
9fiX BMZXA D1k40 CA 92408
St,N MW—R73190 CA 97x108
(909)381.6007 MA 2120
USE OF PERMIT
HINGL.E 3TAM. Y DW 2- 11:00
SFO -LOT ,24 PLAN 3LR.tA. b PIMMIT ]3tJES NOT I'NCLUfJif VWC K '0'YALL Ok
P001,, 7% PLAN Cil EOE FRERE, D CTXOW FOR kR3.I1. PIPLE ISSUANCE OF
SAME PI..A14 TYPE.
TRACT CONSTRUCTION 7,13:5.00 2F
CIARIA.CIIICARPORT (a11 14,3 9.60
1CSITMATM C09r OF CC7.11S'['R17C:".0 ON
lrioelCrGlalf)
PO4WM. &TWMARY
COINSTl UCT1011 FEE 101-000-418-000 VA9.00
PLAN CHECK FEE 101-000-439-319 $134.46
MECHANICAL L FEE 101.000-422.000 $72.00
. ,
,ZLECTRICAL PEP, 101-000-420-000 $122.15
PLUMBING FEE 101.000.419.000 $131,213
STRONM MOTION FEE, PMJD 101-000.241-000 $113.02
GPIN)INC FEE 101.400.42j-000 $20.00
DEVELOPER IMPACT FEE $1,5►0� 00
s b � y+.
2
RUB -I rAA,% CONg7.'RUMON A14- 1'S -AR CRICK
S3,1114.48
mail :PRE -PAIL) ms
$0,00
TO AL PLTMIT'Ir:TS DVE NOW
$1,174,421
RECEIPT
DATE
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
Return Air
Steel
Combustion Air
Roof Deck
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
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
Gas Test
Electric Final
Waste Lines Z {.cn
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:
peptemW 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:
CENT(iRy HOMES
Century Crowell Communities
C� ✓ts�
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.
Sincerelv,
CENTURY CROWELL COMMUNITIES
MARTY W. BUTLER
cc. Gare 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
a
01/22/01 09:08 FAX 760 346 7276 PARAGON INSUL.
INSULATION CERTIFICATE
IC -1
45.725 CAMINO VISTA _ LA QbINTA
Number and Street City
Riverside 27519 Il24--1
Description of Installation
1 ROOF
Material
grand Name
Thickness (inches)
Termal Resistance (R.Value
_
Brand Name
2 CEILING
.
Brand Name
Batt or Blanket Type BATT
Brand Name CERTAINTEED
Thickness (Inches) 12 _
Thermal Resistance (R-Valug) R-38
Loose Fill Type BLOWN IN
Brand CERTAINTEED
Contractor's min installed weight square ft 0.615 Ib
Minimum thickness 14
314 inches
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -value)
I
3 EXTERIOR WALL
Frame TyDe
A. Cavity Insulation
Material
Thickness (inches)
B. Exterior Foam Sheathing
Material
Thickness.(inches)
4 FLOOR OVER GARAGE AREA
Material
Thickness (inches)
5 SLAB FLOOR(PERIMETER
Material
Thickness (inches)
6 FOUNDATION WALL
_ Material _ _ , Brand -Name
Thickness (inches) — - — Thermal Resistance (K -V
Declaration
I hereby certify that the above insulation was installed in the building and the above location in confon
Energy Efficiency Sfanderds for residential buildings (Tide 24, part 6, Calftnia Code of Regulations)
Certificate of Compliance ;nature,
here applicable.
2 1/19101 PARAGON IN:
Item #s Installing Subs
General Conti
Item #6 Signature, Date
5=7"M
ue
ue)
ince with the eurtent
al indicated on the
ULTION
miractor (Co. Name) OR
ct (Co. Name) OR Owner
mtractor (Ca. Name) OR
di(Co. Name) OR Owner
Item#Signature, Date Installing Subcontractor (Co. Name) OR
General Contmctl.(Co. Name) OR Omer
Brand Name
Thermal Resistance (R -Value)
Brand Name
Thermal Resistance (R -Value)
.
Brand Name
Thermal Resistance (R-ValuO
Brand Name
I
6 FOUNDATION WALL
_ Material _ _ , Brand -Name
Thickness (inches) — - — Thermal Resistance (K -V
Declaration
I hereby certify that the above insulation was installed in the building and the above location in confon
Energy Efficiency Sfanderds for residential buildings (Tide 24, part 6, Calftnia Code of Regulations)
Certificate of Compliance ;nature,
here applicable.
2 1/19101 PARAGON IN:
Item #s Installing Subs
General Conti
Item #6 Signature, Date
5=7"M
ue
ue)
ince with the eurtent
al indicated on the
ULTION
miractor (Co. Name) OR
ct (Co. Name) OR Owner
mtractor (Ca. Name) OR
di(Co. Name) OR Owner
Item#Signature, Date Installing Subcontractor (Co. Name) OR
General Contmctl.(Co. Name) OR Omer