0007-140 (SFD)r_ a LICENSED CONTRACTOR DECLARATION
U? "' I hereby affirm under penalty of perjury that I am licensed under provisions of
F- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
W Professionals Code, and my License is in full force and effect.
O =) M License # Lic. Class Exp. Date
r,L LULU 88 B 10131/2(
Kate.'_7
Z r �7% �^,� Signature of Contractor
r` o OWNER -BUILDER DECLARATION .
ca
W w I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ U) 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).
C'') () I am exempt under Section , B&P.C. for this reason
LID
N Date Signature of Owner
ON
O)
IL Z WORKER'S COMPENSATION DECLARATION
C:) 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 Lu �: 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.
CIO Q U ( ) I have and will maintain workers' compensation insurance, as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Nt CarrierGOLDEN):;Ii01..Ir M13,Policy No. NWC-5440 -02
w�
C3
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
3subject to the workers' compensation provisions of Section 3700 of the Labor
.Code, I shall forthwith comply with those provisions. r
Date:, �-+� I Applicant -'3%? i- ,r• i
J ' / / .
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
1 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.
ra. . rm) ) y
t .Slanature (Owner/Anent) 0 , l . 31 f ty9) Date ✓'' Zli
BUILDING PERMIT PERMIT#
0007440
DATE VALUATION LOT TRACT
1100,4M.10 22 2 1
JOB SITE
APN
ADDRESS 45-M OAMTNO1IS"rA
'6044** -009
OWNER
CONTRACTOR/DESIGNER/ENGINEER
C'.t�Tl' _RY CF%GWM1 CO,1 iM1S
CE.NTCYI' Y CROWELL COIMI,? ITM
1:535 SO. -.17° ,MM7T, SSE 0200
1535 30. -D- MWET, SUI 000
SAN BERNAR1DINO CA 92408
SAN BEWARDIN10 CA 92408
(909)381.6007 t.�Li 2120
USE OF PERMIT
SINGly, 1r'AMCIV WTcT.L Tl`TC1
SYD- LOT 32 PLAN 3RA PUAIT DOES NOT INCLUDE HLOCK WALLS OR
POOL 75% PLAN Ci Fff REDUCTION R)R MULTIPLE ISSUANCE
TRACT CONSTRUCTION 1.6119,00 SF
POIZCI,1lPATIO 94.00 SP
0ARAC1WAfiPORT (31� 0,173:20
XST.WX1 .D C09f € F CON•S'fRUC770N
100.4Caio
P 4' M' FEE SUNB9' RY
0011 TRUCTION FRE 101.000.418.000 $443.00
PLAN CHECK FEZ 101-000-X139-318 1133.55
MEC:HAMCAL FEE 101.000.421.000 $53.$0
111LEC'1'RICAL It'1-9 101-000-420.000 $115.51
P1.UMI31N•Ci FET, 101.000-419.000 $12814
STROW13 MOTION FEE - RF.SID 101-000-241-000 $10.05
ORADIM FEE 101.000-423-000 $20.00
DEVEIDPER IMPACT FER $3,907,00
Sl'1!~t4OTIAL CONSTRL1C: IO ' AMD FLAN C.'.1HCY.
t£3,fli 1.d6 .
1XV.4 :PPE-I?AT 1 MIX4
$0.00
! ;- .r=,.1®1 !>'�� 11'EES IiCl.i> NOWS5,011,46
'
RECEIPT
DATE
BY j
,
DATE FINALED
INSPECTOR
;"t
f/
'
INSPECTION RECORD
OPERATION
DATE
I INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings
C¢
Underground Ducts
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
ry
_
����J'L
Compressor
Insulation
�tl_
�"��
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 (o_`�l
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 I
Gas Piping
PLUMBING
APPROVALS
Gas Test
Electric Final
Waste Lines
r7
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
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)
2`toJ
APPROVALS
2Yj
!Z •.p
COMMENTS:
01/22/01 09;08 FAX 760 346 7276 P.9RAGON INSUL.
LATION CERTIFICATE
45.785 CAMINO VISTA
Number and Street
Riverside 27519
Description of Installation
1 ROOF
Material
Thickness (inches)
2 CEILING
Batt or Blanket TyDe BATT
TnlcKness (inches) 12
Loose Fill Type 13LOWN IN
Contractors min installed weight square ti 0.615 Ib
Manufact irer's installed weight per square toot to achieve Thermal Res
3 EXTERIOR WALL
Frame Type
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
Thlckness inches
LA
City
IC -1
M
Declaration
I hereby certify that the above insulation was installed in the building and the above location in confon
Energy fftiency Standerds for residential buildings (Title 24, part 6, Califronia Coda of Regulations)
Certificate of Compliance, where applicable.
2 1/19101 PARAGON IN;
Item #s Ignature, D e Installing Sulo
General Contre
Item #s
00
Item #s
Signature, Date
Signature, Date
General
Subcon
General
ice with the current
indicated on the
(Co. Name) OR Owner
(Co. Name) OR Owner
(Co. Name) OR Owner
$eptembet 27, 1999
Mr. Tom Hartung
Building and Safety Director
City of La Quinta
78495 Calle Tampico
La Quinta; CA 92253
RE: Tract 27519, Aliso I
Dear Tom:
CENT(iRy HOMES
Century Crowell Communities
CC__y'"'Z_- V, _S'43
E F- 2 RECD
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.
Sincerely,
CENTURY CROWELL COMMUNITIES
t-0�-L't
MARTY W. BUTLER
cc. Gar' 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