9905-357 (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 f=Dde, and my License is in full force and effect.
Licep.se # Lic. Class Exp. Date
7_94- B 02128M(
�)ate:'JSignature 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
performance of the work for which this permit is issued.
ko) 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 Policy No.
(This section need no e completed if the permit valuation info $100.030 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 ,3700pof the Labor
Code, I shall for)hwith comply with those provisions. % 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
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 purposes11 .
nature (Owner/A ent)' f /t% �. �/ Date
BUILDING PERMIT PERMIT#
-
DATE VALUATION LOT <t90a.3i = TRACT
05/2711-y9 S108,613.40 •-� 3 (- -- 294581
JOB SITE
APN
ADDRESS -
t POM-P.Mi COURTi
613 7�1a�3s
OWNER CONTRACTOR / DESIGNER / ENGINEER
ADVANCED DEVELOP1MENT CORP. TRADITIONAL BUILDING CO INC
78-615 NAPLES M, 78-615 NAPLES SDR
LA QUiINTA. CA 92353 LA QLIINTA CA 72253
('60)772-0322 CBLk 5750
USE OF PERMIT
.
rrT, Av: -i •r' -r riff
•. w .c.n.ryt . • � a i.v
SNS - LOT S. PLAN ?A - tPO f T DOES NO'S INCLUME BLOCK WALL. O.K..
POOL. P1,AN C[�C:K. P0f;rFfON OF FRFs REDIJC.'.EID 75°;a;FOR M(A.TIPLE
1: - C= -'d At.
TRACT CONS I'}2:12CTION ]1,$34.00 STS
'a
POPKIIr, X"O 76.00 Sr,
GARAGRICARPORT 409.00 SF
ENTIAIA'i`tI:D COS" f' OF COW1':RVICTION
106,613.440
PERMIT FEE Si1MA'YARY
CtiMTRUCTION FER 1011.000-1118-0x1 $671.00
PLAN CHECK FEE $ 11.8!
i ECHArNICAL 'FHE 101-000421-000 547M
LECTRIC.AL H'E . 101-000-420-000 $M- .87
ALMBING FEE 101-000-419-(x10 3134.75
STRONG MOVON FEE- IiES.I D 101-000-241-000 $.10.86
ORADINO FEE 101-000-423-000 $20.00
INfr RA.S'ClEtr1CT`ME FEE M2 5-000-443-342 12„421.06
ART 1N PUBLIC PLACES - RESIr 701-000-255-000 $21.33
SUB -M AL CONSTR:I:fMON 1 ND PLAN CH CK
$3,585.92
LESS PRE=PAID NEI .S
$01.00
TOTAL PERMFf FEES DUE .iN(AV
$3,585.93
FIE \
eTE
BY
t
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
I
Underground Ducts
Forts, s & Footings
Ducts
Stab Grade
Return Air
Steel
Combustion Air
Roof Deck
p —2;p —y
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 - 2 -C --C.> ld'
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
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
— &P
Appliances
Final
Final —/Z. •_ cy
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.1.
Smoke Detectors
Temp. Use of Power
Final a — 3.0 6
Utility Notice (Perm)
COMMENTS:
MAR -02-2000 'i2*04 WESTERN INSULATION 909 o8b 375b P.09/18
V TERN INSULA T®YC N1 INC .
1211 Latham 3=xt, Riverside, Qdiforr►ia 92501
TeL (909) 688-8760 Fax (903) 686-8786
ENSULATION 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:. BEL LA VISTA- TRACT #28458-2
SLOG # 8
SITE ADDRESS: 78621 POMPEII COURT,
EXTERIOR'WALLS
MANUFACTURED: Johns -Manville THICKNESS: 3 5/8" R -VALUE: R-13
CEILINGS,BATT BLOW
MANUFACTURER: Johns -Manville THICKNESS: 13" A -VALUE: R-38
'CEILINGS: BATTS` BLOW
MANUFACTURED: GREENSTONE THICKNESS: 10.3' 'R -VALUE: R-38
GENERAL CONTRACTOR: TRADITIONAL BUILDING
LICENSE NUMBER: .
BY:
TITLE:
DATE:
INSULATI9 CO[YTRACTOR:. WESTERN INSULATION, INC.
LICENSE NUMBER: 481278,
BY:
TITLE: PRO GTION MANAVER
DATE MA 2, 2000
i
ROGER SNELLENBERGER DEVELOPMENT
78615 NAPLES DRIVE
LA QUINTA, CA 92253
(760) 772-0222
(760) 772-0257 FAX
TO: Apex Interior Source
79-553 Country Club Drive
Bermuda Dunes, CA 92201
Fax: 360-3167
Attention:
Denise
Lot & Phase:
Lot 8, Phase 6-2
Date Required :
ASAP
Requested by:
Rita
$ 1,954.00
r)esinn Center
PURCHASE ORDER #
9016
April 3, 2000
PROJECT: Bella Vista Phase 6
Ship to: 78521 Pompeii Court
La Quinta, CA
Homeowner: Whiting
Cost Code: 3186
Hours
Material / Work Required
Unit Price Total
Furnish the following upgraded window covering
Premier verticals throughout
$ 1,954.00
$ 1,954.00
Fresno White
15) Verticals
4) Horizontals
Horizontals with Privacy
TOTAL$1,954.00
5peciai t;onagi nsnnstructions:
;Roger Snellenb er &Associa(tes, Inc.
�\ Cc: Desi
Mli f\IVVVVLCL/VC /11Y✓ f\L I VI\IY
Apex Interior Source
By: .