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0310-205 (SFD).r LICENSED CONTRACTOR DECLARATION '-I hereby affirm under penalty of perjury that I am licensed under provisions of Ghapter 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 640934 11 r.Date !,_t , =' Signature of Contracto(_ 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. Q1) 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 1'dAWHAL UNJOPI F. Policy No. 7363 :,"3 (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,:pr"ovisions' of Section 3700 of the Labor Code! I shall forthwith comply with'those provisioris. 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, inspeciio�n)purposes. ' S tom. I A tYN �,.�J� ^~!, �,�:,�W,,... Date Signature (OwnerPAge.t) - BUILDING PERMIT PERMIT0310-201 DATE VALUATION rAkY LOT TRACTJOB SITE ADDRESS �!' ✓% 1 �'J.Cui�.�e�� ��Er `..�ei�t APN '4918^dam �iL�-Y7 OWNER CONTRACTOR/DESIGNER/ENGINEER 'A Vii' 91 MEA HOMES A,A.Qi wr#i, CIA 9e.8813. LA.-,VfA. C 929831 11 (9 f i� 833-8 i , Li 6976 USE OF PERMIT 'WL) - 5.UT 3 ., FLAN Cgtl F )fVKJd1 }; ;3Ul:a t.'UT l L.'L1UU ifLA.X; .. WALL',,,' 1100 , i3PA OR 15i IUNIIWAY 11S'F'RO}SCH RC . CUST01.4 ON "WC'f RYK Zt6%u4100 ssF AXWCARNN41' 5F RRI)IMAUXT) C0.1107 OF CONSTRUCT101114 229,748M -.../„c)NOTRIie"T10 .1 )"RE'.- i 01 -0004.18-000 PLAN C HE;C:.X F& �3 � a � � _000 -4S91 -31f, Z'�':,XICA),� y,p.t-tai©-r:0�t?Ctf�=1 d. a S'Kt'7140 All 0T!G •'•'!'% S'• PX -SID Cii -G+flb-7.+x,7 -040 $22-07 OIcr5,l n.C` W FRE IM -000-423-1000 5168 ,n9VJ1rWPrW PER 'ART 'N PUBb.,ll: r°1i11?XC S - R:E'.`�iC. 2.70-000-145-000 974.3:' TUB .'YOTAI, CO STRUCM3fi1.€W) CSF'OC $4,91 ] .,r,;i '5235 PI E- 1AD T -RIKEN DUE NOW D .. NOV 0 4 2003 RECEIPT FI_NA_Nt'E I b_A% .�i BY DATE ONA INSFF�T �� '� INSPECTION RECORD a OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs ; I Underground Ducts Forms & Footings i I Ducts Slab Grade ; f 000, Return Air Steel [ Combustion Air Roof Deck I I _ Exhaust Fans O.K to Wrap I I F.A.U. Framing f Compressor Insulation i I i(J Vents Fireplace P.L. i I Grills Fireplace T.O. i I Fans & Controls Party Wall Insulation Condensate Lines Party Wail Firewall I i Exterior Lath I I Drywall - Int. Lath I I ,I ;I I I Final Final i Z „ BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs ; t Electric Bond Footings I Main Drain Bond Beam I I Approval to Cover iP Equipment Location Underground Electric 1 Underground Pibg. Test Final I Gas Piping ` + PLUMBING APPROVALS Gas Test Electric Final ; Waste Lines 1 t Heater Final Water Piping I I Plumbing Final Plumbing Top Out) I Equipment Enclosure Shower Pans ii O.K. for Finish Plaster Sewer Lateral , I Pool Cover T ' Sewer Connection I ; Encapsulation Gas Piping ' f Gas Test } } Appliances it i i Final I 1I 1 it Final I I Utility Notice (Gas) ' ELECTRICAL APPROVALS Temp. Power Pole I I Underground Conduit Rough Wiring ,► Low Voltage Wiring Fixtures �+ Main Service Sub Panels Exterior Receptacles G.F.I. ) I Smoke Detectors ; i Temp. Use of Power If II Final 1 6 Utility Notice (Perm) COMMENTS: _ .. _ • ' APR -02-2004 FRI 11:50 AM WESTPAC AIR COND. FAX N0, 909 739 9509 P. 10/24 histallation Certifirale: Residential CF -6R Site AddrSsl PERMIT # 641-32S . Prickly Pear Drive -- l.1tL1l1.liN;li 1N1� URM11A1'ION SUBDIVISION: Trilogy (rii La Quinia Shea Homos - Trilogy - L,aQuinta Cl'1 Y: La Quinta 60311 'Trilogy Pkwy C'OUNTYi.R.iverside 1.► Quii►lii, CA 92253-7642 INSTALLING C:ONTRAU I'UIt: WFr%T PAC AIR COND1110N1NG 2. I%0 TE ➢' 1N, F0RM)V1'ION . DIS'FjRjt�l TI_QN TMC i' Olt PIPING R- TYPF. 17ur ible Ductwork Flexible Ductwork in Aliic and -Will have a R -Value 1letwull Floors of 4.2 or Better I, the underiign d, verify that the equipment listed in the category above my signature is the actual equipment iut,tatlCd and, (hat the: egoipstilent meets or exceeds the requirements of the Appliance Efficiency Standards. Tn a(lrlitiun, (have vvrilicel that the equipment is equivalent to or more cflieient than the equipment specified oil the Certificate; of Comptimice suboullyd to denion5lrntc compliance With tho'Rnergy Efficiency Standard~ for ccr,i►lcniial huil�lii►gs, • 1. HEATING iNFORMATION 11RX171NO MANUTACr HFIATTNG UNfl' ACTUAL. EFF. HEATING EQUIP IMATING h,QUIP. MAKE MOD T, 1 AFUR CAPACITY WAD Furnace L cnnox G40U11-488••090X 80% 88000 U40UI1-48P,-090X 80% ...... 4, CO(11.1(i(i,)NFORMATION COOLING MAN(11-ACT comp I?SSOR ACTUAL EFF. CO OUNG UQU1P COOLING T:QiJIP. MAXP', MODEL 4 SEER CAPACITY LOAD A/C Lennox13ACC-042 12 13ACC-042 1•he buildi►►g LIC si' n heat loss and design heat gain rate have been detcm-,ined using a method specified in Section 150(1) of the Pnci-,Qy 1311ietency Standards, and are. two of die criteria used for equipment sizing and selection 6,1111?HMO;;TATIC' EXPANSinv VALVE ('fXV): Thermosiatie GxpausionValve (or Conunision approved equivalent) is installed and access is provided for inspection. Yes No N/A 6. SC1i11Vi[ 1"1'1:1)13Y ' UATF: Z2!t&11iog11VACContr;ictor "•f. .: //I%f</."l+•i V"'i.Ynl,•I.r. �•N/r r'Y,'/�I:'. 'I/.!ri NJ!✓J•r:/Y'/.'✓V./.':4I."/.'///%'Yi'/.rh'%:Y/Y.'%M."Yr31'VV%YY./Y/.'/.I� J,/.`:w%:rY:/+Yf✓JVJYNr.•Y�YI'lrvY r: r../`•r!'Y•/•!:: •'l.�Y: YI,n �'!.•rIn•'�� 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 at 60-325 PRICKLY PEAR LANE LOT 58, LA QUINTA CA CEILINGS: TYPE: BLOW MAUNFACTURER: Certainteed THICKNESS: R-38 WALLS: TYPE: BLOW MANUFACTURER: Certainteed THICKNESS: R-13 GENERAL CONTRACTOR: SHEA HOMES . LICENSE # s� BY: TITLE: "r. PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517 BY: TITLE: ACCOUNT REPRESENTIVE DATE 1 l lcd Y i r i 'r;rrriimirRrniririi.�iiriiiiiirirn'n�iirrrrrrririnrrlYnirm�miiisrr>iirir.�'MJwr/�nv�vr/n�! ,�vlrivc�v.�rirr�vrirryriri irirsrrririiii�iYrxiuie+'ir�rryiira..'.iriri I.r•.iii n�..i ;�. INSULATION CERTIFICATE This is to certify thaliQsulatjon has been installed in' conformance wit a current energy regulation, California Administrative Code, Title 24, 'State of CalifqKia, in the building located at a i CEILINGS: \ ' . /01 TYPE: BLOW _ MAUNFA�6TURER: Certw1iteed THICKNESS: R-38 WALLS: TYPE: BLOW MAUNFAC RER: C ainteed THICKNESS: R-13 GENERAL CONTRACTO HEA HOMES ICENSE # BY: TITLE: PARAGONS MID BUILDING PRODUCTS A MASCO Co any LICENSE* 221517 BY: TITLE: ACCOUNT REPRESENTIV DATE: ' r i Y ,v:/A•IY/I/!'I..I..IY%//Yfr.M'///.'N/7/I///.r/r?./.`rN/•'r/73?%rYJ'Y/Y7.f/YYtl'Y.+YYJr//Y.II/IR/.//1/1'Yl'w'/YX/%7%lY/%Y/JSMNArYI.iY.Y1'YY%J'Yr'MA'N�YrYY►Yr✓.YY/%VNYY9fii YYYYY/fY/.r% NNIIN///.�rli/.%/llr�: /ti