9909-282 (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 Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
f�1'/�i bv�
( /
\,Date "� Signature of Contractor f.. b
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. '
( jI 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
permt is issued. -My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
(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 provisi? s-of'S'Mion-3,700 of the Labor
Code, 1 %ha1%forthwith comply with thoe-provisi ns.b/
—Dated w
V
3 t�
Warning: Failure to secure Workers Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize_Le�sentatives of this City to enter upon
the above-mentioned pr�p'erty forr p� ti" -_A p�"�oses.
�Slgnature (Owner/Agent) th_ Date
BUILDING PERMIT PERMIT#
DATE VALUATION4�,•�l LOT TRACT
ice• i• �; tt
JOB SITE
ADDRESS %�WSO CITRUSAPN
749-M,7".0
OWNER
CONTRACTOR/DESIGNER/ENGINEER
Sk-EFF4f'L-D ist")hi iS
S�3i:�'? �3?Ll ff? 1F 5
i C'RA.►V+1t3£ 6E 325
3400 CENTRA. AVENUE ''.5
RIVERSIDE f,A !Q'506
RIVIERS 0r, 1..t0 97 SW,
(S�fb9)M?-5352. C_`i3t.7i W11)
USE OF PERMIT
' 3s 10�fi�:,00 �C�:�' . .
.00
C:';AI ACO.J1 3'tiW01,ItT G.}IN-* SF
�h.idryd.t�'�R �r.T.►' ���� R �i,d`M•� �`�.��id4��AaYll, itt�ilT� Y
ery.:�a��i.:� i.��'n�
�:il� ttiJt: ! lc:r 1rt+ait 101-000-41P,060 V, P46 00 •
P4 -AN r7f•?Ff,K. i" E", f0 1-011911.439.3,8 A97497
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INit:fw+.MAXIC°AL.
WX.(: MCAL FEE, 101-000-420ANO
4 4?f',-NO Nit �'FK3nt f c?+T ._ ctF?StD 3(1�. 40$-24 J 4#�
VE-VE1.01-I fi 131dt7l1CT FIT $1.!tt/700
cttFS-I'sfi`��i,CON h'"1'tti.flil�fe�LVC).�D!, 01 C°Fii.C'
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RECEIPT
DATE
BY ;bf} j '
DATE FINALED
INSPECTOR
INSPECTION'RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
- 1-= L
Underground Ducts
Forms& Footings
/2
Ducts
Slab Grade
Return Air
Steel
Combustion Air
'
Roof Deck
Exhaust Fans
O.K. to Wrap
(j CAU
F.A.U.
Framing
Compressor
G•
Insulation—
Z= y —i, tJ
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
7 Gd
Final
��
POOLS - SPAS
BLOCKWALL APPROVALS
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
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
_! // �
�7
Pool Cover
Sewer Connection
i%�
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low VoRage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
- 4/
Utility Notice (Perm)
9 '.
Jul -19-00 01:52P
The Citrus Course Homeowners Association
July 19, 2000
Mr. and Mrs. Henry Coates
79-080 Citrus Street
La Quinta, CA 92253
Re: Pool, Spa, BBQ, Raised Planting Bed, Patio Extensions and Walk -way Additions
Dear Mr. and Mrs. Coates:
The Architectural Committee has approved your revised application as submitted. This plan
shows the 5' fence on the side yard and has removed the stonework at the front.
If you have any questions please contact our office at 760-346-1161 or by fax. Thank you for
your submittal.
Sincerely,
On beh f of the Archit ural Committee
Citrus Course Homeowners Association
By: Ken Mitchell, Architectural Committee
cc: Dale Brooks, Architectural Committee
Mr. Graham Balog, California Pools 8t Spas
73-550 Alessandro,, Suite t5gPPalm Desert, CA 92660 h. (760) 346-1161 fax (760) 346-9918
P.02
WESTERN INSULATION, INC.
4211 Latham Street, Riverside, California 92501
Tel. (909) 686-8760 Fax (909) 686-8786
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 LOCATED AT:
TRACT / PHASE: CITRUS - TRACT # 24890-7
LOT# 6
SITE ADDRESS: 79-080 CITRUS
_ ------------------------------------------------------------------
EXTERIOR WALLS
MANUFACTURER: Johns -Manville THICKNESS: 35/8" R -VALUE: R-13
CEILINGS: BATTS� BLOW
MANUFACTURER: Johns -Manville THICKNESS: 13" R -VALUE: R-38
CEILINGS: BATTS BLO
MANUFACTURER: Greenstone THICKNESS: 10.3" R -VALUE: R-38
------------------------------------------------------------------
GENERAL CONTRACTOR: SHEFFIELD HOMES
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRO CTION MAN GER
DATE April 13, 2000