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9910-198 (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 MOWN Date 10'9Zlf 10'9ZSignature 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). O 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: O I have and .will maintain a certificate of•conse&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. ( ) 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 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%f the Labor Code, I shall forthwith comply with those provisions. Date: Applicant Warning: Failure to secure Workers' Compensation coverage is, unlawful and. Shall subject an employer to criminal penalties and civil fines,up to $100,000, in addition to the cost of compensation, damages at provided for. in,Section 3706 of the Labor Code, interest and attorney's,fees. IMPORTANT Application. is hereby made to the Director:of Building and Safety for a permit subject to, the conditions and restrictions 'set forth on his application. 1. Each person upon whose behalf this application is.made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as 'a result of this applicaton agrees to, & shall, indemnify & hold .harmless the City of La Quinta, its officers, agents and. employees. 2. Any permit issued as a result of this application. becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation: I certify that I have read this'application and state that'the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent /7✓ .✓ .,/�.�/T4�'' Date ! )4 • ' PERMIT# ' BUILDING PERMIT�,s�Q, 6I DATE if 6/ y (` VALUATION� y� �$�+yt + � LOT 6) TRACT 1953 . ADDRESSJOB SITE "P2�`T��®l�iaSyS�&� APN �ro-�FE-46 OWNER CONTRACTOR/DESIGNER/ENGINEER (.3I,;3QHANT AND Qa11PIA10 t' AM �,'t�'ILy,, AMIS ASSOC, ,31"Ic. 77-!OOO V.EN*UE OF,*- t'HE gr..tVi-98 : 77.900 AVENUE OF INE S17M S PALM Dit~SBAff CA 92213 PALM DESEWr CA 4221.3. (760)3145•2.6+2.6r 09110 5201-4 USE OF PERMIT SINGLE FANIA DWR AAING aI D. L40 d.9. PLANA 3R. PEWT i�OW N'OT TN011LIDE, �LtdK. i1Jl+.�.1 OR V00L.758A XUD1JC1'1OA F v f 0.Nj A4,QL-T11'LB ISSUANGE O Ss ME, PLAN TRACT CONS AIR= ON 229,2 3J 'SI TIOR.MaA. 1 12fi.a7+J SF' tKATIPM COST SIR 133 GAO 55 C.014s:TU I09M i0d-XEl-419d)0 .. i1�74i.fid? °YJStl CHECK FFE .1014f00-439_348 Yv'.ffxIGIA!'aic.A.. FIX., FETE; i4➢�-(3I?.eY©'LtE50,a3 �� r�N�)t)•�p{F.�/�a�yD.:;��+�•�-4��N((AA►/(D�� �ti �''! y��INCI.�g�ra/ryvlwtC�'rE'>T�T�¢�� ���'�.��^�F,€oo CUIL! ' FLE Ut"+i�Y.u.S•e� :4tkxN.s�t."i' f+�;a` �f,�tf7.4i3 C,..t # i 1 t' '� I4iC i' d.t+l �1J.�f;�.iC: i°€.AG,h``� tZtv.�iti.; i��-ild?�^2�+�•Lt€)�1 u:•yh:pt� �� i-^'; i N LUS PRY. -PAID FTES, $0.00 RECEIPT DATE BY�^�O DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs p 01, Underground Ducts Forms & Footings / Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap Framing Z F.A.U. Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wali Insulation Condensate Lines Party Wall Firewall Exterior Lath _ L Drywall - Int. Lath Final 13C� BLOCKWALL APPROVALS Final 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 �=-1�� �_ Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral -Z - - BQ Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test e C rQ0 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) $-3® COMMENTS: l m N 13N m m Certificate-of Insulatto your U me hub= iosulaled with C UbmTeed Fiberglass tnsnlation which me dc*nod A m for todayS SMO sraWM& and wa want% MWW rawmemeats- F�berg�ass.is inrbrganic and therefore p dy nmwmW a&-We, so it does not have to be tiedted o with fm-nmudant chcmuals thm will Idady lose their eff6dwenem aver time. L. bur ani beta DeM4 � with chemicals that can comde wiring or'mdal ' F>berglass grill not ah?so moisture nor vviil it settle overtime as may odw bmhdi n mateaiats Z an C r This also cardfiies lbal 0mainTeed Fiber Glass 3nsotahan has been pro sionagy msmalled m this home D 0o pcavide the Wkrwing theratal pedormaaoe.. '. o Job Nance: Sonrisa Tract . 25M Ptah 3 phase: 3 D N. Lot No.: 64 Job Address: 79-417 Naevo Dr., La Q®itd: CALn D y Ceiling Area: R-39 Unfaced Garw Ceiling" -10 With laving Above m Werior Wafts: Ovtz�>�� EzWrbr Walls: R-13 Unlaced U With living Ln Par(t2y Wypal�ls: Above Lnm Siakvn&actor.. OriInsulation CA, InG 6D08 as 97707 (0011l270 Lie7 t![69109 SlgIItdd • • conchlta Ortii4 Seccetary%fTreasurer -ter— R Scott JenlPdns, Presidefnt^or— Loa Merola, Director of Operations Officer R- meads resiamm to heat flow. The higher the R- value, the greeter the insulating Pm=. Z Ask your builder far the fad Sheet on R values. Keep this certificate with your other o valued papers. if you ever sell this htrnte, this coMcate shaald be passed on m tha buy+rr. ru . CD . a N N M Certificate of Occupancy City of La Quintal Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: Use Classification: Occupancy Group; 79-417 NUEVO DRIVE SFD Bldg. Permit No.: 9910-198 R3 -U1 Type of Construction: VN Land Use Zone: RL Owner of Building: OLIPHANT AND WILLIAMS Address: 77-990 AVENUE OF THE STATES City: PALM DESERT, CA 92211 Building Official By: GREG FOX Date: 7-31-2000 POST IN A CONSPICUOUS PLACE