Loading...
0006-180 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapleer 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 11 188 8 �� 6 � ll:/31/2( Date,kI/�� 6 Signature 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. ( ) 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 GOLDM4 RAOLE INS,Policy No. 1J6�JC r"I+i40���fr2 (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 tothe workers' compensation provisions of Section 3700 of the Labor tde, I shall forthwith comply with those_ provisions>I Ate: t© �r..5 /rii) Applicant ~�. %. V -(l 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 bove-mentioned property for inspection�purposes. Ignature (Owner/Agent P ' J l "` r� --' 'Date/ ' BUILDING PERMIT PERMIT" ATE VALUATION LOT 180 TRACT $150,444.70 11 20158 JOB SITE APN ADDRESS 7079 G.A:T.1;,Tf;1Y0R.Tf+,: 7P►9-.02:2-037 OWNER CONTRACTOR / DESIGNER / EN (NEER CrJWU 2Y CRO LL CIMAI1Ni°I`10 CEIv!'I`i RY CROWE4, C0)&AVW 1535 SO, 1..)" 3TRM, MY& 0200 1535 34, *D6 7, 110LT, SMx#200 SAN BEAR-DWO CA 92408 SA14 BERAiARDWO CA 92408 (909)381.60W CBLR 2120 USE OF PERMIT HINGLE FAA U -Y DIVE.1190 SFD- LOT I 1 I'l h'N IA -R. PZRMIT DOn NOT INCLUDE OLOC:K WAL,I-S OR POOL.. 'S % PLAX CHECK FRE REDUCTION FOR 15181) WCE OF SAMR PLApi 'TYPE CUSTOM CONSTRUCTION 11303.00 S9' i3ARAWCAPWORT (SP) 9,106.00 EI7 Inm COST or CUN'b`Ti RTY1011 0B 150,449.70 CON:1'I'11.< CTION FE9 101.000.41 t3,00f3 5815,00 PLAN CR CK F90 101-000-439-_318 IMtIF!',�iF WHICAL FEE 101.000.121.000 $5330 ELF,CTR.ICAL FEE 101-000-120-000 $106.81 A' a. PLUMBING FRE 101.000.419000 5137125 STRONC MOTION OZ.E . RIESID 101-000-2A 1-900 $15.04 ORADINO ISN 101.000x423-000 $20.00 1 DEVELOPER IMPACT FEE $1,907.00 ESUB-TMAL. COITMUCTrON AND PLAX C1.ufj.1& $:3,222.42 L= F:EZril-PAM $0100 IFIVIrAt PERMf Y _FX8 DIVE XOW $3,222,42 A z22 RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs —Zr o IK -7 Underground Ducts Forms 8 Footings Slab Grade — Ducts Return Air Steel Combustion Air Roof Deck Exhaust Fans 0. 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 BLOCKWAL PROVALS Final _�, POOL ° - PAS 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 / Sewer Connection �� (� Pool Cover Encapsulation Gas Piping Gas Test Appliances Final Fin (Gas) � —4Util' Notice '"/ Gas ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Vottage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) TOY sr-O—A G Ss MAY -25-2001 1558 WESTERN INSULATION 909 696 8756 P.12%27 VMSTERN INSULATION 9 INC. 4911 Latham Street, Riversidc. CaUl r & 42501 TeL (909) 686-6760 Sax (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 A% TRACT / PHASE: A-UNA%FAIRWAYS - 20158 PHASE 2 LOT # ; 11. SITE ADDRESS: 78.079 CALLF NORTE LA QUINTA, CA I(TERIOR WALLS: MANUFACTURER, JOHNS MANVILLE THICKNESS: 3 618 " R -VALUE: R-13 CEILJuGSi BATTS BLOW ? MANUFACTURER: GREENSTONE THICKNESS: 8.1" R- VALUE: R-30 CEILINGS; BATT BLOW MANUFACTURER: JOHNS MANVILLE THICKNESS: 11' R- VALUE: R-30 GENERAL-CONTRACT-Olk CENTURY HOMES BY: TITLE: DATE: INSULATI!QN CONTRACTOR: WESTERN INSULATION, INC. LICENSE NUMBtA 481278 BY: TITLE PR 'PION ANAGER DATE MAY 2 5 2001