0008-285 (SFD)-LICENSED CONTRACTOR DECLARATIONS
I Hereby affirm under penalty of perjury that l 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
734094 At IM 03I311'2f
Date �� f1a-Signature of Contractor �-
tf
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
c ien 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.
ZURICH-ANIRMf".�AN WCS=09.6.0�
(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 of the Labor
Code, 1„%he11 fort with comply;.with-those'provisio
Date: j A plicant
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
fora 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 propert�rty,, ,for
ri�inspectdon purposes. /
Signature (Owner/AgentDatf•y/ ��✓a•
BUILDING PERMIT FERMITtI
DAT VALUATION LOTF3'TRACT
28960
JOB SITE
APN 3�p
ADDRESS gypl+rM AY
Rye
OWNER
CONTRACTOR/DESIGNER/EN('(NEER
C1WrEX ROWS
CF TC HOMES
22180TlAM.Low t R = i•� 9Ll=150., .
2280'V+PAR137:.OW CMCM Km7r iso
CORONA ` CA 91720
CORONA CA 91 72ti
("9)219.4000 CJUt 5761
USE OF PERMIT
GJ T% FAMUX AWELU 0
Sk)-LOT55 PIAN 3OAR P1ZPJAIT DOES NOT MCLUDE 81,OiCR O-
POOL7''a% PIAN CKWX IFFY, REDUCTION FOR PutiJ-IA1PLE iSSUANCE OF
SAME PLAN TYPE
k dUSTOM CON tTRLJCTIO14 36W.00 OF
PORCH/PA110 53S oa "
C'iAReaK7MARPORT (0) %5$00
E<9rJ� XrEJD Mgt OF CONSA'.�1.r0110M
2",148A30
j�'yy•�`.���yygg qqt�ry �y�0pf �y,jy/
S.'M..n«l4s.Ra., Sf d:ls17lJA� 3
-
CONU' TOXTPON MR 101-000.416.000 %11,72i,GI7
PLAN GI3 E= FEE 101.000-439-319
MECHA141C.AL F&E 101-000-421.000 SI M00
F.1,ECPRIC'A1, M, 101-000-420-000 $173 79
PLUMBINO FEE 101.000.419.000 $19949
VRONG MOTION FEE - REBID 101-000-241-000 �26.8I
OR.ADINO FEE 101-000-4r$-0 0 $20,00
1NKtASTRUCrU". FRE 225-000-443-34.2 $1,901.00
IL -J"1
ART IN PUBLIC PLACES - RMYE 701-000-255.000 $1+6137
'
(;`"
12
SUP-TOTAY- COWS I'RU(,t1101,T AR' D P)AW CW3 CK
XMIS PRVE-P AID PEPIS
T;', .:60.00
40TAL MOW FIMS DUE NOW
S4084,20
RECEIPT
DATE
BY //��j
DATE FINALED
INSPECTOR
A
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footing
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck(jD
_
Exhaust Fans
OX to Wrap
F.A.U.
FramingCompressor
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 2�
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
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
j 6
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)
COMMENTS:
-
APR 30 2001 -3 43PMSCHP19 b CONTRACTORS, • ,.347-1BjJ P.5`
J.s;O9.M.:VYJ"n. .:D;Nr✓v WV A,hI U7JLfr.W;9Yi'KkYJff'dM6:fVA: PSIriW]Y✓n4f�yi1N1?H'gVJY�HA1.'W:RwMR)1}9YAJfSYk:d'.dllW.i,i'/IM1?P.':0ii!'LdF•?1.N..VW/.0.'RY6+G!Yr-i.Xi"M.MtiUttl.•.f.^.W.M.f.F1'NiV�ML/,r•N,A JYf NSffliL.�
-'INSULATION CERTIFICATE �
'- This is to artify that insulation has been installed in• conformance.with the, current energy E.' '
$, regulation - California Administrative Code, Title 24, State of California; in the building at
} _ ; PGA WEST — PHASE 3— TRACT 2860
- I LOT 58 t�
' CEILING:
'j w TYPE: Fit trglass BATTS MANUFACTURER: Owens/Corning - THICKNESS: R-36 12'' f
TYPE: Fit )rglass BAITS MANUFACTURER:. Owens_ /Corning, '' THICKNESS: R=38 12" BLOW '
TYPE: Fi erglass Batts' MANUFACTURER: Owens/Corning •THICKNESS:R-13 3 1/2" a
GI NERAL COPJTRACTOR: CENTEX HOMES' LICENSE' x
BY: 4 a '' TITLE: z
j SCHMID. • IS UL`ATION•CONTRACTORS, INC, A LICENSE#221517 C-2
BY: " d 1%d TITLE: PRODUCTION, MANAGER- DATE: 04/30/01
` � Y.•BY+ie'NSC�J.,aGHtOib. L:'4:f['!C'.'O!!.'P•6.J'✓•I, k,1l�i,HY6f.l�iTl N.y1.CI�:IC: :7iNVY.(®/4YL15{9i1�272A1?H7�9, AiT�d�VAR.Tb4-G/iYGYVIiel.:ASIG.4F9YlfflAl�2iGt%►/YriM'�IXe:/.GI:RiSBRL.iC/Ts'�I.(�GRrtiIA]�tTGi�A:4NiG.:db.P,fO'fL7wGi•,ruF�Ad: •
'J''unV;i:?1f+]I%..%•"J�Y?✓.s:R7.:DGs •lf�A`MYNYJ YAILMq::di'EkNPA..yXA:A.iP••PArFcry�IYA: tri/.1cIF0♦rAi:rr+lmFr+uT:IY Il/CdY l:�'CltfiGwX :t'r'v1Lif':i nrw•IN<.fLYN.I.'».Y^•Yf.WLitY:Wil'..n.:lJ.infs'.RSV./YUIiL1.':(Y.W.O�-0.:�c+�'<oG:NGIX:TJ.!F'lK4
I a j
INSULATION
CERTIFICJ4TE
This is to C rtlfy that insulation has been installed in conformance with the current energy
regulation, 'alifomia Adminlstrative Code,'Title 24, State• of California, in'the building located at ^ "
PGA WEST. PHASE 3 - TRACT 26960
t
'LOT 58
CEILINGS
x TYPE: Fibi' `glass BATTS, MANUFACTURER: Owens/Coming THICKNESS' R-38 12" z
TYPE: Fibs'•glass BATTS MANUFACTURER: Owens/Coming , THICKNESS: R-3812" BLOW • -
3. - WALLS: •1 , ";..
TYPE. Fit :rglass,Batts „MANUFACTURER:.Owens/Corning THICKNESS: R-13 3 1/2"'�
GENERAL 'ONTRACTOR: CENTEX HOMES LICENSE #
BY: TITLE:
SCHMID II SULATION CONTRACTORS, INC: LICENSE #221517, -C-2
• x
BY. TITLE: PRODUCTION MANAGER DATE: 04i30U01 f
�i!•.•.:.C.;fY!�MfY/1W-fY1!'�'S,it•[O'LI•A�l1:N.9'�i IS'I:"<r6.?'d:A:�1'NIN�br'd'Y.lilfJA`b;�ieiPn�YN:1i.6'YI.aEC'OiO'nSdrY�O.:IV.ID.';BedL'N^N.•iLC'OTI'1XYCJll:1rI.L'-:w1-t_Ibin)Ndl•d.'.@'i': �S'.ff"oi's f+V..II.TO •:MtF:.r•6.11C-J. U(.a+ K . .
., . _
_of.OccupancC_ertificato,
�-
�. .�
a
Cityof. La Quin�ta.
- a.0
Buildingand SafetyDrtment epa
of
This Certificate issuedpursuant 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: 80-625 SPANISH BAY
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: -0008-285 _
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: CENTEX HOMES Address: 2280 WARDLOW CIR, STE 150.
City:.' `CORONA, CA:, 91720,P Y
By: RICHARD CKIRKLAND
Date: 7/2/01 ;
Building Official
POST IN A CONSPICUOUS PLACE
l