0008-271 (SFD)_ LICENSED CONTRACTOR DECLARATION
.,I herebyi�affirm under penalty of perjury that I am licensed under provisionsPf
Chapter 9 (commencing with Section 7000) of Division 3 of the Business a
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
734094• AA f(C 03/31/2(
Date 31 Dpi 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
.peLformance of the work for which this permit is issued.
.a) 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.
ZURICH AMERICAN WC8322096-03
(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, I s all forthwith complyawithtt se provi5ions/1
Date: f ' 0 0 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 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_inspection purposes.
Signature (Owner/Agent):' �i Date '-�1'
Vii•.. ���?•d.`'^4tkr"FNs'Lyifl�.
�0
'BUILDING PERMIT PERMITS
'
DATE VALUATION LOT • Z6lV6JS�7� TRACT
tY
�•�' $2 4;2�T4B+U 07*
28%0
JOB SITE
ADDRESS
0M70I5-SBAL�1i 1F d X :.
APN
.775 -MI -017
OWNER
CONTRACTOR / DESIGNER / EN (NEER
C1 A1m HOMES
CX,griiahm
2250 WARI?LOW =CJA SUIT%1'.150
2260 WARM/= i -M=, VUHRT 150
COii„OWA CA 91720
corn io,
CA
91720
�-
(909)2,79-4000
CW
5761
USE OF PERMIT
S�3Ai't31�:I7A1V�fi.1t' 1�'iA%1Q:�3ka'G
SFD•LOT17ISLAN4CL - PERMIT DOES NOT MIC U.DIL SLOCKWALLS OR
FIOOL._
CUSTOM CaNSTRUCTION .31,142.00 9F
PORCH/PATIO 454.00 STS
GARAC3F/M. RPORT (SF) ' 15,4$4,80
ESrTE!"TED COST OF, CONRRUMON
26434"
'CONSTRUCTION FEE 101-000-418.00ID $1,217.00
PLAN CHECK FEE 101-000-439-318 $993.13
ri s.
MECHANICAL FEE 101.000-421-000
ELECTRICAL FEE 101-000-420.000 $176,23
PLUMBING FEE, 1012000.419•'000 $199.75
ST1iCiAiCi hds7i101Pi FEE • 12F511? 101-000-241,=000 $26.43
s.
Ca
GRADING FEE 101-000*423.000 $20,00
�
i 11. r �;
INFRASTRUCTURE W% 225-000-44:3-34.2
ART IN PUBLIC f'1.ACM - RESIN 701-000.255.000 $160.71
MM -TOTAL C00121n 2.UCTION AND PI^JW CHFCK
$4,792.27
IX83 PRE -PAID FERS
$0.00
TOTAL PET i :1�' i 6 U10'E NOW
$4,79127
RECEIPT
DATE-�
DATE FINALED
INSPECTOR
It
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings Z
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
RA,.U.
Framing G
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
/
D7II - Int. Lath
/i a ar
•
.Final
Final 117a34r d
BLOCKWALL APPROVALS
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
—/ 7 Ov
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
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 Power6/
Final
Utility Notice (Perm)
COMMENTS:
SEP 26
200'1 8:29RM ',SCHMLD-CONTRACTORS 760 3471897
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INSU1 ATI®N 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
-
I PGA WESTISPANISH BAY - PHASE 3 = TRACT 28960'
'
` LOT 17
CEILINGS:=
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-3812" BLOW
TYPE: Fiberglass BATTS MANUFACTURER: OwenslCorning '-THICKNESS: R-38 12"''
WALLS;
r -
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning'THICKNESS:R-133112"
GENERAL CONTRACTOR: CENTEX HOMES ' 'LICENSE: -�
-
BY: TITLE:.. a
.
- SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517 C-2 I
-
BY: TITLE: PRODUCTION MANAGER .DATE: 09126101.
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INSULATION -CERTIFICATE
;Gy
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
+PGA
WESTISPANISH BAY - PHASE 3 • TRACT 28960
,-LOT17
. -
F)CIL
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-38 12" BLOW
V
`
TYPE: Fiberglass BATTS MANUFACTURER:.Owens/Corning, THICKNESS:.R-38.1?-"
•
WALLS
TYPE: Fiberglass Batts - MANUFACTURER: Owens/Corning THICKNESS: R-13 3.1/2"
GENERAL CONTRACTOR: CENTEX-HOMES ' `LICENSE #
BY: / TITLE:
•SCHMIDINSULATION CONTRACTORS,INC.. ' LICENSE #221517 C-2�
j� TITLE: PRODUCTION MANAGER DATE 09/26101
BY:.
•
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`
T*Certificate-of Occupancy.
City of La Quinta
Buildingand 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,fo/%wing:
BUILDING ADDRESS: 80-706 SPANISH BAY
Use Classification:' SINGLE FAMILY DWELLING Bldg. Permit No.: 0008-271
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: CENTEX HOMES ,
Building Official
Address:. 2280 W,ARDLOW CIRCLE, STE 150.
City: CORONA, CA., 91720
By: BILL GORDON
Date: 1/25/02
POST IN A CONSPICUOUS PLACE
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