0010-083 (SFD)LICENSED CONTRACTOR DECLARATION
hereby affi`rm Urider penalty of perjury that I am licensed underprovisions of
Chapter 9. (commencing with Sectiori 7000), of Division 3 of the Business and
Professionals Codq;,ancl my License is in full force and effect.
License# Lic. Class Exp. Date
7.
.e /ate
Signature of
Contractor_�;'. J
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjdry that I am exempt from the Contractor's
License Law -for the following reason:
( ) 1, as owner of the property, o . ir;. my I employees wwith wages as. their.s6le
compensation, will do the work, and the structure isnot intended or offered for
sale (Sec. 7044, Businesst Professionals Code).
1, 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 -1. C B&P.C. for this reason
Date Signat6e 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.jhe work for which this permit is issued.
I have and will' maintain workers' compensation insurance, as required by
Sebtion 3700 of the Labor Code, for the performance of the work f6r which this
permit is issued. My, workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
XURICH-AMERWAN
(This section need not be completed if the permit valuation is for $100.00 or'less).
( ) I certify that in the perform . ance of the work . for which this -permit- is issued;;
I shall not employ any person in any manner her so as to become subject to the
workers' compensation laws of California, and, agree that if I should become
1. s6bje6t to the workers' compensation proviSicins,of,Section.,3700 of the Labor
Code,., shall forthwith complylffitliIroie provisions.
ate:U If"",.;. 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 Dire'ctqr of Building and Safety
for a permit subject to the; conditions and restrictions set forth on his
application. . . I I
1. Each person upon whose behalf this application ismade& 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, agent's 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
ssuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
certify that I have read this application and state that t ' he above information is
correct. rrect. 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 ab'ove-mentioned,prooerty'fdr'lnspection purposes.
Inr/A e bate'
BUILDING PERMIT PERMIT#
DATE VALUATION LOT' -,TRACT
JOB SITE
APN
ADDRESS
�?'VAMM BAY
OWNER
NER
CONTRACTOR DESIGNER EN (NEER
221XID WMI-DIAM CMC,%X,WTrA 1 �O
2280 WAFI-WW UPS -44 WMI, 150
CA. 91?20
WR014A : Ck%. t9JA120
(909)Z79-400 5761
USE OF PERMIT
SM),Lar 64 PLAN 26L.K.WMAT DOES' NOT INCLUDE
7W, PLAN CTIECK REDUCTION FOR
MulllffPLE IMANC15 or S"E PLAN TYPE
CUSTOM CONSTRALFCTION ZW100 OF
PORCHIPATTO W.66 3F
GARAWCARPORT tP) 1:059A
'T I Or COMM
MMMTM COW ZIDMOH
248,Z X&310
PERWI, FrKrt gummay
CIONSTItUCTION n9-9 101 _000-4141' _000 $1,163.00
PLAU ME011 P"91? 101-W10-439-318
PARMANIVAL KrE 101.000-421-000, till."
F1A2r,TWCAJ, .101-0004-20-000
PLUMBIWO FEE 101-000-419-000 %4"1141
STRONO MOTION Yft - .R231D 101-000.241-000 134.83
ORADWOFF-9 SAO
WMAIISTRUCTUke, FE -9 225-000-443-31,42 si'mi.90
A1191' MT PUBLIC PL&C-29 - kFS11. $120.87
OUB -TOTAL ff-A-4 MUMION AND PLAW QIWX
$3'953.61
IFIS3 PIRE-PAID ME. 3
$0.00
TUTAE, P113MUT -10505 '.WOW
RECEIPT
DATE
BYJ
DATE F INALED
INSPECTOR
/P
I
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings2 _
2
�
Ducts
Slab Grade
1�
Return Air
Steel
Roof Deck
�/
Combustion Air
Exhaust Fans
O.K. to Wrap3
/2 D�
[ F.A.U.
Framing Z--V.:;-;A7-vL,
�_,�/
391or
Compressor
Insulation
�.6 `t
Vents
Fireplace P.L.
`•. Grills
Fireplace T.O.
t Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath _ _
_
Dr 11- Ir.. L th _
to
(ole'
71—
Final
_
/?i��J/Q/
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
_
/��3/
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
_ _
�j/�3 _
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
f%
Utility Notice (Gas)
3A if
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)
_
_��
CENTER HOMES
SPANISHBAY ®PGA WHST
CITY OF LA QUINTA
78-495 Calle Tampico
La.Quinta, CA. 92253
To Whom It.May Concern
This letter is to verify that all of the O'Hagan Ventilation System vents for clay tile applications are
installed correctly and within all manufacturer's recommended specifications.
Number of O'Hagln.Vents`Installed -
Lot #
Plan # .:
Phase
Tract # 28960
Sincerer
Sr. Field Manager
h
APR 30"2001 3 5OPM SCHMID CONTRACTORS - 347-1897
. '. �?IM!/.:1d1�cti0';YM^•'a[.,5+.�1(p..A,'4rtirrlllal!% r:A.:H.`2Y0:'A::Wd'-%lP..'�iPn::'d%;vla•OR.>i �.A.Y,YA:T.vOtW�G.%.ICaYSSIr Nu(Yt' �'s[J.!,µ A.Lsy,04 �.iury.:v.:uuu✓.a,•r wfla:nGG."14wt•:rs�t-ali."w1:tJ`sr<Y®Itl•2N,'O.B: •
1
INSULATION CERTIFICATE � f
This, IS to ertlfy that Insulation has been installed in conformance with the current energy d
c regulation -California,Administrative Code, Title 24, State of Californis, in the building at.
4 PGA !NEST — PHASE 4 — TRACT 28960
LOT 64
CEILING: 2
F TYPE: Flk :rglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-38 12"
' TYPE: Fit ;rglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-38 12" BLOW
' WALLS: a
TYPE: FI erglass Batts MANUFACTURER: Owens/Corning THICKNESS:R-13 3 1/2" z
� . T
n 01 NERAL CONTRACTOR: CENTEX HOMES LICENSE:
j BY: TITLE: _
SCHMID JSULATION CONTRACTORS, INC, a LICENSE #221517 C-2 a
BY: TITLE: PRODUCTION MANAGER DATE: 04/30/01',.
x t
• S%..:w}iC•HW.AYIt:Y�GM.U'%Oi(Cfd`��JXIMCd CLY.ZV.IF1R'r>P'�/•7:/�!!a7IIYaW.I.lnt�YQL'1RtiM.YF'.(f281X55R71pNYmV,P.t.'ORJiilai!.W�tfd"M'YAli'/.Wt,Ld6iR(a:YY:i/k"/.Wb.%WVNAA21r,4GacNJMI.I�Y.atY�llfiiW.W.a4' J.+44lYARwP.4V.O.n�
�AAY�bi>✓•i4LRlrC,+K.:P'?T1'A.%8H'a"�ia['! /FY..ON.w7.:WAIS/ei+8N!S/734stRA�+dIW:9!X•:tfIGYFTRC2424JS.iL'✓.M. RI�fBFLgY'r'-O:CIWiY.:RntIAUP•fMI.PI.PYWr3../wMiA4Y.H:is4t:is'!/.Yi.OtbtLG:l::.'l.ii✓.IYG'X!.'P.AGfy<aYIJ/.{G✓r: �:�
f
INSULATION CERTIFICATE
This Is to c . rtify that insulation has been installed in conformance with the current energy
regulation; :alifornia Administrative Code; Title 24, State of California, in the building located at
PGA WT — PHASE 4 — TRACT 28960
ES
LOT' 64 ,
1.
CEILINGS
i TYPE: Fibs 'glass BATTS , MANUFACTURER: Owens/Coming THICKNESS: R-38 12'
TYPE: Fibs 'glass BATTS MANUFACTURER: Ovens/Coming THICKNESS:.R-38 12" BLOW
WALLS:
TYPE: Fib irglass�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'
BY, TITLE: PRODUCTION MANAGER , 'DATE: -04130!01' �s
r rj umrarn:r.Mrra::svr,..o:x..,avr. wn»a•!,.e.�nrx::a•;uum7xrrw•r+na.iHiwiz..aura;,r..yr;uoc.u'earrwetrsrvzvro,f:wraarnrrnrm.e'arzoxr,:iscira:rnrrrtr..r<r<vru3ragirariw �;,orav,:ti:.rrrriann,w.•rv.
Certificate -of Occupancy
City -of La' Qdinta .
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.
80-787 SPANISH BAY
Use Classification:
SINGLE FAMILY DWELLING
Bldg. Permit No.: 0010-083
Occupancy Group:
R-3 Type' cif Construction: VN
Land Use Zone: RL
Owner of _Building:
CENTEX HOMES
,Address:
2280 WARDLOW CIRCLE, STE 150
City:
CORONA, CA., 91720
By:
GARY HARTMAN
Date.
12/7/01
Building 'Official
POST IN A CONSPICUOUS PLACE