0106-296 (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
P_ro%essionals Code, and my License is in full force and effect.
Lioonoo # Lio: Claoo Enp. Dato
714 188
in
Date ~~' -/Y-y t' Signature of Contractor 0 `
V �
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 1, 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:
Cartier Policy No.
COYs�'� f�.A,f�3�� 3N'�; 1�iW{,'•-�4�i31r€1-4�
(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 shall forthwith comply with those.provisions� �±
Date: -1 1 /.- /. Applicant ,.f
fi 7_7Z7,
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. 1
r '� " �sl "� Lli c�»erG r
Signature (Owner/Agent) { a.�� %� Date T_.
BUILDING PERMIT PERMIT#
DATE f VALUATION. LOT TRACT
JOB SITE
ADDRESS — 7
APN
54.814 TANGLEW00.3D
OWNER
CONTRACTOR/DESIGNER/ENGINEER
`C i;e`ti. Y CROWELL COMMIrWM
C:ENMY CROWELL CM&ALTN`JiI'!t A
1535 go., IT mm= aY'z in -Do
11315 30, TM "IMM'IT,1.0260
:SAT :�TAI2DWO CA 92408
SAN MR14A2MUTO CA VZ 08
(909),381-15407 C,L'l14 2120
USE OF PERMIT
KNITTER & ASSOC
S10 - LOT a6 PLAN 7AR • PERMIT t7OF.S NOT 1A11':1..UDE i'i.f OCX WAYa4
iiC. I., OR DRIVKWAY APPROACH, 750A PLAN COfRM Pftf RX..3JYIf;i1M
APPLIED FOR MU191PLE 3A:I4A'R, PLAN TYPE Si,1H.A+ ITT1✓O.
Cl1OTOM CONSTRUCTION 489&00 V
FORC HtPATIO 194,00 SP
OARAC fCARPO'RT X6,00 SF
1<' STIMA1 C OY' r OF C0NFJRVC`. b+ N
20D,345.00
Pk:1W13`M MUMARY
CONOTR11C r ION FU 101-0100.418-0114 $99,1109
PL P%H C:13WK FEE 101-000-4:39-318 $201..83
KWHANICAL FSE 101.000.421-000 $92.00
?1,,=WCAL K%, 1811-000-4213 00 $129.74
PL1JMRiRIG F1;R 101'"000.419.000 $169.50
tr'
S°1'PON, 0IACIT.IO'N FES - Rt=RD 101-000-241-000 $20.0.3
t i"WWO FFIR 101.000-423.000 $20.00
DWELOP,L31:IMPACT MZ $1,907,00
ART 04 PUBLIC PLACES - RP -51E 701-0006251-000 006251-000 $.$S
•;�,80M40f`A%. C1T�RiJ'C11<1' Alii k�x AAT C'FEt:3fS31.'D
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�� LF05 PRE-PAUMMI
so. W.
t .1 3 2001 ' ° • P.MU' ' f Dry:+.NO
4� JUL
e
CIT f Or' LA EPJTa�
• CE DEPT ..
Fii�:,i\
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RECEIPT
DATE f
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS'
MECHANICAL APPROVALS
Set BacksUnderground
Forms & Footings 11y6Vil-
9 W1
Ducts
Ducts
Slab Grade t/I
-�pl"
Return Air
Steel
Roof Deck
/�/ jj 6j(�
Combustion Air
Exhaust Fans
0. K. to Wrap
��,� �(/ 6J(� "
F.A.U.
Framing
/L _5
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
/��lb� Cb/1 O
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
Waste Lines
_
�
Electric Final
Heater Final'
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Sewer Connection
�f�l _
Pool Cover
Encapsulation
Gas Piping
Gas Test
_
//fid/per
Appliances
Final
COMMENTS:
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. Vse of Power
Final
Utility Notice (Perm)
Cert ficate.o .1osi lation I
Your Home has been insulated with CertainTeed Fiberglass -Insulation products, which are designed-
-for today's safety standards and tomorrow's energy requirements..
Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated..
with fire -retardant chemicals -that will likely lose their effectiveness overtime. It as, not been treated
with chemicals:that can corrode wiring or metal:: Fiberglass will not absorb moisture nor will it "
settle over.time.as.mayother insulatioh materials.
This also:certifies that CertainTeed Fiber Glass Insulation has'been professionally installed in :this home
to provide_the following thermal performance..
Job Name: Tournament'Collection. Tracts 21846-3 Plan #:-3AR Phase: 5
Lot.No.c 36': Job -Address: 54=814 Tanglewood- La Quinti, CA
Ceiling Area: R-38 Blown Insulation Garage Ceiling: Non Access:
With.Living Above & Sloping Areas
'Exterior Walls: R-13 Unfaced Batts
Overhangs:, :Access Attic:
With Living Above
Interior Walls: R-11- Unfaced Batts Between Floor:
(Bathrooms, Np Closets
Subcontractor.— OJInsuladon Co.,.Inc.
42620 Ri Nedo, Temecula, Ca 92590.
Signed
Tom Berry, General Manager- emecula Branch
R= means resistance to heat flow... The higher the R- value; the- greater the insulating power:
Ask your builder for 'the. fact sheet on R values. Keep. this certificate ,with your other
valued papers. If you ever sellthis home, this certificate should be passed on to the buyer.
Certificate of Occupancy
City of La Q dinta 4'
i 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
l :
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 54-814 TANGLEWOOD
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0106-296
Occupancy. Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: CENTURY CROWELL COMM Address: 1535 S. D STREET, STE 200
City: SAN BERNARDINO, CA., 92408
By: BILL GORDON
Date: 2/7/02
Building Official:
POST IN A CONSPICUOUS PLACE