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9909-235 (SFD)LICENSED. CONTRACTOR DECLARATION U) �) I� I hereby affirm under penalty of. perjury that I am licensed under provisions of +-,.;,� �• Chepter 9 (commencing with Section 7000) of Division 3 of the Business and W4. ` ..Professionals Code, and my License is in full force and effect. O =)M License # Lic. Class Ex Date r-- Ci U) i W W, 10131 Z ` (Dated . �fSignature of Contractor Q. V . �; I J U 6 OWNER -BUILDER DECLARATION W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's ~ C License Law for the following. reason: . Z_ - ( ) 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). cr) () I am exempt under Section B&RC. for this reason U7 N Date Signature of Owner O N rn d Q WORKER'S.COMPENSATION DECLARATION �, Z I hereby affirm under penalty of perjury one• of, the following declarations: n � p () 1 have and will maintain a certificate of consent to self -insure for workers' K w compensation, as provided for by Section 3700 of the Labor Code, for the, D J. Q performance of the work for which this permit is issued. Yl Q U ( l have and will maintain workers' compensation insurance, as required by j UQ Section 3700 of the Labor Code,.for the performance of the work for which this L rn F permit is issued. My workers' compensation insurance carrier &• policy no. are: Z Cartier, Policy No. O Ci GOLDEN lIAGLE MS. NWC 344063-01 J (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 3 subject to the workers' compensatign provision s;ofiSection 3700 of the Labor Code, Is /all f�t .with comply with,those provi6lo s,. /Date: Appkant /Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil.fines up to $100;000, in addition to the cost of compensation; damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the .conditions and restrictions set forth on his application. , 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit'work is performed under or pursuant to any permit issued. as a result of this applicaton agrees to, & shall; indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced, within. 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is • correct: I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above- mentioned C property for inspection.purposes. Si nature (Owne /A ent• BUILDING PERMIT PERMT# DATE VALUATION LOT ---�a� - TRACT �9r JOB SITE yy7���� ADDRESS f s5*18 TANal��!:� (3C3 '4. , APN 769-2,%-"7 OWNER CONTRACTOR/DESIGNER/ENGINEER C:}?;�''Tt. Y CROWE LL COMNIC NI MES ' C'E Ti'LRY CROWEL'L •C®mmuhfi' us 1y15 so' av, STiRE ET 'I'E: v200 1535 so. "1D" bY1'i�El~"r,.S'1`C. #200 SAN BERNARDINO CA 92408 SARI 8FRN,ARD1NO CA 92408 (W)11Mt f37 , CBL# 2120 USE OF PERMIT SMUP 1:A1.:MI S' WELLING • t SFD - LOT 4. PLAN YR, - P -MO T DO.ES NO'1 1MMUDE 13LOCK WALL OR POOL -PLAN C1rMM' FEE RMUMD 7S°10 FOR MMTMIX .ISSUANC13 00 SAME PL.A14 TYPE. CUSTOM CONSTRUCT'ION ' 2,39$,00 SF PORCRIPATIO 176-00 G.ARAM- CARPORT M6100 SF ESTINIXTED COW i3:F Oft%S'I'RIXI 710N 20812A.60 'PEER Nj11T FEE SUMACkRY - , .. . COI\'M.i7C'I'.ION Ft.E `I 011 41100.418_.00 D �993.tiU PLAN CHECK FEE 1f1=UO043%9-:31$: WICHANXICAL PlE 1044=421-0009tf'>.'11 ,~•✓ 1.... k� 1C°I;C4ICAI.'F�E 1tD1.-f1{N?-�i2.f!�ji30 $152,75 PLUN INGFEE 101-00041�LLl(ItJ x1.74.5© $TRON+Ci.MOTIONM•-REQ [D: 10.1-000-241-0 MJ f' ; GRADING Eke I Q 1-000-42:� OiMU MOO � r X f �ri DEVELOPER MPAC"P F3 U $1.907.00 ART f •PUBLIC PLACTnS - PX2Si.L 701, -WO -24554000, 1 r7 t., SUB-TOTY% CONS"1 tC KIWAND PLAN (AACK Li'S$ .911E VA,ID FIX W....; TOTAL :PERMrf, + +.E S DUE NOW S3„S"2VAS.. RECEIPT DATEDATEFINALED INSPECTOR :4A INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footingsd _ Ducts Slab Grade /�� Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap _ �p _ ( F.A.U. Framing �vv I Compressor insulation Vents /� Fireplace P.L. Grills Fireplace T.O. i Fans & Controls Party Wall Insulation s Condensate Lines I Party Wall Firewall I Exterior Lath _ r Drywall - Int. Lath ap i F F Final FinalPOOLS -SPAS BLOCKWALL APPROV' LS 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 I Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral//A/0v__ t Pool Cover t Sewer Connection 2 _ € Encapsulation Gas Piping Gas Test 37 Appliances t Final COMMENTS: Final Utility Notice (Gas) ; ELECTRICAL APPROVALS i 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) Certificate of Insulation 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 over time. It has not been treated with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it settle over time as may other insulation 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 Tract: Tr21846-2 Plan #: 3AR Phase: Phase I Lot No.: 9 Job Address: 55-318 Tanglewood Ceiling Area: R-38 Blown FIberglass Garage Ceiling: Non Access: With Living -Above & Sloping Areas Exterior Walls: R-13 Unfaced Batts Overhangs: Access Attic: Knee Walls: R-13 Unfaced Batts With Living Above Interior Walls: R-11 Unfaced Batts Between Floor: Subcontractor:. OJInsulation Co., Inc. —�� 42620 No Nedo, Temecula, Ca 92590 Signed Tom Berry, General M ger- Temecula 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 sell this home, this certificate should be passed on to the buyer. r 1 d. rAL%To- lull 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: 55-318 TANGLEWOOD Use Classification: SINGLE FAMILY DWELLING Bldg.: Permit No.: 9909-235 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: CENTURY CROWELL COMM. l o� Building Official Address: 1535 SO. D STREET, STE 200 City: SAN BERNARDINO, CA., 92408 By: DANIEL P. CRAWFORD JR. Date: 7/27/2000 POST IN A CONSPICUOUS PLACE