9909-231 (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
Professionals Code, and my License is in full force and effect.
License! E Lic. Class ti Exp. Date 11
Signature of Confracto, A -�L 4
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that.l am exempt from the Contractor's
License Law for the following reason:
(.) .1, as owner of the property, or my employees with wages as theirsole
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). r
() 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 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.
(V.1 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.
f;i 11,3�k7J;Et1.�"iLg 1P3a' N`'di'G.,$1�9eiti�fl,!
(This section need not be completed if the permit valuation is for $100.00 or less).
() 1 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 Sectlon,3700 of the Labor
Code, I shalfff^o rthwith comply with hose provisions ki
Date: �, /�-' J`io• Applicant A—t.`�.,J�...
yWarning: Failure to secure Workers Compensation coverage.is unlawful and
shall subject an employer to criminal penalties and civil fines lip to. $100,000, in
addition to the cost of compensation, damages as provided fo"r 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/Agenf)�—w.'`°-.°,� Date @
PERMIT-#.r--
ERMIT#.r--BUILDING PERMIT
BUILDING
DATE VALUATION fwejg, @k. LOT �i�1 TRACT
JOB SITE .: a w r •• y��£1 p�
ADDRESS 5,�+37T II!�!'�dr+�r�GN7�axi.), b
APN
iii`^�+�i•��I
OWNER -
CONTRACTOR / DESIGNER / ENGINEER
CMINI "TRY CROWS L Ci3MME1'gt�'YJES
193 SO. "D" S'@:REE"F, VE: 1p,(* .
1535 SO. "RY
SA24 KERNARDINO CA MIN .
SAW :SIER?IARDINO CA. 9740
USE OF PERMIT
SINGLE FAMUN I WEL LMI
,%D'- LOT 6, PLAN 3JR. 4 FERM'>fIT liC��S'€3�D ib��d.iXlYf: i3t �C`!s: �A'Ai Y,
OR K)OL.:I1`1I. N ClI[kA:IN, F.F212 LfCC ) 7X� FOR, MCI4,'4IA?>, B :f.S.11LIANC.E W
SAW PLAN `Is S':I' &
CUSTOM CON.>IRIUi "PION RM.w.1 {11!8.48 SF,
d�U@iy";ld>rx.�CIC) A7Fs.t719 b';i
CfARAG . CARPOI T W.00 sy,
C<tiN YRUCt'1C3N:HE,: 101-f.W-4184(0 $994,00
PLA71t,I474FCK F t j. -r . t'+�_•39s3 $�t?4.;t1.
-
NIL(TIANICAL M-76 $93.50
Inn
#. iCTR'dit",t L-11,,MM: , 101-000420-00 sisvis
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ART RN 4't:ILLIC P6 itCHS - W3.8 l: 7014JW2,55-S!t}i1.�0LO
t•_J
..ESS PRT'-,PAtV FrE3
.10.00 '
RECEIPT
DATE
BY
FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms &Footings
��
Underground Ducts
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
_
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
Final
_
POOLS - SPAS
BLOCKWALL
APPROVA S
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
_G 9
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
—!G
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. Use of Power
Final
Utility Notice (Perm)
AUG -16-2000 WED 03:25 PM SPATES FABRICATORS FAX NO, 7603974724 P. 02
SFATES
FABRICATORS SALES INC.
Residential, Commercial & Floor -Trusses F.
i .
August 15, 2000
Re: The ..:
Touniament Collection by Century Horries at PGA West
To Whom 1t May Concern:
:t At the request of Century Homes, Spates Fabricators was asked to inspect and analyze
the roof trasses at The Tounuunent Collection by Century Homes at PGA West.. We `
were requested to inspect the trusses for any possible damage caused (after we had
completed and delivered the trusses) by the installation of roof dormer vents on Lot 6.
r
Upon our inspection -of these trusses, it is our finding that no trusses have been
Structurally compromised as a result of the vent installation.'
If,%..e can be of any further assistance, please let us know.
David Spates
Vice President .,.
` 85.438 MIDDLETON STREET, THERMAL, CALIFORNIA 99274 • (760) 397-4122 • FAX (760) 397-4724
Certificate of -Insulation
Your Home has been insulated with CertairiTeed Fiberglass Insulation products, which are designed
for today's safety standards and tomorrow's energy requirements.
Fiberglass. is inorganic and therefore permanently noncombustible, so itdoes 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 #: 3BR Phase: Phase I
Lot No.: 6 Job Address: 55-372 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 o Nedo, Temecula, Ca 92590
Signed '
Tom Berry, General 41a 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.
N