9987-485 (SFD)i LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that) 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,# c. Class Exp. D to
�i.% .par -,.J ."'. %•
• ate/f �` /f Signature of Contractor..^ '"'��� m"
OWNER-BUILDER,6ECLARATION
I hereby affirm under penalty of perju.ry 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).
( ) 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 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 requiredby
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.'My workers' compensation insurance carper & policy no: are:
Carrier1JN1TED PA.C1 IC 1145 Policy No. NWAW1789
(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.1 should become
su�p)ect to the workers' compensation -provisions ofSection 3700 of the,k�or
' JC�ode; I shall fo hwith comply with those `promislo
ate:Applicant=-•r'�,
• "- r
./�'` ./ -f�'"';'a�''
Warning: Failure,to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the. Labor Code, interest.and attorney's fees.
IMPORTANT Application is hereby made -to the Director of Building and Safety
for a permit subject to toe :conditions and restrictions, set forth. on his
application.
1.. Each person upon whose behalf this application is made& each person. at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as -a result of this applicaton agrees to, & shall, indemnify
& hold, harmless the City of La Quinta, its officers, agents and employees.
2. Any permit'issued as' a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will•subject'permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter•upoh
thel*a'bbve-mentioned property for inspection purposes. / 4s
/ e t': ✓ Date
y.rSignature (Owner/Agent)—,-0-
BUILDING&O,ERMIT PERMIT
_ 0"
DATE ! VALUATION ,677'90. LOT � , TRACT' 28603.1
JOB SITE
ADDRESS L
x
OWNER
CONTRACTOR/DESIGNER/ENGINEER
STEVEN NVALKER HOMES
STEWN WALIKE& HC.tMES
it l li�fDil i,:a. � ...
7t.6 1NDYA?vr�.,�VE.- .
'RM.RSIDE CA 925041 ..
RMRSIVE CA 92504
(90)794-0840 G'K0 5357
USE OF PERMIT
SFD -.1.111. IS,.1-'LA1d 3* ijix. OUT _t3t)ESNKYT ft'A)OE PLOCK 5k►AI , 01 .
POOL. 73''.°a iZ1%.DUCI'I:ON ` O'.KA N C6I:LT, FEET ;fO12:.Mfx,'1'.1PLF ISSUANCE.
OF SANIR PLAN 79
CUSTOM CC114S'1`:RUC'1'164 :3,450.00
POR.CV/P.N 110 24.5.0f) SP
QARt %:1CAKP. JPtT 519.00 8:1+ .
M'.9MMT91) C05t OF CONSTRUCTION ION
204,07."
PrU2i0 ffFEESUMMARY
COid'3'f;RM" [ONRi�?{-{l1i4 I$-Ot1fi $.1,00 .i3i3
PLAN CFMCK FEE
Mt.:HANICci'C.FEE
ELEMO UC:'AL FE
PLUMBING BINA:3 F.W.' W12150
STRL N(IMO'.P,° ON FEE-:RESID 101-000.241-000 $20.47
t'7tF►IIING "Moo
ART IN PBLIC PLACES- RXSOi1 701 -0W255 -000701 -0W255 -000L
SUB -TOT -AL C0NS`ff((K,'H0,N-.A1ND PLAN CHECK
- W-01.3,32
LESS PRE -PAID FEES
$0.00
TOTAL. PEAMITFEES DUE NMI"
RECEIPTDATE
BY
DATE FINALED
[IN SPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade �
G
Return Air
Steel
Roof Deck
S?�•�— /
Combustion Air
Combustion
Exhaust Fans
O.K. to Wrap
0
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
8S
Final
Final
POOLS - SPAS
BLOCKWALL
APPROVAO
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
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
A,/
Pool Cover
Sewer Connection
7�'
Encapsulation
Gas Piping
Gas Test
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. Use of Power
Final
Utility Notice (Perm) 41
AUG -30-2000 ,15:53 WESTERN INSULATION 909 686 8786 P.04
WESTERN jNSULATHONt INC.
421 L Lathe 8treet, RivcrJide, CaMraia 92501 "
0 586.8786
Tel. (909) 686.8760 8x (909)
INrIFICTE
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:
TRACT / PHASE: RYDER HERMITAGE SERIES - 28803.1 PHASE:
LOT # , " 18_ _ _
H -
SITE ADDRESS: 57=253 SAINT ANpREWS, LA'aUINTA CAA
EX
19RIOR WALL _ _ w•. ..._
MANUFACTURER; JOHNS MANVILLE THICKNESS: 3 %z" 'R -VALUE: R-16
CEIL{NGS '' ATTS BLOW
MANUFACTURER. JOHNS MANVILLE THICKNESS: 13" R -VALUE: R-38
L'Ig; BATTS BLOW
MANUFACTURER:-GREENSTONE THICKNESS: 10.3 R -VALUE: R-38
GENERAL COMTRACTOR:—'STEVEN WALKER HOMES
-LICENSE NUMBER:
BY: -
TITLE:
DATE; Y X
INSULATION -CONT• RACTOR: WESTERN INSULATION, INC.
LICENSE NUM 278
BY.
TITLE. OFFIC91=97MAEH
DATE August 30, 2000
a '4
r
Certificate of Occupancy
City of La Quinta
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:
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group:
57-253 SAINT ANDREWS
R-3 Type of Construction:. VN
Bldg. Permit No.: 9907-485
Land Use Zone: RL
Owner of Building: STEVEN WALKER HOMES ' Address: 7161 INDIANA AVE
-1-.4, /4-t.
Building Official
City: RIVERSIDE, CA., 92504
By: DANIEL P. CRAWFORD JR.
Date: 10/3/2000
POST IN A CONSPICUOUS PLACE