9907-482 (SFD)r`a 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 # Lic. Class Exp. Date
745003
ODate ��" %' �"�' Si nature of Contractor
g ,r
OWN ER-BUILDEWDECLARATION
I hereby affirm under penalty of perjury 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). • . .
( ) 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:
(, )t 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..
(y(j 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.
•LINT TSD PACIFIC INS NW -A2017896-00
/896-00
(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
de, I shalljorthwith comply with those provision ?'
Date: 7.: yi `� Applicant.-- . '"'�- 1-e
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 186 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 bove-mentioned property for inspection purposes.
4Signature. (Owner/Agent) ''N ' Date/Y- 2'
BUILDING PERMIT PERMIT# .
DATE VALUATION LOT ?ri. ,TRACT ,
d t A $204si'1',t90 '-<--13il4iat)3-1
JOB SITE
APN
ADDRESS ^7_. _
1 "C Toiti�'6�, es
(5fS,-�%A
'76.x-1191} 7
OWNER
CONTRACTOR/DESIGNER/ENGINEER
STEVEN WALKER. HOMES
STEVEN 17tr.AL E& HOMES,
7161 INDIANA AVE..
7.161 :INDIANA AVE, '
RINIERSIDE CA 92504
RIVERSIDE CA 92.504
(1909V$4-0840 t :E"L:1 5357
USE OF PERMIT'
_ rte � '� • ��: '
,9f D - LOT 35, Sri AN 3A, .PMAT IDOE4 NO d INCLUDEF BLOCKWALL (.3I:.
POOL. 750,:4 REDTICTIO74 TO PLAN CWC K FEE FOR MULTIPLE ISSUANCE
OF SANIF PI -AN TYPE
CUSTOM CONTS111RIJC1.10N 2,450.00 .Sf
POR.CIIIPAkTit.) 245.M K3'
OAh2.rw. EIC.ARPOR'1 53A.01) SF .
L+'Si11MATE D M9T 01? CONS11`RCIK.°1'.ION ..
204,677.4%
PER11111iff FEE -SUMMARY
CON1'TP.,UCfION tTp_ ?.t71-4tk1-<b1 �3 $,l;fj47.bt!
PLAN CHECK FEE $20. 13
FJ EG"TttICAC. C I01`4J6420- 5754:03
PLUMBING FEE 101-�1O5An4I.9-01353 $iP�2,.�0
s 3'RONO NOTIONI FM - RESID • 15)1-00-241-000 S20.47
GRAD M. FPS bt11 4lt)()>423.Oi�i3 $�ii.Oti
A11T .SN PIJBJ..S.0 PLACES - RIMU701-0-00-255-000. $261 A9 .
.
DEVELOPER IMPACT FIS � t„Afi331.01)
SLID-TCSI Al C{7iVMl:UG ION-Al+fD PLAN-CHECK
$3,823.32
aESU-1AID FRES
W011
T F.AL Pr_# R1k'L T ,H E +1 S .1DFUX ND` V
$.3,923.32
RECEIPT
DATE
BY .
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings _
Ducts
Slab Grade Q
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U.
Framing f/�
Insulation -�
Compressor
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
%LE:
Drywall - Int. Lath Al
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
_
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
OX for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
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)
COMMENTS:
AUG -;30-2000 15:57 WESTERN INSULATION 909 686 8706 P.
r
!
t i�FATERN IN ULAT10"' INC*
. 4211 Latham Street, RivBMMe, CDAN nla 42501 ,
TeL (909) 6864760 Fax (904) 686-8786
IN31PLATION CERTIFICATE
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 SEMIES — 28603-1 PHASE:
LOT # 15
SITE ADDRESS: 57.301 SAINT ANDREWS, LA QUINTA,CA ,
EXTERIOR WI 6L
MANUFACTURER: JOHNS MANVILLE-, THICKNESS: 3 YaR-VALUE: R-15
CEI GS: „ • BATTS BLOW
MANUFACTURER: JOHNS MANVILLE THICKNESS: 13' R -VALUER -38
GENERAL CONTMCT®R: STEVEN WALKER HOMES
LICENSE NUMBER:
BY:
TITLE: "
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBS ' 78
BY:
TITLE: OFFICE AGER ,
DATE .August 30, 2000
' Y
1
• i
1Z
TOTAL P.13
- C
"Certificate of Occupancy
City,of La Quinta
_r
Building and Safety Department OFTM `sV
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: 57-301 SAINT ANDREWS
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9907-482
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: STEVEN WALKER HOMES Address: 7161 INDIANA AVE
City: RIVERSIDE, CA., 92504
By: DANIEL' P. CRAWFORD JR.
Date: 10/9/2000
Building Official
POST IN A CONSPICUOUS PLACE