9907-481 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty -of perjury that.1, am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Buslness•and
Professionals Code, and my License is in full force and effect.
'License # Lic. Class Exp. Date .
JDate ��- j� Signature of. Contractor_ '
• '" j°
OWNER -BUILDER DECLARATION'
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).
O 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..
(4 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:
Carrier Policy No.
(This section need.not a competed 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>6 Labor
Code, I shall forthwith comply with. ose provisions)
APPlicant
►Late: «% -^�i'.�
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 applicator 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
2
e above-mentioned property -.for inspection purposesf/
Signature (Owner/Agent) r%�% %�` Date✓�'�
BUILDING PERMIT -,.-.PERMIT#
DATE VALUATION LOT7.'1�� TRACT
tfj/y 41 x a
JOB SITE
ADDRESS.
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
VEVEN WALKER LININS
WEVEN W.Rt KER HOMES
7161 INDIANA A E.
71.611 it DIANA 1 VE. .
R.ItVERSIDE CA !'2.504
1UNfEkSIDE :.t. CA 92504
COLO. 5357
USE OF PERMIT
c+ n � . t cr t.W
• ,
SPIT - LoT I4, PI -AN 2A, PERMIT t*ES NaC I�CLUDiCRL.OICK WALL OR
.POOL, 75%REDUC'.HUN :j'OYI,A2'31~W"..M: FOR2AMT)PLF'3SSUANI ." .,
C3bnom com-S°I'C<i!C'n N 2.' 79.00 :(3F
�€'OPICI'i%€aATIO 4ai 00 6:71`
GARACEICAPFW9 635.00 %F
Esumim'D COST OF Can a: CT(ON
M,69610
PERMIT J."E ; SUMMARY .
CC+l�TS'd'R1K .r1,0 .FEE 10.1-t1t C-4la-000
PLAN CIMCK FFY, 101-000439%.318
h4MMUCA1, F 14 1 tiRt1- Y-fiiQO �ri2:tJi)
ELEC'IIUCAL FM, ' 101-000-40("00 31,53.4'
Pi.UhIBIYNG FEE 1.01.-00040-000
STRONG MOTION, IEEE -RESID .101-000.241.000 520,07
eRAI INO FIM 101-00042'3-000 $20.00
R.RT,4`N.PUBI.IC P1,ACh'S - RESJr. 70.1-000-255.000 $251.74
DERE MPEG wipwr FFE $I,9o►`�,00
SUB -TOTAL CONS170JIMFIONAND PLAN CHECK
LI SA . I H-PAICI.FEES
$0.00
V�
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
ti INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
1 1. A
Underground Ducts
Forms &
_
Ducts
Slab Grade
f%
Return Air
Steel
Combustion Air
Roof Deck
0.1
Exhaust Fans
O.K. to Wrap
_
F.A.U.
Framing GtZ &f_1
Compressor
Insulation
Vents
Fireplace P .
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL
_
APPROVALS
steel
Set Hacks
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
O.K for Finish Plaster
Sewer Lateral
Sewer Connection
f
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
_
3/
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)
i
SEP -21-2000 16:03 WESTERN INSULATION 909 686 8726 P.'W"13
T1vNq I
4211 Latham Street, Rivccaidc, California 9250.1 =
Tel. (909) X385-8760 Fa X (909) 686.8786
INSULATION CKRTIFICATE
THIS -IS TO CERTIFY THAT INSULATION HAS SEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALSFORNIA ADMINISTRATIVE CODE, TITLE 24,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACT 1 PHASE: RYDER HERMITAGE SERIES — 28603-1 PHASE:
LOT # 14
SITE ADDRESS:, 57-317 SPANISH HILLS LANE, LA QUINTACA
EXTERIOR WALL
r
MANUFACTURER: JOHN LE; THICKNESS: 3'/a." R-VALUE:;R-15
CEILINGS:
�TTS
BLOW
MANUFACTURER: JOHNS MANVILLE THICKNESS '.3" R -VALUE: R-38
,
------------------------------
•GENERAL CONTRACTOR: STEVEN WALKER HOMES '
LICENSE NUMBER:
BY;
TITLE;
DATE:
INSULATION TRACTOR: WESTERN INSULATION, INC.
LICENSE NUM 7�
i
BY: '}
TITLE: 'OFFicr=—mmf1AbER
DATE August 30, 2000
m
_,W 1- rrfirxvr&:a�e�-f►Y: • i%.r " n a
Loll
City, of a{ Quinta �
Suildin and Safe ty. Pe artmisint- Of
This Certificate issued pursuant yto'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 buildingiconstr;uction or use. For the following
BUILDING ADDRESS,' `' ,.. .57-317 SAINT ANDREWS
Use Classification: SINGLE FAMILY DWELLING Bldg:': Permit No.: 9907-481
Occupancy Group: R-3 'Type of, Construction: VN :L'and Use Zone: RL
Owner of Building: STEVEN WALKER,HOMES Address: 7161 iNDIANA AVE
City: RIVERSIDE, CA., 92504
By: DANIEL•P. CRAWFORD JR.
Date: 9/28/2000
Building Official
POST IN A CONSPICUOUS PLACE