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0207-106 (SFD)r�. N LU - O 5 C) C3 U*)" Lu �Z►� (D 0. O H� W w I— a U) Z 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 331 B 3/13VOI Signature of Contra t9. .rf OWNER -BUILDER DECLARATIO' Nr 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: . ( ) 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. e,) 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 5,1A:rg 1 U7dO Policy No. 1608301-612 (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 Code, Ihalforthwith comply with. hi ions. Date: � O Applicant ° `� r fig ' XI A F.- v Warning: Failure to secure Workers' Compensatijcoverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the. Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety, for a permit subject to the conditions and restrictions set forth on hiss. application. 1. Each person upon whose behalf this application is made & each person,at`: whose request and for whose benefit work is performed under or pursuan6o' W any permit issued as a result of this'applicaton agrees to, & shall, indemnify . & hold harmless the City of La Ouinta, its officers; agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation.. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building r., construction, and hereby authorize representatives of this City to enter, upon : the above-mentioned property for inspection purposes. Signature (Owner/Agent) •`"'{ Dat$'_:! ' BUILDING PERMIT PERMIT# tl DATE VALUATION LOT __— TRACT cf 1,1i�idl 46" LOT JOB SITE ADDRESS `i�i S'Oi,M ��{JAS .✓ APN OWNER CONTRACTOR / DESIGNER / EN (NEER• CRV t our WEVI, Z.P. ASHBROOK 1'3IEV1,%4PIVIENT t,"OMPAITY 5140 AVEfi11:DA MCIMS 5 14 0 AV72, -EN C.r";RUM6 D C "A, 9'20431 CAP.1:.9BAD CA 92001.; (IC0)804^fi.86e� 5376 USE OF PERMIT 3OLEX LY 5FD - IDT46 PLM 2.A.. PURMT DOES NOT INC>`I..Y E79 BLOCK; WALIA POOL, SPA OR DM A' YAPPROACH, ?M PIAN CHECK 1 ia.I1.,DUCTX0*H FOR MUL,T1PLZ RA'StYAXC°E OF !ME 1?l..AWrYPE. CUTY0M C0141RUCTION ?,615,008F j! O RC:HMA.`.I'10 526100 SF GARIs►CiMARPORT 5 7,00 SFS ESTMA11D CWT W CONSTRUG" ION 22.1,157.40 PERMIT NIX MADJARY C-`ONOTR'UCl'S.C3NFRE, 10l-000.41.8—om S1;4t66,5D PLAN CHWK 81-W 101-000.4394,319 0117.42 MECHANICAL FTi:t 101.000.421.000 $11110 ELECTRICAL W, 101-00"20-000 $11531 M.4.TMFi-Nor:'; , 101-000-439.000 1111.0,73 ""RO'NO MO9'.iS:` N 1'"iPt . RRSID I il .WLD-241-000 ORADE90 ? 101400-423-000 G�ES,OlD 0ZV 1.,0PEdR. 3M1'ACT ME 82005m iRT 04 P[ BUC s1,,%C E9 ' M131t 170.000-4415-000 , 'n� 4T1-T0`1,'Aa. C:<)j4t. 1`kUCPt.1CaX AND PL AN M -.9 7 P 0MIT TWINS D1: E NOW S, 4,212_V ic CITY OF LAQUI A FINANCE DEPT r� RECEIPT DATE � .2 BY i DATE F ALED 103 INSPECTOR 01 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backsf I Underground Ducts Forms & Footings D Ducts Slab Grade Return Air Steel Combustion Air Roof Deck O.K. to Wrap / Q$A Exhaust Fans F.A.U. Framing / s Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath DVwall - Int. Lath 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 Gas Piping PLUMBING APP OVALS 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 Gas Piping 11 _ Pool Cover Encapsulation Gas Test 3 Appliances 1 Final 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) Q COMMENTS: ` v k • SMINaf DRIVE, Desert �y' �� ENERGYS�r�ADI:C Services — P.O. Box 621 Ph/Fax (760) 564 -2044 - Rancho Mirage, CA 92270 Cell: (760) 835.7939 Email: RKrown6237@aol.com CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF -4R A, ILS Imo 0g: 4/�S #►kms0_3 Project Title Date 'rQUIWIA A!514 sgooK 1�n m rA iKI1-riF. ro'ect Address T Builder Name V E VA lo L Li E: -1i176 -CA 601-30 st3 l P SA IJ 2. Builder Contact —� Telephone Plan Number 760 3 3 G fZoy P l' H Er at r Telephone • Sample Group Number C�)JR�O132�I�.. a3 �.o-1 474 (2kwIT 1 enifying Signature - Date Sample House Number Firm: DESERT �IJ�fCCi'(.SE2�/) C_ES HERS Provider: d • H •.�•�.R.S . Street Address: Ra BOX (pZ I Ciry/State/Zip: GhlotjI�IyE. �,�• 022270 Copies to: Builder, HERS Provider HERS RA.TER,.COMPLIPA CE STATEMENT The house was: El -Tested Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form comply with the diagnostic tested compliance requirements as checked on this form, ❑ The installer has provided a'copy of CF -6R (Installation Certificate. ❑ Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform retums in lieu of ducts) ❑ Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. ❑ MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Duct Pressurization Test Results (CFM a 25 Pa) Test Leakage Flow in CFM If fan now is calculated as 400cfm/ton x number of tons• enter calculated value here Measured values If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) _ Check Box for Pass or Fail (Pass=6% or less) ❑ ❑ Pass Fail ❑ TH ERMOSTATIC EXPANSION VALVE (TXV) ❑ Yes ❑ No - Thermostatic Expansion Valve is installed and Access is provided for inspection ❑ ❑ Yes is a pass Pass Fail /(n1-IMl� , �-a-V► �� 4 Certificate of Occupan�cy Qum& r.?. LycoroMTM ,YC,, ixa G� 0F9�� Building Y p & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying: that,, at the time of issuance, this structure was in compliance with the provisions of the Building.t Code. and the various ordinances of the City regulating building construction and/or use. ' r BUILDING ADDRESS: 57-655 SEMINOLE DRIVE Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0207-106 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Special Conditions: NONE Owner of Building: CRV GOLF WEST, L.P. Address: 5140 AVENIDA ENCIANS City, ST, ZIP: CARLSBAD, CA 92008 .rte a By: STEVE TRAXEL Date: 06-09-2003 Building Official POST IN A CONSPICUOUS PLACE CV O'0) a< '. O.. W LL'_ , U U 5� LICENSED CONTRACTOR DECLARATION I hereby :affirm under penalty of perjury that I am licensed under, provisions of 'Chapter 8 (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 760335' B 3/31/03 Date Signature of -Contractor 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). ' ), 1 am exempt under Section B&RC. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION . hereby affirm under penalty of perjury, one of the following, declarations: O 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 required. by Section 3700 of the Labor Code, for the performance- of the work for which this ' permit is issued. t1Ay workers'compensation insurance carrier & policy no. are: = =-STATE FUNAT - - _ .Policy -No:- No;- =.: (This section need not be completed. if the permit valuation is for $100.00 or less). '1 cern that in the erformance of the work for which'this , rmiTis issued; %) fY P - _ pe 1shall not employ any person in any manner. so as to become subject to the workers. compensation laws of Cal'rfomia,,and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor —Code, l shall forthwith comply with those.l rovisions. . Date: Applicant - _ 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.7equest and for Whose benerif work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnity & hold harmless the .City of La Quinta, its officers, agents and employees. I 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/Agent) Date BUILDING PERMIT=PERMrr# 0207-106 DATE VALUATION $221.157AO LOT 46 TRACT 2914?!1 JADDDRESS $7-655 M01MOLE DRIVE APN . 762-3804= OWNER' CONTRACTOR/DESIGNER/ENGINEER CRV GOLF WE8'P, L P:. ' AMROgK DEVEIAPMENT COMPANY 5140:AVENWAENClAN9 5140AVENIDAENCINAS .. CARmAD . _ CA 92wo CARI.ZBAI? .. CA 920M . , (76U)804?6868 CBL# 3376 USE OF, PERMIT SINGLE FA)M Y DV1ELLINE3 SFD - LOT46 °PLAN 2A . PERMIT DOES NGT INCLUDE BLACK WALLS. P0014: SPA OR DRIVEWAY. APPROACH. 75% PLAN CHECK FEE -REDUCTION. FOR MULTIPLE .ISSUANCE OF SAME PLAN TYPE. CUSTOM CONSTRUCTION' 2.615.00 SF PORCHIPATIO 525.00 SF OARAGEI<CARPORT 5344.00 SF ESTIlI+ ATED COST OF CONS"Tl IICTTON 221,151.40 PEFaD.TFEE SUBdM1IRY. CONSTRUCTION FEE:,, 101 -M -418 -ON 51AE" . - --PLAN CHECK FEE-�. - - 141tw i 39-319`-: X22?42 . MEL'HANICAL PEE 101-000-421!-000;l1 t:00 ELECTRICAL FEE, 101-000-420-=. .$135.71- =135.71•PLUMBING PLUMBINGFEE :: 101.-000-419-(= 5181.75 ' STRONG MOTION FEE- RESID 101-000-241-000 432.13 GRADING FEE _ 101"000-423-000 _ _..... $20.00 _ _ DEVEIAPER-IMPACT PEF.' 1{"1,405.00 I ART IN PUBLIC PLACES - RESK 270-000-445-000 SUB -TOTAL CONSTRUCTION AND PLAN CHE(.'ZG 21 2.39 I= PRE PAID FEES e . ; ;..$0.00 TOTAL PERMIT FEES DUE NOW .44,212.39 RECEIPT DATE 9Y DATE FINALED INSPECTOR h `Lam a,•� ,c ,, ,,.,- I, �. � ruriCa" e� of�.0ccupang,%.�. w ,tel r {� ,. _" tee• .h •�'Y.� '£+•.w—M , }'T y. .� \ r Sit T„ar� I !� y ,r Y r, y _ j � � � • !� - 2C i Y �ip e-1 ^' `'C• L_ 1,•�['-• Her,•�r' - ,� : t,�i✓ a•+� -�'^,� • ��.- ' INKMORATM 7 " k� l w • j: u .�' 1, �'3 iT.� ��� _ y r - + A. �. .�� of9 " �.��: Bu�ld�ng &Y -Safety Department = r. `Lam a,•� ,c ,, ,,.,- I, �. � ruriCa" e� of�.0ccupang,%.�. w ,tel r {� ,. _" tee• .h •�'Y.� '£+•.w—M , }'T y. .� \ r Sit T„ar� I !� y ,r Y r, y _ j � � � • !� - 2C i Y �ip e-1 ^' `'C• L_ 1,•�['-• Her,•�r' - ,� : t,�i✓ a•+� -�'^,� • ��.- ' INKMORATM 7 " k� l w • j: u .�' 1, �'3 iT.� ��� _ y r - + A. �. .�� of9 " �.��: Bu�ld�ng &Y -Safety Department = ��.. • \' w�,�t ~� j J+ il '„ 'Y 4� `.�'I S' :� (- �F'CI L' 1' .'a , - •-� - •^4 • , ., O ..y I n ` ` -•►r��-33. L• 1. _ f ,� 1 -�'� f - _ } " i !1 .z�•l ,� f -n 3Th s Ce'dtificate is ;issued pursuant to ;theYrequi ements of Section;109; of'. the California Building�U �'Code,`� certifying that,i of„the time,' of issuance, ,this structure Ywas in, corripliance °with the - r; :provisions' -of, the '.Building,,,Code• and _ the-�various ;ordinances of the City"regulating building',,, a r -i v .rc:r. a .."constriction and/or ,'use. -. «L i J � ��fi} f � U L.-:. T tir ' �` ' \ ����[ 1 �• �y �} � f. ~ ~ � .. {� V! i 1 } � .. � ` i - f •� If •y' +z .�`� h• 'i; E � ��1 7 - •�rh - " ly •'moi.' � t� _ !. ° '•BUILDING7ADDRESS: 57=655 SEMINOLE�DRIVE • . F R`+.. Gln, l• T � .y: � - � � r -- .., - - .. ., ./'c'd-. ` .%. c, .� Cf � �� � .3 ;. •ty ``a' Use classlfication:.SINGLE:FAMILY DWELLING ` r ra'-_ � t �� �[ � ,r{ B.uilding Permit Noi 0207-106 max;_ ti � �,.« 'LO+ rr;, Ile `a Y''• �P. -�� - ^•` � -- h� ��. i�*wr �� .G {?'' Occupancy Group: R 3. ._ �'` Type of Construction:'VN ` '� 'f land,Use Zone: RL ' ;,.3 � 3 _ -_Y •Fy .:{ .. vi •5'4 V � t - � ^,CT+•” � '' �Y . �. .. � r 1 f'` r ..+ - ..-Special Condition's:•NONE :. :^ ` •�F i, '"" ^�, ,c 7'- r Cry - t T r' -^�� V. ♦t; '„a ."'� X. -`,i r � ia�_.t.� T _�..� { .,,}': � a•"�:�. -� -n. G � �`•iLn J� v. �: � �• Y ' - " _ P � ?.� z. Fid Lys '"i.+ 2�. . � � f. _ - 4r s ,.. _ A.` y � �x� � � i d,+ti' �• w n� r%:5 ^r (. 3•W _ I .-....F , � - .� -` _ 1 ,. . •y1 1T- s �r:'•�--t^ a i .. -. i a.. �� 7!' r _ ,� ..' 3 .r` y - � { � °.• �e - 'Owner -of Building: CRV GOLF WEST;,L.P: . '�• �,cAddress,°5140�AVENIDA'ENCIANS' ;t' ANT � - .. ! 54 .- .� I S• ' j' [: -a + J - A� � City, S,T; ZIP: CARLSBAD, .CA `92008, �4 B 'STEVE TRAXEL Date:•06-09-2003. z ' F: Building:Official • ''� '. ��'`�` `� •�C �h' ` i'- t x:.'� 1 _; _T.;�-. Cryy C. r` , `..,,' �1 • v POST.INA'CONSPICUOUS PLACE'