9907-477 (SFD)LICENSED CONTRACTOR. DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions c
Chaptel-0 (commencing with Section 7000) of Division 3 of the Business an
proiesSlonalS Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
r� 748004 B , 004.30/2fI1/15/ate�ate 15 VAignature of Contractor �� •�! � y��"���'�
OWNER -BUILDER DE NLARATION
I hereby affirm under penalty of perjury that l am•exempt.from the Contractor'.
License Law for the following reason:
( ) I, as owner of the property, or my employees with wages as their sol
compensation; will do the work, and the structure is not intended or offered fc
sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensel
contractors to construct the project (Sec. 7044, Business & Professional:
Code).
() '1 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 worker;
compensation, as. provided for bj Section 370.0 of the Labor Code, :for thi
performance of the work for which this permit is issued.
(.�r) I have and will maintain workers' compensation insurance, as required b,
Section 3700 of the Labor Code, for the performance of the work for'which thi;
permit is issued. My workers' compensation insurance carrier & policy no. are
Carrier Policy. No.
LWIED PACWTC M3 NWA2017596.00
(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 thr
workers' compensation laws of California, and agree that if I should becomr
subject to the workers' compensation provisions of Section 3700 of the Labo
Code, I shall forthwith comply with thlose provisions. '
V6ate: .1-,I + a' Applicant. �; �,..:.r: c + ';s �ri�✓'
Warning: Failure to secure Workers' Compensation coverage is unlawful an(
.shall subject an employer to criminal penalties and civil fines up to $100,000, it
addition to the cost of compensation, damages, as provided for in Section 370E
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director'of Building and Safet!
for a permit subject to the conditions and restrictions set. forth on hi;
application.
1. Each person upon whose behalf this application is made& each.person a
.whose request and for whose benefit work is performed under, or pursuant.tc
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees
2. Any permit issued as a result of this application becomes null and void i
work is not commenced within 180 days from date of ;issuance of suct
permit, or cessation of work for 180 days will -subject permit to cancellation
I certify that I have read this application and state that theiabove information i;
correct. I agree to comply with all City, and State laws relating to the buildin(
construction, and hereby authorize representatives of this City to enter upor
the ,a6ove-mentioned property for inspection purposes.
+'Siignature. (Owner/Agent) . l_ Date 7 �-
v
if
BUILDING PERMIT PERMIT#
j
�—
�7.4o
DATE VALUATION LOT �— TRACT
JOB SITE I _
ADDRESS "71M,�-PANT HHU.XS L E
APN
761-090-078
OWNER
CONTRACTOR/DESIGNER/ENGINEER
STEVEN WALKER HOMES
917EVEN 'WAT.>KER-1-iOMFS .
7161 INDIANA A.VF,.
7161 TNDIANA..AV$,.
RIVERSIDE Ck 92504
WYERSIDE CA 92504
'
M97840"G i l,tl S:aS?
r
USE OF PERMIT
j
r
SINGLE FAMILYi;)'WILING
SFID - 1.0T it, PLAN1,0.PEI�cMI'T A1C ZS � 9`i:{�T► CL�dtiE 3 .4 'i WALL OR .
POOL,
CUSTOM CONSTRUCTION 2,101.Ti0 S
PORCHI'PAT1O 2M.00 ; F
E" aARtRO&CARPOR'l'
MIAVATED COST Or, CONINIMM ION
vs9xnao
PERMIT .FEE SID MMAitY
CONS't'RtlCMO2dP'EE 101-M-418-000 $916.00
PLAN CiffiCK FEE. ?01-000-439-:318 $732.60
. `fiiICA1 cPiE • 101-0W, 410-f300 �r4a.ca
'PLUM, WHO FEE, . 101-OW419-M $162,50
I
STR.ONGx, IMOTION FEE, - RESID 1.0.1-M-2.4,11-000 $17.88
ORAI�trac3 l' EE 101 -�iflA-423-fH3t) 320.00
t
ART IN `13 M IC:PLACfs3 - RESIV 701-000-2 515-000
DEVELOPER IMPACT FEE lS:l,.9A7.�i1
r
t
'
SUB-TrJ'DAL CON91TRUC-110N AND PLAN CHECK
f
LESS PRE -PAID FEES
$0.00
I
TOTAL, PERMIT FEES DUE NOW
$4,2!' D.1.15
I
.
RECEIPT
IDATE
1BY
I DATE FINALED
INSPECTOR
v
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade J
Return Air
_
Steel /
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap ad
F.A.U.
Framing Z
Compressor
Insulation 3 7 —
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
-
Exterior Lath -�
Drywall - Int. Lath
61
Final -z' ���
BLOC KWAL APROVALS
Final
POO S - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
-
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALSGas
Test
Electric Final
Waste Lines / %Q
Heater Final
_
Water PipingPlumbing
Final
Plumbing Top Out 7ZEquipment
Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
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)
AUG-30-2000 15:5? WESTERN INSULATION 909 686 8786 P.12
vv TE"-IN�AT��Ng INC
nFESAIT
y.
4211 Lath— Stmt, llvorside, Celifocal8 92301
Tal. (909) 686.8760 Fax (909) 686.8786
f .
INSIR ATION 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 SERIES — 28.603-1 PHASE.
LOT # 11
SITE ADDRESS'- 57-397 SPANISH HILLS LANE, LA DUINTA.CA r,
EXTERIOR WALL
a
MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 '/2" R-VALUE: R-15
CEILiN®S: BATTS BLOW
MANUFACTURER: JOHNS M ILLE THICKNESS: 13" R—VALUE: R-38
GENERAL CO�NTWTOR: STEVEN WALKER HOMES
' LICENSE NUMBER: '
BY: F
TITLE:
DATE;
• INSULATION'CONTRA.CTOR: WESTERN INSULATION, INC.
LICENSE NU 8
BY:
TITLE: OFFI GER
DATE , Auguste 30, 2000
0
L;Vrthucate,0f4'UCCUPa,n.C'y
-�-
. r �
City of La Quinta
Buildingand Safety.Department����OF
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 than following:
BUILDING ADDRESS: 57-397 SPANISH HILLS LANE
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9907-477
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: STEVEN WALKER HOMES
Y
Building Official
Address: 7161 INDIANA AVE
City: RIVERSIDE, CA., 92504
By: GARY HARTMAN
Date: 9/22/2000
'POST IN A CONSPICUOUS PLACE