9907-471 (SFD)LICENSED'CONTRACTOR DECLARATION.
•1 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 iri full force'and effect.
License�#�$� Laic. Class Exp. Date
t F 04 M-/204
Date Signature of Contractor
OWNER -BUILDER DECLARATION.
!.hereby affirm under lienaltyof 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.
.m
( ) I have and will aintain 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' compensatiori-insurance, carrier 8; policy no. are:
Carrier .ilNIT.ED:PACW� IC INS Policy`No,
(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 ofaCalifordal andlagree that if I should become
subject tolthe workers' compensation provlsioiasjof Section 3700 of the Labor
Code, Irs forthwithall;�comply witll<.?hose p� oxinionsv�—
Cate: 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 be 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 Cluinta, its officers, agents- and employees.
2. Any per 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.W nth BR City,' and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned proper{ fcr.inspection purposes.:
Signature (Owner/Agent)�L� Date
r °
BUILDING PERMIT
PERMIT#_._
DATE j j� t . . VALUATION �.p7�LOT;
V TRACT
JOB SITE 37-413 WAN ILSH HIL...S 1aAIHC
APN
ADDRESS
OWNER
CONTRACTOR/'DESIGNER/ENGINEER
STEVFNWALKER. HOMES -
S'I"R"VEN WALKER. HOMES
7161 INDlj\NAAVF..
1161 WDUkNA.A,.VE.
RIVERSIDE CA 92.504
RIVERSME CA 92504
USE OF PERMIT
SINGLE F.A.RiIllGY DWELI.i 10 '
_ . .. ..
till P0; 3X c t 114awt mwo� k-
POOR.. 71% REDUCTION TOM." C,'TWCK FW—F(?; ld;RA: , IPLE IS.suANC.E
OF SANTE FLAX. TYPE
CUSTOM COrN3`I'ROCTI.ON 2,49x .00 3F
PORCHIPATIO 245,00 $k
GARACTE/CAwP T 339.003r
M�•i .64P8PS• S:iR/. Li hTl ��, Yr d1�a74.lYski Ertl[. iIAV
204,67 4.A0
P.CEtI+UT 1:! F..E SUMMARY
CO'KSTRUCTION FMI 101-000-4.18.4)00
$1,ffi7.fti?
PLAN CHJfi m m 101.000-439-318
i:ZCi%ANICAL 11M 101-000421.0(g)
E'I:EG". WCAL EEE .1Q)-005-420.0 }0
Iri iJl�4lii�it% F.E 101-000-41..9-000
$162.50
S'1RONO MOTION FU, - RESID .101-000-241-000
GRADING. f 11;1-t)!T{) •d'�'
..?J;tf2�J
AR•t IN PUDYAC: PLAC S - 121 SIL 7kl1.-1100 •a }5-AOi!
a2�A.f:4
OOPrR IMPAcr:FEE
Silk•'10TAL-C0:N9'RrL3C'TiT[0N AND PT -AN Co: ECK
$3„823.3"
L,E:SS. PRE -PAID .C.E)~,S
'mao
TOTAL Ptr Rktff b"E&S DUE filQI, , c'.
-� ° 53,823,32
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms &Footings
Slab Grade
Steel
Roof Deck
_
/ y
Ducts
Return Air
Combustion Air
Exhaust Fans
O.K to Wrap _
F.A.U.
Framing p V // dII
Compressor
Insulation Q?,QL
Vents
Fireplace P.L.'
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
_I-AiDa
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
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
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)
J
��^;T'-°""V`�'^'. J. w+.. .r.t- - .. �• ^1JKa M!"'►� t• T ryw.r �' _ "F-r"�!hF �'rcas'p-Meaty' . • . ra 1.� . .. T _ i ; •�j1'"'Y' a,++{'a'�' .. -_ .. _ � .. + .
u Al
i0r#ca te. * gar `, Occu�c.
Uit
of.L7
0
aQuinto..y':.
itf
��Idong� andwFSa:fety Department MOF-
,.
This Certificate issued pursuant to ttie_'requirements of Section -709 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 fol%vvIng:
BUILDING ADDRESS-.'-,�a .,, 57-413 SPANISH HILLS LANE
Use Classification: SINGLE FAMILY DWELLING Bldg., Permit No.: 9907-471
Occupancy. Group: R-3 Type-ofConstruction: 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: 6-21-2000
Building Official: '
a
'POST IN A CONSPICUOUS PLACE