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0005-329 (SFD)t" LICENSED CONTRACTOR DECLARATION f`. YI 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 # I Lic. Class Exp. Date 7 7..JJ 7 10/31/2( Dat'C� 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). 'y () 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. ( ) I _have and will maintain workers' compensatidn insurance, as required by Section 3700 of the Labor Code, for theperformance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. 05ID4 KA01,13INS eJC NWC-944b8d-f3s (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 ernploy any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if.1 should become subject to the work rs' compensation ro inions ofection, 700 of the Labor Code, I hal forth comply wit os . rovisi • ns. t✓ ca _ P Date: replicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines -up to $100,000, in 'addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit'• subject to the conditions and restrictions set forth on his application. ' 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work- is performed under or pursuant to any permit *issued as a result of this applicaton agrees to, & shall, indemnify , & hold harmless the.City-of La Quinta, its officers, agents and'employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance° of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I'have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter, upon the above-mentioned property for n'spectio purpo es. G (�✓ jam. Signature (Owner/Agent). ._ �Date _ PERMIT# BUILDING PERMIT 111 ' "` • DATE VALUATION LOT_ TRACT _ - i, JOB SITE ADDRESS 43-690 TAURUS C(;OYG' APN OWNER = - — - CONTRACTOR/DESIGNER/EN (NEER r. Ilan. Ti RY crtow LL commuN ' us C1?,NTCURY CROWELL COWAUNT :CCrS 1535 S©. T' MEET, UTA, 0_7tgD 1535 so, 17)" VMMIT, MR 0200 SAN Ti l A.la [3IAiO "!� 92408 SAN ATAI3.UIh O ` CA 92408 ' (90$- 381 115M CBIA • 2120 USE OF PERMIT SINO•Iz FA1v1I,Y 3:yWMI1 NG SA1)- PLAN 2AR LOT 36 PERMIT D09S NOT INCLUDE EL,OCK6AiAL1„ OR - P40k. TRACT CONSTRUCTION 2,023,0 211 P&C1d/PAT10' 45.00 SP C9AIRAWC:ARPORT (9F) 312:32.00 ESTIMATND COST OF. COOSI'RUC.#'xON 1 D gyp? 1S 9.�0 PERjw r Frik SumKiLR Y (IONSTRUC'1'lON I'ETI 1014*4161 000 $Y06.00 PLAN CHECK FIFE 101-000.439-318 $#'i� 41 MECHA141C'•AL IFEE . 101.-000.421-000 $47.00 .. ZL ECTRICA.L FEE 101-000-420-000 $113.71 PLUM1 ING FEE 101.000-419.700 S134,7S STRONO MOTION fgtE • RESID 101-000-241-000 CRt.A.IJTr1O FRE 101.000-,429.000 $20,00 DEVELOPER IMPACT FEIp $1,907.00 SUB -If OTAL CONfRUCT'1:ON AND 1;',LAW CHECK USS PRI? -PATI) M=. $0.00 .,i�::#..,;,•.i�€,.,�'�.'I`01.t�..�+1..,I' -t +. #C3?Rr:,1•.'F.'P4 94 RECEIPT DATE BY DATE FINALED INSPECTOR "I INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings �j / _ // _ 6� Underground Ducts Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath 00 �:ZMt Drywall - Int. Lathp�pJ Final 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 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 Pool Cover Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) (o p 'ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.1: Smoke Detectors Temp. Use of Power 22— Final 5 Utility Notice (Perm) 0422— WESTERN INSULATION, INC. 4211 Latham Street, Riverside, California 92501 Tel. (909) 686-8760 Fax (909) 686-8786 `INSULATION 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: STARLIGHT DUNES 23773-5 LOT # 36 SITE ADDRESS: 43-690 TAURUS COURT LA QUINTA, CA ------------------------------------------------------------------- EXTERIOR WALLS: MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13 CEILINGS: BATT BLOW MANUFACTURER: ' GREENS -NE THICKNESS: 10.3 R- VALUE: 13-38 CEILINGS: BATTS BLO MANUFACTURER:-' JOHNS MANVILLE THICKNESS: 13" R- VALUE: R=38 , GENERAL CONTRACTOR: CENTURY HOMES BY.-' TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, INC. LICENSE NUMBER: -481278 BY: TITLE: PRODUCTION M AGER DATE