0006-297 (SFD)LICENSED CONTRACTOR DECLARATION
Ihereby 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
748004
Date C /'7 �� k", ignature of Contractor
�4►.: 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).
( ) 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' 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 UNITED PACIFIC! INS Policy No. "Al 191345-00
(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 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
C de, I sial f rthwith comply with those rovislons(
ter" Applicant�e�
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
thee -above-mentioned property fojr inns`�eotlon purposes.
ignature (Owner/Agent)!� t 1�_ . Date°=' )
r7
1/! BUILDING PERMIT PERMIT#
"00W-'2207 ?
'DATE VALUATION LOT TRACT
29347
JOB SITE
ADDRESS 73 'it l�?� _W4y
APN
767-330-040
OWNER
CONTRACTOR/ / EN INFER
S'I'1+NM WALXFk HOAM
3TVWWJALJMRk10M0
7161 MIANAAVC.
7161119)7ANAAVE
Rr-f ;'RMDL, CA 42504
RIVERS= CA 92504 -
(909)784.0840 CBU 1357
USE OF PERMIT
WN'C" P'A vfiLY DVTL7_ WG
SI'0- 1,01' 33 PLAN I.CR PERMIT 6095 NOT INCLUDIs BLOCK WALLS OR.
POOL. 75 % PLA.14 CHECK FELT 11,E4UCTION FOR ISSUANCLE OF 4E
Pl." TYPE
CUSTOM CONSTRUCTION 3,451.00 SF
PORCEPATIO 351.00 SF
OARAOFICARFORT (3I) 16,699.20
$S"TE!"M COST OF COI SMUCIBOX
290.667M
PS�."I:IAw FEE subaL RY
CONSTRUCTION }SEE 103-000-418-000 $1,308,00
PLAN CHECK. FEE 101-000-43£9-318 $369.62
MECHA141CAL, FEE 101-000-421.000 9130,50
EL WTRICAL FEE 101-000-420-000 $722.04
PLUMBING FEE 101.0300-419.000 $220,50
STRONQ MOTION FEE - SID 101-000-241.000 $i9 O?
ORADINCI FEE 101.000.423-000 $20,00
DEVOL.OPER IMPACT FE $1,907.00
ART IN PUBLIC PLACES - RESIE 701.000-255.000 $.226,b7
BI3E TOTAL CONfITt2LJCilON AM PLAN Ca-UuM
$4,:333.40
LESS FAR -PAID FEW
$0.00
{
;.. Tbtwtt �- ms Duc now
$413. IAO
`
RECEIPT
DATE
BN�
DATE FINAL
-p� �Q_
I PEC
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings d+;h — % ao
Ducts
_
Slab Grade ,g j—
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
0. 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 /
Drypall - Int. Lath
e
Final `,
BLOCKWALL APPROVALS
Final
Steel
POOLS - SPAS ,
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg, Test
Final 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
Final .�
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduft
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power d
Final
Utility Notice (Perm) • " - a 7
COMMENTS:
C. • :.. °e
Certificate of Occupancy
City of La Quinta
Building and Safety Department'.
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 the following:
BUILDING ADDRESS:
Use Classification: SINGLE FAMILY DWELLING
55-735' TURNBERRY WAY
Bldg. Permit No.: 0006-297
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: STEVEN WALKER HOMES
Building Official
Address: 7161 INDIANA AVE
City: LA QUINTA, CA., 92253
By: BILL GORDON
Date: 3/27/02
POST IN A CONSPICUOUS PLACE