9907-153 (SFD)Zin
Certifica of panc- ..
Oil,
City of LaQuinta
B uilding and :Safet Depa'rttnOnt
This Certificate issued pursuant to the requirements of Section,1109 of the Uniform BuildingCode,
• . r -` 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 fo/1o'win
g.
BUILDING ADDRESS: j 54-724 SOUTHERN HILL - - -
Use Classification 'SINGLE FAMILY DWELLING Bldg. Permit arNo.- 9907-153
'
Occupancy - - •f •
P Y Grou p: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: SOUTHERN HILLS LLC Address: 1430 E.CHAPMAN AVE STE •100. -
`- City:. ORANGE, CA., •92886 -
-�� a, By: DANIEL P. CRAWFORD JR.
t• Date:. 10/19/2000
Building Official
POST IN A -CONSPICUOUS PLACE
LICENSED CONTRACTOR DECLARATION „ °1
I� 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 infull„force and effect.
License # Lic. Class w Exp. Date
'Iof�Y:J• �S
.02i29/20i
�Da a r'� E Signature of Contracto +
•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 witti wages as their -sole
compensation, will do the work, and the'structure is not intende'd,oroffered for
sale.(Sec. 7044, Business & Professionals Code).
( ) • 1, as owner of the property, am exclusively contracting with•'iicensed
contractors' to construct the project' (Sec.., 7044, Business & Professionals
Code). r'
O I am exempt under Section B&P.C: forthis reason> • '
Date Signature of Owner _
WORKER'S COMPENSATION -DECLARATION
I hereby'affirm.•under •penalty of. perjury one of the.,following'dec,larations:
() I have and will maintain a`c'ertificate 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.
(.NQ3 I have and 'wilF.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 7py•t�' yy, w�vSS ��yy Policy No. 1� Y¢*s q q��
�.I�.1�J.JL.R4Y A 1�`iJ+i. • .+ ,iY OW i,..Jt17;71) ,100
(This section need not be completed if the permit valuation is, for $100.00 orless),
( ). 1. 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, L shall forthwith comply with hose prowslons / r
ate
Appllcant �.^i7:✓fC-�'t�
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. •1 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'proprtyefor inspection purposes.' "
Vignature (Owner/Agent) � Date i
PERMIT #
BUILDING PERMIT'
DATE j � '1, VALUATION� ,4,63 LOT T. , - � 9 J TRACT
JOB SITE _7
ADDRESS \�&/_&* y AAv_'i�an+• ~ e�?.
APN
OWN��E��+.R/�g,ii
CONTRACTOR _-
}7�;a� ��q� /fyy'yq qq C yf 6S PP
•)�.Jl.� �er,"gJ.RN bJ.fLLS LLC
�/ENGINEER
g/DESIGNER
y �_�-
�.��+ A. yY.p_�y-- 1,
-R,�.,c,7:JA„�,�"laSi•0.[r<�i,9lJ6J<.I;q,f:wR`TJ-1It,LS,: ,LC
430 E CI t�T3tl>i.f�.c�{ .:l''J` a"i` .tt�t1
7_S<. t7�): �3A FiI:VD
MANGE Af+ "rt~ L 92886
L. �il�i:N'T'A C A. 922MV, .
-$4R7
USE OF PERMIT
SCD -LOT 15 i}iAN.2 .R ?_M3T��i.ESNOTING^l:i,:DE,-8VXK'w:A11(YA
PC�f..1�Z, PLS (.;��(� �.i1.f:3'C.f� i'.ti:.yty i��'1?d,9.�3 �•'t:?�'i 1�+11'J3:,1'ti��,'.�.� �`k9.1£i.11�ii`R"fA;i. -
34020-00 i3.(:'
t't.RIZC14/p f10, 0.t30 ALL{'
C ARA(f3 i(:ARX''kf, 565,40 SF
taT.reD COST ddffil C1,TX1S r.%ILICT.ION
2,56,4 3.90
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LESS PRE -PAID V0.
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RECEIPT"
DATE
BY f
S
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
_
Combustion Air
Roof Deck
Exhaust Fans
0. K. to Wrap
_
F.A.U.
Framing ozp-p
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
�p
/ 00
Final
BLOCKWALL APPRO LS
Final
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 APPROVALS
Gas Test
Electric Final
Waste Lines
7�/ Y
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
G
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)