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0306-334 (PLBG)LICENSED CONTRACTOR DECLARATION 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 in full force and effect. License # Lic. Class Exp. Date f40"i'34 13 r / Date ' �7. 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). ( ) 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 Sed, n 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 N,t TPM,.�Uw UN"(ft K Policy No. IN FS10 (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 WSection 3700 of the Labor Cooe, I shall forthwith comply with`tho"se` provisionsr--- — . U'ate. •+ 1 Or 0'1 -"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 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 property for inspection purposes. ,Signature (Owner/Agent) T Date + . ,. • BUILOINGTERMIT PERMIT ^ N DATE VALUATION LOT `IDS TRACT JOB SITE lF� 7� e�ti.�F:" BSs J ADDRESS APN OWNER CONTRACTOR/DESIGNER/EN (NEER C` �S.�Hf!Ai.'10MES T—k ({Ulim t AI 91.883 LA QTJDITA. CA 92883 `CN39)e33,8996 es ff M6 USE OF PERMIT 4%11+1'i i:t'iaJ �.. xiy l'wYi 4LJfefV x.Nrf l':J,T•. \r Yi i.r :J.rY\� .. : RIV11 w,7 4-10 C SIT s?A' CUIN�'Jt'.i`RU-MON PLUM-DIN01 Pep I01.00T�419.000 $13,00 ` Iul j° UNC'20 20 C€r Or- L1>10 -.-- �iFs`�V:�''s:}";'.F►,�.,'>✓f.3?t���i3.fi3'C'yTln�1'.�3��5 ��L:A,AI° C`��t �;i k3.4�E= TOTAL I�MAQT PT.29, DUE VOW RECEIPT DATEBY J�' ` DATE A7 IN PE R 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 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 Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS 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 Ile 4 Appliances Final Final D 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) COMMENTS: Coral Collection Lc) k 1-0 7�) tt J f4 1�1 . seg--- -- C f,�1� r f� � I I �y PATIO MASTER I+ I BEDROOM I NOOK s= r _I LF Z GREAT m6 ROOM ------ , r� _-' OPL DOOR V NO, KITCHEN ------- zI REF �' ----- ---PY GOATS - ANTR J MASTER ® ----------- �' i I uNEN ENTRY I; WALK-IN i WALK-IN BAT ® aosET BAT 2 0 Q I O J �------- WIi l PORCH I F== OFT ---- LAu. SINK ` I ------ OPT SERVICE BEDROOM 2 DOOR 2 -CAR GARAGE 'J !----------------------- ! ---------------------- L- -I OPTIONAL 2' OR 4' GARAGE EXTENSION ,- - � 7 i I ---------------------- ' Maure a Plan 4210 • Elevation A 1,355 sq. ft. Shea Homes for Active Adults reserves.the right to discontinue or change specifications or designs at any time and any prospective buyer is aware that any w promotional materials that have been viewed may have extra features or improvements shown therein which may not be included unless specifically provided for in the purchase contract. Prices, features and amenities are subject to change without notice. Measurements may vary slightly without incurring any obligation. Floor plans will vary depending on exterior design. Check with your Sales Counselor. M.ustrations and renderings are artist's conceptions and are not intended to show specific detailing. Model homes have been professionally decorated for your convenience in viewing how furniture and accessories may be arranged. Among the decorator items are certain light fixtures, ceiling fans, floor coverings; wallpa er, custom paint colors, window treatments, furniture, built-in cabinetry-, mirrors, Pictures and accessories which are not included in the price of the home. Landscaping and certain outdoor additions are also excluded. Please ask your Sales Counselor for details about these items and the options that are available to you. Pursuant to Fair Housing amendment Act of 1988, housing at Trilogy at La Quinta is intended for occupancy by at least one person 55 years of age or older per unit.