0102-123 (SFD)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
71 4168 B ? 0/31/2(
Date f / 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&RC. 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 Policy No.
GOLDEN %AO1,,.S IMS, 1 t<=WDR'42
.(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
Code, I shall forthwith comply with those provisions. n
Date: F /- 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. r„
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 comme,iced 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 inspection purposes.
Signature (Owner/Agent):' Q) 14'791 x Date 11 i- t
BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT
JOB SITE
APN
ADDRESS
OWNER
CONTRACTOR / DESIGNER/ENGINEER
.
(IMI R, iOY3OI C68YYWrL
1-MJR L\OWG1L ry LLWVNrTS
1..335 so, 41Y 177 RM, MM 41.2.00
1535 so, RD" MIREM", ' 3">Y- $1201)
' IN PORNAIWIW 0 :' Ar 9?A W
m�t�' ?E.�ik:�'c i��d�f.":�3wo �°�y..ryp9(2��t &.A
(909-)181-6007 L.I. 111 .4 2120
USE OF PERMIT
03NIGyAAiLYy YM.l7
i
S.MPLAN ? ,OT 3 PERMIT DOESNOT 1NCF,UDE
I3%t"?tuMAFA�,"IFOWDRIV>yWAYAPY'ROACH
rRUCTION 2.10700 OF
PORt:;"ATIO 206.00 Sr
r
COST OF ��•ORMUCR.M.a.I.iO
17161515 u Lw'Yl
,g iLRp�r �v�,p ��7g y�•n/r �, (.S�/;,gIPX„7KYJf.NAWD
��.I7..1C1 Si17t6':t1i,1.��1L Z 1
CONSTRUCTION FM 101-000-418-000
�$000,0111
/�,�v
47
1d9EMM41CAL RX 101 -000-421 -000 $9810
Z L.1?',t"TWC°AL, IFEE 101,000-420-000 S't T7.t?
PLUM BIM FES '101-000-419-000 000 1167.50
STRONG W.0110N. PKE • RESID '101-000-241 •000 $17.66
ORADINO ME 101-000-423-000 $20.06
F7,2 M-000-443-342 $1,907.00
n
�(��7 '•� I��p•� Ag /y t �,�4, iC1T,yy fi�i �^y�,}• A gy �` [��y'� � y�y y
qA!� ,I��•
2 2001
j� yFEB .2
0'
RECEIPT
DATE it ' BY
DATE FINALED
INSPECTOR
f,tr
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
,Q
Underground Ducts
Forms & Footings
/ _
u t7
Ducts
Slab Grade
G Z Q
Return Air
Steel
Roof DeckExhaust
WE
Combustion Air
Fans
O.K. to Wrap
-/,—
� - - .3 /,�
�'
F.A.U.
Framing
Insulation
6'�
Compressor
Vents
_ _
Fireplace P.L.
_ -�
Grills
Fireplace T.O.
_
Fans & Controls
Party Wall Insulation
_
Condensate Lines
Party Wall Firewall
Exterior Lath
0D qq
lam' `liC�
Drywall - Int. Lath
Final
Final
i 9— y
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
!i�" ��
Pool Cover
Sewer Connection
%�y
Encapsulation
Gas Piping
Gas Test
_y
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles .
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
CENTURY
VINTAGE
DOMES
By Century Crowell
Dear Greg:
DL�/
July 26, 2001
Mr. Greg Butler
Building and Safety Department
City of La Quinta
78-495 Calle Tampico
La Quinta, CA. 92253
RE: Lot 1 Tract 29586 (Duna Fairways)
l -l' OF- I P0HINTA
JUL % 7 SEC°g
8lril_Cjlr�R�� �isvrl ,�
10,
I would like to request a six month extension on the building permit for the above
referenced lot (see attached copy of the job card). This lot was not started because we
needed it for a construction staging area for the geogrid retaining wall that was adjacent
to it. The wall is nearing completion and within the next 30 days we will be able to begin
construction on Lot 1. The initial permit is due to expire on August 22, 2001 and we
would not be able to have the first inspection by that date. Thank you for your assistance.
Sincerely,
Marty W. Butler, Project Manager
Century Crowell Communities
I cc. file, Gary Weintraub, Jeff Nygren
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
DATE 5101 _ BY
z ftem5LoI'� A�VaugCD m"1 41CA102-
1535
South "D" Street, Suite 200; San Bernardino, California, 92408, (909) 381-6007, Fax (909) 381-0041
1 -800 -BUY -CENTURY!, http://www.centuryvintage.com
c
FEB -18-2002 14:09 WESTERN INSULATION 909 686 8786 P.02i24
- WESTERM INSULA°T'ION, L.P.
4211 Lath= Street, Riverside, Callfarnla 92601
TeL (909) 685.8760 Fax (909) SM -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:
TRACTlPHASE:—DIJNNAFAIRWAYS TR#20158 PHASE 3
LOT *: 7_l, IV
1,51TE ADDRESS:'78-140 CALLE LAS RAMBLAS, LA QUINTA, CA
EXTERIOR WALLS.-
MANUFACTURER:
ALLS:MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 518 R -VALUE: R-13
CE S: BATTS BLOW
MANUFACTURER: GREENFISER THICKNESS: 8.1 " R -VALUE: R-30
CEILINGS. BATTS BLOW
MANUFACTURER: JOHNS MANVILLE THICKNESS: ill' R -VALUE: R-30
GENERAL CONTRACTOR: CENTURY HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, L.P.
LICENSE NUMBER: 794484
BY:
TITLE: PRODUCT115N MANAGER
DATE: FEBRUARY 18, 2002
Angi Benjamin
78140 Calle Las Ramblas
La Quinta CA. 92253
April 3, 2004
Century Vintage Homes
1535 S. "D" street Suite 200
San Bernardino, CA. 92408
CERTIFIED MAIL: 7002 0510 0002 7992 0633
Ref Property structure @ 79140 Calle Las Ramblas
La Quinta, CA. 92253
CI7Y OF t_A r4.II� dA
APR 7 o RECD
BUILDII,yU
This letter is to put Century Vintage Homes on notice of my deep concern for what is
happening to my home. The South exterior bearing wall of my home is set back
approximately 8 feet and runs parallel to a 14 foot high retaining wall that Century
Homes built on the Duna Gardens property line. There is a wing wall perpendicular to
my exterior wall that has settled and been repaired at least twice and has settled some
more by pulling away from my house. Another new crack has developed. There is also
a concrete slab on the same side of my home and it too has settled and pulled away from
the foundation by at least a'/2 inch. There are some hairline cracks occurring along the
base molding and the tile floor in the master bath water closet area. This too is on this
exterior wall. The drive way to my home has 2 panels that are cracked. You have sent
your personnel out to inspect and I was told you would repair and replace. Nothing has
been done and it has been over 3 months since your people were here.
I have real deep concerns that the soil under my house foundation was disturbed and
adequate compaction was not completed prior to construction thus causing the house to
settle and move.
In my shower once again in the master bath the grout between the marble tile is
expanding and rising above the tile. The shower is cleaned every week and this _
expansion and the discoloring of the grout is not normal.
I want someone to inspect these conditions, take corrective action and provide me a
written warranty that my home is safe and does not have unusual settlement causing
additional cost to me now and for the next 10 years.
:in y
enjami
CC: Building Department, City of La Quinta