0103-018 (SFD)LICENSED CONTRACTOR DECLARATION
<<,hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
C14 W Professionals Code, and my License is in full force and effect.
O 0
License # Lic. Class {Exp. Date
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LLJ
Z ti Date w ��~� � Signature of Contractor
(D O 4.
J U C:) OWNER -BUILDER DECLARATION
LUaLU I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z ( ) 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).
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11�-eDate Sinatuof.:OrierJON
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CL Q WORKER'S COMPENSATION DECLARATION
O Cc I hereby affirm under penalty of perjury one of the following declarations:
Lo O () 1 have and will maintain a. certificate of consent to self -insure for workers'
X LI compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
M Q U ( ) I have and will maintain workers' compensation insurance, as required by
OQ Section 3700 of the Labor Code, for the performance of the work for which this
d un un I— permit is issued. My workers' compensation insurance carrier & policy no. are:
* Z Carrier Policy Nu.
Cb '5 VATF. FUND 1509193-9.9
(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, a9d agree that if I should become
3 subject to the workers' compensatio p rprovllons,of Section 3700 of the Labor
Code, I shall fort ith comply with `osb rovlsi�s
Dater "' Applicant of -
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, end State laws relating to the building
construction, and hereby auth • rize representatives of this City to enter upon
the above-mentioned property or jrn pection purposes. 4�
Signature (Owner/Agent) =`t ` °" Date/_'_2_()/
2~()/
s
BUILDING PERMIT PERMT#
DATE VALUATION LOT 0103-(141
TRACT
JOB SITE
ADDRESS
APN
518 DA9,091JON1AMN
(AW0 ;B404
OWNER
CONTRACTOR / DESIGNER / EN (NEER
D F iP.ttiITINks W3* ;iw; k!
Wt?RTZ I,7 , iin0.pw_NT, :11.3'c'
P.Pi1tM DE�1:wW 5. A 92260
3's"hL.S:PL .f,1.C.iP7 ER.t.
6..A 92260
(760)168-29555
i•
d"', U10 5028
USE OF PERMIT
SPO,, u:aT 10, P'U14 MU, PLRll IT t;}OPS NOT [N,=UVF k0CK
WA1.S.,6P001JA:PP11OACH DRIVENAY ^ M. A,..1iN efikK RBi, REDUCTION
Ir
W" wig mul
`'RAC. � CON3TR.pC`P1C. N 71100.00 SF �' HIr LW � ��
POR.C°1 IRAT11 63.00 V
0ARAUXAR.PORT (81Y) 14,366,80
r.
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�r,�wyr�•y�
••qq��11��,�7/:(����qq aa�e���rrq� ry('��'��„g� ! t/�•p �,y'4, p(
6: r��.R.b9if�dr,59D `.ZAs up L51•xi7fb�d�4/W..LC.to,F.`I
q �� �Kq�.;
1529171 1,130
py.ralial If FEW 91UMMIRY
t",4,3OfTRVC'•TION P U 103-000-418-000 $7.44.50
PLAN CDiEr-K* IME 101 _000-439-31 R $139.46
1� RCt . ASCC t1t,: {?' • 101.00".21-000 S60.00
E1,rx"T1rJCAL' ! EI 1G1�Ct���st1-t��a $.f.b1.Csfi
rixu .1rgC1111 101-000-419-000 $144.30
'oA'fs'Mg0&10T10W "M- 8 11'3 101-000- 241-000 �D1.93
0RAM)INGREF, 101 -WO -423-000
D 1 VIF-L :)iPER IMPACT F�k•,1 �1,2et7,91U
S'£M-3"t, J AL CON '13I'FfUMON MoM PLAN C & R(N'.
S:5,1, 6 4M
LESS PT..ir✓-P k.1':0 $0,00
J TOTAL FE1•e'1V r FFYIS DI ,NOW
RECEIPT
DATEBY
� �•
.
� i ti
DATE FINALED
INSPECTOR
t
.
INSPECTION RECORD
• OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
_ Y
Forms & Footings 2_`y_ ` �,
Ducts
Slab Grade
J
Return Air
Steel
Combustion Air
Roof Deck
_
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing-��
Insulation
7_DJ �'/
Compressor
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
_
/D.�/�l
_�
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
3 I �_3 ���'�
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 Pip'
Gas To;��/�
j
Applin ices
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)
AUG -10-2001 13:32
WESTERN INSULATION
909 666 8786 P.09i19
WESTERN INSULATION, L.P.
4211 Latham Street, Rlvernide, 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: SUNFLOWER /129623/PHASE 2
LOT #: 10
SITE ADDRESS: -- 79518 DANDELION DR. LA QUINTA; CA,
EXTER OR WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13
CEILINGS: BATTS BLOW
MANUFACTURER: GREENSTONE THICKNESS: 10.3 " R -VALUE: R-38
CEILI GS:BATTS BLOW
MANUFACTURER: JOHNS MANVILLE ^ THICKNESS: 13 " R -VALUE: R-38
GENERAL CONTRACTOR_ WORLD DEVELOPMENT, INC.
BY:
TITLE:
DATE:
INSULATIONCONTRACTOR: WESTERN INSULATION, L.P.
LICENSE NUMBER: 794464
BY:
TITLE: PROXJCj4bN MANAGER
DATE AUGUCT 10, 2001
M
9 ®R
�p 0�-�
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
O REINFORCED CONCRETE TRUCT. STEEL ASSEMBLY O
0 POST TENSIONEDRETE
O REINFORCED MASONRY 0 FIRE EHHER
PROOFING `
JOB LOCATION( Q ` .8,4� LA 4`1_ \C ^ V
ry
REPORT SEQUENCE NO.
TYPE OF TRUCTUREE y ,
Zf N 44�6
PERMIT NO.
DA
o r
DAY OF WEEK
MATERIAL DESCRIPTION �� O�
ARCHITECT
IN STTOR
HRS. CHARGED
E% 0 Ism
ENGINEER
ASSISTANTS
HRS. CHARGED
ENERAL SUB
INSPECTION CONTRACTOR TRACTOR ��' (i� ��� ` CONTRACTOR S .4 ct,
DATE
BAS c 10691E CA -P
.� Codt-tjU Com
��0- ` u gS
C slv es���
-190
COPY SENT TO CLIENT O
CONTINUED ON NEXT PAGE O
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF M`/
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
SI N TURE OF REGISTERED N TO
SCA o
TEOFIDFAREPORT REGISTER NUMBFR
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:
79-518 DANDELION DRIVE
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction:
Owner of Building: D F PARTNERS, LLC
Building Official
V nl
Bldg. Permit No.: 0103-018
Land Use Zone: RL
Address: .74-333 HWY 111 STE'103
City: PALM DESERT, CA., 92260
By: DANIEL P. CRAWFORD JR.
Date: 10/11/01
POST IN A CONSPICUOUS PLACE
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