0103-026 (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 N Lic. Class //Exp. Date
743967 � ;"—/#V, It . 12131/26(
Date 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, Businessf & Professionals
Code).
O I am exempt un er Section B&P.ro for this reason
'Date;'Y� ✓? - Signature :of"Owner- 3
`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 whirh 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
his,,-
permit is issued. My workers' compensation insurance carrier & policy no. are:,
Carrier Policy No.
Vd?t"6'L, FLIND
ND 93C!)13!J F•��
(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
Code, I shall forthwith comply with ose provisions.
Date: r 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. 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 fo? inspec on purposes.
Signature (Owner/Agent) ✓ Date—"'�_
BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT
�IaB9,�;Y�7iT 2 29623
JOB SITE
APN
ADDRESS
79-5393�
9 At"S�M1�.�A:iOI :t)J�:iV
604-MUM.
OWNER
CONTRACTOR /DESIGNER / EN (NEER
WALT) . IKVI1 01,,i&W, INC
74`•333 TIWY 1 1 3 5'17, 3 W
'14`,333 HVTY" 1 I 1 VU I °.Y:i
ALM DR .T CA 92260
RA IroL IDMM 1' CA 92260
(760>568-2955 101114A 5028
USE OF PERMIT
aYN'.VVI:StaaS�'.,yC.�.!11Td`3RArL��.�7i.5'YYYY.l�.'.ar�.�eJ{�gbq{.Fttpe
t,[ [t �.ry �y 1, J BLOCK.
SUD v LOT3, Y.Y�AN . A, .{-���aJV'SAi' G.O I'- b'VOrT BFVIaI!4UDIK .s <
IYALLAPOOLIAPPROACH 3PWL ;14.Y -15%, PL,AN CHEC' K,'PlIK MOClMION
FOR ISSUANCE, OF SAME PLAN `t'YP& A cwt
civ. r 1
✓r , Y ;�
` AACT CONSTRUCTION $1010 `aid MAR
02 2001
Al
Pcy ��.�}�r'P3 �.p�i. rAtpr�� ryt ., +) A n. no SF " �g�p pgyy o
'!.,��+9Ziil`ilYA+l4�!'AR.C't:'lh"a 4, f�bs`IG7.7. i1 a�b W ® U
pq (c� � � (�p�p
L Y `mn:��U �
•��vvpprr a�p�@��pp,�L PP ttoA Y �q�Ly�r �y�q1 p��y��L, �5t
.F;mFa',AdEp.�l:;'L/F-0 Sr�08' �L.9.,�` �',�id\6Ati�Wj,�.�'...r�7N.�J.�
q ryf p ��y
149,711112y0
A
CONSTRUCTION FEE 101-000-41$-000 ORSO
PLAN CHECK PRE 101-000-439-319 VIAS 36
MXHAWCAI, MIR 101aNO-421-000 ftso
KLfz.L°3 Mr-AY,,M 101000420_000 $134.0
P11Ut B940 M 101.0002419.000 31613 35
S"'RC9NQ Ah'Of10311 Pon, . RLSI0 101-£l O-241-000 $?.4.917
0RAD W0 F.F.C; 101 •-0t1 23.000 $20-00
DB11'R1.s7P€. t IMPACT FEE
SUB -170T AL CO: '.t`L UC T101'f AND PTUX CHWX�:1;
a 2.11
T(YJCAL I'M,Y9..4 FEMS KITE .LV'4.6 YW
U g 'dimly o.
RECEIPT
DATE ,
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings
_ _
�
Underground Ducts
Ducts
Slab Grade
J
Return Air
Steel
Combustion Air
Roof Deck
1_
Exhaust.Fans -
O.K. to Wrap
_ �,�E}�--
/�
F.A.U.
Framing
_
_ Z"_�
Compressor
Insulation
_ �/ //
`3 U� "%
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
y�
Final
_Final
POOLS - SPAS
BLOCKWALL AP'IPROVkj-S
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
31
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
_� (O _ �'�
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
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
Qr/
Temp. Use of Power
Final
Utility Notice (Perm)
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:
79-539 DANDELION DRIVE
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction
Owner of Building: D F PARTNERS, LLC
Building Official
VN
Bldg. Permit No.: 0103-026
Land Use Zone: RL
Address: 74-333 HWY 111 STE 103
City: PALM DESERT, CA., 92260
By: DANIEL P. CRAWFORD JR.
Date: 9/20/01
POST IN A CONSPICUOUS PLACE
AUG -10-2001 13:33 WESTERN INSULATION 909 686 8786 P.17i19
WESTERN INSULATION, L.P.
4211 Letham Strect, Rivcrside, 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 #29623/PHASE 2
LOT #: 2
SITE ADDRESS: 79539 DANDELION DR. LA QUINTA, CA
EXTERIOR WALLS
MANUFACTURER: JOHNS MANVILLE THICKNE _-35/8 " R -VALUE: R-13
CEILINGS: BATTS -�-eCOW
MANUFACTURER: GREENSTONE THICKNESS: 10.3 "
CEILINGS BATTS BLOW
MANUFACTURER: JOHNS MANVILLE THICKNESS: 13
GENERAL CONTRACTOR: WORLD DEVELOPMENT, INC.
BY:
TITLE.
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, L.P.
LICENSE NUMBER• 794484
BY:
TITLE: PR6 TION MANAGER.
DATE AUGUST 10, 2001
R -VALUE: R-38
R -VALUE: R-38