0103-011 (SFD)LICENSED CONTRACTOR DECLARATION`
�I hereby affirm under penalty of perjury that I am licensed under provisions of
h7 Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
'N W Professionals Code, and my License is in full force and effect.
C) ch License # Lic. Class Exp. Date
r,- ' o U.)
LU
oZ r� Date Signature of Contractor'
CO 0.
J F- C) OWNER -BUILDER DECLARATION
W WW r` I hereby affirm under penalty of perjury that I am exempt from the Contractor's
tD 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).
C0 O I am exempt under Section B&P.C. for this reason
LO r -
N Date J1 -.. le Signature of Owner �,1:' llF/ :�
CL Q WORKER'S COMPENSATION DECLARATION
p 1 hereby affirm under penalty of perjury one of the following declarations:
Lo FZcc
O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W !�= compensation, as provided for by Section 3700 of the Labor Code, for the
O � Q performance of the work for which this permit is issued.
ED Q C) ( ) I have and will maintain workers' compensation insurance, as required by
O V Q Section 3700 of the Labor Code, for the performance of the work for which this
li rn H ' permit is issued. My workers' compensation insurance carrier & policy no. are:
It Z Carrier y+h 6.F ��t Policy No. 14 A fi F�t1
l< (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
3 subject to the workers' compensation provisions of Section 3700 of the Labor
Code, Is hall forthwith comply with tf�ose/pr,'ovions.
Date: `°-41 Applicant �fhf ff �.•�'
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 for inspection purposes.
All
Signature (Owner/Agent) /( Date
x.
BUILDING PERMIT PERMIT#"
DATE VALUATION LOT TRACT
$129261.�t?
JOB SITE
APN
ADDRESS
79 W Xyt 'TJAIOX D 19
604-472-W4
OWNER
CONTRACTOR/DESIGNER/EN (NEER
D F P.ft,RTMERS, L
'WORLD D;s'tlELOPMENT, WC
74.333 ENTY I I I WE 103
74 -333.1 -MY I l A VE 103
P.AL1AD.`USPT,.'r CA 92260
PA1.M.DFZZKf CA =60
(760)568-2955 C -13 L4 AB
USE OF PERMIT
17,p11.{Ap.H 1,,,!P7�{-R�Q3yt��+I'�f��7�QdN��"3 e+l�gJr{ Yt3CL�.,U11?,9 E�/t�y"h-
(yip�pay-(,./nOT
'�t1,R'JIJWF'Lry:�44.fZ�9-RC.4J.�4.•¢L !.�'di1Y 6, V11d� S. - !:l%V I'P.41'iS�c M1.. ,{i�,NPQb.�d�,.•:.r� �/�I..`•ki L11Z�4��F
KIR IDSU,!• 140 OY SAME P1,AN '> `i ?X
+
� "°� Y
���LA (..IV
TRACT CONSTRUCTION 2140.00 5F
iPORCHIP.ATIO 65.00 5y
Q? MAMCARPOR'i (91) 14,30: 20
WSTIMA: M.) CO—ST OPCON.M'RUM ON
129,261-V
PERMIT FM WAMMARY
COr .TMUCTION, PRE 101-000-418-000". M14,59
PLAN CHECK PFE . 101-,000-439,,318 $153.46
MEC:liANTC,A.L FEE 101.000.4.21-000 SAN
EIXTRICAL ME 101-000.420.000 Sig;,"
PLUDARF00 FM 101-000^419.000 $144,50
'STRONG Z49C7TIOI t FEE 0101b^ 101-000-241-000
0AADINO RF 1X31.000.4 23.000 $:10.04
i3P,'S+'EWPER.tM1ACT MZE $1,907.00
4
IMM PR P AID I
$0M
"1'4S':m 11TRIALY :�'�°.111:R :DILTS B O W
$:5,164.0.
RECEIPT
DATE }1
',
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
I
,
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings 1lQ �_ "
m
Underground Ducts
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
O.K. to Wrap
t{
S2�
--®_L
�_
Exhaust Fans
F.A.U.
Framing
S l_I o
��e32
Compressor
Insulation
�eJ3C
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exte�r�. mathO/
Drc7,r,.,l�
6�
_
Final93/�
Final
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 t Z
�r`��
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
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
OCT C3) 9���a � � >�z`�u� °N S11
ELECTRICAL
APPROVALS
Temp. Power Pole
&ImozT
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.FJ.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
AUG -10-2001 13:30 WESTERN INSULATION 909 686 8786 P.02i19
WESTERN INSULATION, L.P.
4211 Latham Street, Rlvcreide, 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 # : 17
SITE ADDRESS: 79546 DANDELION DR. LA QUINTA, CA
-------------
EXTERIOR WALLS:
MANUFACTURER: ' JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13
CEILINGS: BATTS BLOW
MANUFACTURER: GREENSTONE THICKNESS: 10.3 " R -VALUE: R-38
CEILIN (:�BATTS BLOW
MANUFACTURER: JOHNS MANVILLE THICKNESS: 13 " R -VALUE: R-38
GENERAL CONTRACTOR:, WORLD DEVELOPMENT, INC.
BY:
TITLE:
DATE:
INSULATI-ON CONTRACTOR: WESTERN INSULATION, L.P.
LICENSE NUMBER: 794484
BY:
TITLE: PPOWCTION MANAGER
DATE AUGUST 10, 2001
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:
79-546 DANDELION DRIVE
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 . Type of Construction
Owner of Building: D F PARTNERS, LLC
Building Official
Bldg. Permit No.: 0103-011
Land Use Zone: RL
Address: 74-333 HWY 111 STE 103
City: PALM DESERT, CA., 92260
By: DANIEL P. CRAWFORD JR.
Date: 9/13/01
POST IN A CONSPICUOUS PLACE
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
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑
O POST TENSIONED CONCRETE O ASPHALT O OTHER
❑ REINFORCED MASONRY O FIRE PROOFING
JOB LOCATION �w / 1 i O� 01Z
REPORT SEDUENCE NO.
Ty PE S OSTRUCTURE3/ � �S �
zi:
PERMIT N0.
OA �
on
DAY Of WEEK
MATERIAL pESCRI^ q (6 0-3 La -r " (?
ARCHITECT
I C TQ
HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION CRAL SUB 5
DATE O TRACTOR W o e(ten , CONTRACTOR
a- z
U)e - 6e x: , -&AA qej
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 MV
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.
GN TURE OF REGIS? R 1 SPECC
V 10
A E F REPORT REGISTER NUMRFR