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0306-202 (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 Date 1 r Signature of Contractor .0 � 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 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' workers' compensation insurance Carrier & policy no. are: Carrier STAi'�..:i�' Policy No. TM390-0% (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 3700,66he Labor Code, I shill forthwith comply with those provisions. ' Date: �"y' 'Applicant r - 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 up the above-mentioned property.for inspection purposes!'7 Signature (Owner/Agent) % Date ` BUILDING PERMIT PERMIT# DATE / / VALUATION •51R7,975WO LOT f TRACT i?r393s�2 JOB SITE 7940S DE SM 1, SOL API 772--4W.00; ADDRESS OWNER CONTRACTOR / DESIGNER / EN (NEER I'Tr 1401ARS :LLC M; D-402. :f tJBOXIX717 14 21 X 4 :4M.F'� IIrYDRTV& 6 C1051414990 USE OF PERMIT � 3f3ALi.% F00f, SPA, OR 1');211tfRWAY. PPROACH TRACT C01:33'fRUCTS0:4 3,19)xv arr `P FPiORCH,fRA,"tA'IL7�v�,tt.y� 13[ily(* wi or C,4'1NU:C.3ZVC11SON -1671 9,79M 9 �/yp /{ �{ /� }, ✓iitJY e7S riS•WN�JV:t9 l.IiSf I¢I.�1'^L!'lrl-416-000 tir•♦Tr.�JJQ PiAl. C.;HWX 1zl:F' 101-CD0.4_2 ..31.8 W -,as 45 MECHANICAL FITS 1 `)i,-tD(?f1-411-000 A14S 00 I?;T Fts''z'TzIr..AL FVZ, 101-000-420-000 PWI MBINGFER 10! -00( D419 -OW '-'f"1, ONO MO:'.','O:N PEF: N P.PZIC 101-000-24 s 1.000 OP•,.1 IDINCI ;tE19 W-000-423-000 3 -4%00.423.00© W. r10 rNPIY'EJ..OM TAPPIACT 3`7Ar'. .t�'Oi.flO ff� r���"i`'.Atif^t�?'Nt'�F�'t�'�:��l�i��tt�a.•r�ti �c."T••'i.TT.I�`.t�. E' �i,;t:3f.iaj � _ . --__ ..-�.,,- i ---� f r j� :t.��"� i3RL�T'r`�:['� .�.�•.�s rt'.U�? /f ` �_ ✓ ~ RECEIPT DATE BY �- y DATEFINALED INSPECTO — INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings - - Ducts Slab Grade - - 3 Return Air Steel - r-1 - j Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Sag Compressor -Insulation Z2 -p Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Q Final - Final — - s 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 OX for Finish Plaster Sewer Lateral Pool Cover Sewer Connection - - Encapsulation Gas Piping Gas Test Appliances Final COMMENT P�- Final_ Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring - O3 Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles 444 G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) _ Q :::r�..•nnrts7•vrarrzrrre!Yi'Y�^nvY7,•.Yrri+X+'rnx�'Y.v�wriN?•rs7aN»,»�.b,»�»:rraxs+nTrocirr..aaw��nw:rn�raasre�r�,.,,rrrvY�a+�»'H'vt^..,^n»�r,, r:rarer.<rrvcr•>rn•rn:^x%Yo:.•y,✓.,;•, ;: r.�::. •:n. r:..: ,r�,..�.:, r 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 at 79-895 De Sol A Sol, Lot 108, La Quinta, Califomia CEILINGS: TYPE: Batts MANUFACTURER: Certainteed THICKNESS: R-38 WALLS: TYPE: Batts MANUFACTURER: Certainteed GENERAL CONTRACTOR: RJT Homes THICKNESS: R-21 LICENSE#: BY: TITLE: PARAGON SCHMID BUILDING PRODUCTS, A Masco Company LICENSE # 221517 BY: Pry TITLE: ACCOUNT REPRESENTATIVE DATE: 2/18/2004 �5�.:1;r.�,Kxn'S'Y;Y�r:�t7�svmv:�:;�5!Yraiv:xcige�.wia.e�vlv.:ai;wA'W'�.u!�r;rarsv.:e!ess�av.•me�nrv[drD�KA!:va�rvr:.m. mar.�nrar�R�:O'D�1bavw^r.,7.a�au.,nrsfvearenro-w�v.� ••rr��vvrr..vn•:,,::! v: r:w.wvf: �:,�.c s INSULATION CERTIFICATE i, This is to certify that insulatio has been installed in conformance with the current energy regulation, California Administ ive Code, Title 24, State of California, in the building located at r. i r CEILINGS: TYPE: Batts WALLS: TYPE: Batts MANUF GENERAL CONTRACTOR: BY: PARAGON SCHMID BUILDING ER:,Certainteed rtainteed TITLE: UCTS A Masco Com BY: TITLE: ACCOUNT REPR THICKNESS: THICKNESS: LICENSE # LICENSE # 221517 NTATIVE DATE: 2/18/2004 50 - Coil, Certificate.of ry 4 V a w5 9► Y Building & Safety Department. GRA � �9 of This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 79-895 DE SOL A SOL Use classification: S.F.D. Building Permit No.: 0306-202 Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: R -L Owner of Building: RJT HOMES LLC Address: PO BOX 810 City, ST, ZIP: LA QUINTA CA 92253 By: G.SHOWALTER �a Date: 02/13/04 Building Official POST IN A CONSPICUOUS PLACE . 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: 79-895 DE SOL A SOL ,LOT 108, LA QUINTA,CALIFORNIA CEILINGS: TYPE: BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-38 WALLS: TYPE: BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-21 GE L NT R: RJ ES LICENSE # 47 �EaS TITLE:S�C. A O SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 B TITLE: ADMINISTRATIVE ASSISTANT DATE: 11/14/2003