The URL can be used to link to this page

0305-103 (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. Classg Exp. Date 545 13 WO A/ f • Date ! /y'��/� Signature of Contractor.' / ' 1�3 J- l �' 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' compensation insurance carrier & policy no. are: Carrier ST-kil? PI -ND Policy No. 1 05-02 (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 Califorhia, and agree hat if I should become subject to e workers' compensation provisions of Section 3700,,, the Labor Code, I�shall forthwith comply withithose provisions! �,Ddte: 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 authoize_representetives of tliis City to enter upon the above-mentioned property for inspection'pdrpose ,/ lr Signature (Owner/Agent) o, {' .t :1a , e .� '•�— — Date �• �'P BUILDING PERMIT PERMITN t7.l05-1i1l-) DATE VALUATION *15,9,734_00 . LOT 105 TRACT rf { 7�, JOB SITEJay XD DESOL A SCOX. APN 7112-400-0V ADDRESS OWNER CONTRACTOR / DESIGNER / EN (NEER LSO B xxtl14 14121 K W_jTY.i`i7:H:2 MITY DVINE CA 92253 PROMN, 85034 (602)25'1r1656 C,RL4 4990 USE OF PERMIT i!d'dA^ f'.P� B'M{A'lls] .)/f'ltlSLi. h'f�rLISYAI a 1JVY N 6tlV a d:hlbG'n.4/l„t'ar Vl.NJ'MP. , WAL-1 3�ci{7.i+y ��' ACR ------------ nn Qa TRACT C0N3TitUC f X'$17 9F Tu 0 9 2003 1?C).RCHYPATIO 7 6141 EF JU al/#•i2MOWCARPOlt6' 6li.1?C S CIF QUINTA F AA NCE DEPT. y:S''TIulm-nN cosm t1 r comakumoy, 1 ij.j !,000-4'18 - 0 01D 11kA'IN C..H10 : i. :fa lU' 000-439-3%R fi14.5� MECHANICAL Y&C 101 11000 El= 7',R1 CA L FK9, t ti C -000-420-ON) $201, 313 KIUM1iYHO FEF 1 t: ? -000-419-000 9 190, 00 STRQdOMLl;04 f79 o EI.17 10 -000-24. 11 - 004'.) $f 9.97 , ORIAOR.Mt'S1-0`,70^423-O0'J 515.00 i)LV';e=Pw;'.tNP CT PA:X 31h.; --T iTAL CO2+TM •.)t_11t}ATAND $4•!7 Vkl :14 f��I1:�,5q,:�%•� pRi�AK;' � � �L•�� Ly7p�S�.�L'�.r�X:+-P6Sn.Al i,�.. W'] $6, �\•Aio Z:�2LP •1.�..+�r!.Fdi'+U �� C•S`..E,.}��`S .W !.• f;+ � ti.�� id'•dU t 1. l •..'"R 4 ' RECEIPT DATE BY D1 LE INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings — Ducts Slab Grade j — Return Air ' Steel% _ Z / - rj Combustion Air Roof Deck Exhaust Fans O.K. to Wrap - 9 - 3 F.A.U. Framing 1 Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final - Final — BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pbg. 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 z Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances - Final 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) COMMENTS: s.-�= •� �� i3� 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: 79-900 DE SOL A SOL ,LOT 105, LA QUINTA, California CEILINGS: TYPE: BATTS MANUFACTURER: Certainteed Thickness: R-38 WALLS: TYPE: BATTS MANUFACTURER: Certainteed Thickness: R-21 4AN ONT C : RJT HO S LICENSE # 6 qo / TITLE: St,Q �tR) ft;A �U� SCHMID BUILDING PRODUCTS; A MASCO COMPANY LICENSE # 632072 TITLE: ADMINISTRATIVE ASSISTANT DATE: 11/14/2003 9/9/03 John Hardwick RJT Homes, LLC 79700 5e Ave LaQuinta, CA 92253 14712 SW SCHOLLS FERRY RD # 328 BEAVERTON,OR 97007 PHONE: 503-524-8268 FAX: 503-213-6222 0 9-M3 RE: Structural Observation - Lot 105 John, Page 1 of l 4 Sample observations were made of the above house to ascertain whether the general intent of the construction documents is being followed. With respect to the structural items that remain uncovered and easily observable, this appears to be the case, with no deficiencies that I am aware of. Mike Nelson, PE NGIf� John Hardwick RJT Homes, LLC 79700 5e Ave LaQuinta, CA 92253 14712 SW SCHOLLS FERRY RD # 328 BEAVERTON,OR 97007 PHONE: 503-524-8268 FAX: 503-213-6222 0 9-M3 RE: Structural Observation - Lot 105 John, Page 1 of l 4 Sample observations were made of the above house to ascertain whether the general intent of the construction documents is being followed. With respect to the structural items that remain uncovered and easily observable, this appears to be the case, with no deficiencies that I am aware of. Mike Nelson, PE