0202-178 (SFD)O C3 Ln
W
oZn
to 0O
H�
r
~a
C0
Z
cr)
U)
N
O�
Ua
It Z
T_ 0
Q J J
M _J
Oma
CL 0)
Itt Z
ao 5
r-0
R
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
114'1 E �S 1;}13 IrXI
Date "'' Signature of Contractor I -u1
OWNER -BUILDER DECLARATION
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
Sfon 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:
Censer OOLJM EAGLE INS,: Policy No. tiWC:-M*63-03
(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 of the Labor
Code; I shall forthwith comply with those provisions... r
Date: 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, indemnity
& 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.
r
}^
Signature (Owner/Agent) `+'' Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 0207-! !'o TRACT
U197-4
JOB SITE
APN
ADDRESS W_7741)1CCXeATWEfON 117,01 T
604-0-17-006
OWNER
CONTRACTOR / DESIGNER /ENGINEER
C1131RiCRYWCMMUN11qn
C'MiTRY(:.1R0WE,LLMIYN6(Y!S
1535 SO, 020
1535 30. TO ME #2.00
SAN k3F+.�NARD19G CA 92409
:i,rA4BR.RMAFiDi,1` O -17,A 92408
USE OF PERMIT
SFD-1.%i`t` ',�Y PLAN X. PERMIT DOES NOT INCLUDE BLOCK >r' .A LLS,
P001., SPA Oil DR.IVI? V.A.''IrAPPRO.IaCI-J. °1S°YiIBEDUCTit:itl TO PLA14 CHECK,
FEE MA MULTIi'UE ISSU.AMCF OF S. 04F PI..1! W. TYPE.
TRACT C 014a'I'FtCt'CTIO.N U00.00 OF
PORCHIPA.TIO 49.00 ,.fir
0AR.ACtEIC.`-AMIORT 425.00 n?
T.[mA}.'. D Cf7s C OF CO:I'iMUE"1.I;OR
3061Q.3 70
CO NST R,UCT1011 PEP, 1014M-418.00'4 W4.00
KAIN C HIZCK k'l+,l? 1()I -W0.439-318 $1;48.06
M'Ef: HANICAI., FE G 101-000-421-000 $60.04
ELECTRICAL left 101 -000 -4 -20 -NO $119.(110
PJAINIMMO FER 101-000-4.19-000 $130.00
STROT40 MOTICrO FFE - RESID 101-000-241-040 $10.66
a l40 F 101 -(*0-21.000# 814.00
DEVEI.,C)PBUt 1MPAC"I' FE.R ifii,99?.OLt
•4
9t7T',-'3��1"J�tac:Q.1 'ff1i3C'T1:t�?1R.l ).i?i +I r' ,CTC
S:3XK19.67
7,R50l�k:'
— TO' AL :PP:RMr 1111 N 1)UE NO
$3A49.6
Y;
RECEIPT °�` L +
DATE _ ;a
810, y` f
D INALE
INSPECTOR
M
; '? �' :►� % ��% a ''�
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
- Z
Underground Ducts
Forms & Footings
- -
Ducts
Slab Grade
. Z
Return Air
Steel
- Z
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
16 ,v- 2
Compressor
Insulation
6- _ z.
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
BLOCKWALL APPROVALS
POOLS _ SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
- Z
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
- (j
Encapsulation
Gas Piping
Gas Test
O Z
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 Dev
Utility Notice (Perm)
COMMENTS:
ti
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:
79-774 DECLARATION COURT
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: 13-3 Type of Construction: VN
Owner of Building: CENTURY CROWELL COMM.
__1__&"4_t
Building Official
Bldg. Permit, No.: 0202178
Land Use Zone: RL
Address: 1535 SO. "D" STREET #200
City: SAN BERNARDINO, CA 92408
By: STEVE TRAXEL
Date: 9-30-2002
POST IN A CONSPICUOUS PLACE
Ww"i"AAA,WAMW�Wtllfr/✓•t�1:M.AC..�wwrAiAwMR1 MN' "a'+!wNi;A'MTlre w�:o+s�.b1!aNMWJ'+'+'�rwi✓iINbYYM raeonlsvaRNI!IiWA"lKP•w'.n.vNA'7Civ%f:i^J�
INSULATION CERTIFIGM
z
This is to certify that Insulation has been installed in conformance with the current energy
regulation, C$Ilfomia.Administr ** Code, Title 24, State of Califomie, in the building located at: r
79.774 Declaration Court, Lot 27, M0ntleall0-N9TIta9e, La Qulnta, Call la
TYPE: BLOW MANUFACTURER: CERTAINTEED THICKNESS: R-W
WA
Pggn'g MANUFACTURER: CERTAINTEED THICKNESS: R-13
4
UENERAL CONTRACTOR: CENTURY CROWELL COMMUNITIES LICENSE #
R
BY: TITLE: 450-2-1Sg . -
PARAGON SCHMID BUILDING PRODUCTS, A.MASCO COMPANY LICENSES 682072
r
N
k
BY: TITLE: ADMINISTRATIVE ASSISTANT DATE: 12112!2002
iM/YM•'7Al�fllhA4C1R�M�Y/�'�N�+�R�
Installation Certificate: Residential CF -611
Site Address
79-774 Declaration Court
1. BUILDER.INFORMATION
Century Homes
1535South D St. #200.
San Bernardino, CA 92408
INSTALLING CONTRACTOR:
2. PROJECT INFORMATION
DISTRIBUTION
TYPE
Flexible Ductwork
in Attic -and
Between Floors
DUCT OR PIPING R -
VALUE
Flexible Ductwork
Will have a R Value
of 4.2 or Better
PERMIT #
SUBDIVISION: Heritage
CITY: La Quinta
COUNTY: Riverside
WEST PAC AIR CONDITIONING
I, the undersigned, verify that the equipment listed in the category above my signature is the actual equipment
installed and thatt he equipment meets or exceeds -the requirements of the Appliance Efficiency Standards. In
addition, Ihave verified that the equipment is equivalent to or.more efficient than the equipment specified on the
Certificate of Compliance submitted to demonstrate compliance with the Energy Efficiency Standards for
residential buildings.
3. HEATING INFORMATION
HEATING MANUFACT HEATING UNIT ACTUAL EFF. HEATING EQUIP HEATING
EQUIP. MAKE MODEL# AFUE CAPACITY LOAD
Furnace Lennox 80UHG4/5X-100 80% 100000
80
4. COOLING INFORMATION
COOLING MANUFACT COMPRESSOR ACTUAL EFF. COOLING EQUIP COOLING
EQUIP. MAKE MODEL # SEER CAPACITY LOAD
A/C Lennox 12ACB60 12
The building design.heat loss and.design heat gain rate have been determined using a method.specified in Section
150(h) of the Energy Efficiency Standards, and are two of the criteria used for equipment sizing and selection.
5. SUBMITTED BY
(9Y]A
Signature Installing HVAC Contractor
DATE: - -.L -
Jan 28 02 iis,37a . Rionard 9.impson
661 947-6888 p.4
WSW tis . hL, AV P A PJn iii` Qk'j7-Lt a rjg..kwi�Iz'" R'IC$
Dt L.PAMCE REVJCnON _
TPt mor+r•rrs.fe s cd Rcolht (CY0.41 P! T! TA)
1.142 How
If Fm Y !' *a+:Mt w rit!: efia x m moor of *m or as 11,7 .. i IQ Ani rtrpa*
- b e(tftmsA omor ostie2its�td vn;m i wv
isi %2 inow is nemteimuio, � = ---- .,� c•+--
.._. .... ate.. �T..rt...L.+wlY1�A��,eTlwlwel^.e�imlDiOli..NMiriltiy).••
1�11tlte(,1D't'tili.Mt -- •vow iw.-«..t,... �..
Paw irkoksme rowdom solob
)q 13
Pails hail
❑ R : ACRO!, TM— MMAIAMM ONLY -'tis Atlbwbq A{msmOagr isNag was emgdao& .
lluot Pm Praasauiration al 4scanmod � (CI+M)
CHWK ARI6R AIMMMING WAW
❑ YOM 0 1V0 0.1 ftexs m pla teat 4r i kw o p eowitmioa time
0 Yo ❑ No ❑ Viond wq odi m of iyad Co mmums f 1 r1
o PM Fail
OTW.FM(WTATIC Wl VWvve (MVI
Yt, Cl No 'f6aanlmtstio ILsptmtaes V" (or cam: chief upp w#sd
equiVeteoc) in ittdallod mod Aaom iw pawl W,hr isepo Ou 0
Yes is a pw !' V49
❑ MW DEMON
I. 13 Yes ❑ Me RCCA M and n rade osdeuladom laevo bean ,
Owl I)odp.b = So pleas and dual jeolkdw makfiew
pbmw.
2. O Yct+ ❑ No T'XV Is Wftl d or Vat Clow Im boas rveiifod, If 4o TXV.
vo>tidw he &VO mmohdx 4odp Svm CF -11L
Moasatod°Mea Itlativm
❑ ❑
Ym rw bulb 1 and 2 is a Pate Pon Fog
1. tlwt . v1+ do is about dio4t q4o ** roodim +sad *4 wa& I pmosu nd.aomwoMed va lite tad(w) in in
wad8altiimno 1MIl dw IbraatapitaAou orodie 1'Itut builder*A pmWde dw IUM pmvodar a w►py or the (,I,' -6R
wig W by &* buitdw ohvMywt or stab4oarradors otnlil h* dvdfdkvpwdmswduSmWlmAJWm arm duo A4viaauu ik for
oomprimtoc aedll.l
� a
Tcuta Dec how{Co. Nao�p
itrfi tamd tJo2cesl cmbwltw (co Naee)
Copy -rfk owmiav Impurumasd
IRM I%vidw (ireppBdtlo)
Building Ownvr at Occupoincy
3aatet ry 4, 2M