9806-026 (SFD)C0
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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Ghapter9 (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
691684 B A % 7/31/98
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 thework, 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. 704,4, Business & Professionals
Code).
() I am exempt under Section , B&RC. for -this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
>4 1 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 Policy No.
STATE FUTdD
(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 Sect' n 3700 of the Labor
Code, 1 all orthw' h comply with ose provisi
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, 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 autho ize representatives of this City to enter upon
the above-mentioned property f 'inspectiopur se
Signature (Owner/Agent) • Date _i '
BUILDING PERMIT PERMIT 9806402°DNTR°`"
Ci
DATE VALUATIONSIOl,S95.34) LOT 3Q TRACT 2135
JOB SITE
ADDRESS '45-,37:1 IDEERBRWK CI RCL.E
APN 604.3"001
OWNER
CONTRACTOR/DESIGNER/ENGINEER
INCO HOME,S CORP.
INCO HOMES CORP.
1282 W. ARROW HWY
1-282 W. ARROW HW Y
UPLAND CA 91785
UPLAND CA. 91785
CBI-# 3318
USE OF PERMIT
S' D
LLT A0, PH 2C, PLAN..313. 8FD - Pli'RMff i s0ES NOT 1%Ni7,!_LrDP BLOCK
W AILS OR POOL. PLAN CfiECK PORTTON OF FEES RE2UCiED 75%, FOR. t,
MULTIPLE I[SSUPUNC:E OF SAME PLAN TYPE. � d` -1 -TD
AUG 16� L91��
TRACT CONSTRUC PION 1,694.110 SF
PORCWPAT I0 97.1x1 SF ,�
t
GARAG i�CAR.TIORT 419.00 SF • f f �
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� � j' F ; ^� �^ t � 5 `d
ESTIMATED COST OF CONStRUCI'ION
w1,59 s-31)
PERMIT FEE SUMAiARY
CON5'1RUC'TION FEE 101-000-418-000 9k►1G.*�
PLAN CHECK FEE 101-000-439-318 $136.23
MFCRAMC-AL FU 101-0013-121-000 W.59
hi-EC"IRICAL FEE 101-0w-4120-000 $1.16.24
PLUMBING FEE 101-000-414-000 $148.00
STR(: NO MOTION IEE - RESLD 101-000-241-M 110.16
GRADING FEE 101-000413-000 $W.00
RNWf AS'TRUC-D:IRE flii 225-000-443-34? B�,236.fr
ART IN PUBLIC PLACES - 61;.'x11, '701 -000-255-M)
SUB -TC TAT CONS1'RUC-710N AND PLAN CHEC J<:.
�i1., It).l..it•1
LESS PILE -PAID FEES
`Ai,`mo
TOTAL PERMIT FEES DUE NOMI
S:3,408.4o
ECEIPT
DATEBY
DATE FINALED
INSPECTOR
INSF'PECTiC�N RECOO RDD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BULDENG APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade Q — —
Return Air
Steel A
Combustion Air
Roof Deck . 5- — r
Exhaust Fans
O.K: to Wrap _ Z ^
F.A.U.
Framing $'— 4
Compressor
Insulation (5 o
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath / -2T-
Drywall - Int. Lath —Z3 —`[ Y
Final
Final
BLOCKWALL APPROVALS
POOLS o SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBHG 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
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
C LECT=ALS APPROVALS
Temp. Power Pole
Underground Conduft
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
r
final .
Utility Notice (Perm) �, _
COMMENTS:
JAN -14-99 THU 16:53 WESTERN INSULATION FAX NO. 9096868786
WESTERN INSULATION, INC.
4211 Latham Street, Riverside, California 92301
(909) 6864760
(909) 686-6786 Fox
INSULATION CERTIFICATE
P. 04
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:
LOT#:
SITE ADDRESS:
EXTERIOR WALLS:
DESERT PRIDE TRACT #:2:5.995-2C
30
45-375 DEERBROOK CIRCLE, LA QUINTA, CA
MANUFACTURER: JOHNS -MANVILLE
CEILINGS : BATTS
MANUFACTURER: GREENSTONE IND.
GENERAL CONTRACTOR:
LICENSE NUMBER:
BY:
TITLE:
DATE:
TH .J 3 5/8" R -VALUE: R-1.3
BLOW
THICKNESS: 8.1" R -VALUE: R-30
------------------------------------------
INCO HOMES
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: Production Ma ger
DATE: JANUARY 14,1999
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