9806-028 (SFD)LICENSED CONTRACTOR DECLARATION n
I hereby affirm under penalty of perjury that I am licensed under provisions of
H 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.
CLicense # Lic. Class; Exp. Date
,)
ti W LO
r 6108 B ,1f 8
Z 1 Dat - Signature of Contractor
o
Cc 0''
r- U OCID
WNER-BUILDER DECLARATION
HLLJ ~ I hereby affirm under penalty of perjury that I am exempt from the Contractor's
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).
COI am exempt under Section B&P.C. for this reason
N Date Signature of Owner
O�
0- Q WORKER'S COMPENSATION DECLARATION
p X I hereby affirm under penalty of perjury one of the following declarations:
Lo H O�j�' 1 have and will maintain a certificate of consent to self -insure for workers'
X W c6mpensation, as provided for by Section 3700 of the Labor Code, for the
• O I Qperformance of the work for which this permit is issued.
to Q O ( ) I have and will maintain workers' compensation insurance, as required by
p U Q Section 3700 of the Labor Code, for the performance of the work for which this
d rn I_ permit is issued. My workers' compensation insurance carrier & policy no. are:
It Z Carver Policy No.
cb5
Cy g
(This section eed n'of be completed if the permit valuation iLTNDs Tor $l�0.00 or less).
( ) I certify that in the. performance of the work for which this permit is issued,
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, I shall forthwith comply with lose provisions. 1
Date: Applicant ,(�
L
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.
certify that l 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 props or inspec�ti n p rposes.
Signature (Owner/Agent) ' Date
BUILDINGPERMIT PERMIT# CONTROLM
DATE VALUATION LOT .9006-028 TRACT 474 O I
5.120.647.00 31 ?SSJ
JOB SITE
APN
ADDRESS
45-395 D)E I ;➢tBROOK. CIRCLE
604-304-002
OWNER
CONTRACTOR / DESIGNER / ENGINEER
[NLD H01VIES CORP.
INCO HOMES CORP.
1_82 W. ARROW HWY
l 282 W. ARROW C- WY
UPLAND CA 91785
UPLAND CA 91735
CBL# 3318
a
USE OF PERMIT
+1
` •i
LCAT 31. FSH 2C . PLAN 4AR3. SFD - PM- 11T DOES NOT INCLUDE F;
TtirsrT CON. TR(7CTIQN 2.008.-W SF
-
POIR(ftif yAT 0 14.00 SF
0ARAGVCiVkP0RT 33100.14F ::,;°�!�
y.,
ESTIMATED COAT OF CONNT RIA'710N,,
'1211,647.411
PFRI%IIT FEE SUMMARY
CONST RUCCION.F!2 10144-118-000 $713.00
PLAN CHECK FEE 101-000439-318 $591.16
-
MECHA`VICAL FEE 101-000-421-000 S471X)
WXC-IRICAL FEE 10.1-000-42Q-000 $130.44
PLUMBING FFX- 101-000-419-000 S148.00
STRONG MOTION FEE - RESID 101-000-241-000 $12.06
GRADING FEE 1171-000423-000
(NFRASTRIJt.: PURE FEE 215440-443-342 S_.7It).m
ART IN PUBLIC PLACES - RESIF3 701-000-255-0170 $31.62
SUB-1)gT_AL CON.) fRUC't' ON'AND PLAN CRLC1s
$4,421(i6
LESS PRE; PAID VVIS
$0.0()
TOTAL. PERMIT FE VS DUE NOW
34,423.66
RECEIPT
DATE
By
DATE FINALED
INSPECTOR
i� SPECTION RErOO �D
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BULLDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
0 24tUnderground
Ducts
Forms 8 Footings
_
Ducts
Slab Grade
Return Air
Steel
A
Combustion Air
Roof Deckj
-.
Exhaust Fans
0. K. to Wrap
Framing
//-13
—
F.A.U.
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
l -z5 -�
Drywall - Int. Lath
Final
Final
BLLOCKWALL AP( Rov S
POOfLS - SPAS
Steel
Set Backs
Electric. Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
IPLLUMfflNG 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
m _ or
Encapsulation
Gas Piping
Gas Test
Z o 6
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. Uce of Power
Una9�'"/
Utility Notice (Perm)
COMMENTS:
November S, 1998
City of La Quinta
Mark Herald/Steve Traael,
RE: Lot ;tl, Inco Homes
Desert Pride
SuperIntendent: Don
I am writing to sammarize'the occupancy issues and the exceptions to standard
policy we need and how it will be handled in order to meet your guidelines.
1. We would like to occupy the home without the standard flooring. We have a
contract to do tile and carpet throughout the home with l'alm Desert Carpet.
I have discussed with Don about placing the black stripsheeting in the
areas requiring tile. Don has a diagram. The reason we need this exception
is because the builder will not allow anyone in the home until after
occupancy and we do not want to pay the builder"ii design center over $2X[ extra
for the same thing we can get at Palm Desert Carpet. In addition, black
stripsheeting will be placed,around the -fireplace because the -fireplace will
also have matching tile.around it..
2. The other issue is occupancy without the standard four foot trellice and concrete
at the back of the. house. Because of insurance issues, ire will be having the
D (� pool put in after occupancy. Be want the pool a)ntractor to put in concrete
along the entire back of the home as well as an alumawood solid patio cover
along the back of the home. This cover will extend a nb,-f— m of four feet
W( V� from the back of the house. This exception was already j;ranted
by Stan'in-
your Community Development department. Be, as well as Dca, has a diagram of
what we're planning to do.
If you need contracts, diagrams, or any further information: please do not
hesitate to contact me at
L� Bruner/Kelly Bruner
,Ai --08-99 FRI 16;41 WESTERN INSULATION FAX NO. 9096868786
WESTERN INSULATION, INC.
4311 Latham Street, Riverside, CaRfonda 93501
(909) 686-8760
(909) 686-87" Flex
INSULATION CERTIFICATE
P. 03
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: DESERT PRIDE TRACT #:23995
LOT#: 31 Id /_ /9 A/ /_/
SITE ADDRESS: 45-395 DEERBROOK CIRCLE, LA QUINTA , CA
-------------------------------------------------------------------
EXTERIOR WALLS:
MANUFACTURER: JOHNS -MANVILLE THICKNESS: 3 5/8" R -VALUE: R-13
CEILINGS : BATTS 3LOW)
MANUFACTURER: GREENSTONE IND. THICKNESS: 8.1 R -VALUE: R-30
GENERAL CONTRACTOR:
LICENSE NUMBER:
:BY:
TITLE:
DATE:
INCO HOMES CORP.
INSULATION CONTRACTOR: WESTERN INSULATION., INC.
LICENSE NUMBER: 481278
BY:
TITLE: Production Mangier
DATE: JANUARY 8,1999