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9902-057 (SFD)U F_ 04 LL1 W o Z .r- 'D�o I., co _J0 F- .a . U) Z. J 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 7431867 13 Date rry �" Signature of Contractor OWNER -BUILDER D I hereby affirm under penalty of perjury that,l'am exempt from the Contractor's License Law for the following reason: !/ ( ) I, as owner of the property, or�rny 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 Ihereby 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 Policy No. . STATi::F'17N� i X9393-9II (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 l should become subject to the workers' compensation provisions of Section }3700 of the Lalb& Code, I shall forthwith comply with those provisions. ,r Dater rte/ r> Applicant •�� / Warning: Failure to secure Workers'ompensation overage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,00.0, 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 upon the above-mentioned property for inspection ppurpoosses...,, Signature (Owner/Agent) �.••- `---"+'��r Date BUILDING PERMIT PERMIT# DATE VALUATION LOT 9902-4057 TRACT 1 . (� W� $79,69 -% 39 8019 JOB SITE APN �1 ADDRESS 78-325OFSERT WAY W� Rf 769-79%-413'7 OWNER CONTRACTOR/DESIGNER/ENGINEER 1I1l1 DAN D, LLC WORLD DE'vTLC)PMENT, INC 78-129 CA 1,,E ESTADO, #1104 PO BOX 132R_7 LA QU.KrA CA 922-53 PALM DESERT CA 92253 (760)771-5571 CBLN 5028 USE OF PERMIT RIMIM11.l tiAMYI 1t rR ..i twrl, L0 T39, 'PI.,N MR. 80) - PERMT DOES t�T WCLIJDF, 8LOC1C WALL O P©01— PLAN C1.W K..FFE RE ICED 750 o .FOR. AIIJLTIPLE ISSUANCE GST' S AMIE PLAN TYPE IAACC C014S'1`RUCTION 1,2;3'7.063 Si • PORCHr'PA'J`IO 66.06 SF GA1! AGiV0kRPORT =656.00 5F3' J.+STIAIA l:..V l..03T OF ly\Jl'In7,CRU Mt. ON �agp✓`�«31� PERMIT it+`EE SMIMA,RY CONSTk1JC:TICIN FW 101.000 -418 -OW $549.50 PLAN 04FLCK FE 101-000-439-318 $115.92 MCHAMMC,AL V,`RE 101-000421-{lw $41.03 EI.f L"'.Ti ICAL'!:EE .101-000-420-000 1102.67 PLUIVIBI G FFA, 101-000.4119-0t)0 S 133. if1 STRONGFEE - RES 11) 101-000-241-04Q $7,97 Ci"1ADVITO M 101=000-423-000 $20.00 TN RASIRUCTUR1eFVE 215-0ff0-443-34? $1,1773:49 SUB -"1 MAL CONSTiZ{J(MON AND PLAN CHECK $2,750.05 LESS ?1U'-PAJ D MES '1,00 TOTAL Ply Ft1M FEE S DIN NOW r tc P'� ATE BY f ' (, DATE FINALED INSPECTOR U ` l" il;, INSPECTION RECORD j OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing 4. - g _ T 7 Compressor Insulation A/ - Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath 4- Drywall - Int. Lath 4 - 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 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 Pool Cover Sewer Connection Encapsulation Gas Piping t 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: .} . -. ., +4 a APR -30-99 FRI 07:21 WESTERN INSULATION FAX NO. 9096868786 WES'T'ERN INSULATION, INC 4211 Latbam Street, Rivarride, California 9x501, 19091686-8760 (909) 686-8786 F= pMI1iF.% I I! x "Afl 1. _ P. 05 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: THE SEASONS VILLAS TRACT #:28019 LOT#: SITE ADDRESS: C78-325-DESFR_T FALL.WA�Y, LA QUINTA, CA ------------------------------------ '=------_---------------------- EXTERIOR WALLS: MANUFACTURER: JOHNS -MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13 CEILINGS : BATTS (25 MANUFACTURER: GREENSTONE IND. THICKNESS: 10.3" R -VALUE: R-38 Where inaccessible for Blown Insulation: BATTS BLOW MANUFACTURER: JOHNS -MANVILLE THICKNESS: 13" R -VALUE: R-33 GENERAL CONTRACTOR: 'LICENSE NUMBER: BY: TITLE: DATE: WORLD DEVELOPMENT, INC. I_NSIJLATION CONTRACTOR: WESTERN INSULATION, INC. LICENSE NUMBER: 481278 BY: TITLE: Production Manaor, DATE: APRIL 30, 1999