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0101-142 (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. Class Exp. Date IDS C11}2( Date f~+ Signature of, Contractor J d OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for,.the following reason: ( ) 1, 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 Constructthe project (Sec. 7044,1 Business & Professionals Code). ,. • O I am exempt under Sectiom B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION F 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 Policy No. STATE FMS (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 t5ose pr6is' ns. �!e Date: Applicant- Warning: pplicant Warning. Failure to secure Workers' Compertsation 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_ t 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 purpose Si nature (Owner/A ent)�•( /� `P'"t~ t lY• tI Date BUILDING PERMIT PERMTN DATE % VALUATION a LOTS ��.';-� TRACT J013 SIfe i APN ADDRESS .T _. f��t fj w i`i'�3td ,F ot,1'?'' OWNER CONTRACTOR/DESIGNER/ENGINEER LA Q2.WIXNULAB LIX oRt."W ,Y JJ:D WILOP1A.1 it INC" 293.5* A0011RA RQA;D #204 2938, > A00URA ROAD IW4 AWGRA.MLUS 016, 91 101 A0017R 3'•fM2' S CA, 91301 (8)o: INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings ��- Slab Grade Steel Roof Deck O.K. to Wrap Framing Insulation �,Z- _ _ _ 2 / fj/ f� 3 !S6( 'fi�p/ ✓ltd �S�p/ Sr- Underground Ducts Ducts Return Air Combustion Air Exhaust Fans F.A.U. Compressor Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wail Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. L�a h _ (p� A _ Final �D�I�f� _ BLOCKWALL APPROS Final 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 _ Waste Lines _ Water Piping Gas Test Electric Final Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral newer 1 onnection vacs Piping Gas Test 3�T7�t�l Pool Cover Encapsulation Appliances Final COMMENTS: >4A& / 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 (Penn) X3/6/ WESTERN INSULATION, L.P.' 4211 Latham Street, Riverside, California 92501 Tel. (909) 686-8760 Fax (909) 686-8786 INSULATION CERTIFICATE THIS IS TO CERTIFY THAT INSULATION HAS BEENINSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: TRACT / PHASE: THE LAURELS @ PGA WEST/MODELS LOT # 16 SITE ADDRESS: - 54871 WINGED FOOT. LA QUINTA, CA ---------------------------------------------------------------- EXTERIOR WALLS @ 2X6 FRAMING:. t MANUFACTURER: JOHNS MANVILLE' THICKNESS: 6 3'4 " "R -VALUE: ;R-19 EXTERIOR WALLS @ 2X4 FRAMING: MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 R -VALUE: R*13 CEILINGS: BATTS BLOW:' MANUFACTURER: GREENSTONE THICKNESS: 8.". R -VALUE: R-30 CEILINGS:c:BATTS BLOW MANUFACTURER: JOHNS MANVILLE THICKNESS: 11 R -VALUE: R-30 - GENERAL CONTRACTOR: GREENEWAY DEVELOPMENT, INC. BY: TITLE:. V -DATE: INSULATION CONTRACTOR: WESTERN INSULATION. L.P. LICENSE NUMBER: 794484 BY; TITLE: P CTION MANAGER DATE J LY 11, 2001 T i• ri' ,:n• LOT CITY .10FIA QUINTA Y , B ILDiNG &".SAFETY DEPARTMENT. .777-7012 YOTION REQUEST LINE" 777-7153 Of Y-ffi]FAS LLC W_ 0 . r Contractor EVELOPMEN.T INC Permit 01.01442 06N'4DS lN-.-,.P0NSFl!W0US PLACE I NSPECTOR'ML ST,,$,I,G N ALL .-APPLICABLE SPACES 1 WINGED FOOT - 5587 JOB ADDRESS SFD-PLAN 2G -A R 1 16 PERMIT DOES NOT INCLUDE B40C"ALUIOQAPPROACH IJDRIVEWAY 'tip kpF T10N DATE IF: FOUNDATION A;SETQACK,.,. /7 FOOTING;$TEEL MAIN GROUND Sygr M; GROUND PLUMBING, 1 PRE-GUNITE: ELECTRICAL GRQUNI I:WQRK-7. DO NOT POUR CON. ALL ABOVE HAS BEEN SIGNED. ROUGH ELECTRIC. ROUGH PLUMBING ROUGH4.GA S AS TE 3 HEATING &VEML--;VC E FIREPLAZ ROOF 0/ BOND BEAM U.N. lu'-WmAt' GROUT'. 0 4!: .0 8, FRAMING -1 N—S U LATION' PRE -ROOF COVER NO. -WOR UNTIL ABOVE.HAS BEEN SIGNED . DRYWALL INTERIOR -7 EXTER10fI:LATH* POOL PRE PLASTER FE A GATE A �MR:SEPTI.0 TANK.. • F FINALS ELECTRICAL: Aumsm FINAL GAS TEST HEATING A/C HOUSE NUMBERS' JOB COMPLETED Q TEMP POWE... & ABOVE 1�?V" RCLIKI RIGH- L WIGH- TO RN ON (TIES ORP CA(�UPY BUILDING J —7— _ 1 t , Certificate- of Opp q-� City of. La Qu'in ta Building and Safety Department OFti� 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:. 54-871 WINGED FOOT Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0101-142 Occupancy Group: R-3 Type of. Construction: VN Land Use Zone: RL Owner of Building: LA QUINTA VILLAS LLC Address: 29395 AGOURA ROAD #204.' City: AGOURA HILLS, CA 91301 By: DANIEL P. CRAWFORD JR. Date: 10/24/02 Building Official „ POST IN A CONSPICUOUS PLACE p / l 1 t , Certificate- of Opp q-� City of. La Qu'in ta Building and Safety Department OFti� 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:. 54-871 WINGED FOOT Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0101-142 Occupancy Group: R-3 Type of. Construction: VN Land Use Zone: RL Owner of Building: LA QUINTA VILLAS LLC Address: 29395 AGOURA ROAD #204.' City: AGOURA HILLS, CA 91301 By: DANIEL P. CRAWFORD JR. Date: 10/24/02 Building Official „ POST IN A CONSPICUOUS PLACE