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0006-061 (SFD)N4IlJ •. �p c'7 d� ' W `- r` oZr coo i. _J t ~LUa to Z o) LO N ON U_ °) Z Lo 0 0 J.J mQU U O Il rn F ,qT Z_ co 5 �0 Q 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 �? 418 u 1W l.2( Date -,�� Signature of Contras oea-� 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 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 () 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 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 CS©1, DEN l:AOL'1s1NS. Policy No. WC150062-02 (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 tie wo kers' compensation provisions. �Secti n 3700 of the Labor Code��s alto comply with'f x e provisions. 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 authorize representatives of this City to enter upon the above-mentioned property for iDo ec ltlt o purpose � Signature (Owner/Agent) Date r t ' PERMIT PERMIT# . �/�� ��•BUILDING DATE I VALUATION LOT (3006-061 TRACT 660 (�(6 6' s111r' .90 44 23773-5 JOB SITE APN ADDRESS 7&.eS5 C7'A1<. ,XY Di", -026 8-026 OWNER CONTRACTOR/DESIGNER/EN (NEER CENTURY CKOWELL COWvi1INiT,EE3 CENTURY CROWS COMMUNITIES 1535,10, "13" tWREFT, IDTF_ #200 1533 Do. 117 OURFET; ;E, 4200 SAN RLUMARDINO CA. 92408 SAN BEWRRDWO CA 92409 (909)381-600, CB110 2.20 , . USE OF PERMIT WNGLE EAMMY 33WFLL2 0 Sill• 'PLAN 3 SR LOT 44• PERMIT DOWS NOT INCLUDE BL.00:KIYALLS OR POOL 75%PLAN CHl3 K iTZ REDUCTION FOR MULTIPLE IN, UANCE OF , SAME PW4 TYPE. TRACT CONS T RUCT1014 2,410.00 3F POR.CI- tPATIO 29.00 3p CkARAWCARPO T (3i) 011173.20 COST OF CC)Ttln".tT=iWY170M 141,593.90 PEAWf M SURN1AP-Y CONSTRUCTION I + + 101-000-418-000 E'1nb.S0 PLAN CHECK FEE 101-000.439-318 $161.80 ME'CHAMCAL FFP, 101-000--121.000 m.00 ELICT)•3,1CAL FZR, 101,000-420-000 $127.59 PLUM131NO FEE 101 -000-419,000 $134.7 S RO140 MOTION F'.EE -111.0 101-000-2A) -000 ORADINO ME 101.900.423.000 $20.00 10L+`VEI DPER. IMPACP FEE $1,997.00 3-M TOTAL C'ON:1iRUCTION 13ND PLAN C MCX $3,728.8U _ LESS PRF, -PAID F� $0.00 t.*f, ,-rry} ra� + ki v•d '-TOTAL '-•O;C'AL 3,')MMIE P IMS D[3.i NOW 4� _•yr.t,..a��• RECEIPT DATE BYIr/��) DATE FINALED INSPECTOR , INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs / Underground Ducts Forms 8 Footings Ducts Slab Grade % .– Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap Framing F.A.U. Compressor Insulation / j G – Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final _ Final i _ BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground P[bg. Test Final I 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 Sewer Connection / Pool Cover Encapsulation Gas Piping 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 C� Final Utility Notice (Perm) C 0_ COMMENTS: WESTERN INSULATION, INC. 4211 Latham Street, Riverside, California 92501 Tel. (909) 686-8760 Fax (909) 686-8786 INSULATION CERTIFICATE 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: STARLIGHT DUNES 23773-5 LOT # 44 SITE ADDRESS: 78-885 GALAXY DRIVE LA QUINTA, CA ------------------------------------------------------------------ EXTERIOR WALLS: MANUFACTURER: CEILINGS: MANUFACTURER: CEILINGS: JOHNS MANV LE ATT GREENSTONE BATTS MANUFACTURER: IJOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13 BLOW THICKNESS: 10.3 R- VALUE: R-38 PESS- THIO 13" R- VALUE: R-38 GENERAL CONTRACTOR: CENTURY HOMES BY: TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, INC. LICENSE NUT;: 1278 BY: io� TITLE: PRODUCTION ANAGER DATE