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0203-285 (SATT)Lj O =)M d r W � o Z r-- Zo 0 0 _J L) W W I— a U) Z M L0 N ON U °) Q Lo Q 0 X W L= mUU O CL M 1-t Z_ coD r0 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 0 76&-595 :B c a it, b 44 Date S`10-69. 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 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 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 TATEPIT14iD Policy No. 169361 �_fj (This section need not be completed if the permit valuation is for $100.00 or less). (>)�l 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 those provisions. Date: 05 µf* 0>1 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 Ibis t application. 1 1. Each person upon whose behalf this application is made & each personat „ 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 sugb 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 purpos S. ^ Signature (Owner/Agent) �!- ��=! Date '�� '`� " 1•'G: BUILDING PERMIT PERMIT# DATE VALUATION LOT 02,03-28S TRACT $,�I1i113 �3.2�U5 / 28+01 JOB SITE APN ADDRESS 47- 70 OMMU D.R WAY 649-030-M5 OWNER CONTRACTOR //DEIGNER/ENINEER yyRnJRtS, TTP DCC DEV., INC dba dC,RT C 08 aDEV . -74.760111GITWAAY 111 0,3200 -1 8-600101-M T I] 1 LVDIAXWP122 CA 32210 1:.,AQt�:t� A CA 92253 (760Y111-3345 Mft 21 so USE OF PERMIT SPA , Ia1. 00.79 UTik7' i'1, PLAN 18. P1P.,3CMIT'DOES NOT WCl,,t3M POOL. 2PA, i8L0C-X -WA1A,% 011 D12.Ttj'EVAY A.Pk'lWACH. 7W REDUC` I -01d IN PLAN CHECK Ff?E'LPOR MULTIPLF 13�j"UANCF.OFrxiiIMZ'E-LA14'E'YPLY ' SIAWD COST OF C0,11113 -48,010.00 VOMSTRUCTIM FEE 101a00041.8-00 > 1:14.3100 PLAN CNE10 ' 1T"t•� 119. 1101-0000-139-318 �V1�9. 4311 MEGi�I. IRIC'AIJ >s CeA 01-00-421-000u+C;iY O rLM- RICLAL PRE, 00 P.i.UMBINC IM19 101-000.4.19.000 U&SO a'eRONO Ia4d?TION ME �. RESl.D 101-000-241-000 $19 DWRLOPER I?ti PA,11,1 FFR, 1,St+l,©fl D--- --.� - 1-11"0•�1C.,614MMCUOITARD T)T: N4CF7,C.''1� $2,180,31 t+ US, 1' �1T5 rivi � $0,00 MAY . U 6 2001VTA_L PMWf YERS DUE POW CITYOFLAQUINTA ' FINANCEDEPT- RECEIPT DATE I DAT NALE INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings z9'' Ducts Slab Grade Return Air Steel Combustion Air Roof Deck 49. e z- Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation .. s p Y 57 Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath o L s — 7— z= 9' Final Final BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines r Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection 3 S 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 Final Utility Notice (Perm) i A!P COMMENTS: =C_ INSULATION CERTIFICATE IC -1 d-dr.;s Nrml: Numb2r - e 'S _7Civ:5: Description of Installation 1. ROO Thickness (ir.ch:cs)� 3 r -- T�::tee: Rcsis:?nee CEIL1tiG ( J Bat: o- E!an'cet Type �7. � E:s-d Name �1�Y\� t���.Yl ()L��S1 Thickncsa- (inc`he ' . s' �i>" T ^ -. lsistar.: (1 `-aluc) Loose FillTypc'k ,J,/\ Brand Contractor's r::i installed weigh:/it' _lb Mini _rt t:tiekness inches ,,lanufacturces installed weight per square foot to echieve Thc.—.nal Resist`: ce (R -Value) 3. EXTERIOR WAT L A. bl�ivs' 1,.Xa-US Material i66-�-sBrzrd Na -c �i � l�S Un yl 0__ Thickr:ess (inches) 6/— Thermal Resista^ce (R-Valuc) B. Exterior WC -&O Material RSC.. S Br2.r.d Name Thickness (inches) 17---2 Tr=a: R=sistaace RAISED FLOOR �.11eri'1 Thic': ncss (inch. -s) SLAB FLOOR.RFRIMETER IV/9t:.:isl Thickncss (inches) Perimeter Insulaticn Dcpt; (inches) FOUND,'•.TION NVALL LNtatc.ial Thickness (in.chcs) B, and N_: -r T i:= --fl r csistance (R-Valuc) T<ermnal Resistance (R -Value) Tce=a! Resistance (R -Value) Declaration I :._roy ccrify tha! t.:: 3� J�'C irsuhlicn xis ir:s:311:d in loca:icn in cor.fc,-na cc with t-hc ccrr.n! Enera; EjTciency for residcntia! bvilci^.gs ( i itic 2,, °a- 5, Ca'i: mi3 Cod. o,`R::g_laiens) as indica,--d on the Cc'i:i.ate e`Com�'i3�c , u a piic351e. It_- -s S;i¢r -._, De:. Ins'.11lir S;.bccntr actor (Co. Nan-,) 0 Ce ,:-al Con:-nctor (Co. Nine) OR 0wr.c: I:c.•n , _. e, D3:c Sia , D2:_ !-,:alling Subcontractor (Co. Namc) OR C. acral Ccr.trc:or (Co. Namc) OR Owner Irs:aili Sc`c0n=3ctor (Co. Narno) OR C _! Ccr. t,-3c:or (Co. \3:.,C) 0R O'A'nrr Standard Notice of Work Completed and Not Completed NOTICE - All reccommedations may not have been completed. See below- Recommemedations not completed.This form is prescribled by the Structural Pest Control Board, with whom a copy must be filed by license within 5 days after completion of work under contract. THIS IS A NOTICE OF COMPLETION ONLY, NOT AN INSPECTION REPORT ADDRESS OF BLDG STREET CITY: DATE OF COMPLETION PROPERTY 47-765 Gertrude Way La Quinta CA 92253 08/22/2002 INSPECTED: CO. CODE 233 FARMER TERMITE CONTROL AFFIX STAMP TO P.O. BOX 5155 BOARD COPY ONLY BELLFLOWER CA 90706 (888) 340 -BUGS (562) 920-7571 FIRM LICENSE NUMBER PR1401 COMPLETION STAMP NUMBER Notice of completion Sent To and date: Owner's Name and Address: Copies sent to : This is to certify that the folowing recommendations on the above designated property, as outlined in STANDARD INSPECTION REPORT NO none . date : 08/27./2007. REGISTRATION STAMP NO: none have been and/or have not been completed. Recommendations completed that are in accordance with Structural Pest Control Board's rules and Regulations: Recommendations completed that are considered secondary measures under section 1992 of Structural Pest Control Board's rules and Regulations: Cost: $ 70.00 Inspection fee : $ 0.00 Others : $ 0.00 Total: $ 70.00 Recommendations not completed by this firm Estimated Cost: $ Remarks A soil pre-treatment was performed on this property in accordance with Structural Pest Control Board regulations. Signature If you have questions regarding the work as outlined above,you should first contact the licensee noted above. Id satisfaction is not obtain you may contact the Structural Pest Control Board at Los Angeles - 213-620-2255 Sacramento - 916-920-5323 You are entitled to obtain copies of all reports and completion notices on this property filed with the Board during the preceding two years upon payment of a $2.00 search fee to: The Structural Pest Control Board, 1422 Howe Ave.,Ste. 3, Sacramento,Califomia 95825-3280. AT13:4220030313 Certificate of Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Bu#ding 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: 47-765 GERTRUDE WAY U-57 Use Classification: SINGLE FAMILY ATTACHED Bldg. Permit No.: 0203-285 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: CR Owner of Building: MIRAFLORES, LP Building Official Address: 74-760 HIGHWAY 111 #200 City: INDIAN WELLS, CA 92210 By: STEVE TRAXEL Date: 03-21-2003 POST IN A CONSPICUOUS PLACE