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0203-244 (SATT)Fa LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that f 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. Licenser# LLic. Class ��.�qq Exp. Date o VJ Date 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). r ( ) 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 -1 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 gTK.L11?UIYE� Policy No. 1603616-02 (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, 1'shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if] should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with hose provision"s. Date:" Applicant— Warning: pplicant Warning: Failure to secure Workers Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building a iddSafety for a permit subject to the conditions and restrictions set forth on. his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a iesult of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such i permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City,^apd State laws relating to the building - construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. ' n ; Nr, Signature (Owner/Agent) 1%' I'�F �_��'"` r�+�•• Date •, i BUILDING PERMIT PERMITN DATE VALUATION LOT '3''244 TRACT •�C�©' B9, V9� ] I9.4O5.hI i JOB SITE APN ADDRESS 47-9X5 Oz.s UDF. WAY fA9-03r&045 OWNER S CONTRACTOR / DESIGNER / EN (NEER Art t.A l ai'�11"�"1, LP DCO DEV,, WIC dba 1.:�1'�`ci.iw`RT CIT1 8 DEV. 74.767 HURWAY 11102%) 78.6500IMUTTWAY I I rP1'1��`'�.ilU'I*' X C.A. 92210 1:AQU31.t+1TA CA 92243 C"K50), 771.3345 cml* ?I so USE OF PERMIT - 8Q.-TOL,P, FAM:CLY .ATI"AOHM SEA • .ea1,#aW), UNIT 1.7, PLAN 18, PFSRMIT WIM NOT INC'L,UDE POOL, SPA, BLOCK WALLS, OR DRWIWAY APPROACH, ' SIA REIDU ION 1W Pi..f N CHECK FEE FOR MULTIPLE 10.0913.44,11CP OF SAME PLAN T'A'PE. TRACT T C$?WSTRUCTION W0.00 BY COASTRUCTION FEE 101-000-418-000 $343,00 PIAN CHECK 'EPA 10"A-000-439-318 $79 1.111 MECHANICAL I+Erw 101-000-47,1-000 $3$.50 ELECTRICAL FEE 101 -WOK 420.000 $56.80 , PLUMBING KE 141.000-419.000 S81�.50 STRO1401E OT1GY03 FEE , %tKSID 101-000-W-000 $3.30 LRA♦ 9LOPER,1MP,AC':T FEE S1,569m n - S1'.FB., TAL �TT 0M AW) PLAN CITICK 52,180.:11 {� �J LESS PrMl-rA3D Y1r',!BS $0.00 (VIA, Y 0 3 1002 ` u -L P113mv nx-s VtTE Now MYOFLAQU1NTA FlNANCEDEPT. M tx , RECEIPT DATE ter's !'rs BY 1hi DATE FINALER1 FINALE INSPECTOR aSje INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs--� OZ' Underground Ducts Forms & Footings Ducts Slab Grade — Return Air Steel -0,2 Combustion Air Roof Deck , 0 2 Exhaust Fans O.K. to Wrap ®- !?• % F.A.U. FramingO ' Compressor Insulation o • 1. p Z $% Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath — p Z 57 Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS _ Waste Lines -l�p-- Water Piping Gas Test Electric Final Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection ��;� . p� Encapsulation Gas Piping Gas Test , I,Z •0 2_- 57 Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit .Rough Wiring ' Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) A . 2/ �✓ % COMMENTS: INSULATION CERTIFICATE IC -1 �i:r A�ar_Ss Descriptiott of Installation 1. ROOF Thick css (ir.c .cs) \J' Per ni: Numbzr T*1-: ,Z: RCSiS:dace (� Va!u:) 3g Z. CEILING11 rr Ba'.: o- Elan';et Ty pr�ya—(-5 E;s-d Namc �;L>1� MC Xl ()t-« 0 Thic ncss(inc'-s` l3" Ti:e: a' ^sis:ance (R 'aluc) Loosc Fill Typc ga )tN Brand Contractor's mi- installed weighyft, �C lb t:nickness lL�inches Manufacturces im-stalled weight per square foot to aclli vc T-c7.Resistance (R -Valve) 3. EXTERIOR WALL A. Material Br2id Na -c Thick.r:ess (inches) — Thermal Resistance (R -Value) B . Exterior t,tJCt.. O Material y S 3t2r.d NL -,—c Thickness (inc' t!s) 3' TI:e.^^.,ai Resistance (R-V3ILe) - 12 RAISED FLOOR Thic'.cricss (inches) SLAFj FLOOIL'?ERi`SETER ?�atcrisl Thickric5s (inches) Perin-.cter Insulaticn Depth (inches) FOUNDATION ViALL M.atc.ial Thickncss (ir.chcs) B, and N a Rcsistar.c (R-Val.rc) B, -and, Name T,'cr al Resistance (R -Value) B. -area Na-::,, '' 'a IRVMu'c) Declaration I acre-Iy eer'ir' that t::_ 3.',ovc insulation \til$ _. ,.._ 3`;J'._ !oca:icn in, ecnfC-m1a ncc w:th the currcn! Ererg: E-iere� S:or':�.� for r-_sidential buildi-eyes (Title 2< Fa 5, Ca!i:onii CO�c o` R:gaLaens) ss indica!-,d on the c�Cor-:;.ia::c L Ds:c Ins!a:l: JZL�-Cntanor (CZ). Namc) OR Cc,-.:. al Cor::-azor (Co. Vine) OR Ownc: �1 ta: rc, Da:c S:, n .:r-. , Dat_ l-s:allir.g SL! •-miactor (Co. Namc) OR Cc: era! Cc, tractor (Co. ; amc) OR Owner Irs:aili-� Sc`co=actor (Co. Namo) OR C. 2! Ccr.t:+..,,;(Co. N,amc) OR Ou.n:r A-36 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 47-925 Gertrude Way La Quinta CA 92253 08/05/2002 INSPECTED: CO.CODE 33 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 I COMPLETION STAMP NUMBER Notice of completion Sent To and date : 03/13/2003 Owners 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 date : / / REGISTRATION STAMP NO: 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: Recommendations not completed by this firm Cost : $ 70.00 Inspection fee : $ 0.00 Others : $ 0.00 Total: $ 70.00 Estimated Cost: $ Remarks • • n • •w • •n thig nronerty inarrordancePest Control:•. • •n 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. AT21:0420030313 , have Certificate of Occupancy City of La Quinta BuBding'and Safety Department 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: 47-925 GERTRUDE WAY U-17 Use Classification: SINGLE FAMILY ATTACHED Bldg. Permit No.: 0203-244 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