9812-158 (SFD)BUILDING PERMIT PERMIT #
LICENSED CONTRACTOR DECLARATION
DATE )2 VALUATION $7,51,071.40 LOT )7 TRACT
1 12si 1C;
I hereby affirm under penalty of perjury that I am licensed under provisions of
APN 761-500-103
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Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
OWNER
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Professionals Code, and my License is in full force and effect.
'RIELLY HOMES, INC.
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License # Lic, Class Exp. Date
NEWPORT BEACH Ck 92660
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719113 B M9160
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(9491719-4975 C:BL#3 5337
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Date Signature of Contractor
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OR POOL. PLAN CHECK FEF REDUCED 75%FOR MCII.'I'IPLE ISSUANCE OF
&MME• PLAN 'ME.
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OWN ER-BUILDER/DDE"CLARATION
C:(JSTO141 CONS'rR11C"r1OiV 2,81£3.00 SF
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I hereby affirm under penalty of perjury that I am exempt from the Contractor's
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License Law for the following reason:
EST[1d9ATED COST OF C:OlNST UCPd01N
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) I, as owner of the property, or my employees with wages as their sole
CONSTRUCTION FEE 101-000-415-000
compensation, will do the work, and the structure is not intended or offered for
PLAN CWECK1 *LZE 101-000-439-316
sale (Sec. 7044, Business & Professionals Code).
'V.LF=.K;IC:A1. FFA- 101-000-420-000 $171.87
( ) I, as owner of the property, am, exclusively contracting with licensed
PI, U*i%fB.ING FEF: 101-000-419-000 $187,75
contractors to construct the project (Sec. 7044, Business & Professionals
GRADING FEE 1£31-.000-473-100 $20,60
Code)..
fidF ASTRU(.'°'URE FEE 2.25-000-443-1-112 $5.:136.32
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() I am exempt under Section , B&P.C. for this reason
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ON
Date Signature of Owner
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SUB-TCYrAL CON S RUCTION AND PL.NN CHECK
$7,599.:30
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WORKER'S COMPENSATION DECLARATION
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I hereby affirm under penalty of perjury one, of the following declarations:
$7,599.30
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() 1 have and will maintain a certificate of consent to self -insure for workers'
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compensation, as provided for by Section 3700 of the Labor Code, for the
DATE
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ED
performance of the work for which this permit is issued.
INSPECTOR
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( ) I have and will maintain workers' compensation insurance, as required by
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Section 3700 of the Labor Code, for the performance of the work for which this
My insurance &
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permit is issued. workers' compensation carrier policy no..are:
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Carrier Policy No.
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GOLDEN .EIVIXE TNS. A;WC 476055-01
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(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 -prov sions of Section 3700 of the Labor
3
Code, I shall forthwith comply with'those provisions.
Date: Applicantt -,e _
Warning: Failure to secure�Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
1
application.
1. Each person upon whose behalf this application is made & each person at.
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
•
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for. inspection purposes.
Signature (Owner/Agent$!'' Date ,^�3
BUILDING PERMIT PERMIT #
DATE )2 VALUATION $7,51,071.40 LOT )7 TRACT
1 12si 1C;
JOB SITE
IfADDRESS 91,040 GOLF VWDRIVV
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APN 761-500-103
OWNER
CONTRACTOR / DESIGNER / ENGINEER
R19ELLY HOMES, INC.
'RIELLY HOMES, INC.
23 CORPOiRATE PLAZA, ##245
23 CORPORATE PLAZA, 9245
NEWPORT BEACH Ck 92660
NEWPORT BEACH. CA 92.660
(9491719-4975 C:BL#3 5337
USE OF PERMIT
SINCILE .FN.AMILY DWELLING
LoT V, iRLAN MR. SF - PERMIT DOES NOT iNCLUIX BLOCK. WALLS
OR POOL. PLAN CHECK FEF REDUCED 75%FOR MCII.'I'IPLE ISSUANCE OF
&MME• PLAN 'ME.
C:(JSTO141 CONS'rR11C"r1OiV 2,81£3.00 SF
PORCHNJAT10 1,280.00 SF
GARAGE/CARPORT 787.00 S.F
EST[1d9ATED COST OF C:OlNST UCPd01N
251,971,40
t ERNfYT'rt+EE gfI1iTR4ARY
CONSTRUCTION FEE 101-000-415-000
PLAN CWECK1 *LZE 101-000-439-316
WCHKKICrAL FEE i0.1-000421-000 5117.50
'V.LF=.K;IC:A1. FFA- 101-000-420-000 $171.87
PI, U*i%fB.ING FEF: 101-000-419-000 $187,75
STRONG MOTION FFli - ib!'s.'SM 109-0+70-241-000 $25.20
GRADING FEE 1£31-.000-473-100 $20,60
fidF ASTRU(.'°'URE FEE 2.25-000-443-1-112 $5.:136.32
.
fl:.7"IN PUBLIC Pt ACES RES11; 701-000-255;000 $379.93
SUB-TCYrAL CON S RUCTION AND PL.NN CHECK
$7,599.:30
L1�SS PIKE -PAID LES
80100
DEC 2 4 1998 TOTA1L, PERMIT FEES( DUE NOW,
$7,599.30
'
{RECEIPT
DATE
Eh ' ! c
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings / 9
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
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
BLOCKWALL APPROV LS
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
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
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 41
Utility Notice (Perm)
COMMENTS:
Certificate of Occupancy
City of La Quinta
Building 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:
81-040 GOLF VIEW DRIVE
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction
Owner of Building: RIELLY HOMES, INC
Building Official
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Bldg. Permit No.: 9812-158
Land Use Zone: RL
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: DANIEL P. CRAWFORD JR.
Date: 12/22/99
POST IN A CONSPICUOUS PLACE