9906-237 (SFD)�} LICENSED CONTRACTOR DECLARATION
•.• . U) I hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
`. tv On Professionals Code, and my License is in full force and effect.
i, o ce) License # Lic. Class Exp. Date
Ci % �i9113 i3 0212912011
Cr
k o Z ate Signature of Contractof"
I> A-
0 r,- ��
J U � OWNER -BUILDER D CLARATION
ULU I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z( ) 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).
ce) () I am exempt under Section B&P.C. for this reason
Ln
N Date Signature of Owner
Q N
O)
CL U Q WORKER'S COMPENSATION DECLARATION
Q fr. I hereby affirm under penalty of perjury one of the following declarations:
Lo
r l. -O () I have and will maintain a certificate of consent to self -insure for workers'
X W L compensation, as provided for by Section 3700 of the Labor Code, for the
O _J<-_J
performance of the work for which this permit is issued.
CD Q U (i I have and will maintain workers' compensation insurance, as required by
Q U Q Se tion 3700 of the Labor Code, for the performance of the work for which this
d LO H permit is issued. My workers' compensation insurance carrier & policy, no. are:
z Carrier Policy No.
r-: 0.
J(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
suel
the workers' compensation provisions of Section 3700 of the Labor
C hall forthwith comply with those provisions./- k F
Vte: '-/ %✓ Applicant r.' �.'_ -^ , ., •
pp
16-1
Warning: Failure to secure Wkers' 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. 9.Q.
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, liagree to comply with all City, and State laws relating to the building
constriction, and hereby authorize-re�resentatives of this,City to enter upon
the above-mentioned property for insp ction'purposes.
/ignature (Owner/ gej)�"•ate .--"
BUILDING PERMIT PERMIT#
DATEVALUATION $2J1.971,40 LOT al l TRACT
JOB SITE�
4 =� rV _ 61(wc
APN 761-500-0"
ADDRESS
WNER
CONTRACTOR/DESIGNER/ENGINEER
WEILLY Y( NOES, INC.
MELLY tIOM S, INC.
23 CORPORATE P,LAZk #2145
2.3 CORPORATEPLAZA, 4245
NEWPORT.k EACH C.A. 92660
NEWPORT 13RAC 1.4 CA 92660
(949)719-4975; CI3T,•€1 5337
USE OF PERMIT
SM - I. -T-1E PLANIAR PRRt4'[["�'.�te1l ' NG1` its�I:tit3.� I3LtK k
WALL OR ,POOL.
F �
i
CUST'CIMP C'O.sNSTR1aO; notzv Za^i.s 00 S
P(')RCIfI A:ffO !,u`3[3.Ot) SF
QARA,1UFJ ARPl7RT M.00 SIF
&S7"IMATED CO3YOF CONSTRUCTION'
t,' MITIFRUC'lION F'lif' 1014900-4184)00
Pie"— CifEt."KFFP ?tiP�(1t!ti..�0�9rit�? gQh!�.✓rJ
NIE-CITAN1CALF1: 4101�000- 21-000 $117.50
tI c;'lTtic A%.Flffi. 101�•000-4110.000 $171..87
I'E.41t��t0INC���.l 14),1 (}01?-419-41ttt) $It3�.7J
' SIR Onic'yM MY!! ON WT, 1? Yr) 1(?E4106.1741-0f*
^R.rol7T1101~"21 101-000423-M.
ftpT-f, i71%J 'fvtt21-TZ 225-000-443-342
AR— TN` KIVIILIC P1..10:.X3 -- f BSIC 701-000-255-000 S379,93
SUR t(YDKI, C0NS'1Tt.UC'1' 0t4,r N1.7 P1,AN C14
$8,316,97
LESS PRE -PAID PEES
1$01.00
�WAI, d'CRMff F EWS1 013fe NOW
S8,31607
RECEIPT
DATE
BY/
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
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 & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROV LS
Steel
POOLS - SPAS
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
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral X,
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test Jf�
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)
COMMENTS:
®ro�,Y
NOV-08-2000 15:03 WESTERN INSULATION 909 686 8786 P.07i20.
� r
WESTERN INSULATION, INC.
4211 Laawm Street, Rimside, California 92501
Tel. (909) 686-8760 Pax (909) 686-8786 \\
INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE COBE, TITLE 24,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACT / PHASE: PGA WEST - PHASE 1 B
LOT # 48
SITE ADDRESS: 81-115 GOLF VIEW DR, WEST COVINA, CA
EXTERIOR WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS:' 3 5/8 " R -VALUE: R-13
CEILIN
MANUFACTURER:
CEILING
MANUFACTURER:
ATT
JOHA49MANVILLE
TT
JOH S MANVILLE
BLOW
THICKNESS: 6 3/4" R -VALUE: R-19
BLOW
THICKNESS: iii R -VALUE: R-30
--------------------------------------------
GENERAL CONTRACTOR: RIELLY HOMES
BY.-
TITLE:
Y:TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
6 ) I
TITLE: PRODUCTION MA ER
DATE NOVEMBER 8, 2000
v
D
R GE10',',
7 8 2 Zi,'. AVLY,��OboFiN�,�i
-P 11
......................
WEY.
ROOFING INC
August 17, 2000
Mr. Steve Gibson
Rielly Homes
81-120 Legends Way
La Quinta, CA 92253
Re: Legends @ PGA West, La Quinta, California
Dear Steve:
Below is a listing by lot number of O'Hagen vents installed per your roof plan specifications:
If you have any questions; please feel free to contact me at 949-260-7925.
ou'
Pick %ay
Vice President, Operations
17182 AQ&Mn1Vr, AMM
MW E, CA 92614
949126&70W
9491652-4960 W
M
48
3RA
25
49
4B
26
50
2RC
23
51
3B
24
52
4RA
26
53
6C
27
58
5RA
26
59
X
24
60
6RB
27
61
4C
26
62
6RA
27
63
5B
26
70
5A
26
71
4RB
26
72
2A
23
73
5C
26
74
2RB
23
.75
3A
25
If you have any questions; please feel free to contact me at 949-260-7925.
ou'
Pick %ay
Vice President, Operations
17182 AQ&Mn1Vr, AMM
MW E, CA 92614
949126&70W
9491652-4960 W
M
x
Cerliricate Aff of Occupancy o�� � o�
City of L a Quinta �
Buimng iand Safety Department OF,.��°`'�
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: '81-115 GOLF VIEW DRIVE
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9906-237
Occupancy Group: R-3 Tape, of Construction: VN Land Use Zone: RL
At .
Owner of Building: RIELLY HOMES, INC
Building Offici
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: DANIEL P. CRAWFORD JR.
Date: 6/26/2000
POST IN A CONSPICUOUS PLACE