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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 #t Al Lic. Class Exp. Date/
7191 .1: B i 02l29not
ate Signature Of Contra -,torr,
C�
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 Policy No.
CKYU.'f''�1l { 3 ai~il.i:- ih'v 3: i4NWC 414055-02
(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, an agree that if I should become
subje t to the workers' compensation pro Iv sio s of Section 3700 of,the Labor
Cod�l soh II f rtyith comply with those= r.Q-u�is_ioJ,�s.� `
°gate: � Applicantr,5, • r < .- c'"�
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 State laws relating to the building
construction', and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspe�tioh 4oses,
siSignature (OwDate .lam
BUILDING PERMIT PERMIT#
DATE VALUATION S278,901.40 40 LOT d TRACT 279938-11
JOB SIA
ADDRESS 81-.1x5 Gou WCAA IJwvt
APN 7'61-50WO06l
OWNER
CONTRACTOR / DESIGNER / ENGINEER
IUEEL LY HOMES, INC.
WELLY HOMES. INC.
23 CO:RPORKI'.1~ PI.A7.A, 0245
23 CORPOiiAiB PLAZA, #2445
NEWPOKI F1£ACI4 CA 926+64
NEWPORT BFAC 14 CA 92660
(949)719-0751 CBUt 5337
USE OF PERMIT
S INCILIRKNAI1.1'DWELL -NO
,31Ti - LOT 49 .iii>AN 48 - PEtRN417 DORS 140T INCLUDE BLOCK WALL
Oil KJO1..
Tltuw"i tC3F 3,2=40 SP f
$C//.��; (STO�rZ�ij p�.�"+I{,v��
1 Vi1�+i1UPK'LV940.00 S*
CIARAdi CAR KNU..' 53,E
1.&t.f'1ATE'D C�c ,V.�i.GINS5siUCTION
4 P, vt$
p'.l:i
CONSTRUCTION F : 101-000-41"00
Y1,ANr,ffFC9 FEE 1{Il-i)fl(j�.314.�to� St,b?9.3�
&.sC!J-MNICAL To 10.1,M421 -000 �i3.:t.csv
141-000420-000 $185.99
P1.1JN11t.INOFEE ±f' 1-000-419-i1tiC) 5,199.75
cTXRONC#MOTION : EY,—RESID 101.-W-2141-000 $1277,39
01RADIIN01 E'L 14.11.000.423-000 $20,00
f9r, kAS'TRU=1'RE-'FEE 225-40011-493-342 35,993.99
AR'I IN PUBLIC PLA - RFSIL '101-000-255-000 $4.47.25
S jB-1VTAL- CONST YN!3C'.`i`?O?V .fl]ND PLAN t;'KC K
LESS PRX-PAID .R- S
10,40
'413 M ITIRMMl'C .1="22,2x211 DUE, Now
59,281.255
Awr-3
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
Qd
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
APPROVALS
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
Pool Cover
Sewer Connection
Encapsulation
'Gas Piping
Gas -Test
Appliances
Final
Fina!
Utility Notice (Gas)
ELECTRICAL
Temp. Power Pole
Underground Cpnduit
Rough.Wiring
Low Voltage Wiring
Fbdures .
Main Service
Sub Panels
Exterior Receptacles
G.FY. , ..
Smoke Detectors
Temp. Use of Power
Final
Utility ,Notice .(Perri).
APPROVALS
COMMENTS:
�* NOU-08-2000 15:03 WESTERN INSULATION 909 686 8786• P.08i20
WESTERN INSULATION, INC.
4211 Latham Street, Rtvcrsidc, Callfornia.92°-01
'Pel. (909) 686-8760 Fax (909) 686-8786
INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSULATION HAS SEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24,
STATE OF CALIFORNIA, IN. THE BUILDING LOCATED AT:
TRACT / PHASE: PGA WEST - PHASE 1 B
LOT # 49
SITE ADDRESS: 81-125 GOLF VIEW DR, WEST COVINA, CA
EXTERIQR WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13
CEILINGS: BLOW
MANUFACTURER: JOHNMANVILLE THICKNESS: 6 3/4" R -VALUE: R-19
CEILINGS: ATT BLOW
MANUFACTURER: JO NS MANVILLE THICKNESS: 11" R -VALUE: R-30
-------------------------------------------------------
GENERAL CONTRACTOR: RIELLY HOMES
BY:
TITLE:
DATE:
IN CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODUCTION M GER
DATE NOVEMBER 8, 2000
fiIl �V,
08/17/2000-13: 07'
DA AUL
vl:y
3-
DAVEY.
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 specifieations:
If you have any questions; please feel free to contact me at 949-260-7925.
eOU'
k
y
Vice President, Operations
17182ARAMONGAMM
AWE CA 92614
949rAC-79W
949/852-4160 FAX
48
3RA
25
49
4B
26
50
2RC
23
51
3B
24
52
4RA
26
53
6C
27
58
5RA
26
59
3C
24
60
6RB
27
61
4C
26
62
6RA
27
63
513
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.
eOU'
k
y
Vice President, Operations
17182ARAMONGAMM
AWE CA 92614
949rAC-79W
949/852-4160 FAX
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:
81-125 GOLF VIEW DRIVE
Use Classification: - SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction:
Owner of Building: RIELLY HOMES, INC.
Building Official
Bldg. Permit No.: 9906-238
VN Land Use Zone: RL
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: DANIEL P. CRAWFORD JR.
Date: 2/5/01
POST IN A CONSPICUOUS PLACE