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61
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
71113 8 02120 "M
f
.0/ate -, - ��Signature of Contr
Lr
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).
( ) 1, 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.
GOLDEN F.A3.;LE iN s,
(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 proviso s of Section 3700 of,the Labor
C9de, I shall forthwith comply whose pr0.visions:�
ate:
,iD/✓ /% Applicant -21X,_
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, and State laws relating totthe building
construction, and hereby authorize re i esentatives of this City to enter upon
the above-mentioned property for inspection purposes.
ignature (Ownef/Agefit) ` ~4 �%+ _ -� -Date—X-. t f
BUILDING PERMIT PERMITN,
')�Iliis-2� 1
DATE
114;j VALUATION $314,47 20 LOT h-2 TRACT -�
-7/1
JOB SITS '
ADDRESS L VIF � .
7 I61-50(WU
OWNER
CONTRACTOR/DESIGNER/ENGINEER
Tt.ii:F,t.Y �iCa�l er, :fC'.
MELLY-
Z3 CORPORA F PLA7A, ff245
23 CORPORA: CE t la. ZA, h243
NEWPORT B.I,.ACT I CA 92660
NEWPORT SEACL1 C'.A 926
,949)7! 9-4975 0,B1, '532;7
USE OF PERMIT
SiNGjLt FAMILY D WELUNezcr
�.
SM - .LOT G2 PL,A1 6AR - ZsMWT DOFFS NOT INCL i70E 73I.00K
WALL 011 K)OL. 75°x'0 }?;f AN E,':MS`K Ffti, KWXK�17-11ON f•'OR A4IOLI7•iNl..f
ISSUANCE OR SAME PLAN YVIP&
Cf F S T M CONS TRUC*VON 3,698.00 Sr
P0RC.FQPjV
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
/
Ducts
Slab Grade
ZZAM&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
�S
Final
Final
BLOCKWALIL'A.'PPROVArS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
B nd Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. 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
i
Appliances
N
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
X;
Final
Utility Notice (Perm)
COMMENTS:
NOV-08-2000 15:04 WESTERN INSULATION 909 686 8786 P.13i20
iM'TERN INSULATIONv INC.
4211 Latham Street, Riversidc, California 92501
TeL (909) 686-8760 Fax (909) 686-8786
INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSULATION HAS BEEN 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 # 62
SITE ADDRESS: 81-130 GOLF VIEW DR, WEST COVINA, CA
EXTERIOR WALLS:
MANUFACTURER:
CEILINGS:
MANUFACTURER:
CEILINGS:
MANUFACTURER:
JOHNS MANVILLE
BATTS
JOHN MANVILLE
! �ATT
JOHN NVILLE
THICKNESS: 3 5/8 h R -VALUE: R-13
BLOW
THICKNESS: 6 314" R -VALUE: R-19
BLOW
THICKNESS: 11" R -VALUE: R-30
GENERAL CONTRACTOR: RIELLY HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACT: WESTERN INSULATION, INC.
LICENSE NUMBER:,481278 ?
BY:
TITLE: PRODUCTION M N
DATE NOVEMBERS, 200 ..
08%17/2Q00
ROOFING
-.:DAVEY '�'Q "Nii
3RA
R
2
Q
26
50
2RC
23
51
all EY
ROOFING /AFC.
August 17, 2000
Mr. Steve Gibson
Rielly Homes
8I-120 Legeuds Way
La Quinta, CA 92253
Re: Legends @ PGA West, La Quints 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.
0
lPikeky'
Vice President, Operations
17182 AAACMOY AVENUE
LqVV&, CA 92614
04W260 -79M
949I652-4160 F,4X
48
3RA
25
49
Q
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.
0
lPikeky'
Vice President, Operations
17182 AAACMOY AVENUE
LqVV&, CA 92614
04W260 -79M
949I652-4160 F,4X
lAS
Cady of La Quinta
Building and-Safety
r
Departm e'n�
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: 81-130 GOLF VIEW DRIVE
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9906-247
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: RIELLY HOMES, INC Address: 23 CORPORATE PLAZA, 245
City: NEWPORT BEACH, CA., 92660
By: DANIEL P. CRAWFORD JR.
Building Official
Date: 7/13/2000
POST IN A CONSPICUOUS PLACE
0