9906-246 (SFD)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.
Licens X19113 tic. Class Exp. Datej`)0/11,9
ate i Signature of ContractoIre,
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 C;OLDF N: EA01,11: INS. Policy No. NWC A 74603 5-02
(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, And agree that if I should become
subjedt to the workers' compensation,provlslons of Section 3700,of the Labor
Code J, hal�l fort wit comply with�those� ovlslons_-,
ate: ..p1 APPlicants``,.r-
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 to the building
construction, and hereby iuthor ie representatives of this City to enter upon f
the above=mentioned propehy_,for i spection'purposes.,
signature (OwnAa !�---.�DateJ '
PER
BUILDING PERMIT MIT
` 1,T Z4
rs277V/I �'� . 161 nf;.if?-1�4
DATE_7/ lei 01 VALUATION LOT TRACT
JOB SITE
APN 40.1 -.MI) -901
ADDRESS -
V
CONTRACTOR/DESIGNER / ENGI.NEEROwN€R
�\IBLLY 1.110 ES,1YC.
;'� CORPOR.tl e f.:.PLAbk, #245
2-1 l,i RPOtUTE PLJQ�, 4245
.NEWPORT HfiAC;H CA 92660
NEWfjc3It'i' € EM -214 CA 9V%0
(949)719-4975. CBL# 5331
USE OF PERMIT
SINGLE FAMILY'DW LG1NG
iill U - 9..V I0-1. MAO Oki +. M, KWA.1 71V1S' I:Nla.t I N%.LU.01s A: LV1.,15 WAIA.
Clic i�t�txe. 75Uo i�1.iiN �#t4iP.;{s kr#� itt?7.�11G I,'ilarf i�t:ift MfJLl'.f'iPl.l~
s;`1hi ANC , OikSAMA.PLAN'l'K3,?E.
CUSTOm. coNvyRumox 'x„22100 SF
PC'iRGOATTO 940;w 81:
OARA.C3'EICARII iXI' 7$6.00 SF
ff
i
- 7,$ [d'P.etm o Y.'li'n or! i..OIN's. 1).i UTo G
� t'CDi9.A.40
PERMIT FE E SUMMARY
4CONSIRUCTION k'fifi 10] - i0i 418.000
lyirA,N C! #tECc; } 1 til-frT�(n!11.43-�31A1l51 v2�g+7.��Sn
ibfE°'.;I ir`? LAICAL. IMI
,fi1XX:M_1 AL IEEE 10i -Ott -420-000
I'LL N! GFEE 101-000-419-000 $195►:1
S'.tRONO 1k41Y_f1 ?'+N.1~'i_s-k 'ESItJ 01 -OW -2,41-000,
01 A13INOFEW 1,01-000-42-1-01M "i►.QO
INf ASIRWI'[I-12. , FEE 225-000.443.342 S5,993,99
AfU TN 1Yi.ft3LIC PLACES -''RES J: 701-t}t3G-255-000 $447.25
S{ 3)�.:'1Y)TAL CO:N�"!�ti tt710N AND P!,-A`hf t t�:<<Clz:
9,509,22
LESS PRE -PAID Ft 1~S
$0.00
TOTAL 3<a4.RMIT FCES DUE NOW
tr �yti,d 1
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 AID 4
.Framing
F.A.U.
Compressor
Insulation
Vents
Fireplace P.L:
Grills
Fireplace T.O.
Fans & Controls
Party.Wall Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
Drywall - Int. Lath
s
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final r'`...
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
OX for Finish Piaster
Sewer Lateral.
Pool Cover
Sewer ConnectionEncapsulation
Gas Piping
Gas Test S
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)fit VV
COMMENTS:
i
NOV-08-2000 15:04 WESTERN INSULATION 909 686 8786 P.12/20
WWTERN INSULA'T'ION t INC.
4211 Latham Street, Riversicic, 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 #/ 61
SITE ADDRESS: 81-140 GOLF VIEW DR, WEST COVINA, CA
EXTERIOR WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS:. 3 6/8 " R -VALUE: R-13
CEILINGS: TTS BLOW
MANUFACTURER: JOHN -MAINVILLE THICKNESS: 6 3/4" R -VALUE: R-19
CEILINGS:ATTSD BLOW
MANUFACTURER: JOHN ANVILLE THICKNESS: 11 R -VALUE: R-30
GENERAL CONTRACTOR: RIELLY HOMES
BY:
TITLE:
DATE:
.INSULATION_ CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODUCTION MANAGER
DATE NOVEMBER 8, 2000
D4V
ROOFING INC.
August 17, 2000
Mr. Steve Gibson
Rielly Homes
81-120 Legeads Way
La Quiota, CA 92253
Re: Legends @ PGA West, La Quints, California
Dear Steve:
DAVEY; ROOFING'': INC '"-"'';_. ` Y -.:;s' »r. r f,
y� 1}•. r .AGE 01, { ,
iii
xW
Below is a listing by lot number of O'Hagen vents installed per your root plan specifications:
�Jl
f:.lt;':::Y:':m i '
.. ........ ... ..
`• T• �
08/1712900
13:0 949 852 8732
3RA
49
4B
Ali,
50
2RC
>
)
f
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
D4V
ROOFING INC.
August 17, 2000
Mr. Steve Gibson
Rielly Homes
81-120 Legeads Way
La Quiota, CA 92253
Re: Legends @ PGA West, La Quints, California
Dear Steve:
DAVEY; ROOFING'': INC '"-"'';_. ` Y -.:;s' »r. r f,
y� 1}•. r .AGE 01, { ,
iii
xW
Below is a listing by lot number of O'Hagen vents installed per your root plan specifications:
�Jl
f:.lt;':::Y:':m i '
.. ........ ... ..
`• T• �
J� S . 3? •x:: i
..25.... ,..... .
48
3RA
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.
Aick
Py
Vice President, Operations
17182 AQWMONr^ AVFME
OWE, CA 92414
049/260-79A0
949/882-1160 FAX
Certificate ofOccupancy
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 followi"p-
BUILDING ADDRESS: 81-140 GOLF VIEW DRIVE
Use Classification: SINGLE FAMILY DWELLING Bldg.. Permit No.: 9906-246
r
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: EIANIEL P. CRAWFORD JR.
Date: 8/11 /2000
Building Official
POST IN A CONSPICUOUS PLACE
6 i