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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 # Lic. Class Exp. Date
7191.13 B
1-1
ate —�`��Signature of Contraor�
v
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.
(*Q 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.
�iJJ.a71:a4�} 11G1,F� i'vY,�'> ni`,a`(; 47 60.5-l02
(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
/ pro sons�of Section 3700 of the -Labor
Cade I s II forthwith comply with theproviss.
�ppicant,Pte:
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 370.6
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 authorize=representatives of this City to enter upon
the above-mentioned property for in pection purposesE,1ty
5�
r _ ,,Sig' nature (Owner/ge-•Date
BUILDING PERMIT PERMIf)g 0:.
DATE VALUATION S.25](, 7140 LOT r TRACT 2803- 1
/I /V — .
'OB SrADDRESS S I4#tT-143'Wb1F- :1�4''.[10i. IVF
APN 761Z00-006
,OWNER{tLJ,
CONTRACTOR / DESIGNER / ENGINEER
i ppm ryw 2I
O4VM' 1d 1J lr ��IVI Rw..•� T V.
�t.(,.a.UlrY } A!•.1N� v, INC.
23 CORPORATE PLAZA, #245
23 CORPOTUM P.LIkL\, #-245
NEMP(:31t3 REACH CA 92660
NmPOw1'BRACK CA '92660
(949)'71.9.4975 CSL -0 5337
USE OF PERMIT
iYLE hAMLYllVdfal.UNG
St; ,i) - LOT 51 PLAN 38-KRMIT DOES NOT INCLUDE 03Ld3CK WALL
C* VOOL, 751,4 Y AA0 aIECK FEZ, eX-L JU •: f'1GN FOR MUL1,Tff1L),
:ISSLIANC'Et Oft SA& E: PLAN TYPE,
C1USTOMCON5TRUCTION, 218;8.00 Sp
P ROHMA.TiO 1.,280.00 81170
QAR&y'ElCA323?0&f 787.0Ej tir.
CT OF �11,�,� rr.Qrt
za7..AR
03N`3'MUCT1.0N F.HE 101. •d00 4103-0(00 SO • 1 r 1.5o
3AR(€'R FFF; !(1], 11() 4i4=3i5t V3*921
,13 OLAT%jrtiIT,f+ , 101 -OG -421-M 1.7.50
E-U.CTRICAL r-J."I 01-000.420-000
1!L UMBINO PEE 10:1-1)00-419-000 $.187.75
STROM kik tl()w PFIF - R.F."W ? -2414)00 ray1)
G.11, )IN'G rtai 1f01. •()(00. 02-3 t��10 3 J.fff1
.:
JNF,11A STMITtW3FEE 21.5-OCKI-143-344 55,286.32
ART 1N KIALIC k'.LAC1 S -13!3131[^ 101-00 0-25:-000 S379.93
SUB-'T'[.3rAL t ;OMORAJG"1°.1ON �\ND :PLAN CHEMK
LESS PRX-P ID FEES
$0.00
�i
a�
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
jr3
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
pD
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL
APPROVALS '
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 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
tiv
Appliances
Final
COMMENTS:
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.1.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
NOV-08-2000 15:02 WESTERN INSULATION 909 686 8786 P.05/20'
f � ,
VMTERN INSULATION, INC.
4211 Latham Street, Riverside, 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 # 51
SITE ADDRESS: 81-145 GOLF VIEW DR, WEST COVINA, CA
EXTERIOR WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13
CEI: BLOW
MANUFACTURER: JO MANVILLE THICKNESS: 8 3/4" R -VALUE: R-19
CEILING TTS 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 MANAV4,R
DATE NOVEMBER 8, 2000
J, '-^. ,08417/2000,-1-3:
"-0[
DAVn
48
3RA
25
49
Mt
26
50
2RC
23
51
3B
24
a4VEY.
ROOFING INC.
August 17, 2000
Mr. Steve Gibson
Rielly Homes
81-120 Ugeads 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'
Pi I'� y
a
Vice President, Operations
17182 AAkd7reONr,- AVENUE
OWE, CA 92614
9491260-7900
9491815.2-1160 .FAX
48
3RA
25
49
413
26
50
2RC
23
51
3B
24
52
4RA
26
53
6C
27
58
5RA
26
59
X
24
6
6RB
27
6
61
4C
26
6 62
2
6RA
27
63
5.B
26
M66-
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'
Pi I'� y
a
Vice President, Operations
17182 AAkd7reONr,- AVENUE
OWE, CA 92614
9491260-7900
9491815.2-1160 .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:
81-145 GOLF VIEW DRIVE
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction: VN
Owner of Building: RIELLY HOMES, INC
Building Official
Bldg. Permit No.: 9906-240
Land Use Zone: RL
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: DANIEL P. CRAWFORD JR.
Date: 11/28/2000
POST IN A CONSPICUOUS PLACE
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