9906-241 (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
�. W
N Professionals Code, and my License is in full force and effect.
f O =) th License # Lic. Class Exp. Date
r- w LO 19.1 8 0 �`20i
r
i (.
�o Z r-- /ate <�`Signature of Contr. ,, J %
cD O
J U C) OWNER -BUILDER DECLARATION
WLU 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).
( ) I am exempt under Section B&P.C. for this reason
LO
O N Date Signature of Owner
rn
d Z WORKER'S COMPENSATION DECLARATION
'IT CD I hereby affirm under penalty of perjury one of the following declarations:
Lo Fa- O () 1 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 Q performance of the work for which this permit is issued.
m Q L) (�()' I have and will maintain workers' compensation insurance, as required by
O 0 . Section 3700 of the Labor Code, for the performance of the work for which this
fl rn permit is issued. My workers' compensation insurance carrier & policy no. are:
? Z Carrier Policy No.
ob O G0LD ijli' 9AC1i,E 1741,1, %NWC 47605..5-02.
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 Cal ifornia,..and,agree that if I should become
subject to the workers' compensation,p/visions of Section,3700 of the'Labor .
3 C9de, �I Shall fortwith comply withtFiose roulsions
Date: -� �•G�Applicant �.x" r/ .F:�. %•- �C—'�
, y
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 application 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
thea ove-mentioned property for.insptection purposes,
t.Signature (Owner/Ag r / `✓�
�j� .
/// BUILDING PERMIT PERMIT
DATE 7/1/� VALUATION $279,901�� LOT ...Z TRACT 2idi'1
JOB SITL "� , " -""'� -
81=155 c•(�tf VIEW aiR:1'W �"
APN
7FJfl-�04i iN)6
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
RI ELIX 11010ES, INC.
RIELLY 110.,NMES, MC ,
23 CO.IZPOK.A:rc 1'1:.AZA, #1245
23 CORPORATE KAP,!'.,'#245
'NEWPORT BEACH CA, 92660
NEWPORI' BEACH CA. 92660
�r
(949)719•-4975 CKIt 5-417
USE OF PERMIT
SWCil..f;, F.FiI�I,T 1' [YWE1.I.rW,)
>
9PO - LOT 52 PLAN 4E%12 - PE1RXRT DORS NOT INCLUDE BLCXK
WALL Ott POOL. 75% PLAN a i€X-K. FEE, mUG"r1ON FORM.U1,11PLE
KWANOR, OR SA14C: VL AN TYP&
CUSTOM CUNSTRUCTION 11.222.00 at:
PORICITlt"J" 1C) 940.00 $F
C' �ARAfJkYCAi1PQWf 786,00 SF
lAM11.V,i�.fl;M:..to COS`[* 9.,%F'lt'ii'FVn7TAlU MO
rs,901..40
Pk KNOT FFV, Sia -1 NIAR
C:ONSrWC"114:I.V HE, 101 -M418 -OW $11266.t3Q
P1,A4d QMCK ME 1:11- (KW 439-3.18 X257: i5
INuCPAN11C:A1, PIT "F: 1fI� flQO-d2:-( $111.00
E.EC'TRWAL ME 101-000-420-000 $185.99
I'LU1!'1f3Mt: i 101-000-419-000 $199.75
STROKO, .W, TION 1fTv - RESID 101-000-241-W $27.8.0
GRADING FEE 101-000-423-000 $20.00
11tirFRASTRUC7'CTi<k 'FIX 223-000443-342 $5,993.99
ART 1N 1?URL);.C;PLACES - k2ti.S113370,1-000-25000 $447.25
SUB-TOTA , C.'O'NSi'iCilMCIN tM. MAN 41'fTCK
p,s ).22
LESS PRIETAiD FEES
1$0.00
'f€Y At, PEWMiT FEE 44 OP.ENOW
'
�2i,gQ'9:2'2
ori A 5 .i
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Q
Ducts
Slab Grade
A4,
Return Air
SteelCombustion
Air
Roof Deck
Exhaust Fans
O.K. to Wrap
y
F.A.U.
Framing
p J
Compressor
Insulation
Vents
Fireplace. P.L.
Grills
Fireplace`T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wail Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVA S
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping.
Plumbing Final
Plumbing Top Out.
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral .
da
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
°UiidergroOnd Conduit
-Rough.Wiring .
Low Voltage Wiring
Fixtures
Main' Service
. Sub: Panels
Exterior Receptacles
G.F.I:
Smoke Detectors
Temp. Use of Power
Final -
Utility Notice. (Perm)
COMMENTS:
.. NOU-08-2000 15:02 WESTERN INSULATION
Pf
909 686 8786 P. 04/20
WESTERN INSULATION, INC.
4211 Latham Street, Rtversidc, California 92501
TeL (909) 686-8760 Fax (909) 686-8786
INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORNIA ADMIN,STRATIVE CODE, TITLE 24,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACT / PHASE: PGA WEST - PHASE 1 B
LOT # 52
SITE ADDRESS: 81-155 GOLF VIEW DR, WEST COVINA, CA
EXTERIOR WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13
CEILINGS BATT BLOW
MANUFACTURER: JOHNS' -MANVILLE THICKNESS: 6 3/4" R -VALUE: R-19
CEILINGS: ATT$ BLOW
MANUFACTURER: JOH MANVILLE THICKNESS: 11" R -VALUE: R-30
GENERAL, CONTRACTOR: RIELLY HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: e&
TITLE: PRODUCTION MANAGER
DATE NOVEMBER 8, 2000
X8/17%2900 13 07�
_124
�V
WEY.
ROOFING INC.
August 17, 2000
Mr. Steve Gibson
Rielly Homes
8 1- 120 Legeods Way
La Quints, CA 92253
Re: Legends @ PGA West, La Quints, California
Dear Steve:
DAVEY!,--- ROOFING
Below is a listing by lot number of O'Hagen vents installed per your roof plan specifications:
i3
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
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
ck y
Vice President, Operations
17182 AqkCh?6&Mr,- AMVJX
PPE. G192614
949/260-79M
949/=-4160 FAX
:t.
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: 81-155 GOLF VIEW DRIVE
Use Classification:
Occupancy Group
SINGLE FAMILY DWELLING Bldg. Permit No.: 9906-241
R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: RIELLY HOMES, INC
!�b'6't
Building Official
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA 92660
By: DANIEL P. CRAWFORD JR.
Date: 11/21/2000
POST IN A CONSPICUOUS PLACE