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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
701I:3 B '201
pate / w Signature of Contrao of F -
v' 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.
(fy 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.
(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
works' compensation laws of California: andNagree that if I should become
subject to the workers' compensation' provisions of Section 3700 ofsth'e Labor
Cp
, de, I ,sfiall/ ytI comply with'tiiose p ovisions/ r i
mate:? Applicants
v'
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 autho'rfz ee rr presentatives of. this City to enter upon
the above-mentioned prop&rty-for inspection'p rposes.
Gignature (Owner%� nt!) � �=-G-<—, Date '
BUILDING PERMIT PERMIT#
4"0&-.244s4"0&-.244sTRACT
DATE VALUATION LOT 11,459 1288-18-1
_7/,
JOB SITE _
ADDRESS � Tt=i Gi3Ll� i :l<T► IIV>>v
APN
761-506402
a
OWNER
CONTRACTOR/DESIGNER/ENGINEER
RTUILLY HOME',,, INC.
RIELLY 1,10, ,.8, INC.
23 CORPORATE PLAZA, #245
23 COR!'C)AKFE PLAZA 0245
NEW'P01dT .J3tr;ACH CA 92.660
NEWPORTBEACH, CA. 92W
z
(949)719.4975 CBL# :5337
USE OF PERMIT
SINGLE P11.iIL ENVE'LLING
Std - LOT59 PLAN 3C - PiiraU'i DOGS NOT lNC1,UVE .13LOCP
WALL OR PC.XAi 73% PLAN ( NIFCX.'E'LX REDUCTION FOR NUr.i'1'1I Lb
i:3SLJANCI OR, SAME P1.Akti '1"9''.PE.
CUSTMICO,NS'I`lRilCTION 2,818.GO SF �
PORE: VIOA.TIO 1,280.00 31/
(1ARAGOCAitPOWP 787,00,1F
CONSTRUCTION zip 101-000-418-000 $1,.171.50
PL CfWN, K FER 101-001-419.319 $7.;9,231
;�ii:Clitd3�itC'rle; i• F. 10.1-000-421-000 $117.50
EL.I�CTPUCAL IT, X 10.1-000-120-000 $171.87
PLUMBING lJ1«4>f10-�1�-000 x:1137.75
;
STRONG IA41OiMN f - iE.Sl,) 101-000-10-000 $?.5.20
GRDING is 101-000-423-000 $20.00
INFAAST1tiJi"1tt RE ME 225-000-413,•313, $5,286.32
AWr IN 1?Uf3l 1:C PLACES ES - F.ttESID 701-400-25S-000 $375F.93
C•0f'1 (Xi r1( N .AAD PLAN f,:HEXX
n7a5®4,x{1
LFESS PRE -1. AID FEES
x;).40
TOTAL .3'�F.':#'tM13i•FREA :MIC NOW
Si, 59+9 30
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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 RetuAir
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap /S fi
F.A.U.
Framing
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
Final
Final4ZPOOLS
BLOCKWALL APPROV S
- SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final f
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
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 (Rerrn) . .,
COMMENTS:
NOU-08-2000 15:03 WESTERN INSULATION 909 686 8786 P.10i20
WESTERN INSULA'T'ION, INC.
4211 Latham Strcet, Rlversidc, CaMornla92501
TeL (909) 685-8760 Fax (909J 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 4 PHASE: PGA WEST - PHASE 1 B
LOT # : 59
SITE ADDRESS: 81-160 GOLF VIEW DR, WEST COVINA, CA
EXTERIOR WALLS:
MANUFACTURER:
CEILINGS:
MANUFACTURER.,
CEILINGS;
MANUFACTURER
JOHNS MANVILLE
OAT
JOHNS MANVILLE
oi TS
JOHN ANVILLE
THICKNESS: 3 5/8 " R -VALUE: R-13
BLOW
THICKNESS: 6 3/4" R -VALUE: .R-19
BLOW
THICKNESS: 11" R -VALUE: R-30
GENERAL CONTRACTOR: RIELLY HOMES
BY:
TITLE:
DATE:
INSULATION CONTR CTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: 4!5�s
TITLE: PRODUCTION MANA ER
DATE NOVEMBER 8, 2000
08/17%2000
13:07 ;;` 949 852 8732 r °;;.' T
DAVEY ROOFING't:INC=
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49
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41
50
2RC
23
51
3B
24
52
4RA
26
a4VJY
ROOFING INC.
August 17, 2000
Mr. Steve Gibson
Rielly Homes
8I-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 specifications:
- .f3l6fit�ktiY�S4`c�:'•:•.'3:"# =��i1q���': t:a:,:' �`.�,`�+�C�1
a���f�tf�q'�
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.
Aick
Py
Vice President, Operations
17182 ARMStROn AVENUE
RW E, ca 92614
9491260.7900
949/852-9960 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: 81-160 GOLF VIEW DRIVE
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction:
Owner of Building: RIELLY HOMES, INC.
Building Official
VN
Bldg. Permit No.: 9906-244
Land Use Zone: RL
Address:, 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: DANIEL P. CRAWFORD JR.
Date: 1/3/2001
POST IN A CONSPICUOUS PLACE