9906-242 (SFD)U)
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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 {
ate , -1�-/Signature of Contrac
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).
( ) •1 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 %4:t'Ct l AG1� ffgS. Policy No. 1'v1fC 47 4=5SyC1¢
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) •1 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
subjecrto the workers' compensation provisions of Section 3700 of the Labor
Goode I shall forthwith comply with thoseions. /1
yDate: y�`"• Applicant � �� prove
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for.in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize„ representatives of this City to enter upon
the aabove-mentioned property for inspectron purposes.
%f-, 1,�c
Signature (Owner/Ag Date
nt) �"" "�/ �=T -
BUILDING PERMIT PERMIT "06-242
DATE VALUATION �;��+$,47�3, P•1D LOT S3 TRACT
JOB SIT VIr40! )' DRI_Vg
APN lbft-�t6�;�1u@J
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
yy3�t)) Y`{ yam+ �j
14{�i,1... y 1.10.NIES, iV'eI.
9�1..Li,.. LY 11. 4 N41 ES, IltlC
23 C(D:RPORA71'E ?` AZA, 5745
13 C O PORATE PLA7,.Ei #245
NEWPORI'.MA.CH,, CA 92660
N.f.w'oit'I B-c—Acii CA. 924560
USE OF PERMIT
S15N GSL FAM13.A' LAyPU.1.,NG
Si' D - LOT S3 iILAN 07 - PERNN7. r fit itS NOT 04C`•i.t/ E BLOCK
WALL OR 1'(;9L?L,.
CUSTOM i''CNSTR.UC'Y'tC'N 3,698100 SIT,
z,
iyU.1iC4.1JPKC10 W.00 Si:'
GARA.CQtl CARPO.Wt M4.00 Sig
E TIAI "i, CWT Orl CONS- MUCTIM4,
314,473 ,21,i1
P.ERINUT :FRE SUMMARY
C0_►YS'4'RUC'1`i()_N F%6 1014M418 -M)
PffYt,,AN(714-,!"kFy'lYEJ* `gni �1c1 S,rfi1
14 /��!;!ryil/�(�1-4iQ-/iii
Si'f,13C114l�J1C' A1,. 1' Y•1 : i 1d.�. • L! V V':.ia�. 6,' V1J!i ..D j. � �. S!1
i,ti~(;'iUCc:At: Ci:3 iia -C iJ-d."rt)1iGU SAW.2i
PLUMBING YHE SAS09,75
S't`t7OW(IMt-?'110N'T"�,-R,r-�W) 101-1 ln-?41-Mn $114s
GRADING 17HE 100-flC1J' -123,000 $20.00
1Nl~:ttAS'1'4 JC"fU_T l=3 FEE 225-t' 0-443,342 Sf>lisx).ZG
A.Wr IN PUBLIC PLACi3S - REsSI.D 701---25"5-000
SUB-'?'(7I,`AL C N`.!'F21fi7Flt_)N AND PLAN CHECK
$9,626.76
LESS P:RE-PMD .FEES
$0.00
I 0..9 t•6L R" 1G: RMI T .EnE.WS DUE NOW
$94626.76
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
1. ,
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
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final O
BLOCKWALL APPROVAL
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. 4
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 (Perm)
COMMENTS:
NOV-08-2000 15:02 WESTERN INSULATION
909 686 8786•. P.0220
WESTERN INSULATION, INC.
4211 Latham Street, Riversidc, California 92501
Tcl. (909) 686-8760 Fax (909) 686-8786
MULATION 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 # : 53
SITE ADDRESS: 81-165 GOLF VIEW DR, WEST COVINA, CA
---------------------- :
WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13 .
CEILINGS: ATT BLOW
MANUFACTURER: JOHN MANVILLE THICKNESS: 6 3/4" R -VALUE: R-19
CEILINGS: TTS BLOW
MANUFACTURER: JOHNS NVILLE THICKNESS: 11" R -VALUE: R-30
GENERAL CONTRACTOR: RIELLY HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: (i��
TITLE: PRODUCTION MANA
DATE NOVEMBERS, 2000
cs87/2e00 13: 07 949852 8732, s ': DAVEY :ROOFING'
• ... N
DAV! Y
ROOFING INC.
August 17, 2000
Mr. Steve Gibson
Rielly Homes
81-120 Legeods 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:
a7.Ju'.LY.•:ll�i
:�ii'ri.i��r...�.bs�KH:�%:
i:.lM�::1<.•�diz :tli��y!tii3?:?,:?3
48
3RA
25
49
4B
26
50
2RC
23
51
3B
24
52
4RA
26
53
6C
27
58
5RA
26
59
3 C
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.
Pkky.
Vice President, Operations
17182 A MG AVEAW
19W E, CA 92614 `
449/260-7900
949/852-4160 W
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:
81-165 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.: 9906-242
Land Use Zone: RL
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: DANIEL P. CRAWFORD JR.
Date: 8/3/01
POST IN A CONSPICUOUS PLACE
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