9906-243 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
F= Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
C14 W Professionals Code, and my License is in full force and effect.
O� M
License # Lic. Class Exp. Date
r, Cd LOX;
7a9i 13
o Z yDate Signature of Contracto .. r? Y
co01
J U C) OWNER -BUILDER DECLARATION
W LU r` I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) 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
Dato Signature of Owner
ON
rn
Q WORKER'S COMPENSATION DECLARATION
p cc I hereby affirm under penalty of perjury one of the following declarations:
r � O ( ) I have and will maintain a certificate of consent to self -insure for workers'
X w �= 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 U ( I have and will maintain workers' compensation insurance, as required by
O CJ Q Section 3700 of the Labor Code, for the performance of the work for which this
d 0 Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier 7 lr9 q� Policy No. NW
[ ryy
Cb U 46,iJ�-i.�� .L:lb'4➢i I14 �, .W i C ,17!H0J5't!.0
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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 California,and�agree that if I should become
3 ssubbjet to the workerscompensatio^n,p ovisions of Section 3700 of the,L'abor
,Ode, I shall forthwith comply withrthose provisions.
ate: • /• �% Applicant , :-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 authorize -representatives of this City to enter upon
the above-mentioned prop�e4 forinspection purpses./
gf nature (Owner/Ag,�n 9�ate ,
BUILDING PERMIT PERM' 9 .14s
DATE VALUATION $291-504.50 LOT TRACT
J SITEtv8V174YG6 ;*. �'.4�L�T' A),MV L
APN
61-500-602
s�
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
t\i..r.�.i.i,.Y eiil4'ie�.�✓� I?Jt..
ejui�'..i..������4�iia.�., ii,T�
23 CORP ii rl'M i✓.LAZA, 6245
2- CORPORX i`L PLAZk V245
Nl:'W1, ORTBE.A..CFI C.A. 926W
N,EWIVt: RT BEACH CA 92660
(940)719-447.1 (,BJ,4E 5 37
i
USE OF PERMIT
rif-D - L SOT 48 P airy SAk-;t?.i".:1'UAIT itOES NOT iNCILUDE BLOCK
WALL OR POOL.
c:U�"i'i)M �'c�'N�iTRiT07'JGN' 3,=lt;r�,Ui) �f�
P �ltCi$ity 'i itr 754.00'-,
0AI3.s1,0J9CAJtK) J' N t'l.Ut1 SF ,-
K'..G7tlf A dt�l R %u.i,1` d.0.J�J i� i lR 1 {..CP.A'1i . � rY 4181
2911,2549.5
PI',' WIT FEW SUA"l'MARY
C9NTFRUCrIOT TOVKE I01-GOG-418-000 �y,'+IJ.50
KANt"_FFi_K'N, PCE W! -W -439 -Mg T1,46i
A
MCLUAMICAIL V1,36 101-000421.400 IT.%
81FAC"'3:RK.'AL. i s �.� -Gid)-<}2. •4 ( .0
1':LAI:t11l3(No 101,-000-410-000
RTtG>nrc f YY! OtvF FE,r - R -F4,511) W!4)0-2414"
GRADINF z 3 10 1-000-423.041() ao.fa�
iidFkASTRLI ')'fM M 225-000443-M2 S6.W1.00
1!RY I.TwI•PI.1.BLIC PLACES •- RU- 'M 701-000,255-041(.1 $478.75
SI.TE3-'tY7l �i.. CON$*rRT.JC�'1"ION AND PLAN C:¢Tl:CK
�,�� 400 07
,CSS PRE -PAID FEES
13.00
TOTAL PERM tMES DUUNOW
54��fDli.tb2
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
z INSPECTION RECORD
OPERATION
DATE
INSPECTOR OPERATION
DATE
INSPECTOR
BUILDING APPROVALS MECHANICAL APPROVALS
Set Backs Underground Ducts
Forms & Footings /Q Ducts
Slab Grade z Return Air
Steel 4 Combustion Air
'
Roof Deck Exhaust Fans
0. K. to Wrap F.A.U.
Framing Compressor
Insulation Vents
'
Fireplace P.L. Grills
Fireplace T.O. Fans & Controls
Party Wall Insulation Condensate Lines
Party Wall Firewall
Exterior. Lath
Drywall - Int. Lath
Final
Final 3 11/ POOLS - SPAS
BLOCKWALL APPROV S Steel
Set Backs Electric Bond
Footings Main Drain
Bond Beam Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final Gas Piping
PLUMBING APPROVALS Gas Test
Electric Final
Waste Lines el 0, Heater Final
Water Piping. Plumbing Final
Plumbing Top Out, Equipment Enclosure
Shower Pans OX for Finish Piaster
Sewer Lateral . Pool Cover
Sewer Connection Encapsulation
Gas Piping
Gas :Test474
Appliances
Final
w
COMMENTS:
Final
Utility Notice (Ga's)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough.Wiring
Low Voltage Wiring
Fixtures
Main. Service
Sub Panels
Exterior Receptacles
G.F.I: t
Smoke Detectors
Temp.. Use of Power
Final
Utility Notice (Perm):F.
NOU-08-2000 15:03 WESTERN INSULATION 909 686 8786 P-09/20 '
WM TERN INSULA'T'ION, INC.
4211 Lath= 9ureet, 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 # : 58
SITE ADDRESS: 81-170 GOLF VIEW DR, WEST COVINA, CA
EXTERIOR WALLS:
MANUFACTURER:
CEILINGS:
MANUFACTURER:
CEILINGS:
MANUFACTURER:
JOHNS MANVILLE
8A
JOHNS MANVILLE
BAITS'
JOHNS MANVILLE
THICKNESS:. 3 5/8 " R -VALUE: R-13
BLOW
THICKNESS: 6 3/4" R -VALUE: R-19
BLOW
THICKNESS: 11" R -VALUE: R-30
ENERAL CONTRACTOR: RIELLY HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODUCTION MANA
DATE NOVEMBERS, 2000
08/17/2000 .13:.07, �.,949i-852-8732z-xt"-,
DAVEY,
ROOFING INC.
August 17, 2000
Mr. Steve Gibson
Rielly Homes
81-120 Legeods Way
La Quints, CA 92253
Re: Legends @ PGA West, La Quints, California
Dear Steve:
D
DAVEY ROOFING 'INC AGE.' 0
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.
2Pou, y -
Vice President, Operations
17MMUSMONGAVENUE
PANE, CA 92614
949)260-79M
949/852-4160 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
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.
2Pou, y -
Vice President, Operations
17MMUSMONGAVENUE
PANE, CA 92614
949)260-79M
949/852-4160 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:
81-170 GOLF VIEW DRIVE
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction:
Owner of Building: RIELLY HOMES, INC.
Building Official
Bldg. Permit No.: 9906-243
VN 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