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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Cpapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force an/ effect.
Licens f 8004 Iic. Class` Exp. Date
4—
Be � r� Signature of Contractor
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.
( ) 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 EJNY'1'Fd9 p,AC1F iC 31N>i Policy No. Y` WA2017V)6,00
(This secti", 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 mariner so as to become subject to.the
workers' compensation laws of(Californa,)and,agree that if I should become
subject to the w rkers''compensation provislofns7bf Section 3700 of the Labor
Code; le'h I� ( Ky'Ji��h comply With those p gyisl�ns`'�
Die:.' (j Applicant ;
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 authorizeireprLsentaitives of this City to enter upon
theabove-mentioned prope forbinspl=curposes.
Signature (Owner/Agent)—i"`� Date
BUILDING PE591T PERMR?
004td J LOT TRACT 2Kb03-1
DATE J � VALUATION, `)
It _• 7.�s -ru-. »erc..��.
JOB SITE t3it5+� li�11 it k^li�'
APN �(1�-s�9ai •Ca iIi
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
SMEN WALKER HOMES
Si' VEN WALKER HOMES
7101. N"DIA.NA AVE.
7161 IND.iAN A. AVE.
RIVERSIDE CA. 92,V4
NIVEUIDE CA. 97-504
(90)784-0840 C BL# 5357
USE OF PERMIT
SlNQLE FJ"-1fl Y DVOEL : NG
S '.0 - L01' 1, PLAN 3A, f+ 41'1' DOES NOT iNCLUU1w,• W.LICK. WALL C t
PC 0L,
CUSTOMCO;iNXfktUC'.1l0N 2,450.00 31:
PORCHPA['IO 245.0 SF
GAR—AGE/CARPORT 5.39,Oti c><
ES1'f!NATCD COST'Ort CONS A'RIA71U'KYN
..04, 9119.il
PIERNIT F E- 9'U h''11V1AR'1y
CC'tI XIMUCY°rOjs VEE 101-000-418-400 $1 f iD7.f}Ct
KAN CHECK FIX 101.000-439-315 aU.Sl
N%C i-AN1CAL � S t l)1.-0011 ^1-t1? 111 tlt5.50
aEC t'1 ICAl. FM" 101. -006 -420 -NO
PI.iJ'1!IR NO $162.40
SlRONt31t+fO'!'ION FEE - REMD 10140-241-000 -241.000 $20.47
MA'DING FEE 10 14=4123-000 n.20.00
AWf IN PUBLIC PLA M: - R.ESW fOl -M-255-OW $25.1.69
. DE VFL OPER IMPACT FEE
4
"lUrAL CONS'IRl.1C ONI At' D PLAN CN Cia
$4,438.70
LESS PRE -PAID FEES
$O.UiD
TOTAL PERMIT FUN 1lillfCNOW
$4,418.74)
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
Roof Deck/
Combustion Air
Exhaust Fans
O.K. to Wrap
_,/�_ _
g
F.A.U.
Framing
S_ _
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
2
��/✓4 AWL
Final
Final I
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Hacks
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
��/J
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
7
Pool Cover
Sewer Connection
v''
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:
WESTERN 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: RYDER COLLECTION - TRACT #
LOT# 1
SITE ADDRESS: 80498 HERMITAGE
------------------------------------------------------------------
EXTERIOR WALLS:
MANUFACTURER: Johns-ManWila, THICKNESS: 3 1/2" R -VALUE: R-15 .
CEILINGS: (qA-TT BLOW
MANUFACTURER: Johns -Manville THICKNESS: 13" R -VALUE: R-38
CEILINGS: BATTS BLOW
MANUFACTURER: Greenstone THICKNESS. k -VALUE: R-38
----------------------------------------------------------------
GENERAL CONTRACTOR: STEVEN WALKER HOMES
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:tojf___�
J%
TITLE: PRODUVON MANAG R
DATE Mav 9, TOOO
3
7
Certificate of -Occupancy
Cit.v of La Quinta
LBuildingand 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: 80-498 HERMITAGE
Use Classification:
SINGLE FAMILY DWELLING
Bldg. Permit No.: 9907-462
Occupancy Group:
R-3 Type of Construction:
VN
Land Use Zone: RL
Owner of Building:
STEVEN WALKER HOMES
Address:
7161 INDIANA AVE
City:
RIVERSIDE, CA., 92504
By:
DANIEL P. CRAWFORD JR.
Date:
5/18/2000
Building Official
POST IN A CONSPICUOUS PLACE
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