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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 K104 tc. Class, Exp. DaJV30120(
,0ate 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
bate 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 1LTNn..'0 PACIFIC TNS Policy No. idWA201'79%-W
(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 Californil and agree that if I should become
subject tolthe workers' compens Q1tion pro lsio�' of Section 3700 of•the Labor
Code; (,shall with comply withKhose pi'oylrsib�r -
Date: PVT 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 authorizel�epresentatives of this City to enter upon
the above-mentioned property for ins ection purposes. j
Signature (Owner/Agent) (`t>r"^ f,�l xIf/� !�
Date d
BUILDIN p � T PERMIT_'
R, !,% ' �+
, t 0 -1
DATE� VALUATION LOT TRACT
4I
A•
JOB SITE l,c..?.-1..-,-4-�- e _-r.•ers,�e..,:,k
.
ADDRESS
OWNER
STEVEN WVALKE01 HOMES
CONTRACTOR/DESIGNER/ENGINEER
STEVEN WVAL1;ER 14OA"IES
7161. INDIANA AVE.
7161 INDLANA MT.
RIVERSIDE CA 92504
WWRSIDE CA 92504
Z91337£S�t-E133%d0 t;i3�! 5-157
USE O§.p ERtk .�1 T.
13
ff\1RFAMILY DV4'C,i.,.%.ING
24
POOL -75% 'REDUTC9`1UN TO MAN CHECK FRE FOR NILTI:f MILK ISSUNNCE"
OF S.ALME PLAN TYPE
CUSTOM CONS'1`RU 101 2,450,003F
a ORCRI"PA"TIO 245.0 'IF
GARAGMAJ'.T'ORT 534.00 'SF
;1+'Xf MhfATD COST OF CONI'M RUC TION''
204,677.903
ERAI T "FEE Si)MMILRY
CONS T>4.i CI.ION FE E .101-0}00-4 i.ft 00
PLAN CHECK VVE 1014WO-439-31i-4 VV5.13
NIRCH ANICA1:,1:EE 101.-e9)0-4214XX) $85.50
1W'LE�",`I TICAL ME 141-G!Jd) S.2f1-{34a 3154.03
PL111Ie BIN'G FTM. 01-099-419-0130 $16250
5'1'11C3NO MOTION FEE - RESID .1.03.011;'{3.24$-000 $20.47
GRADING FM t41-Ob0-=62 5-I30>3 520.00
.AWf INPCJBUM PLACPS.- I ESID 701_000-255-O W $26i.�59
DEVELOPER, HVIPAC T 1M
SUB-'1'01AL C(7NSI'kUCTION ANND PLAN MECK
43,83.32 %
LESS PPM -PAID FEES
r
}
TOT ALP1ll EMIT TE LS DUE NOW
roti y„
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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 A aDucts
Slab Grade
p�j
Return Air
Steel
Combustion Air
Roof Deck
_
1�
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing(y /�
Insulationf`�{Z //i��a
00
Compressor
Vents
Fireplace .L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
jfU
Final
Final
�
POOLS -SPAS
BLOCKWALL APPROVALS
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
Pool Cover
Sewer Connection
_
2s�
Encapsulation
Gas Piping
Gas Test
T�
Appliances
ae3
Final
COMMENTS:
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)
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# 5
SITE ADDRESS: 80546 HERMITAGE
------------------------------------------------------------------
EXTERIOR WALLS:
MANUFACTURER:
CEILINGS:
MANUFACTURER:
CEILINGS:
MANUFACTURER
Johns -Manville THICKNESS:
3 1/2" R -VALUE: R-15
ATTS
BLOW
Johns -Manville THICKNESS:
13" R,VALUE: R-38
BATTS
BLOW
Greenstone THICKNESS:
10.3" R -VALUE: R-38
-7--------------------------------------------------------------
GENERAL CONTRACTOR: STEVEN WALKER HOMES
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODU T ON MANA j ER
DATE May 9, MOO
�'car-gsJicate of Occupancy
City of La Quinta
Building and Safely 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: 80-546 HERMITAGE
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9907-466
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: STEVEN WALKER HOMES
C o-kn
Buildinb Official
Address: 7161 INDIANA AVE
City: RIVERSIDE, CA., 92504
By: DANIEL P. CRAWFORD JR.
Date: 6/7/2000
POST IN A CONSPICUOUS PLACE