9907-467 (SFD)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 anis
Professionals Code, and my License is in full force arib effect.
License7/yM Sc. Class Lxp. DaIdJW264
0/ate ' 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 iss "ed. M,V woCkk rs' c .mpensation insurance carrier & .potic no. are:
Carrier t '. -D Yp l:lFedC 1[�5 Policy No. :N�,!b'A2SJ17i3 6.00
(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
subject to the workers' compensation pros isio/l s of Section 3700 of the Labor
C,Ade, I shfall/forthWdh comply wiytt.ose prods+oRs—
`bate: r ' 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 application 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; �epriesentatives of this City to entef
pon
the above-mentioned property fo'r inspeTtion purposes. . {,
Signature (Owner/Agent) - Date t+ .
PERMITV110111r746 '
BUILDINGAERMIT h� -� 2W.V1.
DATE I' j�f I VALUATION
T �y LOT TRACT
7�fi '!' Pi�A ted/:
1Q C� i
JOB SITE C.:�'r: �t'�r.�ua
APN
ADDRESS
OWNER
S"t'FVEN NWALKER HOMES
CONTRACTOR / DESIGNER / ENGINEER
MT'i,'i: N WALKER HOMES
7161 - DIANA AVE..
1161. INDIANA AV's:.
RIVERSIDE. CA' 92504
IUVERSIDE CA 912504
(909)7 44840 CBL.O 5351
'
USE%l.t�IRldEli FAMILY DWP?'LLING
S C , iaT. iw 00 ' 3: AsSt. 14A
-717ri ''" i w .S.- i' . fj
POOL. 'i% liiMIXTIC1N TO PL t'`£•1F.CK. FEE FOR. Mtf1.':1'WiX ISSUA``ICiE
OF SAME PLAN TYPE
CI.7'S'i'OM.C;ONISTRUC'1'ION -2,379.00 3
POR.CHIPATIO ZX1.00 SF
Qrt1R,fLCr�GA�i1aO,ltz f3S<0t1 ."iP
ITIMATED C09F OF K:"ON:SiTRUC"q"WN
2430t696.10
PERMIT 'FEE SUMMARY
CON STRUCTI0N FEE 101-000418-000 S4s!)3.00
ft AN CHECK fFX3 101 -OW -439-318 $203.00
MWHAMC,AL'FFE 101-000-4214M $92.110
f.„' .K"'IT ICAL PEAS 1101 -OW -420-000
Pi I:IMBINGFEE. z):l���J3J-4D�{3t11) $Id►' X41
Mi2ONG MOTION FM. - REalD 101.0M,24.1-Ot'i0
GRADING ING FFE ,'01-000 423-000 =00
Akr Ih1P(JUIC 11LACES - RE$IC 701.400-255-aatti *25134
(yhkTLCC_1M tlbti'ACT fTm
SVB-1FJ1S,(6.te C.Q4J. .'iR0G1 %1 AI' D PLAN CHECK
$3,90R.1:7
I.,CSi PRE-PiUD FEES
xU.00t
TOTAL PERMIT FEES 6.DUlL NOW
� �-� i �;I;3„114' 2.78
{6 s
�IJ
�k
IJ—
RECEIPT
DATE
BY +
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
I DATE
I INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
4
Underground Ducts
Forms 8 Footings /fes
Ducts
Slab Grade
Q
Return Air
Steel
Combustion Air
Roof Deck
�� / _
Exhaust Fans
O.K. to Wrap
9
F.A.U.
Framing
/ d
Compressor
Insulation
_ _
/ /
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 6 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
,/
Final G�Y'-��
BLOCKWALL APPROVALS
Final
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
��,��
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
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# 6
SITE ADDRESS: 80558 HERMITAGE
------------------------------------------------------------------
EXTERIOR WALLS:
NAMAI 11yd61010:1Z
CEILINGS:
MANUFACTURER
CEILINGS:
MANUFACTURER
Johns -Manville THICKNESS:
(0,TTS)
Johns-Manville THICKNESS:
BATTS
Greenstone THICKNESS:
3 1/2" R -VALUE: R-15
BLOW
13" R -VALUE: R-38
(!F)
10.3" R -VALUE: R-38
----------------------------------------------------------------
GENERAL CONTRACTOR: STEVEN WALKER HOMES
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: gruk ou )�)
TITLE: PRODUC I N MANAG
DATE May 9, 0
Certificate of Occupancy
City of La Quinta
Building and SafetyDepartment
This Certificate issued pursuant to the requirements of Section 1.09 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:
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction:
80-558 HERMITAGE
Owner of Building: STEVEN WALKER HOMES
Building Offi a
VN
Bldg. Permit No.: 9907-467
Land Use Zone: RL
Address: 7161 INDIANA AVE
City: RIVERSIDE, CA.; 92504
By: DANIEL P. CRAWFORD JR.
Date: 6/14/2000
POST IN A CONSPICUOUS PLACE