0006-334 (SFD)z LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that,l am licensed under provisions of
E- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 co Professionals Code, and my License is in full force and effect.
O =) M License # Lic. Class Exp. Date
I Lu�
'*- 748004 13 04/30/2(
o Z � Date -Fir /Signature of Contractor t J�fR%
O
J (-) OWNER -BUILDER DECLARATION `
LU W r- I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ IZ 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
O N Date Signature of, Owner
rn '
Q WORKER'S COMPENSATION DECLARATION
C:) :2 Z I hereby affirm under penalty of perjury one of the following declarations:
0 () 1 have and will maintain a certificate of consent to self -insure for workers'
X w U_ 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.
Ib Q U ( ) I have and will maintain workers' compensation insurance, as required by
O U Q Section 3700 of the Labor Code, for the performance of the Work fortwhich this
d v Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier -Lg4jT I) PACII!IC IINS Policy No. NWA1191&49-90
cw 5
�d
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
subject to the workers' compensation provisions of Secti n 3700 of the Labor
I 3• Code, I shall forthwith comply with those prbui"+ons.
Date: ^�1 Q /IDApplicant ' --� %
} . ,-
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 property for ins�ection purposes.
Signature (Owner/Agent) / t�'�/a' .l Date
BUILDING PERMIT PERMIT,
DATE VALUATION LOT
S�iOLOVcfr✓.�O � % TRACT
JOB SIE�y��•
APN
��+
ADDRESS Of/ f'(SlI —
JY-- j
761-09"78
OWNER .-
CONTRACTOR / DESIGNER / EN INEER -
STEVEN' WALKER HOMES
M''VM u/X"R HOWES
7161 INDIANA AVX
7161 DMIA14A AVL
.RS\ ERSIDE CA. 92504
RJ`11M riE CA 92504
(909)784.0840 CEi it 5357 _
USE OF PERMIT
SMGJ E EA)WLY D79L1 .I�fi G
,
SFD- LOT 46 PJAN 21C PERMIT I DES NOT JNC1,UDF, BLOCK WALLS OR
POOL We % PLAN CI•Iir K FEE REDUCTION FOR 13OUANCE OF 3AME
PLAN TYPE r t
y.,
CUSTOM CONSTRUCTION 4M.00 SIS
n-,1
PORCH/PAI 10 236.00 SF
3ARAGEICARPORT (81) 1%446,00
'
F.131W"TM COST OI' CONS'�'.f.?'O't-".0i`2
2tii3, .90
pkvmnl Is KF18i1M41 SUMMARY
CONSTRUCTION FEE 101,000-418.000 $95:{.00
PLAN CHECK rrei� 101-000-439-318 $202.69
MECHANICAL, FEEL, 101-000#421.000 192.00
ELECTRICAL, FEE 101-,000-420-000 $145.47
PI.t3mora4 Fue 101.000.419-000 $162.56
STRO C MOTION I'EE • RMID 101-000-241-000 $20.09
4RAWN0 FRE 101 X000-42.1.000 $20.00
DZVELOPER IMPACT FE $1,90760
ARX IN PUBLIC PLACE49 - RESIL- 701-000.255-000 $2.29
,
RrB-TOTAL CONVIRUCV014 AND PLAN CIMAM
$3,548.02
LESS PRF�PAID MS
$0,00
TOTAL PXRXCf Irf ZS DUFF NOW
$3"102
RECEIPT
DATE
BY�
DATE FINALED
INSPECTOR
Com' / 6�,,✓
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHAN,ICAI-/APPROVALS
Set Backs A
Underground Ducts
Forms & Footings /%� r,L Ok
Ducts
Slab Grade ��ff �Q
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 & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath /
Final
BLOCKWALL APPROV S
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 _10
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 p 6
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiririg
Low VoRage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
(Certificate of Occupancy
La "City of Quinta
Building -and Safety Department F ti°
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: 80-646 HERMITAGE
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0006-334
Occupancy Group: R-3 Type of Construction: VN Land Use Zone:. RL
Owner of Building: STEVEN WALKER HOMES
Building Official
Address: 7161 INDIANA AVE
City: RIVERSIDE, CA., 92504
By: DANIEL P. CRAWFORD JR.
Date: 9/21 /01
POST IN A CONSPICUOUS PLACE