0006-326 (SFD)8
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 # Lic. Class Exp. Date
748004 B ,t�. 04/30/2(
�te l ► l fd O �. Signature of Contractor' Q �'✓
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:
CarverUNIT13) PACIFIC`, ria Policy No. NIVAI1913,43.00
(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' com pensation rovisions of Sec ion 3700 of the Labor
/bode, I shall forthwith comply withp� o ej/proui ions.,
ate: /, 7 ) 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 bove-mentioned property for�inspee ion purpose
`Signature (Owner/Agent)--° Date/2
BUILDING PERMIT PERMIT/i
- - - - "�
. DATE VALUATION LOT- TRACT
$204,577.90 28603-1
Of .
JOB SITE tq
ADDRESS �� +
APN t`
7E2 -U9 -078
OWNER
CONTRACTOR/DESIGNER/EN (NEER
IMVM WALLIM HOMES
SIEVE14 WA.UCER HOW S
7161 INDIANA AVF_
7161 NDIAATA AW
RIV I; ME CA 92504
RIVERSIDE CA 92504.
(909)764-01340 CBL* 5357
USE OF PERMIT
SING12 YAMLY LIW-[..1.,ING
SIM -LOT OT 5 PS A14 ICPERMIT DOES NOT INCLUDE BLOCK WALLS OR --- s•-: � r
P001I 75 ",e PLAN C;I ECI':' [ EE REDUCTION FOR, ISSUANCE OF 111AIti4L+
PLAN TYPE I's-I '1 i`s i
xr_'•�
CUSTOM CONSTRUCTION Z4�L".00 SY
a� i • I .,.1
PORCH/FA TIO 245.00 Sii'
0ARAGPWA.RPORT F) 10,364.40
ES9WATM COS0r C0NS1.U;n0N
204,67700
iEFIM 911ip1RY
CQNSTRUC HON FELE 101.ON- 418.000 $1,007,00
PLAN CHECK VU 101.000,439-318 $206.73
MECHANICAL FEE 101 r000=421.000 $92,00
I?L ECTRIC:AL FEE 101-000-420-000 $140.03
PLU.MBTNCI FEE 101-000.419-000 $196,50
STRONO MOTION FEE - RESID 101-000-241-000 $29.47
GRADING FEE 101-000-423-000 9?01 0
DEV'ELOPE-9 IMPACT PEE $1,907.00
ART IN PUBLIC PLAC'M - RESIE 701-000.255-000 $11,69
SUB -TOTAL C0NWRUCf10A1 AND PLAN Cku C;IC
$3,600.41
LF -03 PRF -PAID PE3: 4
$0.00
+;'WAL PST PEES D`tTE NOW
$3,6U0:41
RECEIPT
DATE
BYDATE
FINALED
INSPECTOR
� Ww,
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts:
Forms &Footings
Ducts
Slab Grade
Return Air
Steel
417
'Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
1401101 q
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 A PROV 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
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
or
Pool Cover
Encapsulation
Gas Piping
Gas Test
ZO i(
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:
MAl'-03=2001 10:228 WESTERN INSULATION 909 666 8786 P,06i14
ST RN INSULATION, INC@
4211 Lath= at =U Riverside, Ct Uoraia 94301
TeL (909) 686-8760 Fox (909) 686.8786
iNStTLAT ON CKRT-IFICAT,E
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 #28603-1 /PHASE 3
LOT #: 23
SITE ADDRESS: 80-800 HERMITAGE. LA QUINTA, CA
EXTERIOR WALE
MANUFACTURER:
JOHNS MANVILLE
THICKNESS: 3 112 " R -VALUE: R-15
CE1LI
BATTS
OW
MANUFACTURER
GREENSTONE
THICKNESS: 10.3 " R -VALUE: R-38
S:
BAITS
SLOW
CBI
MANUFACTURER
JOHNS MANVILLE
THICKNESS: 13" R -VALUE: R•38
GENERAL CONTRACTOR; STEVEN WALKER HOMES
BY:
TITLE:
DATE:
INSULATION CONIIJACTOR. WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PR ION rNAGER
DATE MAY , 2001
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: 80-800 HERMITAGE
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction:
Owner of Building: STEVEN WALKER HOMES
Building Official
ly1►i
Bldg. Permit No.: 0006-326
Land Use Zone: RL
Address: 7161 INDIANA AVE
City: RIVERSIDE, CA., 92504
By: DANIEL P. CRAWFORD JR.
Date: 7/31 /01
POST IN A CONSPICUOUS PLACE