0006-329 (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 and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
1 f7 8 D {~ Wit
EDat " /� " f o 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 UNITED PACIFIC INS Policy No. NWA1191S0-00
(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'provl ions of Sect' n 3700 of the Labor
ode, fS 'ha hfof h ith comply wit thosepr° vlsio s� �7
�v .c)
/ate:� � �U
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 inss5eectlon Rurp ses.
Signature (Owner/Agent) "�—f��'��
Date
)`6 �� BUILDING PERMIT PERMIT
I.
I./
DATE VALUATION LOT 9 TRACT
$204,677.90 28603.1
JOB SITE
ADDRESS L7^�73ET i,M�• AG
APN
TC1I-(3 •®
t,s
OWNER
CONTRACTOR / DESIGNER / EN INEER
STEVEM WALKER fi0NffiS
STEVEN WAUKER 110MM
71617N1.77I NA AVE,
7161 I1dD1A1,1'A AY'E,
RIVERST.i.3E Cly 92504
R1VMSME CA 92504
(909)784-0840
USE OF PERMIT
SINGLE 1<AMMY DWS22,1 i
> C"`
SH'I3. LOT 7R PLAN 3A PERMIT DOFS NOT INC1,UD? BLOCK WAIAB OR. y"' f I
POOL 7S 9c,PLJ>N CHECK FEE REDUCTION MR ISSUANCE OF SAMEPLAN
TYPE
ATOM. CONSTRUCTIO14 2,450.00 SP
PORCH/PATIO 245.00 Si?
GARAGIUC.AR.PORT (SF) 10.564.40
Effr ATM COS' OSP' CC)MST1 UC1700
204,677190
PEREWfff F=, • If"7FJ1 RY
CONSTRUCTION IM?, 101-OOD-418.000 $1,007,00
PLAN CHECK FEE 101-000-439-318 $206.71
MECHANIC.AI. FEF, 101-.000.421.000 $92.00
IiLECTP11C.a LPEE 101-00".20-000 $149.03
PIUMAINCI Pit 101.000.419.000 $186.50
STRONQ MOTION ME - RESID 101.-000.241-000 $30.47
MADIN'G FEE 101.090.423-000 $20.00
DEVELOPER IMPACT PZ $3,907.00
.FI RT D4 PUBLIC P.LR.CES - RESIT 701.000-255.000 511.64
W.8-TafALCOMSIRUMONAM PLAN CI-TF:,C.I�
$3,60.0.41
IMS PRE -PAM FEES
$0.00
TOTAL FEIMff- Y'IES DUENOW
RECEIPT
DATE
BY1 j/9 c,
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE .`
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 8 Footings
j)
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
p
Compressor
Insulation
/ p
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVAL
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 APP OVALS
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
Q
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Vottage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
/
/�7
MAY -03-2001 1029
kIESTERN INSULATION
-- - - -- -----------
909 686 8796 P, 09/14
WWTERN INSULATION o INC.
4211 Lath m Street, Riversi94 CaUkamia 9230.1
TeL (909) 6845r8760 Fax (909168&8786
IST ON 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 #28603-1 /PHASE 3
LOT#: 28
SITE ADDRESS: 80.836 HERMITAGE. LA QUINTA, CA
............. ....................................................
4E�OR IATALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 1 f " R -VALUE: R-16
rglEILIWSa BATTS BLO
MANUFACTURER GREENSTONE THICKNESS 10.3
CEM GS: BAITS BLOW
MANUFACTURER JOHNS MANVILLE THICKNESS: 13"
GENEML CO, TI�1 RAPTOR: STEVEN WALKER HOMES
BY:
TITLE:
DATE:
INSULATION CONI ACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PFt0QdCTION D ANAGER
DATE MAY 3, 2001
R -VALUE: R-38.
R -VALUE: R-38
�'c
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:
Use Classification:
Occupancy Group:
SINGLE FAMILY DWELLING
R-3
80-836 HERMITAGE
Type of Construction: VN
Bldg. Permit No.: 0006-329
Land Use Zone: RL
Owner of Building: STEVEN WALKER HOMES Address: 7161 INDIANA AVE.
-7-o4-t /4-u�7
Building Official
City: RIVERSIDE, CA., 92504
By: DANIEL P. CRAWFORD JR.
Date: 7/27/01
POST IN A CONSPICUOUS PLACE