0006-306 (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
7'1911.3 Z3 _ � �!'�9/2(
VDDate ��"`l% Signature of Co tractor- -�
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 fl�1LDt:N F �IF,P, INS, Policy No. NWC 47SD5S-02
(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
ubject to the workers' compensation provisions of Section,3700,4f the Labor
Code,I.shall orthwith comply with..those_ r visions:'
((( Date: " wGApplicant/",� �` .v ^e'✓�''c�.--
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. 1 agree to comply with all City, and State laws relating to the building
construction, and hereby authorise `representatives of this City to enter upon
the bove-mentioned property forin pection p"rposes
ignature (Owne`r/ g� n --� _.��' ..Date
r
-TJ 06 BUILDING PERMIT PERMIT#
DATE VALUATION LOT ,r-� TRACT
JOB SITE A� �qow
ADDRESS a;,srMOTE�^039
APN
OWNER
CONTRACTOR / DESIGNER / EN (NEER
c
Ramy HC MES, INC.
RW -LY I.1;C3MIV4, f14C.
23 CORPORA` E PLA,`l-A #245
23 CORPO.�A'rE PLA-YA; #7,45
NE' WT-'01ZT 8EACH CA 02660
14'E OR!f BRACH CA 92660
(949)719.49,5 CB 5337
•.
USE OF PERMIT
W7.;NCIZ YAWM.X ii"WYLIA G
SFD- TnT aPLAN 3A- PERMIT DOES WOT INCLUDE BLOCK YIIALi.,S OR
P006 15 % PLA14 CHECK FEE M DUCTION FOR 155LIANCE OF 1AM1i
PLAN TYPE
CUSTOM CONSTRUCTION 3,018.00 0P
PORCHfPATI0 1,280.00 SIS
t?P RAWCARPOR-1 (SIS 15,425.20
t
FSMMT :lD COS' OF C`f).1!7&T"Crt`f.0Jq
P
"1,971AO
CON31'RUCTION = 101.000.418.000 $1,111,50
PLAN CHl';C:K FEE 101-000-439-319 $239.23
1AF.CHANICAL FErl 101.0004.21. 000 $1 t7150
M=TATCAL F&K 101-000-420-000 $171.97
T„
PLUI> BIHOEEE 101.0000.4]9-000 S107M
ST RON- 0 MOTION VSH • R-ES1D 101-000-241-000 525: s0
_'i
� -
O.11ADINO FEE 102000.423.000 920-00.
•,:`+ . �
D911MA)'1rR.IMPACT F E $1,90? 00
_
JI W1 M PUBLIC PLACES - RESM 70I-000.255^000 $129,93
C
r { "j
rri QJ
WI3-' TOTAL COINT:,'`1M.UMOI+TAND PJ.=WCID-C`�
"-->
YXuTJ PRF -PAID F=
$0.00
TorTALYli'Mr! +6 DUE NOW
RECEIPT
DATE
B,1f
DATE FINALED
INSPECTOR
f--
_
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS F
Set Backs
Underground Ducts
Forms & Footings (/
Ducts
_
Slab Grade _
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
0. K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final D
POOLS - SPAS
BLOCKWALL APPROVALS'
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
`
��
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
FE$ -09-2001 14:34 WESTERN INSULATION
909 686 8786 P.04i24
WESTERN INSULATION
,INC,
4211 Latham street, Riverside, Califomia 92501
Tcl. (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: # 28838/ PHASE 2
LOT #: 2 -
SITE ADDRESS: 81-025 LEGENDS, CA
--------------------------------------------
EXTERIOR LLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 63/4 " R -VALUE: R-19
CEILINGS:BATTS 8LO W
(2
MANUFACTURER JOHN MANVILLE THICKNESS 11 " R -VALUE: R-30
GENERAL CONTRACTOR' RIELLY HOMES
BY:
TITLE: '
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE; PRODUCTI MANAGER
DATE FEBRUARY 9, 2001
r'
DAVEY
ROOFING INC.
March 22, 2001
Mr. Steve Gibson
Rielly Homes
81-120 Legends Way
La Quinta, California 92253
Dear Steve:
The following is a listing, by lot number, of the O'Hagin vents installed at Legends at PGA West in La
Quinta, per your roof plan specifications:
LOT NUMBER
ROOF PLAN
NO. OF VENTS
INSTALLED
1
3RC
25
` 2
3A
25
3
2BR
23
4
4C
26
5
5AR
26
6
3C
24
7
4AR
26
8
6A
27
9
4AR
26
10
4A
26
11
6AR
27
12'
6B
27
13
2BR
23
14
4A
26
15
6AR
27
16
6B
27
31-
4B
26
32
5CR
26
33
6A
27
34
4AR
26
35
3B
24
36
3CR .
24
37
2A
26
If you have any questions, please call me at (949) 260-7925.
Zn rely
/k /a
Vice Pr sident-Operations
17182 AR TRONG AVENUE
IRVINE. CA 92614
9491260-7900
9491852-1160 FAX
www.doveyroofir)g.com
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: 81-025 LEGENDS WAY
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0006-306
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
+ Owner of Building: RIELLY HOMES, INC. Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: GARY HARTMAN
Date: 10/24/01
Building Official
POST IN A CONSPICUOUS PLACE
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: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction:
81-025 LEGENDS WAY
Building Official.
vni
Bldg. Permit No.: 0006-306
Land Use Zone: RL
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: GARY HARTMAN
Date: 10/24/01
POST IN A CONSPICUOUS PLACE
u u