0006-307 (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
/ '719113
YDate ` �� �' Signature of Contrar
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 Cat>LDE1d 1 A03.8 INS, Policy No. NWC 4700gS-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
Yorkers' compensation laws of California,.and agree that if I should become
/Subject to the workers' compensation provisions of Section 3,700,6f the Labor
CodeA s -all ff rthwith comply with those,proeissio sj
Date:
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 author' iz-representatives of this City to enter upon
the above-mentioned property for inspection pur. • oses!o,
Signature (OwnedAg ntf;�
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 7V ".J <F l
� �
TRACT
$225,746.10
28838.2
JOB SITE
ADDRESS ����
APN
� ) 'WAY
781.170-039
OWNER
CONTRACTOR / DESIGNER / ENGINEER
RMLYHOWS, 79C.
RM -LY HOMES, DIC.
23 CORPORKM PI:d' „ #2"45
23 COR ORA:I'L? PLAZA, #245
NEWPORT BEACH CA 92660
NEW.6'C3I:2"t BEACH
!CA
92660
(949)719.4975
f-� Of-ag
5337
USE OF PERMIT
=GLR FAWLY I3WFE T.I'.NO
'
SM - T.OT 3 P1,AN 28R PIE 2MIT MOMS NOT INCLUDE ISLOC:K �iV'.AfLS OR
POOL,
CUSTOM CONSTRUCTION 2,40-109 SIS
t
IfsORCHtPATIO 1,344.00 SY
C4.�',R.AGEX-AR,POM' (3k) 14.443,20
NSMIATM COV OF C€ DS'fIRWs 1iOR
22-'%-746.10
VER3WTMIR SPRY
CONSTRUC`SIONI EP, 101.000418-000 5110901,0
PLAN CHECK NEE 101-000-439-319 $886.9$
MECH"IC.AL FEE 101.000421.000
ELf,,FC:TRJCSAL FEE 101-0130-420-000 $159.15
!23
P1.UMBINO FEE 101.000.419.000 1180150
STRONDMOTIOt FRE -RESID 101-000-241-000 $-2
��.sr1 E-=:
GRADINO FRE 101=000.-423.000
'
j~gf
DEVE'LoOPER IMPACT A:n $1,907.00
~ '
r,
,AWf IN PUBLIC PLACES - REWE 701*000,-255.000 $64,9"
C�
SOB -TOTAL i:.C?WIRUCM0114 AND PLAN CIMC1s',
$4,438.44
LESS- )QRS -PAW FIMS
'$0,010
T(E' sY_E1Mf 1T,'&7.DUX 4i
$3.A_36,44
' n
RECEIPT
DATE
BY/
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION j
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
.Set Backs
Underground Ducts
Forms & Footings
//
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
IZIM61ftExhaust
Fans
O.K. to Wrap
/419,
F.A.U.
Framing
Compressor
Insulation
S
Vents
Fireplace P.L.
4
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
/
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
p i'lU
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
/ blary
Encapsulation
Gas Piping
Gas Test
2 ot
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 41
Utility Notice (Perm)
COMMENTS:
FEB -09-2001 14:34 _WESTERN INSULATION 909 686 8786 P.05/24
J]
WESTERN INSULATION INC,
4211 Latham Street, Riverside, California 92501
Tel. (909) 686-8760 Pax (909) 686-8786
INSULATION CERTIFICA'T'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: # 28838/ PHASE 2
LOT #: 3
SITE ADDRESS: 81-035 LEGENDS WAY, CA
EXTERIOR WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 6 3/4 " R -VALUE: R-19
CEILINGS: BATTS, BLOW
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: &4��
TITLE: PRODUCTI N MANAGER
DATE FEBRUARY 9, 2001
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.
�erely
.a
Vice Pr sident-Operations
17182 AR TRONG AVENUE
IRVINE, CA 92614
949/260-7900
949/852-1160 FAX
www. doveyroofir)g. com
Certificate of Occupancy
City of La Quintal
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:
81-035 LEGENDS WAY
Owner of Building: RIELLY HOMES, INC
Building Official -
VN
Bldg. Permit No.: 0006-307
Land Use Zone: RL
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: DANIEL P. CRAWFORD JR.
Date: 3/28/01
POST IN A CONSPICUOUS PLACE