0006-317 (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
191 i 3 B .� r' V2 C
VContract/or
a
ate � � "Signature of --'
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, 6f 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:
Cartier GOI,13EJ EAGLE WS'. Policy No. NWC 47005$-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 Calif orniardfi l agr}ee that if I should become
subject to the workers' compensation provisions of Section.•3700 of theta' or
Lode,,I shall f hwith comply with 'thos@r • rovisions: r f
Date01 : " / adApplican��i �" ;,
{i7
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 autliori ee representatives of this City to enter upon
lthe above-mentioned pn3 erty torinspectio ,,,purpo s.
tSlg ture (Owner/" Agenf)s'c^ .� Date
fry
7-0"d BUILDING PERMIT PERMIT"
TRACT
DATE VALUATION LOT TRACT
JOB SITE
ADDRESS
�£I`tH_ iY#3��VA
APN
761,-tFt?i� i
OWNER
CONTRACTO�111SIGNEIIE N INEER
RmmfHOMM, WC.
REELI Y HOMES, DIC.
23 CORPORA t'1v 1'LAZ& 41245
23 CORIPOR K11 O PIAZA 4#2425
.
UEWPORT REAR CA. 92660
IvT WPORT B CH
CA
92660
(9&9)' 194975
C-Dvf
5337
USE OF PERMIT
IX- FAMJ 'Y DVT3 I. WG
SPI3 LC1T 36 ''PJAi),l+l 2CR PERMIT D0F.81 NOT INCLUDE BLOCK VVJt,LLS OR
POOL, 74 % PLAN CIIECIC I+'EL RED(IC T IO)4 IrOR I5,,'3LIA +ICE OF 5AML-
PW4 TYPE y
CUSTOM CONSTRUCTION Z313,00 S
PORCIilPATIO 1,280.00 v
GA.RACJPICARPOIt.T (SF) IWS.20
9as"i':CA+!_A.T 7 CCW i. F C4N.r�'TRU(7r ,DX
251,971AO
CONSTRUC11O14 FEE 101-000.41SI-000 $1,111,50
.FLAN CHECK WZ 101-00.439-319
MECHANICAL FEF101 ^000.421.000 $t i i S0
XLW,TPJC ALYZE 101.000-42...0-000 '171.87
PJ.,YII► BT14 1 FEE 101.000-419.001 SIV.7$
- ST90140 MOTION FEE • RESID 101-000-241-000
ORADIWO FU3 101.000.423-000 $20:04
DEVELOPER tI+IZACT "_U! X1,907 b"v
ART IN PUBLIC PLACES -:RL1311:701.000.255.000 $1.24,93
rpt
�
mw
�
S�.J' 13-T CYIAL C0A3•V1`R.iTM10X AM P%AN CHECK
"-p69.98
M PRE -PAW 1' f
$0.00
:COTAr rIMIN 1T I+A, DUE NOW
,96'3 13
RECEIPT
DATE
BY.%
DATEFINALED
INSPECTOR
F,o
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 8 Footings
Ducts
Slab Grade
—pa '/.L
Retum 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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PI . Test
Final I
I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
AXHeater
Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
ewer ateral
Pool Cover
Sewer Connection
d
Encapsulation
Gas Test
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:
FEB -09-2001 14:37 WESTERN INSULATION 909 686 8786 P.23i24
WESTERN INSULATION INC.
4211 Latham Strut, Rlvc midc, California 92501
Tel. (909) 686-8760 Fax (909) 686-8786
INSULATION CER'T'IFICATE
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 7 PHASE: # 28838/ PHASE 2
LOT -# -- - -- -- 36
r _
SITE ADDRESS: 81-040 LEGENDS -WAY -'CA
---------------------------------------------------------------
EXTERIOR WALLS:
MANUFACTURER: JOHNS MANVILLE
CEILINGS: BA
MANUFACTURER JOHN MANVILLE
GENERAL CONTRACTOR:
THICKNESS: 6 3/4 " R -VALUE: R-19
BLOW
THICKNESS lilt R -VALUE: R-30
RIELLY HOMES
BY:
TITLE:
DATE:
INSULATION (CONTRA TOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODUCTION ANAGER
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:
LOTNUMBER
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
y if you have any questions, please call me at (949) 260-7925.
n erely
�(//��
atnck a,
Vice Pr sident-Operations
17182 AR MCNG AVENUE
IRVINE, CA 92614
9491260.7900
9491852-1160 FAX
www. doveyroofing. com
Certificate of.0ccupancy
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
ollowing:
BUILDING ADDRESS: 81-040 LEGENDS WAY
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0006-317
Occupancy Group: RL Type of Construction: VN Land Use Zone: RL
Owner of Building: RIELLY HOMES, INC
Tom. /4-V�
Building Official
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
'By: DANIEL P. CRAWFORD JR.
Date: 5/18/01
POST IN A CONSPICUOUS PLACE