0006-308 (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
bate Signature of Cont tor""�
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 00LD9H MkOLE INS. Policy No. 14WC 476OS-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
subject to the workers' compensation pr-v,Isi-1 s of Section 3700 of,,the Labor
4ode,.l.s all orthwith comply with those''�rp sioaS
Date: Applicant,
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
co truction, and hereby authorize" representatives of this City to enter upon
t 6 bove-mentioned pro erty for i sp'ectio purposes!
Signature (Owner/Agent' " Date _
PERMIT N
BUILDING PERMIT
DATE VALUATION LOT �- — -- TRACT
$278,90110 ',-4–
x883$-2
JOB SITE �„�
ADDRESS ' el.t '€ :'1C3iifffji S `PYA '
APN
70,470-1338
OWNER
e
CONTRACTOR / DESIGNER / ENGINEER
.0 LY HOMES, b TC:.
RTY HOMES, INC.
23 CORPORATE PIALN #245
23 C0_RPgRA1_MMA7A 245
NEWPORTBEAC9 CA 92660
NE:W'FC)RT.)5EACTI
CA
91660
.
(949)719.497$
CBI,# 5337
t
USE OF PERMIT
SFD LOT 4 P1,A14 PF.R.MIT FOES NO`P INCLUDE S1AXK W.AI,L,S OR
.POOP., f.. .
CUSTOM C`t?NSTRUC%TION 3,an.00 9P
PORCKIIIPATIO 94aco S.?
GARAGFJCARPORT (SUP) 13,405.60
JESi: MA7" COST OF CONSTJZ00,710H
2.7%911! AO
PKnfiT11W SdYWJARY
CANOTAUCMON F"EE 101-000.418.000 511266100
Pl„AX CHECK FEE 101-000-439-318 $1,029.38
MEC14.AISIM FEE 101-000.421.000 5111.00
ty..I..ECTMAL. F&K 101.000.420-000
1_11
1"a.,ONII 940 FI TS 101.000.419.000 $144,'Y3
U
M
STRO)40 MOTION FF' -E - R "I D 101-000-241-000 327.89-
c`3E .]DiNO FEE 101-000.423.000 $20.00
bINE3. QFBP JMPAC T FZE $1,907.00
C-
ART M PUBLIC; PLACM - RIWK 701-000.255.000 $19725
r s" ,_
rT).J
�
SIM -TOTAL Cf���i��s';i°R.VIZ111C}0AN�D!�tpTAt+i`i,Ccl:T�� (`I7�y
S4,94�46.26�
.���y
- L �Zi..c- l`a�M Tins
501011
'forrA J '�3�i.'s` .CSS DU N01�!$4,944,26
A
RECEIPT
DATE
Yf /'
DAT F N ED - I
Dl o
INSPECTOR
*:;.w
r
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
A
Underground Ducts
Forms & Footings
!td
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
_
Compressor
Insulation
IUEVents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
_
POOLS - SPAS .
BLOCKWALL
APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PI . Test
Final I
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
Z
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)
c:. FEB -09-2001 14:35 WESTERN INSULATION 909 686 8786 P.06/24
WESTERN INSULATION INC.
4211 Latham Street, Riverside, CaI fornla 92501
Tei. (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 / PHASE: # 28838/ PHASE 2
LOT#: 4
SITE ADDRESS: 81-045 LEGENDS WAY, CA
---------------------------------------------------------------
EXTERIOR WALLS:
MANUFACTURER; JOHNS MANVILLE THICKNESS: 6 3/4 " R—VALUE: R-19
CEILINGS: BATl'S BLOW
MANUFACTURER JOHN MANVILLE THICKNESS 11 " R -VALUE: R-30
GENERAL COINTRACTOR: RIELLY HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRO DUCTIOW MANAGER
DATE FEBRUARY 9, 2001
"P�'
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.
J.
�nnq
erely
�0-
Pa
Vice Pr sident-Operations
17182 AR rRONG AVENUE
IRVINE, CA 92614
94 9126 0-7 900
9491852-1160 FAX.
www. doveyroofir)g. com
1
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
81-045 LEGENDS WAY
Bldg. Permit No.: 0006-308
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: RIELLY HOMES, INC
Building Official
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: DANIEL P. CRAWFORD JR.
Date: .10/11/01
1
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