0006-309 (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 r Exp. Date
719113 1
Dated Signature of Contrafc�o�r�''�� ��-�—
• Y
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 00L.DM41<.AOLF )W3. Policy No. ITWC. 476053,02
(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,Rand agree that if I should become
s Nect to the workers' compensation-,provisions
¢provlslons of, Section 3700ahe Labor
ode, 11 ff rth�w+itth comply with,those provls�ns,-/�/
Date: �� APPlicant7�i
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 inspection purposes.
Signature (Owner/Agee"t) .• - /_gate �'��'�"'
�..
BUILDING PERMIT PERMIT#
DATE VALUATION LOTS' TRACT
JOB SITE y A�.
ADDRESS i 'ta ��YPsfw WAY
APN
-7451-170-039
OWNER
CONTRACTOR/DESIGNER/EN INFER
PJELL Y HOIas, wc.
:RX.f..11 HONG. 9, INC.,.
23 CC>: PORKYR -A 02+45
23 CORPO1"tANKFI.PLAZA0245
NEWOXr BEACH CA 92660
NEWPORT BEACH CA 92660
(949)719-4975 CBL# 5337
USE OF PERMIT
EM14012 FA*N .Y 12MF IMIG
Ski- LO'f 5 PI..A.N 5 E11.- 'PER -MIF D09S NOT JNCL.UDE BLOCK WALLS OR
PBRVI T .
CUSTOM CONSTRUCTION V06.00 SF
PO12CHtPATIO 754.00 SF
c}AIY.A0VC.AU0RT (SI) upls.20
. H
,V.S' A rED COST or, Ci)wS'mucmon
V1,504.50
C01110TRUCTION ISE 101.000-418.000 51,911.50
PLAN CHECK FEE 101-000-439418 $1,062.30
MECHANICAL FEE 1091.000. 21-000 $117.50
1...w
EL;I�.,CTRICAL FE 101-000-420-000 $143.05
," p
PIst1MSING FU 101.000.419000 SIV -75
STROWID MOTION FEE IZMID 101-000-241 4000 $10.15
(311ADINO Fete, 101-000.429.000 $20.04
DEVELOPER IMPACT FEF,
"d
ART Its PUBLIC PL.ACM, • It.I'.SIi 701.000.2$5.000 S228.76
8TJ9 TOTAL COM RTl'CfION AND PLAT C: TCX
TIESS PIRIE.pAU) PW
$0.00
f l
RECEIPT
DATE
B�, f \
i )t
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
' BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Slab Grade
Ducts
Return Air
Steel
_
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
br
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 �POOLS-SPAS
BLOCKWALL A PROVALS
Final
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
Sewer Connection
/�
Pool Cover
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)
FEB -09-2001 14:35 WESTERN INSULATION 909 686 8786 P.07i24
WES'T`IERN INSULATION INC.
4211 Latham strut, Riverside, California 92W 1
Tel. (909) 686-8760 Fax (909) 666-8786
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 #: 5
SITE ADDRESS: 81-055 LEGENDS WAY, CA
EXTERIOR WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 6 3/4 " R -VALUE: R-19
CEILIN13S: �13ATTS BLOW
MANUFACTURER JOHN MANVILLE THICKNESS 11 " R -VALUE: R-30
ENERAL CONTRACTOR: RIELLY HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: 4/6
TITLE: PRODUCTION ANAGER
DATE FEBRUARY 9, 2001
04
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
4� Iii/ '
Vice Pr sident-Operations
17182 AR TRONG AVENUE
IRVINE, CA 92614
9491260-7900
9491852-1160 FAX
www.daveyroofing.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: 81-055 LEGENDS WAY
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0006-309
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:` GARY HARTMAN
Date: 12/20/01
POST IN A CONSPICUOUS PLACE