0007-117 (SFD)LICENSED CONTRACTOR DECLARATION
r' 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
7191)3 B orz9t�07
Date Y SI nature of Contractor
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.
06 1 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 OO1.L7'N RAOUINSP Policy No. "C 476OSS-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-% gree that if I should become
subjt to the workers: compensatlon,p�r islo)r sof S"ectionv3700 of the Labor
de, I Shall rth,,,w��ilt�t��.}, comply with t ose_provlslons
ate: / '""?Applicant
.P
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 harmlessthe 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 'hove -mentioned property for°inspection urposes.
Signature (Owner/AgeD�� to
..,gent)
BUILDING PERMIT PERMIT#
DATE/VALUATION LOT' TRACT
w' $278,WI O 4 28838.,1
JOB SITE
ADDRESS kLf"4s�an_ 4,
A
761-500-4N
.QTNER
CONTRACTOR / DESIGNER / EN (NEER
23 CORPORATE M AZ 4245
7-3 C ORPORNM FIAZA 0245
1E1n1P0W BEACH CA 92660
NEI WORT DI=H C.A. 92660
(949)719.4975 CBL4 5337
USE OF PERMIT
W401 Y, F -AI& .Y DVM. -L RC1,
Sly - LOT 31 PLAN 48 PERMIT UORS NOT INCLUDE POOL, OR BLOCK
WALLS., 75% PLAN CHECK R.F.D ICTION FOR MULTIP);.E ,18SUANCE
C1JST01:A C01143TRUC:TIO13 %222.00 3F
POR.CHIP.ATIO 940.00 Sid
0ARA01FJCARPOWr (317)1 15,405.60
ESMAIXD 10,03"1 OF CONMITC'S14N
278,901.40
FWWr FRE N"CIMMARY
C011UTRUC TION FEL 101.000.418.000 $1,266,00
PLAN CHECK F 109-000-439-318 9137.35
MECHANIC4, FEE 101.000.421.000 5111.00
CL ECTWC,AL P99 101-000-420-000 $1..94.99
PLjJi!+l131NO Ft.9 101=000419=000 5199,75
STRONG MU ION FEE N 0, 31D 101-000-241-000 $27.89
GRADING ME 101.000.423-000 $20.00
DEVELOPER IMPACT )IFY- $1,907.00
ART IN PUBLIC PLACES - itMU"701-tIt'i9-255-00r0 $i97.25
8U`13�TOTAL C01q81RUC'T.iC)xJ'AFyi�3''{(N�PLM
CTW�CK`�.
$4,172.23
F l
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof DeckExhaust
Fans
O.K. to Wrap
FA.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 7 DZ
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)
�tB-09-2001 14:37 -WESTERN INSULATION 909 686 8786 P.18i24
WESTERN INSULATYON, INC.
4211 Latham Street, Riverside, California 92501
Tel. (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 # : 31
SITE ADDRESS: 81-090 LEGENDS WAY, CA
EXTERIOR WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 6 3/4 " R -VALUE: R-19
CEILINGS:
MANUFACTURER
BATTS
JOHN MANVILLE
BLOW
THICKNESS 11" R -VALUE: R-30
NERAL CONTRACTOR-- RIELLY HOMES
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODUCTIO19 MANAGER
DATE FEBRUARY 9, 2001
0.
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
"1
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
1 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.
n erely/
a�
Vice Pr sident-Operations
17182 AR TRONG AVENUE
IRVINE, CA 92614
9491260-7900
9491852-1160 FAX
www.doveyroofing.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:
Use Classification: SINGLE FAMILY DWELLING
81-090 LEGENDS WAY
Occupancy Group: . R-3 Type of Construction: VN
Owner of Building: RIELLY HOMES, INC.
Building Official
Bldg. Permit No.: 0007-117
Land Use Zone:. RL
Address: 23 CORPORATE PLAZA, #245
City: NEWPORT BEACH, CA., 92660
By: GARY HARTMAN
Date: 1/7/02
POST IN A CONSPICUOUS PLACE