0007-110 (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 B
/ate ,
a —6 -'-Signature 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.
( ) 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 C30LT.)ixN FACILE INS, Policy No. ! WC 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 6'66ject to`the
workers co mpensation laws of California and agree that if I should become
subject to the workers' compensation provlslo s of Section 3700 of the Labor
Code, I s all forthwith com I with Shos�er �sl_ons./�y .�
ate: -- /�.�' Applicant �J�""11 .f
--�
Warning: Failure to secure Wogs' 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 harm less.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 iiQection,purposes.
tSignature (Owner/A,gerJt•). ✓"' i 2—.-Dtate
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 'CUf307�110 TRACT
e- $27>S�Ofl. 2s,. 28$3€3.1
a
JOB SITE APN
ADDRESS "$%:MMMU ,C -WAY, 761-1,70-03.9
OWNER CONTRACTOR / DESIGNER / EN (NEER
RMLLYROMES, r9C.
23 CORPORAME PIAZA #U5
14EWPORT BFACvH CA 92660
USE OF PERMIT
SWOU FAMILY DWI{L:E2 O
R11�1 f HOME 3, WC.
23 CORPORATE PLAZA, 9245
NE'WPOI;rf BEACH CA 92660
(949)719-49?5 CBUt 5337
SF0 . LOT.9 PI.,AN 4AR PERMIT DO -PS NOT INCLUDE POO!,. OR BLDCK
WALLIS.
CUBT014 CONSTRUCT10N X272,00 OF
PORCH/PATIO 940.00 IF
Q&RA®P(CARPOR'P (:,F) 15,405.60
E�i�D CONT O.0C0179IRUCCOn
278,901,40.
pxRMryT riyA.
CONOTRUCTION FEE
101-000-4118.000
$1,26coo
n,«PLAW CHECIC. NLE
101»000-439-318
$029.38
MECHANICAL NIC.ALFEF;
101.000-421.000
$111.00
ELECTRICAL ME
101-000-420-000
$185.99
PLIUMI31NC31i OR
101.000.419.000
$199,79
STRONG MOTICN ME a It,LSID
101-000-241=000
$27.90
ORADW FRE
101c=-423-000
$20,00
DEVELOPER IMPACT 17EE
$1,907.00
ART W PT)BLIC PLAMS - ROME 701.000.25.5.000
$197.23
1711)E*�C9s3'r
101-000-435I-31$
4500.00
- -
SIM TOTAL COWRTRUC71-OR AND PLAN Mll $4,944.26
LEDS PRE -PAW 1=4 -$500.00
TC?'.CAI, MOM FEEN VUE SOW $41444.26
jet
�10 t�jtrU
A
RECEIPT DATE I BY ' I DATE FINALED I INSPECTOR,
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS'
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Cucts
_j
Slab Grade
6D
Return 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 & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
FinalI
Final
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
3 / IV
Encapsulation
'Gas Piping
Gas Test
6
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) 1&7 6F
FEB -09-2001 ,14:36 -WESTERN INSULATION 909 686 8786 P-12/24
WESTERN INSULATION, INC.
4211 Latham Sweet, Riverside, California 9250I
Tel. (909) 686-8760 Pax (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 # : 9
SITE ADDRESS: 81-095 LEGENDA 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:
WSUL TION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODUCTION NAGER
DATE FEBRUARY 9,'2001
I
," .
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.
n erely
2tnck a�y
Vice Pr sident-Operations
17162 AR TRONG AVENUE
IRVINE, CA 92614
9491260-7900
9491852-1160 FAX
www. davo yro oting. com
1
A
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
81-095 LEGENDS WAY
Bldg. Permit No.: 0007 -110 -
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: 6/13/01
POST IN A CONSPICUOUS PLACE