0007-116 (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. Dattel
719113 "t3t`29f
13atte �� Signature of Contrac o� - -!'
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.
(e) I have and will maintain workers' compensation insurance, as required by
S ction 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 001 DgM EA6118 INS,Policy No. NWC 47695S-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
subje5rk�ers' the wocompensation provisions of Section,3700 of teLaborCodeall forthwith comply with those, rovl Ions.
fate: pplicant ,ti''
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., 1,.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"fo�ii spection.purpo
aSlgnature (Owner/Agent-=- --� �=�� Date
L.''' - fr
BUILDING PERMIT PERMIT#
4 G1
DATE / VALUATION LOT TRACT
14,7 ,2I3 C"6
'
Ira
JOB SITE �!
ADDRESS.NJ�� icgY
APN
'%i++CZ_ 7(034.3
WNER
CONTRACTOR/DESIGNER/EN INEER
Rff_q_ YHOWS, WC.
WELLY HOMES, FITC.
23 CORPORNM l LALN 47.45
23 C:'-OXPORA:.C'.E PJAZA, #245
1 ildFC? T 3R4 J CA 926,60
idEWORT R.EAC'aH CA 92660
�P49j 719- 5 M,14 5337
USE OF PERMIT
MC LL3 FANl33 Y 1YW=r9G
SPD -.WT 16 PLAN 6B PF"4T DOES NOT INCLUDt POOL OR BLOCK
WfiLW. S WIPFAW C'If ECK REDU0-TION FOR MULTIPLE 133UA14CE
CUSTOM CONSTRUCTION j098,04 SP
POR.UHIPATIO 712,00 Sly
OARAC1EIC: ARPO.RT (BY) 16,934.40
F1S'W"7XD COST OF f.'0Y4S'TRVCT10N'
31< 4,4 8.20
IPk1ZMI1T M'SUMWXiARY
CONSTRUCTION Fi-eE I0)-000.418.000 SI5392.00
PLAN CHECK VEX 101-00OA39-319 $291.41
MECHA14iCAL TEE 101-000.421.000 $117150
1 LECTRICAL FEE 101-000-420-000 $204.21
PLUM1)INO PU 101.000.419.000 $19917$
STRONQ NICYPION i,1; • R ISID 101-000-241-000 $31:41'
U£LADINO ME 101-000-423-000 $10.00
DEVELOPER IMP ACT FEE $1,9t 7.0f)
ART 1N PUVIAC PLACES - REST! 701.000-255.000 $266.20
1-1%)TAL. C'>CaMMUC`1 014AND PLAN CMD=
$4,439.52
LESS PRE -PAM 14M
$0.00
R1 nA
RECEIPT
DATE
DATE FINALED
INSPECTOR
�b
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE,
INSPECTOR
BUILDING
APPROVALS
�`MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 8 Footings
//
Ducts
Slab Grade
-
Return Air
Steel
Combustion Air _
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U.
Framing
Compressor
Insulation
j
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall -Int. Lath
/3 D
Final
Final
D d 1
POOLS - SPAS
BLOCKWALL
APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
_ _
p/
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPOVALS
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
- ��j
Encapsulation
Gas Piping
_
Gas Test
3
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 4zI
1
Fina
_,Utility Notice (Perm)
FEB -09-2001 14:36 WESTERN INSULATION 909 686 8786 P.17i24
WESTERN INSULATION, 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 # 16
SITE ADDRESS: 81-165 LEGENDS WAY, CA
------------------------------------------------------------------
EXTERIOR WALLS:
MANUFACTURER:, JOHNS MANVILLE THICKNESS: 6 3/4 " R -VALUE: R-19
CEILINGS: r ' BATTS..~ } BLOW
MANUFACTURER JOHN MANVILLE THICKNESS 11 " FI -VALUE: R-30
GENERAL CONTRACTOR: RIELLY HOMES
BY: '
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: lcl&
TITLE: PRODUCTIO MANAGER
DATE FEBRUARY 9, 2001
0
4
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
3.7
2A
26
If you have any questions, please call me at (949) 260-7925.
n rely
a
Vice Pr sident-Operations
17182 AR TRONG AVENUE
IRVINE, CA 92614
9491260-7900
9491852-1160 FAX
www.daveyroofing.com
Certificate of Occupancy.
City of LaQuinta
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: 81-165 LEGENDS WAY
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0007-116
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: RIELLY HOMES, INC Address: 23 CORPORATE PLAZA, #245
City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 5/10/01
Building Official
POST IN A CONSPICUOUS PLACE
lM
�y