0002-350 (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
Citi $Ia .Bi lir31/20(
Date c�� Signature of Contractor
t ,
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that l am exempt from the Contractor's
License Law for the following reason:
( ). I, as owner of the property, or my employees with wagesas -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 (Seca 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 Policy No.
I.Ems.
'ANNYC ti06s->3l
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) I certify that in the perforirlance 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 provisions of Section 3700 of the Labor
Code, I shall forthwith comply with tiose,proypsionsf�
Date: j t Applicant �i
t
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.
21
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. A
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/Agent) j1`'i��' Date
PERMIT #
BUILDING PERMIT
�aE�li
DATE .rro' � VALUATION � � � LOT `7Q TRACT 299.5
`�
d U G I
JOB SITE t� �/�.
ADDRESS �•t_� ��_!.,FKs� fi L �clR(vLE
APN
630x/-040-016
OWNER
CONTRACTOR/DESIGNER/ENGINEER
Ct-wrUpty CRt wr!'LI, CCSw4utTDi E's
Ci tv`.f IRRY CR.01k 3LL,C0A4A4tJN%i'IES
1535 SO, 'WS -MEET, Si'ia. {It=
SAN B ERMA:}WIN0 CA 92408
-SAN }3:FKNAItDINO CA 92403
(909)3 t. -bow CAL:P 2.170
USE OF PERMIT
S-INGLE FAMILY DWELLING
81M- I.t,f 70PLAN dfil- 3'—IuU:7t i' D ?S NOT WALLS OR
POOL. 7501-4 PLAN ULEC Ii t:j::l~ RED C"C ON FOR.-MrJ:[.`I"tPLY l iSUANC.ts Cil' .
l
SAME PLAN s Yt)E.
1..t tiLi •..a..•i+tii�KU,..l3vl`: :,G(s:.•.ttzl ,}.a'
Pc;.RCI-YP TIO z .tw sr
G:'lr A(1FJC.AKis*0Wr +5;35Ov 5
COST OF CON51ARUMON'
132 1*841
. �iv3a s.+Er SUWA -MAIRY,
0N?!'RVCT103 FEE 551.Q0
iVa�Y I'iei�"t;Awl'Ei5 sC1.-{)Ga"i 4b3-()CL1 $�3.SQ
a
ELCC T RACAL MEI4.t-act ri2n-oao $ t3t3:�t�
..
�,.i:l'14�:iMC3 FSE 1Cil-{10tj-4.1�b00 gI3t3.St)
"► ��. .
.`!',9f„lNCtm(1'i;j>7T3'j=_F.E.-.Ff.�i°�j��
vs`IRM)H40 FEL 101-000-423-000
AFRT M PU14 .IC P1,tkCE8 - "M 701-000-255-000 $80.50
�a J
fi;aifZ-Z a r,A,A: C%:) NC f`Tt VC T !0_ N .AND ft. N (,',.MK1Z,
LESS PRE -PAID FEES
$0.00
TOTAL P.a RNH e. FET3 DUE NOW
r�
K
RECEIPT
DATE
BY 1
+1
DATE FINALED
INSPECTOR
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set,Backs
Underground Ducts
Forms & Footings
i %
Ducts
Slab Grade
^_
Return Air
Steel
Combustion Air
Roof Deck
(p , eL-(g0 6
Exhaust Fans
O.K to Wrap
(A _
F.A.U.
Framing
Compressor
Insulation
oo CDS
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
BLOCKWALL APPROVALS
Final
POOLS - SPAS
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
3 r1t —80
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
8 Oo
Pool Cover
Sewer Connection
$ Oa
Encapsulation
Gas Piping
Gas Test
Appliances
JAl 1
tl—
Final
Final d)
Utility Notice (Gas) I Capp,
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 .o
Final
Utility Notice (Perm) o
COMMENTS:
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: MARBELLA II - 23995-8
LOT # 70 ,
SITE ADDRESS: 78-780 WAKEFIELD CIRCLE, LA QUINTA, CA
EXTERIOR WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13
CEILINGS: BATT- BLOW
MANUFACTURER: GREENS TONE THICKNESS: 10.3" R -VALUE: R-38
CEILINGS: BATTS BLOW
MANUFACTURER: JOHNS MANVILLE THICKNE 13" R -VALUE: R-38
--------------------------------------------------------
GENERAL CONTRACTOR: CENTURY HOMES
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: C
TITLE: PRODUCTION MANAGER
DATE NOVEMBER 6, 2000
•y .
CITY OF LA QUINTA
A- REINSPECTION
• BUILDINGS SAFETY DEPT.
FEE* $30.
WILL BE CHARGED IF THE `
�IDaye.to�+•res dewdew r_!•. dn��e
F
PLANS APPROVED ti
=�S �aw�.,r�� ...re=
mta �.
_
512E ,3•• >< '213'
AND JOB CARD ARE NOT ON - r
� °'
DagH 23 XS' ItRMtItR 71i;
O
'APPROVED
THE SITE FOR •A S C ' E D UC
[XDnertv it is �Mvretporl tF at yon
�
Lhe owner
T1 E CHQICE..GW- 3--. _.SQ, 49
FOR CONIIRUCT�N
(NSPECT(0 _ _ED-
N•
°`ems"-�,��,�dett�
—t„r
RaB-- =---.----
- +
OPING CANTILEVER ' _
?
1059
NO°EXCEPTIONS
signarum
POOL CAPACITY._ 0.100 GALS_-
PUMP.CAPACIT.--.. '
I
m
' DATE'
LA Qla\TJ NDMIES
(02 c�►± _
MOTOR I$ STA RITE
_. G
Y
_
. v ,HUDSILLCROSSECTFO\
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- _
' • - • -
0
.
ROCSE
•IIFL• •
FILT£P. STA RRE 300 _ SQ .
G
A
'• '
FILTER HATE _ _102 GPM
• _
-
._
uG0SILL
HEATER LAARS SIZE.'.- 250 -NTLI.
D
.
. -
F
- AIR PIPE `
• : DECK
TURNOVER • _ HRS_
1).
•�' -
I,: EELOW MUDSELL
S..: T -ON L.hIES Z_
3
. - -
set equip. in rear Setback •. _ _.
._ ._
_
RETL.RN LIES 2-
. _
..
..
towall owner to Provide •. - -
-
-
P/L
dine for stem
SKIMMER MODEL.. AMERICAN
C
D
z.4-
`
- .. 4'-2'
`.
FRELSTYIE .,
'ETT
CHECK VALVE Y
GASLINE BYE SDC YES.
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+6•
T:R`: SIDE ..
ADD
STACK
.
PODL LIGHT 400-W CLOCK Tf0_4R
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-- -y 11''6" --- .-
. :r. ,--� ..
iaW�” m
TO HEATER.
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ELECTPoC!tL [tY._5OC'_. .FT. .250
Z
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Ae�seSc+F!Er+=-- _
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t
area
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25'-0'
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CECBI__ SOC ODS 0 G 0-1
DECK�l7PE SALT L R RAY
-
R�
FT. — - --
i
15`-6' •-4'
- -
SPA SPECS._
15'-6
P/L
DESIGXER
SIZE 7' qA. RAISED +18'
"
LIFE — —
LRE 10_0_ WATTS_ _
-
.
- 25' -ES'
_
-
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RANDY/WA
FRILPVEL SEATS 22. 24 2T-
•
..
DATE
DAMWAI1 6- wn1E '- ---'
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DANWAEI TOP TILE.—_— ---
..
P/L s -
-
-
8/30/00-•
REVISED
S�'AiX7E OPEN _ SL,OSED •.
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SOBfJ1T
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master
bedroom
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LIGHT
swn cH
G. & E:
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CENTURY/ JEEF6 LORI YTT)RRIA
AddLes 7.8.7.80.WAKEFnELDCIRCLEACCE'
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KITCHEN
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PALM DESERT TEMECULA
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+
-
73-011 COUNTRY 28910 RANCHO
-
- ^'
E/8'=E' SCALE
CUB OR. STE F-4 CALIFORNIA RD.
,
'NOTE: LANDSCAPE AND FURNITURE
i
PALM DESERT CA: STE 203
92260 TEMECU.A CA.
m
s
ARE SHOWN FOR ILLUSTRATION
O1 4fi-ao32 • ` 92590
N
ONI,V AND ARE!VOT, TYCLLTDED.
(9042676 SIMM- .