0307-240 (PAT)LICENSED CONTRACTOR DECLARATION
I he, eby 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
"/7 7693 k3 4/30AU
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. M workers' compensation insurance carrier &,,policy, no. are:.
Carrier tisfUSl;tt!'71.9i1TL�AL t" Policy No. Y"1:'�:•G.ts�Jii"tl,Iaol:"Tr
(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
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
theabove-mentioned property for inspection purposes.
S ignature (Owner/Agent)) _- -= Date � � ~ U
BUILDING PERMIT PERMITOVDT
240
DATE A VUATION!„�(lCj()jj LOT TRACT ��>f
JOB SITE
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
1137.. I..BRIM MRS INC;
TOLL MO. ,:ii'+RS WC
73-121 FRIZZI VI-1,FINp 41 K.)
13.121 i? ,*D W ARDIiJr 011311
DAL
M DE :.WT CA 5'44
I?h1. A.T??)L.17, P CA 9220
I.Li1'.10 383:1
USE OF PERMIT
P.0310
” •" J Mt+1 ♦ A:
�']•
• .'f.► \ .� Tll)Y/e-(CI L to �'!l
IZU "J.a . a,"•Y r �A.. "-... +." wr. i..sx✓' " Mrs,v x.s s • ".�v� ._ a c+ x "I __c1 c_. ..Wu
Myr OF �,ONS.IRt7t7io p
�,}x�'�+ 7'[��7 c Y,�e }Ir"�r7C'.'{IYx�iTED
A-`t'"wM` .ill. 3,i 6TIT iE��..LOflY M,.*Y
ANylIli$CCKYr+7'Ss` ) ill �Cl►)ti,:k3 t-31;; ��d.13S
M
l:TRMIC3MOM` I FTt:1? • A.14,31D 101.0'ON)":141-000 $150
r_ -- l I
SF.3BI-TO TM, CC►krMITC''7`1011' AND PIAN 077M
RECEIPT
DATE—/
/�
BY `_
FI I(�b
hU
IN TO
! r
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 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
Final
Final
BLOCKWALL APPROVALS
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
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
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)
:.,-COMMENTS:
..,
Lt G O U THIS ENGINEERING
CONSULTING GROUP •
E-MAIL 210 • SVPPORT@a GOUVISGROUP.COM • SALF.S(PIGOUVISGROUP.COM
October 7, 2003
Todd Smith
Toll Brothers
73-121 Fred Waring Drive —Sic. 100
Palm Desert, CA 92260
Re: Muirfield at PGA West
Lot 1
Lot 2
`G:E.C.G.60368
Dear Mr. Smith,
This letter advises that we have observed the structural requirements that are visible during
construction at the time of our site visit.
Ouuvi6 Engineering bclicvcs that the as built construction at the time of our visit (except its
noted on field notes) is in general conformance with our structural plans and relevant
correspondence issued by our.offrce relating to the above referenced dwelling.
We observed the building in its framed condition prior to installation of drywall and stucco. We
observed the visual And Acoevtihle structural requirements. (Exclusions are items such as: size of
footings, reinforced steel in the foundations, roof and top plate splice connections and roof
sheathing).
This report is understood to be an expression of professional opinion by this engineer, which is
'based on his best knowledge, information and beliefs. As such it consists of a report for only
structural elements (as above outlined) and is neither a guarantee nor a warranty, expressed or
implied for other trades or requirements of subject dwelling.
Respectfully Submitted:
Gouvi ginerzft Co
yattiting Group
President
SJB:SV:cb
100703a
o /V, v
Sonny Vin6}►
Project snag
No. C3 "27G �" 1
EXP. 3/31/q5
Der
�C 1 1P► tad'
GOUVIS ENGINEERING GROUP OF COMPANIES *7TH OFFICLS JN: W&B-b72 E: HrTP11WWW.G0U"$0R0UP Cva
4400 CAMPUS DRIVE, NEWPORT SEACH. CALIFORMA 92660 (949) 752-1612 • FAX (944) 752-5321
2JS0EAST TAIIQUITZCANYON. SUM PALM SPRINGS. CALIFORNIA 92262 (760) 323-3090 • P X(760) 325-2863
rirr n n.+rtnr. , l.tn.. r,-.... r•, ..-— - w..w•..... w-....... _ ..- .. , .
TO 39Vd SIAnoo TZESZSL6V6 Lt'.: T T 600Z /LO/0T
01/23/2004' 09:19 9096668786
WESTERN INSULATION
www E TE IN IfLATIe3N, L.P.
421.1 .Latham Street, Riverside,:California 92501
Tcl. (909) 686-8760 Fax (909) 686-8786
CF6R INSULATION CERTIFICATE
PAGE 04/06
THIS IS TO CERTIFY THAT INSULATION HAS' BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE COBE, TITLE 24,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED-AT-
TRACT/PHASE: MUIRFIELD @ PGA WEST I PHASE 1
LOTM 3
SITE ADDRESS: 56-495 MOUNTAIN VIEW, LA OUINTA, CA
CEILINGS: BAITS
MANUFACTURER: JOHNS MANVILLE THICKNESS. 11" R- VALUE: R-30
EXTERIOR WALLS: BATTS
MANUFACTURER: JOHNS MANVILLE THICKNESS: 6 3/4" R- VALUE: R-19
GABLE ENDS & PLUMBING BAYS BAITS
MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 112" R- VALUE: R=11
GENERAL CONTRACTOR: TOLL BROTHERS
BY:
TITLE:
DATE.
LICENSE
BY:
TITLE:
DATE:
23; 2004
WESTERN INSULATION, L.P.