SFD (0306-076)LICENSED CONTRACTOR DECLARATION
I hereb�.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
Profes--jonals Code, and my License is in full force and effect.
License # LLic. Class Exp. Date1.3 (1
777699 Z
41
Date - %� Signature of Contractor S-/"-1",/ /,t
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 1 I&CR Y M*U'.1'1 A011 F Policy No. Z f970;.t; Gfit'?« 1I'oi
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
Framing
F.A.U.
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
steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines 6
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 �d
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:
January 8, 2004
{
Todd Smith
Voll Brothers
73-121 Fred Waring Drive — Ste. 100
Palm Desert, CA 92260
Rc: Muirfield at PGA West
Lots 5 and'
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.
Gouvis Engineering believes :that the as -built construction at the time of our visit is in general
confor t9tlnee with our structural plans and relevant correspondence issued by our office relating
to the above teferenced dwelling.
We .observed the building in its framed condition prior to t itfi lation of drywall and _stucco. We
-;; observed the visual and accessible structural requirements: (Exclusions are items such as: size of
footings, rcinforced.stecl in the foundations).
Thisreport is understood to be an expression of professional opinion by this engineer, which is
hased 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:
Go En " suiting Group 1 /
aced ek;un Magrly 7Pacciub
President�gct. Manager
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04/ Z01 ZrJrJ4 IU: Zb 7W'JbdbblUb WEbILRN INSULATION PAGE e3/07
WESTERN -INSULATION, L.P.
4211 LaUmm Street, Riverside, CaUfornia 92501
Ti -i (909)-686-9760 Pax (9091686-87.86
M*R INSULATION
09)6WO7.86M*RINSULATION CERTIFICATE
THIS IS TO CERTIFY THAT -INSULATION HAS BEEPCINSTALLED IN CONFORMANCE{KITH
THE CURRENT ENERGY RE'GLJLAT-ION,, C IV
ALIFORWA-ADMINISTRAtT. E CODE, TITLE 24,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
MUIRFIELD @ PGA WEST / PHASE 1-
LOT# -
SITE ADDRESS: 81.1'85 MUIRFIELD- VILLAGE, LA QUINTA, CA
--------------------------------------- --------------------------
couNGS: BATTS'
MANUFACTURER: JOHNSMANWUE THICKNESS: 14" R- VALUE: R-30
EXTERIOR WALLS: BATTS
MANUFACTURER:. JOHNS, MANVILLE THICKNESS: 63W R- VALUE: R-19
GABLE ENDS &PLUMBING SAYS: BATTS
MANUFACTURER: - JOHNS MANWLLE THICKNESS: 3112- R= VALUE: R-11
GENERAL CONTRACTOR: TOLL BROTHERS
BY..
TITLE:
DATE:
LICENSN
BY:
TITLE' -
DATE:
794484 '
WESTERN INSULATION, L.P.