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SFD (0306-079)LICENSED CONTRACTOR DECLARATION I Aby 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 77699 Pf 4. X10••. Date f %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. S c( ;) I have and will maintain workers' compensation insurance, as required by tion 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' i w pensation insurance carrier & polic no. are: Carrier LIOUTY 1►tt3Tla.r.,._ -. Policy No. '+YA20)N4i_ 11.Vr (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. te: Applicant 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 the above-mentioned property for inspection purposes. I Signature (Owner/Agent) Date BUILDING PERMIT PERMIT DATE VALUATION MIX79AV LOT 9 TRACT 26 5'^ Si- a 61 0 JOB SITE ADDRESS APN X2-4104KPI OWNER CONTRACTOR/DESIGNER/EN (NEER TOLL DR MHW.T.04C s -';U. BF,07.=:1MRS BIC ?3.121 FRED W'XT1d ; $I00 ?' 121.. ! '►FFARIN15#100 PALM DERW-T CA 92260 1:kI.GE11?RT CA 92V,,*1- ;. 0 674.WV9 CUN USE OF PERMIT f11may,. FAMILY i'+'V41'j:.Lr TC3 a�C*{'isJ1��YLyvA/y�1 VV!5yA,i�1ll4, tRvti�•••'4:i1i.�kw— �fy{Ll I4yJl11ie tL,�A!♦'Ar.J pT �.�. cYT�tl irL��»sr.';..p !tivy+t y� R� _K l7Ai� N_ OLr! #P.A OR DRI ilk' A 7 If:tYl'.RC 'k F•'�Ii. 4%! E[)UC 0X TO PLAN CHZCX M LAUZ TO MU?LTIPLI. 1S3UAY1' i:. 4F 5tls Mr PLAN TYPX C:118TOW C" ''11�3TRUC'T101 4o ,-V 3F PORCH/F°,V' r; 1H 00 SF ?:YMIA;C D COOT OF C +MMITC71011 U1:'`�73.80 PRR%Mr= gumbf.!1%'."Y CONITRUCTION PP 10) -000-418-00*11.: $1,!.%m PLAN CHECK IIrE 9 141_03"39_31 ;? $31330 UtCHANICAL B't1t 101-011XI-421-t>D .' 31X!10 rLWTVCAL FM 101-000-420.00:: $333.0 PLUMBlN('1 M 101.00G -419-.M: $213.00 87Rt3NO MOTION PXt a K8SID 101 _0W-241- t $361.19 C311ADIN13M 101-OW423-006 313.0 # ZVZWPER IMPA,CP ".9 fkO-3.00 ART IN PURUC CLAMS - Rte?( 270 -M.) -A45 -W_, $404-W MM-'1t?i<+` L C"O3•zMUC TION AM.> ',If ►Bt (NWX I. : # )PRF -PAID D ° �J►X. PERAW M: S DUZ 1'iO11Nf' JUN 18 2003 CITY OF LA QUINTA FINANCE DEPT RECEIPT DATE + ^V:♦ BY DAT I ED INSPEZb 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 / Z F.A.U. Framing O Compressor Insulation S ZZ4Z6 Vents Fireplace P.L. t 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 Plbg. Test Final Gas Piping PLUMBING APPROVAL 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: tebruary 27: 2001 Andy Fraser Toll Brother3 73-121 FredWaring Drive, Suite 100 Paha Desert. Ca 92260 Re: Marriield at PGA West GFCEG jobft60368 Phase I la's; 9 Dear Andy Eraser, This letter advises that we have observed the structural requirements that are visible during construction at. the time c_4 our site visit. Gouvis Engineering believes that the as -built construction at the time of our visit is in general conformaru-f4 with our structural Mans and relevant corr®spondsnce issued by no or office relating to the above referepced dwelling. 4 ' We observe-] the building in its framed condition prior to irimilation of drywall and stucco. We observed the visual an.,4 accessible structural requirements. (Exclusions are items such as: size of footings, reinforced s?Beel in the foundations and roof sheathing.) This report s understood to be an expression of _professional opinion by this engineer, which is based on his best.knawledge, information and beliefs. As such, is 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-5ubmitted: GOUVIS Ell`�GINEERING CONSULTING GROUP, INC. Cliff Hattar .. Director. FWd Fp Magdy Yacoub 11Pf(C) :if i`,ii:,�.`•"rcr.;�, CAP!r:,r..uunn.(,;A tia,;r.nu,•nt,7.(::1 '.,,ItL:,.'r(t'.UI' ! III ( Ali iVlittlt(.dv,Vtt'iEt.uu SIMOE) TZEGZGL606 b0.:60 b00Z/i0/E0 Vr,vp;u� iiia: TO 39Vd Fp Magdy Yacoub 11Pf(C) :if i`,ii:,�.`•"rcr.;�, CAP!r:,r..uunn.(,;A tia,;r.nu,•nt,7.(::1 '.,,ItL:,.'r(t'.UI' ! III ( Ali iVlittlt(.dv,Vtt'iEt.uu SIMOE) TZEGZGL606 b0.:60 b00Z/i0/E0 03/23/2004 17:10 7148796419 SIMPSON Strong -Tie 5' 1314 MIN. SIMPSON STRONG—TIE ��l PAGE 02/02 TECHNICAL BULLETIN STRONG -WALL SHEARWALL ANCHORAGE WITH SET EPDXY FOR ACCURATE PLACEMENT OF ALL THREAD ROD (ATR) ANCHORS. • Choose the SWTPF template that matches the width of the Strong -Wall Shearwall. • Use the template as a guide to mark hole locations prior to drilling. • Follow drilling and epoxy installation instructions to install ATR using SET Epoxy. • Place template over ATR to keep anchors vertical and In correct position. • Leave template in place until SET cures unless the Strong -Wall Shearwall is Immediately placed over ATR. 5'_..\ MIN. 8' STEMWALL MIN. (6' MIN if for SW16 or SW22 GARAGE PORTAL o o e . .. • WALLS) . u 0 pe .. 5/8" DIA. ATR 7/B' DIA. ATR 5" MIN EMBEDMENT 15' MIN EMBEDMENT DRILL 3/4' DIA. HOLE DRILL 1' DIA. HOLE DRILLING HOLES • For 718" diameter ATR: Drill 1" diameter hole,15" deep • For 518" diameter ATR: Drill 314" diameter hole. S" deep. • Extend 5" of ATR above finished concrete. • 5" minimum IA distance for 718" ATR. • 1314" minimum Up distance for ATR. NOTE; Far 2 story stocked Strong -Wall applications consult the Englneer of Record. Design loads for this condition may exceed the allowable loads for SET Epoxy. INSTALLING RODS AND EPDXY ©t Q CutODan Atteeh — j — 1vp a1 1 chat) Il '` nnMda• mixing SUSS now@. � r r r r r hat remm, • v + a able Drugs) r V WA • © 1`111-eNp nu bud o1 adhalvs o1110 ` 4 er111-Dtif hole C1111111-Romovo duel !race hob whh the side to Oak In props mmur0 e © ( free Inson:ncchare moll be clean oil eat to t0eotfiod oiFtroo cempraseed air. Chen vAet nylon INlnetm prey color} Eaton oaU1g. Fel free. Insert anther, tumklp elOWlp unto diamotsr and brush and blow out mmolmna dust. here hauwsy, slatting from bottom of hole the anchor contacts the bottom of the depth. Noes: Dual tell In, hOh can reduce the to plsvOm air pockets. WRhdraw nuts hole. Do rrot dlswtb edheshn's hod Ing capacity. U how fila up. dig. cure time. This bulletin Ie effective unUl January 31, 2006, and nNacte Intormatlon available as of October 1, 2009. This information is Updated periodically and should oat be relied upon atter January 31, 2006; e0nt8a Simpson for eutrent Produtl Information and Ilmlted warranty or see www.atroaOUe,conl, SIMPSON STRONG TIE COMPANY, INC. Nome Office N011hweet USA Southwest UM 30111118321 USA Northeast USA Eastern Canada walern Canada 4120 Oubpn Blvd., Ste 400 5151 S. Alport Way 260 N. Paim St 1720 Couch Or 2600 International St 5 Kem6ew Blvd. 11476 Kingston St. Dublin, CA 94568 Stockton, CA 05206 Btee, CA 92821 McKinney, TX 76060 Columbus, OH 43228 Brampton, Onndo LOT565 Maple Ridge, B.C. V2X•OY5 FAX: 925/833-1406 FAX:2QK34.3668 FAX: 714/871.9167 FAX:SIV*42.5379 FAX: 6141876.0636 FAX 905!458.7274 FAX: 604/465.0297 warehouses: Etdisid, CT; Jacksonville, Fl: Kent. WA; Langley, B.C. 800-999.5099 ® Cooyright 2003 Simpson Strong -rig Co.. Inc. Form T-SWEVOXYM to= www.strongtio.com Printed In the USA 0 b4/'Lb/'Lbb4 Tb:26 9096868786 WESTERN INSULATION PAGE 06/07 WESTERN INSULATION, L.P. 4211 Latham Street, Riverside, CeUbmia 92501 Tel. (909) 686-8760 Fax (909) 686-8786 CF6R INSUI ATION 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: MUIRFIELD @ PGA WEST / PHASE 1 LOT* 9 SITE ADDRESS: ------------------------------------------------------------------ 81-215 MUIRFIELD VILLAGE, LA QUINTA, CA CEILINGS: BATTS MANUFACTURER: JOHNS MANVILLE THICKNESS: 171" R- VALUE: R-30 EXTERIOR WALLS: BATTS MANUFACTURER: JOHNS MANVILLE THICKNESS: 6.3/4" R- VALUE: R-19 GABLE ENDS & RWV0ING BAYS BATTS MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 112" R- VALUE: R-11 GENERAL CONTRACTOR: TOLL BROTHERS BY: TITLE: DATE: WESTERN INSULATION, L.P. LICENSE N R: BY: TITLE: PROD ON NIANAGEk DATE: APRIL 6.2004