9004-008 (AR)CV U)
W
O M
rQu7
r1L W
� � 1
a Z
Zo0o
I—
J
t`
W
U)
Z
co
u)
N
ON
U (7)
d Q
Z
Lo
Q O
LL
X W —
M U U
O
a: MLO
qT Z_
ao 5
�O
J
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
732232 B f % :'r' '0 i
Date Signature of Contractor
F✓(r c
OWNER -BUILDER DECLARATION a
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
Stiction 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.
(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.
Date! - ' Applicant /II
Warning: Failure to secure Workers' Compe sation coVe5 ge 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 property7for inspectiontpurrpooses.
-i Signature (Owner/Agent) i I f y h '` Date
BUILDING PERMIT PERMIT#
DATE40 VALUATION Awimis . LOT TRACT 2X'34141
TOB SIfE
ADDRESS :35.717 ,11R C ���JM APN 769-5a"1.4
OWNER CONTRACTOR/DESIGNER/ENGINEER
.+ 0;, ! �! C;2": `R- t1V+S
121965 POIN M DF -L MART .3 -Uri 1 7,00 12865 Pi?l7v'A E DEL &U�R., SUITE E 200
DFL M ei.k CA 92(1 N•::% 0 UEL MAK C;A. 92014-3W
f619148!4W tYWX 5-491
USE OF PERMIT
R_I�.+tiTEAWIIAL AbDF1'1 fN
A.UDITION OF 03 i;i,tEST HOUSETO SIAD UNO.M i. ONSTi2.UCT1 gty.
CU 37 01M CL714 91'R1JC.r ION 6W.00 ST,
. ..aINMIAIAjesA ♦XPYOF i4iYAR.U5Ie
P..FI4g1R41%SUMMARY MA7Y
(10NS17ICi.3C!'TCyN FEF 101 -000 -418 -tai) $164.9)
1}t.AN(,TTFC"K Fr--V-
NP
r--F; ltil- ►- 3� '11i S3Fa2.2u
4 ECI:ftWICAL #, IT3 1.0.1-040-42.1-00 $70.50
ls.(X 1VICALFf;`X 101-M420-000 $40.14
PLkYNIBING ITT 10 1 -OW419-000 $67.75
q'rR(,',N0 MOT(ON 17M - R1 St)j -060-7 .000 V1,73
ITE . 225-000-443-1-42 42 $°�'15.y i
ART zea 11i1PM Pr ACEiS - fturt: 701-000-255-000 $.1.17.0
S(A.-I".LOT...S L tval N,!;� 'l _.Ull✓Tf`; N ,.'iN!) 111AN ( 111-ECK W1tet` 37
LESS PTIFi V.ATD .VTES . 110 f)o
'!'i➢`9'm.. rlaa mur Ti'E:ES DUE NOW .$973.:12
s
FSE \, ATEI BY DATE FINALED / INSPECTOR
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.
Compressor
Framing
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
POOLS - SPAS
BLOCKWALL APPROV S
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
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
Final
Utility Notice (Perm)
The DanDee
CAmmWimiky hits. Lie 732542
ROOF/NG AND CONSTRUCTION
BIDS TO:
13ROOKFIELD HOMES
12865 POINTE DEL MAR, SUITE4200
DEL MAR, CA 92014
PHONE# 858-481-8500 FAX# 564-8317
TO WHOM IT MAY CONCERN.
RE; O-HAGIN ROOF DORMER VENTS
Roofing Proposal
P.O. Box 277 Thousa►rc1 Pahyis, CA .91176
Phone (760) 343-3385 Fax (760) 343-3096
JOB NAME;
HERITAGE COLLECTION
LA QUINTA, CA
BID# DATE 8122100
THE DANDEE CO. INC. HAS INSTALLED THE ROOF DORMER VENTS CORRECTLY, AND AS PER
ENGINEERS SPECIFICATIONS AND OR DRAWINGS AT THE JOB SITE KNOWN AS BROOKFIELD FIOMES ,
THE HERITAGE.
LOTS # 2001-2017 BRAE BURN
LOTS # 3001-3019 BRAE BURN
NOTICE
1lnaprlhp Agprnnnics' I ter, I..:]w fCJldurnrt Cudc of Civil Procedure. Section! 181 et Seri ) any contractor, SUIX0111.181tur, labuter, supplier other person he helps to
T, prove your property but is not paid tnr rias work or Supplies. h;ig a right 10 tlidurtx u :cairn against your property. TMs mean% that. allpr a hptrt hearuiri yutit Jwputty
could be sort by a court nifinm and Ihr ptt.>ts v.4 of tfic sett; used to satisfy the indebtedness This can happen raven if yoti have pt,itr your own contractor in full. If the
:;ttnrnnh:,rlrn. t;tlxver of supotief remains unpaid and if legal action is necessary in rodent or i nforci, thu terms of this contract, the prevailing party shat( Ge entitled to its
tcasonaole attorney fees pill-, as rnsm of still an0 intPre.sk shall accrue an alt suras. which are due 30 days after haling at the rale at 18 "/o per anmum The DanDee Co.
hic, is not responnrble fut &;rays unused by weather, strike, material shortage nr deiay in m;ttel ill supplied to the job or to any other delay beyona its control I hF
nanocc Co Inc. total liability under this conitam or in negtrgenGe is lunitcd sululy to the amount of this contract
We are fully coveied�y_w4rkrngn's yQm�epss�tion and public liability insurance. Carrier£n m���� poti�.y atfmbers available on
request.
Any Iiie(,mon n. O(-vrl4on front the a above specifiwtiuris involving extra cost of material nr Iahnr will only he exCCuted ;purr wriftgn uiders for same, and will txarome
an extra charge aver the sum mentioned in rhos proposal All agreements muSl be iliode in writhing and is based on free access in huading for drfpri Inaping born ntu
irurxa
Prices are based on r_urrent costo of material and labor. 111MOSCS or decreases, will be reflected at time of signing contract.
Ficiore. and or daring roofing operations and the completion of roofing, The DanDee Cc Inc, will not he regtMnslgle or liable for dBmagC caused from
acts of God, such as earthquakes, thundemlormS, hall or Any othor wuallier conditions beyond roofers control.
I)A'IF.
DATE
H Ili PAS DLIZ•' U).
PROI"OSAI, VALID FOR DAYS
ZO'd 3-LIHM W01 dOZ=IO 00—ZZ-6nV