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9812-203 (SFD)
LICENSED CONTRACTOR DECLARATION 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 tol J332212 01 YD esrSignature of Contractor 7 IrOWNER-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. p() 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. 111 sV V.0 (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 3 00 of the Labor Code, I shall forthwith comply with those provisions ✓Date: tApplicant 'J . 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. l=K . IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to K6e" 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 pur oses. f Signature (Owner/Agent) f '01" Date3/Z. BUILDING PERMIT PERMIT# DATE VALUATION LOT yl��?-z!'►'� � : 3 . c� Y►�2�,t;�ia 1.9t► �t JOB SITE APN ADDRESS ,OWNER BROOKF'IELD I OWES SXV DIEGO I IC:. 12865 P6(NT E DEL MAR, SIJ , E.2100 DEI.. MAR. CA 92014 USE OF PERMIT CONTRACTOR/DESIGNER/ TRACT 18341-, 769_510-002 BP.00KFIELD HOMES SAN D11100 D4C, 12865 POTIN 1'E .DEL MAR, SUITE 200 DEL MAR CA 9201.4-M.' ti1�1>4ii1-8500 CLIL# 5350 L( 9, PLAIN 's. SFD - P,ER viii' Da 1v10T NOUIJ , isLOOK WALLS OR POOL, PLAN CE.11:MX FEER13DUM) 75% FOR MMA:"['1PLE .18SLIANCF, OF SANE PLAN TYPE. cus't'om CONSTAuC TION 3,100.00 SF tgsAc"HIPATFO 5.19.00 SF CrAR.ACL:rCARPOItT 7.h„7.00 S1; 041"1`1'1.4 A Va, iA �('l.0 r PIF., P�Pi7 ,.r ev'1:Y/"i �r'!'lf'1 n4l .L`-Y.t tlaL^ff RLL ..7A (1V %,o AWy .i 1,4/11 PE[t11't)I'.t Fant SIJIb MA.1tY. COf;fSTRi C RYK FEES 1014100418-000 V.210.60 PLAN CIVILr_V.1 Eta 110i-000-4.39-3Ot ir45.37 1" v1'�.i.'i1.r'N111e,`AL . Iui.-�vjvV-Fiiliivv aa��"•..w I&LEt:'1'KM.AL FEEiUt-UtiU �i�ll-iJUli S1so.S,3 PLUlN]B IXG 'FF:E $19,42.75 3TRONG MOTION P - RE -SID 101-000-241L000 �2G.20 ORADIN6 FEE 101-000-4234)00 '[1 PRA S`CKt tC"1 tfk6 Fa- 3 ?25-000-4--43-34' ART 04 Pl' RLIC PLAC1 S - USM 701 -000 -2S5 --WO 5406.40 i~"4.l.L141�j, J1i Sm, ronL co&TTRuc-noN AND PLAN CHECK $8,127,65 .LESS Pft&PA.ID FEES �t).t3i1 TOTAL PERI%T P FEES DUE i+ OW 1 $8.127.65 DATE I BY INSPECTOR E. 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 ALIVents 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 APPROV S POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I I Gas Piping PLUMBING APPROVALS 1 11 Gas Test Electric Final Waste Lines 2EVOHeater 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) 17 17 COMMENTS: Certificate of Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section ' 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: Use Classification: Occupancy Group: SINGLE FAMILY DWELLING 55-738 BRAE BURN R-3 Type of Construction: VN Owner of Building: BROOKFIELD HOMES SAN DIEGO Building Official Bldg. Permit No.: 9812-203 Land Use Zone: RL Address: 12856 POINTE DEL MAR, STE 200 City: DEL MAR, CA 92014 By: DANIEL P. CRAWFORD JR. Date: 10/19/2000 POST IN A CONSPICUOUS PLACE The DanDee twky hie. Lk 732542 ROOF/NG AND CONSTRUCTION BIDS TO: BROOKFIELD 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 Thousand Palms, CA .92276 Phone (760) 343-3385 Fax (760) 343-3096 JOB NAME: HERITAGE COLLECTION LA QUINTA, CA BID# DATE 8/22100 THE DANDEE CO. INC. HAS INSTALLED THE ROOF DORMER VENTS CORRECTLY, AND AS PER ENGINEERS SPECIFICATIONS ANO OR DRAWINGS AT THE JOS SITE KNOWN AS BROOKFIELD HOMES, THE HERITAGE. LOTS # 2001-2017 BRAE BURN ©� LOTS # 3007-3019 BRAE BURN NOTICE tinoer the. niecnnnit;s' t ien t..aw (Culdur w Code of Civil Pi3cedure. Section 1181 ei Seq ) any cnntraolor, 301=0b3ctur, laborer. supplier other person he helps to improve your property but is not para for n s work lir supplies, has a nq!d to unfuru; u Gain against your property. Tr -is mans that. atler n nowt heannrl your uwpuly could be s017 by a court rifrinei and lima piano Cllg of tht: sadc used to satisfy the indebtedness This can happen r'vP.n it ybtt nfrve p0i4l your Uwn canhnCtor in full. It the tirrnr nnn:,e;ln . 4rtX.rror Or supplier remains unpaid and if legal action is neeassary to co4eat or enfofac thu terrns of this contract, the prevailing party shall br. entmeo to us icason3ote attorney fees plus all costs of still nnn interest Shall aCcruc art all'sums. which are due 30 days after hitting at the rale a1 lit % per annual The DanDee Co. htc. rs not regponsibte for dutrays caused by weather, strike, material shortage. ni ce ay in n4)ten }t SuvUnc d to tine jot at to any other delay beyona its control I rte �ar•Dcc Co Inc. total liability under this contract lir in negligence is Ivnitott %ululy to tho amount of this contract We are fully cevaved_by_w4rkrrmen s 4Q(pWn,�.dtion and public liability insurance. Carrigr�_n�rtt��iiao policy Dstrnbers available on request. Any Aller ,tion ni LlOwlion fiuui the a above specifications involving extra cost of material or labor ivill only he eaocutOd upun wtilton oideis for same, and will hpcomp an extra charge over the sum menhnnea in this proposal All agreements intiSt be Made in wilthing and is based an free access to building tnr atfe('.I lnriomg tf(irn oto bunks Prices are haled on current hosts of material an(i labor. 111MOSIDS or doereases, will be reflected at Bme of signing contract. ncforc artd or during roofing operations and the completion of roofing, The DanDee Co tnc, will not he reilDonSlple or liagre for tlArnat)e cvusod from acts of God, such as earthquakes, thunderstormv, hall or any otbor weather conditions beyond roofers control. H Ili 1)AND1:L•' CO. r OKI F. DATR i FROFJOSAL VALID FOR DAYS ZO'd 3lIHM WOl dOZ=TO 00-ZZ-113111tY