9904-009 (AR)U)
I—
CV U)
W
O � M
�a�
Cr
o Z
�
OO
F- C:)
�Ur
UJIa
U)
Z
M
U')
C`J
O�
UQ
C —
Z
U-) aCr
0
X W LL
0 _J
I<0
O
aMLO
Z_
co
�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 #12i`rii
Date -\ •Si nature of Contractor°
Vi
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.
SX-1 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 . Y Policy No.
V*Tt'+ `-, Y� .ya;r�i M1h . Yr Al �a•�C.
.AtV�A ti-• Ia' 010
1031VoC' �a 1".f+
(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 `
Warning: Fai ure to secure Work rs' Compensation cb7 is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a .permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) A/Y JUIr 41' Date"? n
BUILDING PERMIT PERMIT#
!1!>tf4-tliY??
DATE
VALUATION t� s33�9(4.4o LOT 9 TRACT 28341.2
ADDRESSTEL
:?:�L(J7 1�kl i� IS UY APN 7169-514-014
JOB Sl
OWNER CONTRACTOR/DESIGNER/ENGINEER
B11100 K IN VL 1)1101%1FS S"A"N t"ITE001.G. HR(Y Kf11�F1:11D .e^tONIFS *"A
1)1�63 POINTE DEL MAR. SUITE 200 12X625 POINTE E DEL. l4lAR, SlUfrh -200
UFL IVIAR C''A 92014-38159 U1.LI, mi it. CA 92014-38'
(619)48.21-9X2(1 C13IN 53 -SO
USE OF PERMIT
R SIDE. TIAL, .ADDrITON'
NDI?i7 iE�$I 1) �i2 C1L S T I;1�ILf:",G TO SFDUND2RCCvNSTRUCT10W.
�a' O'NI ry� +Aire 00a, e��[b
r �xl,ad�% <i3t CWTOL �.ica.ari�i��,�vdL
r Y nB1i'AS
C:(YNS7i'TtUC 1014FEE
101�000-418.000
blf9.�i
KA'N r1RP ..% FNS
ytW0.52
ti.•t:-011CCAL
SI5.26
1_1LUhV41NU 1�.Ul
101-000-419-000
340109
31 {,01.1' NfC)'f',10" I411;i: - ovslr)
1111,.11MI-241.000
$3.40
11 iLr1`+ f'f3iJ:"i`! !IZl; t T 1,
225.000.4.1-1342
$56^.5•!
060 114.PL1j3.(JC kr PLCLS • 1,1.USIC 701-000-215540
StRi-TWAT, CONSTRO tION AND PLAN C:W1 C K
LESS ME"P4MO FEES
TOTAL PERMIT FEXIN 0f;RNOM"
BY
INSPECTOR
'**,9164A.)
a44,
$1,037.13
$0.00
$1,037.13
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
'
04 z
Final
Final V&MMPOOLS
BLOCKWALL APPROV LS
- 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:
The DanDee
G��ky hits. L is 732542
ROOF/NG A /VD CONSTRUCTION
Roofing Proposal
P. O. Box 277 Thousand Palms, CA .91176
Phone (760) 343-3385 Fax (760) 343-3096
BIDS TQ: JOB NAME:
BROOKFIELD HOMES HERITAGE COLLECTION
12865 POINTE DEL MAR, SUITE4200
DEL MAR, CA 92014 LA QUINTA, CA
PHONE# 858-481-8500 FAX# 564-8317 BID# DATE 8122/00
TO WHOM IT MAY CONCERN.
RE; O-HAGIN ROOF DORMER VENTS
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 HOMES,
THE HERITAGE.
LOTS # 2001-2017 GRAE BURN
LOTS # 3001-3019 BRAE BURN
NOTICE
iinapr the mectrtnics- t ter, Law (C:)ldumia Cud of Civil Piocodute. Section! 181 et Seq ) any cnntfactor, suhcon(10, oV, laborer. supplier other person he helps to
improve your property but is not paid tar his work lir RUpplie.S, has 8 right to onfuice a dawn against your property. Trots means mat. Aller a r.(n,rt he8nhp your u,opulty
could be sold my s ronin nnccei and Ih!a pitu;t c!Is of the soli, used to satisfy the indebtedness This can happen even if you have poikf yota own convactor in full. It the
:;ubnnnhactn,. I;rlm,cr u, supplier remains unpaid and if legal action is necessary to nomnf ,;r ynforoc thu tarns of this contract, the prevailing party shall me entitled In IN
tcaSonaole attorney fees plus all cnwts lit still and mtere,S( Shall aCGuu an all sums. which are due 80 days after holing at the rate at 1A'Yo pet annum The DanDee Co.
hie. ,a lint responsible rut delays caused by weather, strike, material shortage ni delay in iwitemil Supplied to Itie job or to any other delay beyond its Control I he.
lhr+Dev Co Inc. total liability under this contract lir m negligence it Itmittid sululy to the amount of this contract
We are fullycovAred�My,wQrkm�n's �Q[Tt�en.sdtlon and public liability insurance. Carriers nWn���po)ic.Y nttmhers available on
request
Any of (101ahor, horn the a above Specifications involving extra cost of material lir tannr will only Im ex=fed upon wtitten oideis for same, and will become
an extra charge over the sum mentioned to chis Proposal All agreements mustbe mode iii wiithing and is based on free access in building tar direct Inaving rforn oto
in,cks
Prices are based on current costa of material anti tpbor. InCre8808 or docreases, will be reflected at time of signing contract.
Before and or during roofing operations and the completion of roofing, The DanDee Co the, will not he resltongltlle or natpe for d8rtlaOe c8usod Irom
acts of God, such as earthquakes, thunderstorms, hall or Ally other weather conditions beyond roofers control.
_....-- ..._._.... _ I)A'I F
DATE
1'I Ili DANDLL•' CO.
I'ROPOSA1, VAI.(I) FOR DAYS
Zola 31IHM WO.L dOZ:iO oo-ZZ-Gn`d