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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 A . 2/W01
ated— l - C4 Signature of Contractor /
/ i/ •r" vL V'-'
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).
( t) • 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
Se ion 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 nno be omp eted if the permit valuation is 9 00.6d 6 ess).
( ) 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.
ate: 2 —,--,.,Applicant- �� � 7,
Warning: Failure to secure Workers' Compensation coverage is u�nliwful 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 inspectionurposes.
Signature (Owner/Agent) A �� Date _Y_
e
BUILDING PERMIT - ' PERMIT#
DATE VALUATION LOT T% TRACT
k. a,.,r1
t1 • �l $241.83910 i:s 2,9003
JOB SITE i
APN
ADDRESS
1055-81&ARAE 1 UIM
759-5.10-002
OWNER CONTRACTOR / DESIGNER / ENGINEER
BROOY:FCELD lqONIES SAN DI 00 WC, BR.00KFIELD 140NIEs SAN DIFOO INC.
12865 P01WE DEL MAR; SWE 200 1'2965 {'OINtE OFaI W0, S9(11TE 200
DEL MAR CA 92014-3859 DEL MAR i:'A 920.14-3R:
(619)481 -8500 CBIA 5350
USE OF PERMIT
02 Y? w `2Y . ` r+] Y w,G
8RN'4602
LOT 1:3, PLAN 2K - Sf D- Ph" RIl41T DOES NOT 1NC'LUDE BLOCK WALT_ OR,
€ OOT...PJ AN L;H13CX FEE ItikMCET) 7,544, FOR MULTIPLE ISSIJ•ANCE OF
AMr,
CUSTOM CONSTRUCTION 2,872.00 SF
POPWIT/PAT.J0 MA.00 SF'
GARAGE/CARPORT 677.Iti1:3F.-'
' VIIIMAT,F;rDCOST OF CONI ST1i111C'iION
I•
Z41,839.20
CONVI'1ZUC1'ION FEE 101-00 AIR -000 $1,135.50
PLAN C14EC3a'. FM 101.000439-3.18 $230,42
1�fC11rS:N'1CAL1`14.13 101-000-4-21d000 $$5,50
Et: ECI R..IC.AL FEE 1.01-000420.000 $171,56
PL11tti16.ING FFR 101-000-119-040 $179.5
STRONG 'riX YT1ONFhE -RES1D 101-000-241-000 $24,18
GRADING FE F, 101-000- 2'3-000 $20100
INF'RA.°31'.RUCTURE,FF_E 225-000-443-342 55,332-40
ARTIN PURL IC PLACES - R1.?:iM 701.000-:255-400 $:354.60
,,SU 0TAL CONSTRUC=1'xON AND PLAN CHECK
$7,534.47
LESS .PRE -PAID f MIS
I0
APR 21 1999
TOTAL. P3E1<ZiN T � ER5 DIX NOW
$1,534.47
RECEIPT
DATE
B,
DAXI /1L DD
l/
INSPECTOR
i
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs i.A A
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 is41.4
0/1S
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PIN. 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 '
Fb(tures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
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:
55-818 BRAE BURN
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction:
Owner of Building: BROOKFIELD HOMES SAN DIEGO
--1-.,4, /-4
Building Official
Bldg. Permit No.:
VN Land Use Zone;
9903-077
RL
Address: 12865 POINTE_ DEL MAR, STE 200
City: DEL MAR, CA., 92014
By: DANIEL P. CRAWFORD JR.
Date: 2/1.4/01
POST IN A CONSPICUOUS PLACE
The DanDee
CAWVmty hw% tic 732542
ROOFING AND CONSNUC TION
BID Q,
BROOKFIELD HOMES
12£365 POINTE DEL MAR, SUITE4200
DEL MAR, CA 92014
PHONE# 858-481-8500 FAX# 564-8317
TO WHOM IT MAY CONCERN.
RE,' O-HAG1N ROOF DORMER VENTS
Roofing Prop'osa.l
P.O. Box 277 Thousaird P,illns, CA .91176
Phone (760) 343-3365 Fax (760) 343-3096
HERITAGE COLLECTION
LA QUINTA, CA
BID# DATE 8/22/00
THE OANDEE GO. INC. HAS INSTALLED THE ROOF DORMER VENTS CORRECTLY, AND AS PER
ENGINEERS SPECIFICATIONS 4N4 OR DRAWINGS AT THE JOB SITE KNOWN AS BROOKFIELD HOMES ,
THE HERITAGE.
LOTS # 2001-2017 BRAE BURN
LOTS # 3001-3019 BRAE BURN
NOTICE
A Jorler Ine 41P.('hAOIrS' I ter Ow Wol trot ria Guth; of Civil f lucedure Section i 181 et Seq ) any drntrar,.lor, gt,hconb:raur, labur ur. supplie• r other person he helps to
improve your property but is not pi - d mr his work Of Mininlies, Mpg Q ngld to onfun:ll a dalm against your property. This means that A1lei' a roin't hE,lrnlf; yow awputy
could be sold by ar rnrtn (dace( mul Ilq: puu:.uc:!!s (d the selc uscd la satisfy the indebtedness This Can happpn raven d yrlti hiwt; (tooll your er-a convactot to fun. If ChB
::utxlnnh:u;tN, I;dKttct qt sui.,Oirf remains unpaid and if legal action is nerAasAry in QQ111:r1 p/ ilnforoa the ticirriti of this eanlracl, the prevailing party snail or. erlhnP.d in its
t0asonaOle attorney fees plus all coma fit %im Ann interest shall ilUrlic an all sums. w itch are due 30 days aver hilitho At the rate at to % per urtrulin The DanDee Co.
Inc. in not rf;gftonsible rut dctays c:euised by weather, strike, material shonade or ofalAy in maten:u svopflud to Die job or to any other delay heyono its cnntrol I hF
f%anDec Cc Inc. total !iabillry under this Contract or ni negligence is limit.:tf so4;ly to Iho amount of this contract
We are fully c�ver�d�y wr�rkmgn s �.9m�t�ll. alion and public liability insurance. Carder�n?i!ng5 D4tmhers available on
request.
Any a11PraU04 of t1Cvtlllott flan 1I)v a abuve specli(atiuns kivoiving eirlra cost nl material or iannr will only the execulW wmn written uicleis for same, Arad will heromF
an extra charge over the cum mentioned in this proposal All agrpements insistbe tirade in wiIlhing and is based on free access to huurlimg tnr nrrert lmomo from Ow
iruralc
Prices are based ail ruRent CnstA of material anti inhor. lncreasos or docreases, will be reflected at time of signing contract.
Before ctnd or during roofing operations and the complBtion of roofing, The DanDee Co Inc, will not be 1`e5-00FIS qlC Or 1111010 fpr damage GZ• IMI from
acts of God, such its earthquakes, thunderstorms, hall oe Any Otlior weal!ter conditions beyond rooters control.
T)A'II
DATE.
fill: OANL)l:L•' CO.
PROPOSAL VALID FOR DAYS
ZO' d 3.LIHM WD -L r. 0Z = LO