9903-078 (SFD)G) f
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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
..�iapter 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
/ 7392:2 i3 ` i 2f x'101
✓bate . '` ij � 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).
( .) .1, 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
J
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.
0 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 Policy No.
Y1' S CO OF S'EA'T 12fi4L' r ;47-05%6
(This sect16n 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 r
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisionsf-"
Date'. ' �.t) � , `9 Applicant f
V r tr
Warning: Failure to secure Workers' Compensation coverages 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.- /
VS gnature (Owner/Agent) 1Y 1 Date �f Y L ay
ri
BUILDING PERMIT PERMIT#
DATE n / VALUATION LOT M-078 TRACT
q' Zo t '- �. �: �
' $262,641,90 +x.14 29003
JOB SITE
APN
ADDRESS �(�'� �yy �L BURN
�+�'} .'�-O�}.[)�7a7i ��J lid'!
769-510-002-
OWNER _ - - - `- i
CONTRACTOR / DESIGNER / ENGINEER
BROOKFIELD HOMES SAN DIEC70 WI C.
13RC)OKF1ELD ROMES SAN DIE00IN'C.
i2865 PtJ fIv"I`T L3Ei: ItUR, (l%TE 2001218651'('3[ht'TE
DEL MAK SU'i'i"Ea 200
DEL MAR. CA 4201.4-3850
DEL, INIAR Cts. 92014-39.4
Eu14j�181.�i2 00 CfJL# 5330
USE OF PERMIT
LOT 14, PLA3 Alk-,y'L-1]- P?.32.i IT DOES Wa iT 1'!v(. LUDE BLOCK WALL C1i1
POOL. PL AN CHFiC{m :LEES REDUCED 73,% FOR: NJUL,1PL :E ISSUANCE OF
ANW, PT.A k.
CUSTOM CONSTRUCTION 3,1oox)n S.r
POR011 ATIO 519.00 SS'
("xMAGEI1C"ARPORT 727.00 ,Sf
i+3S f IMAT��T� CC►S't i )T �'®NS'1.NI;i�'i>'c.tCEN
4�i2,(i; 4.1.94)
Pl RNft f r, EE .15UMNIARV
C0NSTRt.JC`L'LC0N FE"E 1.01-{){30.�fi1�a0{)U $!w'LO.tlii
PL.,\N C'[E(;K FE 101-000.439-315 5.3'
NfF04AMC.M, FEE 101 -00t) -A21.-000 S9 .C►�3
El,.W',71'RJCAL,FEE 101-000-420-001 1;1bti.�a
PLt.fM.81NG F FE 101-000-1-11t9-000
STRONG M0110M FU - PMS1D 101-000-^241.-000
FhE1 101-0(fl+,,(0'��-4234))00 $2A 00
f;��1Tt:Ar�OINtG
ZyCr }
f14R .Fls`.(TMC''ILAEa`1+r 225-000-443 41 $5,754,.1'3
ART 113PC;fRUC—• PLACES701-OM255-000 $4fX60
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SUB -TOTAL CON9MVICTIONANDPLAN CHECK
LESS M&P.A.ID VE 21S
$0.00
0
APR 2 1-1999 TOTAL PERNIIT TEES DUE NOW
$8,:127.65
RECEIPT W r
DATE
BY'
INA
INSPECTOR
Jr
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 8 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
S
Final
Final
BLOCKWALL APPROVALS
POOLS - 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
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Certificate of Occupancy
City of La QU'inta
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: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction
Owner of Building: BROOKFIELD HOMES SAN DIEGO
r . 14--t-47
Building Official
55-834 BRAE BURN
vni
Bldg. Permit No.: 9903-078
Land Use Zone: RL
Address: 12865 POINTE DEL MAR, STE 200
City: DEL MAR, 'CA., 92014
By: DANIEL P. CRAWFORD JR.
Date: 8/14/2000
POST IN A CONSPICUOUS PLACE
The DanDee
c w.rm;y mx. cic 732542
ROOF/IWC AND CONSTRUCT/ON
Roofing Proposal
P.O. Box 277 Thousand Palms, CA .92276
Phone (760) 343-3385 Fax (760) 343-3096
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 BRAE BURN
LOTS # 3001-3019 BRAE BURN
NOTICE
' Under the Merhnmcs' I. ten Law (Golifurma Code of Civil Procedure. Section 1181 et Seq ) any contractor, subconbaetur, laborer. supplier other person he helps to
improve your property but is not pato Tor his work or supplies, has a riotd to enforce a Cairn against your property. This means that, Altera r.+iurt nearing your urultuty
could be sold by a noun nfrirei 21111 ihr ptcN,x;�:�ls of the sack used to satisfy the indebtedness 'fnis can happen even if y,iu have paid your own contractor in full. If the
tiubrnnhr+ctro, lytlp-+rCr ut supplier remains unpaid and if legal action is necessary to co0ert or r ntproe the terms of this contract, the prevailing party shau be entitled to ns
icasonable attorney fees puts all cnsm df stia Ano interest Shall aCGuc an all sums, which are due 30 days attar trilling at the rate at 1A % Oef annus+. 'rhe DanDee Co.
Inc. is Pint rP3pnns,61e rut delays caused by weather, strike, material shortage or delay in mptenal suvolied to the job or to any other delay beyond its control I ne
renDcc Co Inc. total liability under this contract or in negligence is Iv"Ntr;d sululy to the amount of this contract
We are fully covered�y..workmen's �sm&ensation and public liability insurance. Carrier�_n�mes aM0policy Dltmbers available on
request,
Any wiermion oe ixviatnon from the a above specifications involving extra cost of material or hnnr will only be exoCutCd upon written orders for same, and will become
an extra charge Over the sum mentioned in this proposal All Agreements must be made in writhing and is based on free access to building for drrP.ct mooing born our
IrurkR
Prices are haled on current Crisis of material ane labor. Increases or docreases, will be reflected at time of signing contract.
Before ontl of during roofing operations and the compleUon of roofing, The DanDee Co Inc, will not be responsible or liable for tlemage Caused from
acts of God, such as earthquakes, thunderstorms, hall of any othor weather conditions beyond roofers control.
D A "I F.
DATF
1'I IF DANDIiL•' CO.
ZO'd
PROPOSAI. VALID FOR DAYS
31IHM W01 dOZ=tO oo—ZZ-6nV
BIDS TO
JOB NAME:
BROOKFIELD HOMES
HERITAGE COLLECTION
12865 POINTE DEL MAR, SUITE#200
DEL MAR, CA 92014
LA QUINTA, CA
PHONE# 858-481-8500 FAX# 564-8317
BID# DATE $122/00
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 BRAE BURN
LOTS # 3001-3019 BRAE BURN
NOTICE
' Under the Merhnmcs' I. ten Law (Golifurma Code of Civil Procedure. Section 1181 et Seq ) any contractor, subconbaetur, laborer. supplier other person he helps to
improve your property but is not pato Tor his work or supplies, has a riotd to enforce a Cairn against your property. This means that, Altera r.+iurt nearing your urultuty
could be sold by a noun nfrirei 21111 ihr ptcN,x;�:�ls of the sack used to satisfy the indebtedness 'fnis can happen even if y,iu have paid your own contractor in full. If the
tiubrnnhr+ctro, lytlp-+rCr ut supplier remains unpaid and if legal action is necessary to co0ert or r ntproe the terms of this contract, the prevailing party shau be entitled to ns
icasonable attorney fees puts all cnsm df stia Ano interest Shall aCGuc an all sums, which are due 30 days attar trilling at the rate at 1A % Oef annus+. 'rhe DanDee Co.
Inc. is Pint rP3pnns,61e rut delays caused by weather, strike, material shortage or delay in mptenal suvolied to the job or to any other delay beyond its control I ne
renDcc Co Inc. total liability under this contract or in negligence is Iv"Ntr;d sululy to the amount of this contract
We are fully covered�y..workmen's �sm&ensation and public liability insurance. Carrier�_n�mes aM0policy Dltmbers available on
request,
Any wiermion oe ixviatnon from the a above specifications involving extra cost of material or hnnr will only be exoCutCd upon written orders for same, and will become
an extra charge Over the sum mentioned in this proposal All Agreements must be made in writhing and is based on free access to building for drrP.ct mooing born our
IrurkR
Prices are haled on current Crisis of material ane labor. Increases or docreases, will be reflected at time of signing contract.
Before ontl of during roofing operations and the compleUon of roofing, The DanDee Co Inc, will not be responsible or liable for tlemage Caused from
acts of God, such as earthquakes, thunderstorms, hall of any othor weather conditions beyond roofers control.
D A "I F.
DATF
1'I IF DANDIiL•' CO.
ZO'd
PROPOSAI. VALID FOR DAYS
31IHM W01 dOZ=tO oo—ZZ-6nV