9903-082 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
F- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04
W Professionals Code, and my License is in full force and effect.
=),m License # Lic. Class Exp, Date
1�QLO
ti '— � -12212 T3 /� 71281 I
^0 0 vDate ry" ��Signature of Contractor v v t y
(0._•
J U OWNER -BUILDER DECLARATION
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z_ (' )' 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)'.
co () I am exempt under Section B&P.C. for this reason
N Date Signature of Owner
O'N
d Q WORKER'S COMPENSATION DECLARATION
0 1 hereby affirm under penalty of perjury one of the following declarations:
Lo �: O ( ) I have and willmaintain a certificate of consent to self -insure for workers'
X W. LLcompensation, as provided for by Section 3700 of the Labor Code, for the
O' . Q performance, of the work for which this permit is issued.
m
<. Q (V I have and will maintain workers' compensation insurance, as required by
O U,Q Section 3700 of the Labor Code, for the performance of the work for which this
11 u) H permit is issued. My workers' compensation insurance carrier & policy no. are:
j Carrier Policy No.
00
n d F A
Q (This -section, need no be completed if the permit valuation isfor$00.00 or less).
J
() 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 Se -tlon,,3700 of the Labor
Code, I shall forthwith comply with those pr'ovisi his.
�Date,t�r f-GAApplicant f
Warning: Failure to secure Workers' C mpensation coverage is unla , ul and
shall subject an employer to criminal pen Ities and civil fines up to $100,000, in
addition to the cost of compensation, dam ges as provided for in Section 3706
of the Labor Code, interest and attorney's f es.
IMPORTANT Application is hereby made to
he Director of Building and Safety
for .a permit subject to the conditions restrictions set forth on his
application.
1: ,Each person upon whose behalf this application is made & each person at 1
t whose request and for whose benefit work is performed under or pursuaht 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.
1 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 inspe ion p, poses.
1 •... Signature (Owner/Agent) /I_ t Date
BUILDING PERMIT PERMIT#
DATE /' VALUATION LOT V9O3-A82' TRACT
La f $2.4.1,839.20 '4i(f $1 29W3
JOB SITE
APN
ADDRESS
t BRAS:"il
769 -.53041107
OWNER — --- —
CONTRACTOR/DESIGNER/ENGINEER
13ROO.KPiELD HOMES SAN DIEGO INC.
BRC)s7LMFLD HOMES SAN DIEGO INC.
12865 FO TM D91, MA.k Si.iIrks 200
12865 PO NTE DEL MAR, SUM 200
DEL MAR CA 9201.4-3859
DE'1,.MAR CA. 92014.38:
ftil!iidSi-1351)0 CBIS# 5350
USE OF PERMIT
r,'Aar� z� •:+.� .bi Gt •r �r1�t �rti
LOT 1.8, PLAN 2R, -SPT). OF.RX41T i?GE'S N'OT 3N(VIDE BLOCK, WALL OR
POOL. PLAN C'L•1FCK&:RF17UC'E1)'7_50,4F'OP MUL,IPL.F ISSUANCE OF
CUST01\4. is O NSTRtIMON w,87-2.00 SF
PoRC1-UP.ATIO 364.00 ST
G7•AI230MCARPORT 61".00 SF
ESTI 'IXTM0 COST OF CONSTRUCTION N
241,831,110
PEi Uff FEES",01ARY
CON:S11RU(71.1O1+#FEE 101-000-418-000 $1106,50
PLAN C:HFICK ff-E 101-000-•439-318 V.30.42
-MECHANICAL PEP. 101-0(YJ-421-000 $85.50
fIl ECTRICAL FEE 101-M420-000 $171.56
Pt1,tJNWING FEE 1.01-000-4,19-fi#w $179.25
STR()'NG F4ft'311.0NPEE - RESID 101 -OW -241 $24.}8
GRAWJNG IFEE 1.4.1 -MO -1323-000 $.213.010
CNFRASTRUC rU.REFEE 225-00044,V342 $5,332.45
ART IN1?i3k3LIC: PLACES - RE,= 700-(3(0-215.01X1 $334,691)
SWDl 0rAL CONSTRUCTIONAN:DPLtNCYiEGs
$7,534.47
9 LESS PRE-f`At1) prCS
$0.04)
s APR 21 1999 tl PERIN117.FELLS DUE NOW
$7,534.47
a
RECEIPT'
DATE'.-
BY
DATE F NAL D _
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs A
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck $r
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath/
/3
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 I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines 3
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral A
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
Futures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
The DanDee
Cmv%=ky hx. Lie 732542
ROOF/NG A ND CONSTRUCTION
BIDS TO
BROOKFIELD HOMES
12865 POINTE DEL MAR, SUITE#200
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 Thousaiyd Palms, CA .91176
Phone (760) 343-3385 Fax (760) 343-3096
JOBNAME: .
HERITAGE COLLECTION
LA QUINTA, CA
BID# DATE 8122100
4 or- /?457
THE OANDEE CO. INC_ HAS INSTALLED THE ROOF DORMER VENTS CORRECTLY, AND AS PER
ENGINEERS SPECIFICATIONS AN[) OR DRAWINGS AT THE JOB SITE KNOWN AS BROOKFIELD HOMES ,
THE HERITAGE.
LOTS # 2001-2017 BRAE BURN
LOTS # 3001-3019 BRAE BURN
NOTICE
'trndpf the r0ernanirs' I ItIrs t.ow (CdhrurrnLl CUde, of Civil Procedure. Section 1161 et Seq ) any rnntrar..tnr, SOXOitbilctur, labut er. supplier other person he helps to
improve your property but Is not paid for his work or m3ppllP.S, has aright Io wifurw u claim against your property. This meenS that. Alter,9 niiurl tiptaritip yotit uruputty
could be sold by a coud nfricer iiia Ilvc prta,:uttdg pt thu sato used to satisfy the indebtedness This can happen r:vP.n if ynt, have paid your own cun(ractor In full. If the
;:lits nnh:,rtnr. I.tbt,rct or slipover remains unpaid and if legal action is neresr;ary to rollert t)r r,nfofW ttw tarns of this confraci, the prevailing party shall be entived to iia
lcason3Dle attorney fees piu9 ail emit% Of Spit Ann Imprest shaft accrue an all sums. which are due 30 days arter haling al the rale at to !o per annum The DanDee Co.
hu. is not responSlbte fur drlayS caused by weather, strike, material shortage ni delay in matenot supplied to the job or to any other delay beyona Its rnntrot I he
niwocc Co Inc. total liability under this contract or In nrtgagenre Is limitud yululy to Iho amount of this contract
We are fully coyerpd�y.wQrkmQn s 4Qmt-W1.q.a(ion and public liability insurance. Carrieri_ 14rnnS5_ito. poiii;.y nklrnhers available on
request.
Any atter:,.;ion Of dpvlalton horn arc a alcove speciflcatiuits involving extra cost of matrrial or labor will Only be excCUled upon written uldeis for sarne, and will hecomt=..
an extra charge over the slim mentionea in this proposal All egreementS rmustbe iltade in writhing and is based on free access to building for airem ma(imr) li(rrn Our
tAXAA
Prices are based on current costs of material ani lanor. Increases or dacreases, will be reflected at time of signing contract.
Before oriel or during roofing operations and the completion of roofing, The DanDee Co Inc, will not he resl)onslt)le or 881)10 for demage causod from
acts of God, such as earthquakes, thunderstorms, hall or Any ottior wisalher conditions beyond rvoferr, control.
0A I F
f)ATR
H It: PANDEL CO.
PROPOSAL VALID FOR DAYS
Zola , 31IHM WOl dOZ=iO oo-ZZ-6nd
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: SINGLE FAMILY DWELLING
55-898 BRAE BURN
Occupancy Group: R-3 Type of Construction: VN
Owner of Building: BROOKFIELD HOMES SAN DIEGO
Building Official
Bldg. Permit No.: 9903-082
Land Use Zone: RL
Address: 12865 POINTE DEL MAR, STE 200
City: DEL MAR, CA., 92014-3859
By: DANIEL P. CRAWFORD JR.
Date: 11/i4/2000
POST IN A CONSPICUOUS PLACE