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0201-001 (SFD)LICENSED .CONTRACTOR DECLARATION" I hereby affirm under penalty of perjury that I am licensed under provisions of f,A,Chapter•8 (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 7171,699 I3 Signature of Contractor 4110/P2 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. ( ) 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 pA01P1C FMf'1.(3Y1; N Policy No. Whft 04304310 I0 (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: 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. 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) Date BUILDING PERMIT PERMIT# ` DATE VALUATION M6,914.20 LOT . • TRACT 2934 8-2 JOB SITE ADDRESS APN OWNER CONTRACTOR /DESIGNERR / EN INEER i'°C?u PROM, R81ITC, !.'0111.HIZU11 IM M '74-923;R*O�/.1M.,Y IJ,l,' Lk" Vt+4*1' 'Uf. I:2.220 74.923 HOVI-IX 1AWHLW' 1' Si'LfI':l-,2R2:,?® Plf'm DMIt'1' CA 92M PALM ]DE +"I' CA 92260 (760)G74.9699 t: AAs 3832 USE OF PERMIT BI}I) - LOT 23:1;1UNDOC1N 10. PERM`: r)On NOT INC.I, IDE BIX)t;IV, WALLS, ).00.4 BPA. OR DRIVEWAY APPROACH, t;°1 ISPI, . M C0NS f R,Y VTION' 3659100 SI PORCHd17'A110 5a114, a 0 Sty 0ARAC1ii1,"ASt.F'GaWr 713,09 ..F EMMATED C0SJ1 OF COTIR.YC'iJCM+siN ;91:4.70. MRWf FJW SUMMARY CON9TRUCTICYN 1f9t 1011.00"y8_090 S1,+64100 PLAN CHECK VFX 101-000-43,9--'318 $1,CQ3.06 MW-HANIC.AL 101.000.421-000 $9330 ZL ZCTR1C".A'L 1M.R 101-000,, 2t) -WO $M.31 PLUMi3INO FXF 101-000.419.000 $160100 STRCli D MO`.'YCAN F' o RESM 101-000-241-000 $31)469 C9jCz,&D%iIO FWR 101.400-423,00000.423��'i00 MOO T. JZ1►2L0FL+'3t INIPAC`P FZZ $1,907.00 �IkXf IN PUBLIC PUXTES - dtME 277L 0-445-000 $661.29 w , fiT l Z �1 AIsT 1 f:Et ,.[RUCTICil~T "03� _. Aa PMM IMS DUE AOW MCIFLAf�lWA FrAMMOW. •E RECEIPT DATE j% BI— - FI L D� I PECTOR 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 OX to Wrap _ A. U. _ Framing Insulation S Vents Compressor 4 1 Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath _ All _ Final BLOCKWALL APPROVALS Final 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 APPROVA S Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service 7,_ _ Sub Panels Exterior Receptacles _ G.F.I. Smoke Detectors / Temp. Use of Power Final Utility Notice (Perm) COMMENTS: 07/17/2013 20:57 FAX 4002 INSULATION CERTIFICATE This is to certify that insulation has been in ' stalled: in conformance with the current energy regulation, California AdministratiVe Code, Title 24, State of California, in the building located at c-81 \'81=565 Tiburon DtIv Lot 235 he VistaWPGA West, La Quinta, California CEILINGS: TYPE: Fiberglass BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-21 WALLS: 1. .1 . ..., - .. TYPE: BATTS MANUFACTURER: CERTAINTEED THICKNESS* R-11 GENERAL CONTRACTOR TOLL BROTHERS, INC. LICENSE 0 r. BY: TITLE: a PARAGON SCHMID BUILDING PRODUCTS,-AMASCO COMPANY LICENSE #632072 TITLE: - ADMINISTRATIVE ASSISTANT DATE:. 9/1112002 INSULATION CERTIFICATE This is to certify that insulation has been installed in conformance with the current energy regulation, California Administrative Code, Title 24, State of caofornia,.in the building at 511-590 Tiburon Drive, Lot 206, The VistasIPGA West, La Quinta, California CEILINGS: TYPE- BLOW MANUFACTURER". Certainteed Thickness: R-38 WALLS: TYPE-. BATTS MANUFACTURER: Certainteed Thickness: R-19 GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE BY: TITLE: r. PARAGON SCHMID BUILDING PRODUCTS; A MASCO COMPANY LICENSE # 632072 TITLE: ADMINISTRATIVE ASSISTANT DATE: 9/1112002 INSULATION CERTIFICATE This is to certify that insulation has been in ' stalled: in conformance with the current energy regulation, California AdministratiVe Code, Title 24, State of California, in the building located at c-81 \'81=565 Tiburon DtIv Lot 235 he VistaWPGA West, La Quinta, California CEILINGS: TYPE: Fiberglass BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-21 WALLS: 1. .1 . ..., - .. TYPE: BATTS MANUFACTURER: CERTAINTEED THICKNESS* R-11 GENERAL CONTRACTOR TOLL BROTHERS, INC. LICENSE 0 r. BY: TITLE: a PARAGON SCHMID BUILDING PRODUCTS,-AMASCO COMPANY LICENSE #632072 TITLE: - ADMINISTRATIVE ASSISTANT DATE:. 9/1112002 A., Al Miller i Sons Al Mitler Sc Sons Rooting Roonnginc `bu; -.760Surrunit lir. ' Phone: 760/346-121'.4 - N Y "wt (ath�Jral C,iIY. C:l 92-234 FWX 760/311-7097 . •....�� ^'"• mat.: Fd(sile ''X�: 777-1.59f ;. From: Russ 'Miller Gate: Re: lnSpection.. :!5'. Pages:. Gary / Andy, We have inspected all the Roofs at PGA iNest (Vistas and Reserve). All ve'nf.s`."are installed per 'the O'Hagin specifications andj,p& your.plans Thank you, ... Russ Miller ail miners GI11 C. Qrrality Homes by Design August 8, 2001 Ciliy of La Qr1111t8 Building & Safety Department P.O. Boa 1504, La Quinul, CA 92253 Fax: 777.7011 Re: Lot 174 ' Pr01eCr. stns act #'29519'1) -or- Reserve (Tract #293 8-2) (circle one) To Whom It May Concern: This lerter serves to advise you the O'Hagin roof vents have been inspected by the Toll Brothers' representative. The vents are as per plan to our satisfaction, Sh illd you xequire any further information., please let us know. Sincerely, Andy-: Fraser Project Manager.. , Toll BrothersL PGA West 74-923 Hovley Lane East. Sllit- 2-220- Palm Desert. CFS 92260'