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0203-166 (SFD)'LICENSED CONTRACTOR DECLARATION -1,h_3reby affirm ui der.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 7'77b93 3 413CV02 Datet—i -_ Signature of Contractor�`� t . I OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for.th4 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 hich 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 PACIFIC` EMPLOYEE; Policy No. NVUR C4308013 (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 provi ions of Section 3700 of the Labor Code, I shall forthwith comply with those- isio sr' Date: 'I / A Applicant— (I pplicant I ✓'� y V- -Warning: #+--Warning: Failure to secure Workers'' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director.of`Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at . whose request and for whose benefit work is performed under or pursuant to 'r any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/A ent) . i, 'r Date—L//" BUILDING PERMIT PERMIT /1 M DATE VALUATION `• R LOT TRACT � I .. � -I, <., «, 635,�$wao 29348.2 JOB SITE _ ADDRESS s' 17 POI f T1$t 4' � APN 767 -ti f�-•030 OWNER CONTRACTOR / DESIGNER / ENGINEER WIX BW}r '+:xc; 3G3'0:�.7.I.1.ii.©'llMa INC, 74-9,23 TI ��T�, LAHE'IN^NUFf =031 d22C 74.923 HOWI G {' L,4M EAI: UUME2410 PAa.,A1d �i il?Wr C4% 92260 Ch 02260 ^ USE OF PERMIT (SID tdt7'I ��, f LiYI*i`I"Afii.,"T��. PMWI,". DOES 'i4OT.111CLi DLe Bj ack CU970M COMTRUCTION 3,41400 SF PGRCHIPATIO 34.00 SP, GARA.i'3E+dCJ, RPOWr f,14.U0 S? Il 8186 :7( D-Ct3S`I. OF COMMA CONSTRUCTION RRI Pi. I.1 C$IECK FEE 3 ; Id'd��i'I.�iItv'.,AI,i+��; 1Q�^t30fI�4�1�Ci7i� � $tt11.0� pE 10 y -000+�•ti0.4t1G.I iii. _ 9 I5l.I3�dI�ITi4� 1 ZZ 101-000-419-000 :I811 STR.ONa MOTIMI hP r i7.t 910 101-000-24 1 X000 $2S.53 f RARING Pyle 101.000.423.000 $1,410 � DLEVE,OPPM.IMPACT RZ sI+9(r').03 AU Ira PUBLIC kACES - RF.911: 2-70-000-40-000 $214,5 Z. Ec tl�:t{fir C=Y`LC�IiF AND RLAN CM, . $4,9u.93 I M90 TYRE-I)AYD:I: 7i a3B S I'UKf t, Ftmf r M0 DUS NOW ? $419,3 W. RECEIPT DATE BYE D E N / INSPEC 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 _ _ _ _ „p� _ Exhaust Fans O.K. to WrapF.A.U. Compressor Framing Insulation Vents _ Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath. DZ Final BLOCKWALL AOPROVAL Final�� POO S - 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 S 6y Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection /3 02 Encapsulation Gas Piping Gas Test _ Appliances Final C�j�V/5UOMMENTS: ���j� l/lz ��j o lel oo Z� Final Utility Notice (Gas) ELECTRICfi L 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) ✓✓ . Al Miller & Sons =. �. Al hiillcr &.Sgns liggfitIp, . Roonn9Inc. bu-.bo sununit ilr. L�hone: 760/316-1L].4 C:athedral City. Ctt 92> 1.1 �'axI 760/311-7097 Facsimile T x G -C -try / Aimdy(KIroll Brotlim s JPGGA'VVest Fix: 777-1.51% From: Russ Miller. Date: 12-/1-3/ 0 Z Re: inspection PO T Pages:. Gary / Andy, We have inspected) all the Roofs at PGA West (Vistas and .Deserve), All vents are installed per the Q'Hagin specifications and per your plans Thank you, NIIX Russ Miller Tall "Brothe'r's ITn c. Quality Homes by Desig&'- _August 8, 001 C[TV of La QuInTa Building & Safety Department P.O. Box 150 La Quinta, CA 92253. ° Fax: 777.7011 Re: Lot # �Z- Project.: Vistas (Tract # 29349-1) -(-Reserve Tract #29348-2) (circle one) To Whom It May Concerti: This lener 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. Should you require any fin-ther information, please let us know. . Sincerely, Andv Fraser Project Manager Toll Brothers @ PGA West .74-923 Hovley Lane %ast. Suite 2-220 Palm Desert. CF, 9??Fn 10'/08/2013 04:16 FA% •fj003 •ai^_•:.:tviiviz-ia�v:�ciov{iiirsisiir.ii i_aric-r.:.veliianv. r'c•�ii�iii airy- rrr�rnri•.viii•n:c..wir.•iiivaviiaorivirnizviiiii;iiii:ziiinii. _ {-. , 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.Cslifomia, ,in the building located at; T -r• n { 81-895 Tiburon Drive, Lot.32,�The ReservesV FPGA West, La Quinta, California CEILINGS: r. TYPE: BLOW MANUFACTURER; Certainteed Thickness:.R-W WALLS: TYPE: BATTS MANUFACTURER: Certainteed Thickness: R-19 GENERAL CONTRACTOR: TOLL BROTHERS,. INC. LICENSE #�. ' BY: TITLE:.. • PARAGON SCHMID BUILDING PRODUCTS, A"MASCO COMPANY LICENSE 02072 B TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/4/2002 { r:%3'::"iI,'l/A:iJ//.%t%/•J::�'I/.:e/II!>;:J:/1.•Ji'i%/t'J:!//:'I.:'I.%'lJ"//.I:%J//IeAY%'e.�I/f.'l;�//.:%�w///.%i!/a''�iY/J///!,/�i:/:..,��;/y%/;'N./i%1Y/I:•/I/i/N/:•/.//I/II///I////,:{II/ ' I.:I:'II.%•1%l'oib:0,%11.•A'A•Rril'IIItI:4O:0IY:0•!A•II /!,Y/.ill►,00{/Y/V:V,iV{M/1%G!'IIId1a%1%!'O.NOO'Ir,Ilid.Y%O'Y:.%1!.iR,%f/!%F!%�W!'N!1%ISI.'iViMIIHI/I�/.!�!i•l!/I%/!NN�'.I+•i/IYiJ//'I.!II N'.O: o.II[%f!i7YY.w•4.1.: t INSULATION-CERTIFICATE, This•is.to-certify that insulation-has been installed in conformance with the current energy regulation, Califomia Administrative Code; Title 24, State of California ;in'the building located at: ` 81-535 Tiburon. Drive, Lot 201; The Vistas Q PGA West, La Quints, California. CEILINGS: TYPE: '.BLOW MANUFACTURER:<CERTAINTEED THICKNESS: R-38 WALLS: TYPE: BAITS MANUFACTURER: CERTAINTEED • THICKNESS: R=19 -GENERAL CONTRACTOR: TOLL BROTHERS,' INC. LICENSE # By TITLE: f t t PARAGON SCHMID BUILDING PRODUCTS; A MASCO: COMPANYr LICENSE #.632072., B TITLE: ADMINISTRATIVE ASSISTANT . DATE: 12/4/2002 . i!:.i. rsii/aluvii:i iii�rvi�r.�ouscari�i�,r. iciiiri✓cw.••ririr..7cc�,/�,.iwrioieii :,�.is..;nvcynsl�»srsuvi ti,.>!lirvs/r.:c•:�w.ini:+iy,.rr:..:y[I//7/7�Y.i //.7A"I/IS.;.)