0204-009 (SFD)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 #}L�ic. Class Exp. Date y
'7774599 13 /:.r _ 4/30M
Date '` `✓i' ` Signature of Contractor !�•'` a
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I -am exempt from the Contractor's
License Law for the following reason:
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 r , t-•. Signature of Owner
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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:
Carver PACIFIC CMPLOYEW Policy No. i4xU C4309433
(Thi ss
is need not be completed if the permit valuation is for $100.00 or less).
0) 1 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 sha Irfo hwith comply with those,provisions?
Date: �'7. t-•- Applicant ✓%/�""T'
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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. ' 1.
Signature(Owner/Agent) f �� Date
BUILDING PERMIT PERMIT #
DATE VALUATION LOT TRACT
y ) n[y
JOB SITE
ADDRESS
APN
7,ri7�0 0t}�
OWNER
CONTRACTOR / DESIGNER / EN (NEER
`rf::►LL b,-aart-Dom)IkTC
TMT, 32ir tT:8 ]NO
74-YAADIRdt.yAiy�.'p3 .TJkg"22Z0
84"92.311!VSLY?^qErwr11901113.72,10
PAIMMIxSERT CA 02260
1 dAY:.1ua,13'£ S1.,CR."i. CA 92260
(160)674.9539 CBU 383?
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USE OF PERMIT
=011Z IrAIULY DVM -UNG
S.Y •IAT 4 PIEDRA -/t PLAN. I"£32 !II9' DOES 2307 iNtv,f i1F.3E 3 LOCK
WALLAP, Ti'C*14 SEBA, OR R)R.CifEWAY APPROACH.
CUOTOM CONSTRUCTION :k=,D0 OF
PORC E.11:I ATIO 441.00 SIS
0ARAf fC+�fL.t.A POI T "932140 aF
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PET"M UT P1474 9011NMRY
,CrOtSIOr!FO3d:J`1,0114 i''RE 101"(+t-10"418'<000 11,26. st'.40
PLAIN CHECK FEF 101 _000-09-31 $1,009.81
MECHANIC'wAM Titf 101-000,421 -NO $113'"
tLk-TRIC AL,YZ>I 1d1 -!?p4 S2iI--OStO $b:'O.d9
PLU9dIBINO RIF 101-000-419-000 00 8I )150
STi'�C. NO Ia OT1014 TIEZ • RY,31V 101-.000-241-000 $37.54
CPiAUTNO RE 101-000-423,000 4X00
OLd K4)P9 t HNIPACT IMI; $'9,9tY9,4Q
.ART PI'3' PUBLIC PLACM • 0,011270ri9 O.445-0003
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-°�'OT,L CONSMITr.;��.e�� PA 0x11:,
54,63632
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CITYOFAQUIOTA.
FINANCEDEPT
'RECEIPT
DATE
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DAT F
OR
f�«
i•iµ:�
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
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
Final
Final
POOLS - SPAS
BLOCKWALL AOPROVAiS
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 i7 iii
Heater Final
Water Piping
Plumbing Final
_ _ _
Plumbing Top Out
Equipment Enclosure
_
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
_
Sewer Connection ��a„
Encapsulation
_ _
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring J
—
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
12/25/2013
22:55 FAX W-1 VV"
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INSULATION. CERTIFICATE
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This is to certify that insulation has been insialled in conformance with the
INSULATION CERTIFICATE
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current energy
regulation, California Administrative Code, Title 24, State of California, in the building
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located at:
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X81-610�Ti4uron Drive; Lot:8; The-Reser�ves (g PGA West, Rancho Mirage,
current energy
regulation, California Administrative Code, Title 24, State of California,
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California
in the building located at:
CEILINGS: .
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TYPE: BLOW MANUFACTURER:'Certainteed
Mirage, California
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Thickness: R=38
CEL LNG
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WALLS: .
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TY EP BATTS MANUFACTURER: Certainteed Thickness: R-19
THICKNESS: R-38
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GENERAL CONTRACTOR: TOLL BROTHERS, INC.
TYPE: BATTS MANUFACTURER: CERTAINTEED
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LICENSE #
THICKNESS: k-19
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BY. TITLE:
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GENERAL CONTRACTOR: TOLL•I3ROTHERS, INC..
PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072
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{ BY' TITLE: ADMINISTRATIVE ASSISTANT DATE: 2!20/2003
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INSULATION CERTIFICATE
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This is to certify that insulation has been installed in conformance with the
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current energy
regulation, California Administrative Code, Title 24, State of California,
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a
in the building located at:
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81-615 Tiburon Drive, Lot 31, The Reserves @ PGA West, Rancho
Mirage, California
b
CEL LNG
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TYPE: BLOWMANUFACTURER: CERTAINTEED
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THICKNESS: R-38
TYPE: BATTS MANUFACTURER: CERTAINTEED
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THICKNESS: k-19
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GENERAL CONTRACTOR: TOLL•I3ROTHERS, INC..
LICENSE #
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BY:
TITLE: '
PARAGON SCHMID BUILOING PRODUCTS,
A MASCO COMPANY LICENSE # 632072•, 4
BY:
TITLE-:, ADMINISTRATIVE ASSISTANT
DATE: 2(20l2003
. :n%•w i�,isn%tri..:/i•�/.ue�i:.�ir Yl../.u�n;ren%.:�,iui.:.uuv,;.ii-.r..:..'%ir.,..::ir,'r/.:...,i�i..�.%�,.rcwv,%.�iir.:Y.•. :+.iiiv.:.i�v,�Tii�'ryrui.
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T®11 r®ther°s. Inc.
Quality Homes by Design"
August 8, 2001
City of La Quinta
Building & Safety Department
P.O. Box 1504
La Quinta, CA 92253
Fax: 777.7011
Re: Lot #
Project: Vistas (,Tract # 29349-1) -T----Reserve Tract #29348-2) (circle one)
To Whom It May Concern:
This letter 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 further information, please let us know.
Sincerely,
Andy Fraser
Project Manager
Toll Brothers @ PGA West .
74-923 Hovley Lane East, Suite 2-220 Palm Desert, CA 92260
760-674-9699 Fax 760-674-9081
M millpor it lmqnnq-
Rl Z;i11c,'
Roofing Ine'. � su-':so Sunup+:1 ilr. Phone: 760/346-121.4
01- awdral C.;i.y, Ca 92,9-;3.1 F -IX.' 760/321-7097
'fix 'G'arY,/A-nf'v-"m 01a Bmthm'sPGA West
Fax: 777-1519(--;'' '
From; Rush N�ili.°.
Date: . -Z
Re lnsp,�:!Dion
Pages: ".
Gary / Andy,
V P- have.`inspe : the Roofs at PGA idlest (Vistas and
Reserve), All '�venjt$ '- ,are Instailled per the O'Hagin
.specifications �ind per your pla,ris `
Thank YOU,
..;k
Russ !miller