0205-248 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapier 9 (commencing with Section 7000) of Division 3 of the Business and
`Rrofessionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
777699 U30102
Dates 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).
( ) 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.
�#) Dave and will maintain workers' compensation insurance, as required by
Sactiofi 3700 of the Labor Code; for the performance of the work for which this
perrnit,is issued. My workers' compensation insurance carrier & policy no. are:.
Carver }?,g1,G11gC FsMPWYKr� Policy No.S
WLR C`0034318
(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, If Sh 'I forthwith comply With those pr filio'r s
Date: `�) p ti
Applicant—
Date:
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 v
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 al�City, and State laws relating to the building
construction, and hereby auth ;Ize Wr resentatives of this City to enter upon
the above-mentioned propXyrl�in pection purposes.
teegature (Owner/Agent) Date
BUILDING PERMIT PERM'O
DATE�I/ _VALUATION LOTr� T TRACT
��/ (i• ...^ 1Il1J48..��.7i�U - - gW. M..�a'�''�Ti�°`�.
JOB SITE
ADDRESS • —�% ��:�F,�S:J�
APN �►7"�0�
OWNER
CONTRACTOR/DESIGNER/ENGINEER
`iO1:.3..1tI2t0ITWO 114C
TOLL BROITFC INC
74.923 M)VJ?LY .T tAM2 E.Ng.T 811JUE2«220
74-913 T: iCJ"4t'1<<D.,1` .LAN'P E. ST O€?D.'i+.�,Z-220
PALM ]YR11 ;11 CA 92260
F'.A,11Y1.y.DgkEMR..l CA 192}260
�ya�ry
USE OF PERMIT
O :k7%!l?dMY D%W..U114
LoT 30 PLAN cAs,n1A,,0 8. PZRMI f .001Y.S NOT 12N1CI.;l DZ
BLOCK WAt,Yi-.%PONj, SPA, OR I>II.tVLWF9.YAPPROA,CH
CUSTOM CO'iS2Tf✓kUC'nOW 71688/00 QIP
PolzCI€WA TIO 351.00 SP
0A1tA.WCARK)kT OF
E&1:"7i MXD tot 1qr Ole f°fJ.N91w;urlow
22.,3%0(4:713
CClkdb"iRE1,a°yloi41%ut 101-000.418.000 si,i` lso
>aW4 CHRC K 1gC9 '101.000-4.39-5118 W1.91
MEC HA14IC1A1, FR' 101-000-421-000 WV
;tiI,TCfRICA'L lqt 101-000-420-000 V59,57
I' lARADIFiG ftW 101-000-419-'000 9180.50
ST'I2.ONO MOTION FEE W RE ID 1014100-241-000 $2153
1.1RA:Oi4 OIFE9 101.000.423.000 520,40
J')L fflXtPFR IMPACT YZ% p"'105.011
ART IN PUBLIC 1rI.,110E.1s - ii,ESTL 270.000.44 5n(i00 $64,41
9LTA-IOTAL CL". NIST ;CCI l''N AND PL N CTWX
54,911,32
LM Pte!-IAID YnO
$0.00
WYOFLAQUINTA
RECEIPT �r
BV -"
DATE FINALED
INSPECTOR
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
Insulation
Compressor
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
_
Final / 0
Final
BLOCKIMALL 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
d
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 Q,Z fl
Final
Utility Notice (Perm) 4
COMMENTS:
Nov 21 02 08::03a baje Christian S.truc Eng., 71.4. 997 3857 p.1_
DALE CHRISTIAN / STRUCTURAL ENGINEER INC
Y <"
1748 West Katella, Avenue. Suite 208
Orange; CA 92867
997
.l
714 997 114S 714 3857•FAX
r
'
FAX TRANSMITTAL: _
Date:
11/19/02 Sheet I of
To:
Toll Brothers
Attn:
Todd
Phone #
760-275-8825 Fag # . 7607777-1596
From:
Cesar Castellanos
Re:
Norman Course - PGA West..
Toll' Brothers
Our Job No. 00008
Message:
Clarification of Detail "29/S=2" of 60" Wide Series "
Please feel free to call with any questions.
Thank you;
Cesar
DALE
ALE, CHRISTIAN/
DALE A. CHRISTIAN SE 2705
19H
-1Zi- Ul9> ' 1C • �1J I ULL IJMU 1 PICK) 11`A- 1 i otj o 1 4 -)UO1
r . CJG G .
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 California, in the building located at: y
81440 Tiburon Drive, The Reserves@ PGA West, Lot 11, Rancho Mirage, California
CE IN
TYPE: BAITS MANUFACTURER: Certainteed Thickness: R-19
�.
i
WALLS:
TYPE: BLOW MANUFACTURER: Certainteed Thickness: R-13
LICENSE #
GENERAL CONTRACTOR:. Toll Brothers, Inc:
BY: TITLE:
i
PARAGO S 10 SUILDI PRODUCTS, A MASCO COMPANY LICENSE #632072
TITLE: ADMINISTRATIVE ASSISTANT DATE: 3/1812003
BY:
• c:• -.
.o.rn��Hs�air+nr,�w►�wav�m'"^,.""'""r"'""�c'"'""""'wss`�°imw°"rv.�.xrn..a
INSULATION CERTIFICATE
M
i
This is to certify that insulation has teen Installed in conformance with the, current anergy
ve Code Title 24, State of California,in the building located at:
California Administrative
regulation, .
.r
81 -625Tiburon Drive, The Resetves@PGA,West,-Lot 30, Rancho Mirage, California
CEILINGS:
TYPE: BAITS MANUFACTURER: CERTAINTEED THICKNESS: R-19 '
W
TYPE: BLOW MANUFACTURER: CERTAINTEED THICKNESS: R 30
�?
#
GENERAL CONTRACTOR:.Toll Brothers, Inc. LICENSE.•------
13Y: TITLE: -
PARAGON C ID 8UILDING P ODUCTS, A MASCO COMPANY LICENSE # t,32072
BY: ITLE: ' ADMINISTRATIVE ASSISTANT DATE 3/18/2003"
�ipolraElQa�M>l, aR/LT•"c'•�rr�srr�w.�,+w.aFR�.'n�.�.sbfY.�Mor.'.Ia<+.oar4ll/IMMtIf✓>'•
-a.M2 .
TOTAL P.02
;r
To]] rothe*rs, unc®
(duality 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 # 13 0
Project: Vistas (Tract # 29349-1) - Reserv`e ract #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 mmer At Miller Som; Roofilig
Rooting
1"COSummit Simit Dr. Phone: 760/346-1214
Cathedral City, Ca 14223,1'. YILIX! 760/321-7097
07A m
iMilrCeC e
C Bmilimss PGA West
Fax. 777-I.a%
• From: Russ Miller
Date: 311-7 103
Re. Inspection - Cx-> -F 3O
Pages:
Gary Andy,
We have inspected all the Roofs at PG - A West (Vistas and
Reserve). All vents are installed per the O'Hagin
specifications and per your plans_
Thankyou,
ry
V
saj
-Russ Miller
*Certificate 0-f.occ
.-upancy
City of La Quinta
Building and Safety. Degartment
k III'
This Certificate issued pursuant to the requirements of Section 109 of the `Uniform Bui/ding 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: 81-625 TIBURON DRIVE
Use Classification: SINGLE FAMILY DWELLING Bldg' Permit No.: 0205-248
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: TOLL BROTHERS r Address: '74;923 HOVELY LANE E STE 2=220
City: PALM DESERT, CA 92260
By: DANIEL P. CRAWFORD JR.
-7 Date:. 3/19/03
Building Official
POST IN A CONSPICUOUS PLACE