0207-202 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provbons 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
771591 . / �f 4130103
^e
rDate 1 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:
( ) 1, 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). • • J
() 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.
V
( ') 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' ,I': Gifl17A9 T'I 3F ,� . Policy No. WLR '43084318
(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 Arker. ' compensatigNp O'isi ns'of Section 3700 of the Labor
Code, I shall^`o.0 h�rfEh cApplicomply with those lro isions.
Date: ant i,�.I
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, a:,j,,
whose request and for whose benefit work is performed under or pursuaAtt
any permit issued as a result�of this applicaton agrees to, & shall; indemnify
&•holdharmless 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,autliorizeJep'ere entatives of this City to enter/upon
the above-mentioned property fortlo;purposes.
Date
Signature (Owner/Agent) t
BUILDING PERMIT PERMT#
DATE VALUATION p�y LOT Y L_ TRACT
ADDRESS
APN
OWNER
CONTRACTOR/DESIGNER/EN (NEER
TOLLS,
'xa'rLi�:i3ti'+TS
74.9P:]ROV11A1AXE 3x'St.TIM-220
!4_92; HOV L,YLKM AW SUMM,221 t
'PALM. DH=7 VIA 92260
P]4��♦..:R�+llt�¢ n, T CA
��T�,%/2��rt�Wof
USE OF PERMIT
=01S iJ-WG
3F0 ,- L0T 9J, Q1J1N`I'.ti'A A .PERMIT DOLES 1407 INCLUDE ilY.,i:1f"fC WA;I,:L3, .
P004 OPKOR I:7Rf'V':�'4 AYAPPROA.CH
t •
OU:NTO'byY CONSTRUCTION M12. SIF
3x0I2t HIDA T16 320.00 SP'
3114.00 3F
4
CONSTRUCT ION FED 101-M-418-000 t1.290,50
PLal CHECK P`y��.(nr�v 1Y� 8 s.1.,0Y7.[83
/011-QQ��£i�}4Z-8429-33y1
:AYb�iv i'2.i•1�V �6.!tfN .I' EE 10 3 dSi'W 1. -4 i l -000 "4,1 0'
P1.,ECTRIM, SFES 111-000.420-000*
101-000.419.000 $93k.9,
STRO'NO MOTION FER _ ` IO 101440-21 -000
X01140 FSE 101 -TW -423-000
DF-MOPER ASPACT MF, 4�14S.fl0
-ART,04 PUBLIC PLAC. - RESIE 270 -WO -445.,,000 $214,52
-
i *Jt -1C 3'falG CQaSIi J d1��'1' t Jul' AT+3l' I��.t".9 Cid
11,13 PIMP AW -0
$0.00
Q T0T,AL P .'T VU.S DUE TIOW
_W3
SEP' 2 51007 •
Yi :.
CITY OF LA QUINTA T
:' B1 1 DA I ED INSPE
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
r. J
Exhaust Fans
O.K. to Wrap
Q
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
LM
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROV LS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
t�Main
Drain
Bond Beam
_%
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APP OVALS
Gas Test
Electric Final
Waste Lines
0 2
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Piaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
�i-
��8 —
Final
Final _ ,y
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power ?f
Final
Utility Notice (Perm) 777
COMMENTS:
;3/ 10-5 21i 14 ij i - 16 PA.1
INSULATION 9ERT'IFICATE
This is to certify that insulation has been installed in conformanc6 with the Current energy
regulation., California Administrative Code, Title 24, State of California in th
e building located at:
81-60 . 0 T! I buron Drive, Reserves @ PGA We.st,l Lot 7, La Quinta'
California
CEILINGS: .
TYPE: BLOW MANUFACTURER: CERTAINTEED
WALLS:
TyPe-BATTS MANUFACTURER: CERTAINTEED
GENERAL CONTRACTOR- Tell Brothers, 4nc.
I . BY:
TITLE-.'
THICKNESS; R-30
THICKNESS: R-19
LICENSE: fB
vj,00l
PARAG N SCHMIL) ING.PRODUCTS, A
MASCO COMPANY LICENSE # 6:12072
BY:
TITLE: ADMINISTRATIVE ASSISTANT DATE: 4/30/2003
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:
-_81-620 Tiburon Drive, Reseni.es PGA Wist,,Lot 9, La,Q'
Uinta California
CEILINGS:
TYPE: 'BLOW
MANUFACTURER: CERTAINTEED THICKNESS: -30
R
WAILS:
TYPE: BATTS MANUFACTURER: CE RiTAINTEED:'THICKNESS: R'-19
GENERAL CONTRACTOR- Toll Bro
thers, Inc. LICENSE 0
BY:
PARIAGO S
0, S MID BUILD G PRODUCTS, AMASCO COMPANY LICENSE # 632072
BY:
TITLE;, A-.)MINIST
RATIVE ASSISTANT
DATE: 4/3012003
miner & son
• Al 1Vlillcr &Sons lic?ofit�p, '
Roofing Intbu-7Go summit lir- Phone: 760/3nf,-� 2 �:�
Cathedral C:ily� Ca 92_'31. �',�x: 760/321-7097
FW- iM,
1
rrtX Gal y / ,dA.1y@'T011 Br Ot eI NS PCIFA West
FX : 777-1596 .
From: Russ Miller
aatp:/Z/o3
Re: ' Inspection Ga T 9 4gt5510-(JC
Pages:.
Gary / Andy,
We have inspected all the Roots at PGA WestVistas. and
nd
Reserve). All vents are installed p.er the O'.Hagin"
Specifications and per your plans
Thank you,
�I N11.1 t \
Russ Miller
oll9
rothers GInco
(duality Homes by Design®
August 8, 2001
` l
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) -or Reserve �(Trct #29348-2) (circle one)
To Whom It May Conceal:
This letter serves to advise you the O'Hagin roof vents have beeninspected 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
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: 81-620 TIBURON DRIVE
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction
Owner of Building: TOLL BROTHERS INC
Building Official
Bldg. Permit No.:
VN, Land Use Zone
0207-202
RL
Address:
74-923 HOVELY LANE EAST SUITE 2-220
City:
PALM DESERT, CA 92260
By:
DANIEL P. CRAWFORD JR.
Date:
6/4/03
POST IN A CONSPICUOUS PLACE