0202-213 (SFD) (2),. 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 # Lic. Class Exp. Date
Date '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). e _
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code). I '
() I am exempt under Section B&P.C. for this reason
Date Sianature, 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:
Cartier Fdi{:INC PLO Yla£.F Policy No. WIR. 1N.'084319
(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
PERMIT # 0-1-1- ,.
BUILDING PERMIT
0202.2131
DATEof s VALUATION an no LOT TRACT f ,✓7 v "I�
JOB SITE
ADDRESS.^�
APN
OWNER
CONTRACTOR/DESIGNER/EN (NEER
TOLL mClii1ms we
WLL BROI`1:31"s'R3 MCI
74„921 FT0VMY 1 1qE EAST �i"43=2aX243
74,913140VELY L&NE EAV SUITE 2.22 °
PALM .DM, M f C±A 92` 60
]?,ALM JOE -O �v. i, C.A 92260
(760)674,,9699 CHIA 1832
USE OF PERMIT
DWYN »i IG.
S1rf; - TA:)T 14, P11°W14A PLAN. PM RMIT 0098 Ott: T .INC U119 BL=K
WALP001,, SPA OR 131tN WAY APPROACHCOPY
CUSTOM CONSTRUCTION _ 31770.00 3P ”
POR..0 ixY.;E'iATIO 442.00 SY
c' lARA4,,3FJV_kRFOR 732,00 H�
EbT..if1�SA"= 'F.eO& 03' '4ONSX89.WY10J:y
:2175131150.00
CONSTRUCTION .FRE 101-000-41&,000 S1,21i'm
..:
PLAN CHECK FEY 101-000-43-9-31€3 $1,00Y.31
MEC23ANIC;A1, FEE 101-000-421-0 00 $115'so
ElaTZ=CAL PF9 101.000.420-000 $17140
PA.i2M£ INOI FFR 1.01-000.415.000 $1621"
ST90N(3MC17i'YCha1:tE-1=10 '1fl2-1?ilCi-Z4,1•FJtyfl
CfRADWO PEE 101-000-423-000 g3s1,Gn
DLV',," R IMPACT YZE ^41,91i7.�rC1
ART IN POLIC PLACM RPWIT 27€7-(300.445.000 $16&38
FEE DEPOSIT 101-000.439-318 .$250.00
5l:F1!,'2'0T:€ L 0014 'PP.T?C rf 2(:13 PLAV Cl•1�.rX
RE
'WL'AL Pr"fa4ff LME5 ANTE 14'OW
,W&72
RECEIPT
DATE
BY
DATE FI tEID
INSPECTOR- r.
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
44
Underground Ducts
Forms & Footings
Ducts
✓O
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
-10.9-4-6
F.A.U.
_
Framing
_
�.�p
Compressor
Insulation
_ _
Vents
Fireplace P.L.
Grills
r
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
_
Party Wall Firewall
Exterior Lath
O'!�
Drywall - Int. Lath
— —
/
final
Final
_
'APPROVALS
POOL -SPAS
BLOCKWAL
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
Waste Lines
_
Vo
Electric Final
Heater Final
Water Piping
✓a
Plumbing Final
Plumbing Top Out
v
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
_ e
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
i
G.F.I.
Smoke Detectors
Temp. Use of Power
Y
Final
Utility Notice (Perm)
_09'/17/20-6, 23: 08 FAX wiUGG/UU2
.i
IN�i%SON CERTIFICATE
This is to certify that insulation has been Inst ;;ied in conformance with the current energy
regulation, California Administrative Code, Titie 24, State of California, in the building located at:
81-650 Tiburon Drive~ , Lot12, Tt %e Reserves @ PGA West, Palm Desert, California
_
CEILINGS:
t TYPE: BLOW MANUFACTURER: Certainteed Thickness: R-38
s WALLS:
TYPE: BATTS MANUFACTUI.4ER: Certainteed Thickness: RAS
GENERAL CONTRACTOR: TOLL BROTI�zitvRS, INC. LICENSE #
i
o•
s BY: TITLE:
uPARAGON SCHMID BUILDING PRODUCT -1., A MASCO COMPANY LICENSE # 632072
BY; - ITI•LE: ADMINISTRATIVE ASSISTANT DATE: 11/13/2002
:a
0, ?i
e _
!:.._. ...... .:..... ::... ......... .::..:. ......:<<r .n.--._:::5:-. :_....... c. :::r..: _.. .._....... ........o... -c.. ......... ...�. r.._.... .: :a.. ...._...._^:'c<•:. ..-_...-_.as.%.:a^:-....J...^.y?r:..c.-... .. _..
INSIJU,-TION CERTIFICATE
This is to certify that'insulation has beer! Installed in conformance with the current energy
s regulation, California Administrative Code; Title 24, State of California, in the building located at:
i
d 81-645 Tiburon Drive, Lot 28; 'r� he Reserves PGA West, Palm Desert. California
CEILINGS:
TYPE: BLOW MANUFACTOFUER: CERTAINTEED THICKNESS: R-38
r
WALLS:
TYPE: BATTS MANUFACTjRER: CERTAINTEED THICKNESS: R-19
GENERAL CONTRACTOR: TOLL SROT'i•-IE.RS, INC. LICENSE #
t
a
BY: TITLE: -,
it •
PARAGON SCHMID BUILDING PRODUC'�, A MASCO COMPANY LICENSE ix 632072
r ,
TITLE. ADMINISTRATIVE ASSISTANT DATE: 11/13/2002
a .
?:I:'lwiA/.ti/1'%./tlt/.I.I,O'P/I�: �:'I."I. /.✓Y.'IA/: �V'•O%'I./I.IJ/if/.f�'�'�..I.GOA'I'/..I•s.:v.'::.I•I!SIiV.%GSV aI.J[�C�IL%tri..�u•:'F•O.iI.C!3/1fls:4RI0YMi�.�Vi-+iM.�fiK/S•1/S/!C^/+�x�: i:pr: .
L\,110 list S, 2001
Ctry of La `nlnta '
Building & Safety Department
P.O. Box 1504
La Qulnta, CA 92253
Fax: 777.7011
Re: Lot ; 1-2—
Project:
ZProject: Vistas. (Tract # 29319 -1) -or- eserve acct #29318-2) (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. Suiie 2-220 Palm Desert. CA 92260
Al. Millem Sons
At Milter Sc Sons i?�)ofmgr
Roofing Int 63-160
Sirnunii lir. phone: 760/346-121:4
Cathedral Cily, Ca 92234 FM! 760/321-7097
FWimiLo
r i., G�cIry / y(«n'oll I FOW(�I.s PGA West
FaX: 777-1596+
From: Russ' miller
rate: I IIi31oZ
Re: Inspecti+orl
Pages:.
Gary / Andy,
we have inspect'd all the Roots at PGA West (Vistas and
Reserve). All vents are installed per the G'Hagin
Specifications and per deur plans
Thank you,
Russ Miller