0107-257 (SFD)„_ J
' t LICENSED CONTRACTOR DECLARATION
"irl 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 Il 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).
O I am exetbpt/under Section' B&P.C. for/6is reason
Date J Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following "declarations:
O 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 Policy No.
T°�tC:? Yt; 4 'l�i�►IJ '' 1: 'MA C4=434
(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 p,rovision� f Section 3700 of the Labor
Code, I'shall Johhwith comply with those�p o islo s.
Date:' Applicant
Warning'Fai ure'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 W et
for a permit subject to the conditions and restrictions set forth nl
application. I) iii
1:' Each person upon whose behalf this application is made & each pe sole t
whose request and for whose benefit work is performed under or pursjant to
any permit issued as a result of this applicaton agrees to, & shall, ind r nify
& 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 Ivoid 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 informLon-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 inspectigyi rposes.
Signature (Owner/Agent) %; f ' Date
BUILDING PERMIT PERMITN
DATE VALUATION LOT {y'��'�j TRACT
29348-2
JOB SITE
APN
ADDRESS
� 02-6 AS Twunoyq
1_53"23
OWNER
/�DESIGNER 1NpE�E�R
y��/�}+iyy' U'CONTRACTOR
i101"L KlLE:9.i4A.C7.W� S INCAR'P
, }1/EN
I \. T11 B.K.�,3.�:3. RS ii`ye
74.,5*3 HIOVELY 1 ; aT �UA722.220
74.923HOVEL Y l a,T Wfff WITE2-"230
PAI" IYE-W :I„ CA 922611
PA +✓'A
77.�w,,5.�VV3��,11UIERIT
�T92260 �p t.f
f+JY.0)674-SPF 99 (12310 .�83
USE OF PERMIT
SVD,, 171.,E m. QUINTANA- 1?I .k'.MI t OOuS NOT iNCLt:}DY, FILOCK
WAIA/P001. Olt D.MVEWA'1''Ak'PRO1.q CH. 75% PIA''N CHECK FE
REE..01IC'ri.ow FOR IWUANCZ,0F RAME, PLAa °YYPE
CUSTOM CONSTRUC'D`IaN 11012,09 SP
P0Rt."ki PATiO 331,00 S?
0ARAG-RUCARFORT Woo 3F
'I'IMAMD COST (4r CC'DNSI l.dMON
: „1 .20
i ERAUTIi'A U NU /C,f ZY
6< a�59TWJCT104 FEE, 101,40.0-41 a-000
PLAN 4CHECK FEER, 101-000-43-0-318 $250.46
URCHAi4}.CA 11 FEE 101-001ID-421.000 50100'
11`r.&C11P.1rAL Ca'V 101 -000-4,20-000
PL1JPdtB'ING Fri. 101.000.419.000 st"'.10
S'1'}t.ONO Mb'I tli.N MR9 • WMID 101-000-241-000 $: & SH
di.1iAMM FRFI 101-000-423-000 $30.00
POT. s1r9i3?.00
ART 3111 PUB12C PL-WES-1°.TESif 701 w000-255.000 S RSA"
COUffrP.1=10N AWD IYU-0 Cl
AUG- 8 2001 LF'.�'-10Ajr MKS
�o>ma
`I'O'3'.fAL I°AMM':1 m DI ]NOW
$4,19D.56
CITY of LA QUINTA
FINIANCE DEPT
$' s£='s . .
RECEIPT
RE
DATE
BY
DATE FINALED
INSPECTOR :
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
9�p�d(
_
Return Air
Steel
Combustion Air
Roof Deck
�(%/��0(
�j
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing ��//� 6�(%
/ 7�y
i
Compressor
Insulation
(fpZ
Vents
Fireplace P.L.
:
Grills
Fireplace T.O.
;
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
/ /4,
d,) t
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
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
j
Electric Final
Waste Lines
�,
!
Heater Final
Water Piping
j
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Piaster
Sewer Lateral
_
Pool Cover
Sewer Connection
��1
Encapsulation
Gas Piping
Gas Testi/9/��
_
Appliances
Final
COMMENTS:
Final
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
Final
Utility Notice (Perm)
mmmergsons
At Miller & Som; Roolilig
' bll-76U SuSummitDr. Phone: 760/346-121,4B0�flu'nc.
Cathedral Cily; C.1 92231 F,M 760/321-7097
Facsimile
►�, Gary / Andy(47T'ol1 Bmilixs PGA West
Fax: 777-1.5,
From: R ss filler
Gate: -4 l Q 0 Z 2—o7— 12v;s;;;2dF
Pe: Inspection-
Pages:-
Gary
nspectionPages
Gary / Andy,
We have inspected all the Roofs at PGA West (Vistas and
Reserve), "All vents are 'installed per" the Q'Hagin
specifications and per your plans
Thank you,
Russ Miller
04/12/2002 15:32 9092920P -q SCHMID CONTRACT:rNG PAGE 08/09
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INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, California Administrative Cade, Title 24, State of California, in the building at
81-675 TIBURON DRIVE, LA QUINTA, CALIFORNIA 92253
TBI 25
CEILINGS: _
w TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-38 1 ?" BLOW
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Coming THICKNESS -R-, 1,51/2',
GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE:
BY: TITLE:-
SCHMID INSULATION CONTRACTORS, INC.
LICENSE #221517 C-2
TITLE. PRODUCTION MANAGER DATE: 4/ 2/02
INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, California Administrative Code, Tile 24, State of California, in the building locate :d at
81-675 TIBURON DRIVE, LAQUINTA, CALIFORNIA 92253
TBI 25
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Coming THICKNESS: R 8 12" BLOW
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: OwenslComing THICKNESS: R-21.5 /2"
GENERAL CONTRACTOR: TOLL BROTHERS, INC. 'LICENSE #
BY: TITLE:
SCHMID INSULATION CONTRACTORS,, INC. LICENSE #221517 C-2
E�.r TITLE: PRODUCTION MANAGER DATE: 4/1210 t
TOP "r°o in ers in C.
Quality Homes by Designo
August 8, 2001
City of La Quinta
Building & Safety Department
P.O. Box 1504
La Quinta, CA 92253
Fax: 777.7011
Re: Lot # �s
Project: Vistas (Tract # 29349-1) -o(-Reserve Tact #29348-2) (circle one)
To Whom 1t 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, CFS 92260
7rn_r,�s_c�aa r-�•, ian ; �� nne•
c
nz�
Certificate of,Occupancy
Q City of La Qu'inta.
Buildin and Safety Department
This Certificate issued pursuant to the requirements of Section 709 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regq/ating building construction or use. For the following:
BUILDING ADDRESS: .81-675 TIBURON
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0107-257
Occupancy Group. R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: TOLL BROTHERS INC
Building Official
POST IN A CONSPICUOUS PLACE
Address: 74-923 HOVELY LANE E STE 2-220
City: PALM DESERT, CA., 92260
By: BILL GORDON
Date: 4/19/02