0107-256 (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 # Lic. Class Exp. Date
X30/0.2
Dateq 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 riot 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 ex mptt under Section' ' B&P.C. for this reason
bate#.' Signature of Owner
WORKER'S COMPENSATION DECLARATION
F 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 Seddon 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:
Carrier Policy ,No.
PACIFIC 04PLOWW 'WLR C°43084319
(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 :Sect'on 3700 of the Labor
Code,I shall f ' rtwith comply with those p rgviislo s
Date: -- Applicant
Warning:+Faii)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 Safety
for a permit subject to the conditions and restrictions set forth op-.his—
application. I Dat
1.-Each person upon whose behalf this application is made& each personwhose request and for whose benefit work is performed under or pursuant
any permit issued as a result of this applicaton agrees to, & shall, indemrilfy
& hold.harmless the City of La Quinta, its officers, agents and employes.
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 cancel) Ition.
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'npppeEcti n purposes. .;
Signature (Owner/Agent) o"a_�`' p Dal
PERMIT Jt
BUILDING PERMIT PEE
DATE VALUATION' LOT�`j. TRACT
. - .. • iT.6K��rf�IYJYei4tY .i � �'��:1ni R+4.
JOB SITE- '
APN
ADDRESS
OWNER -
CONTRACTOR/DESIGNER/EN (NEER T
74-9 3 Y-10VI W LAW, Wfffmnsz-220
'14.9231a0M 1AW3W, r 30T Y.E24 -22.0
pfilm�3��°•ti��aT CA 92260
iE+'A%.M: ,S°Oi1 CA 92260
(760)674-9699 MW 3832
USE OF PP{E•CRYeMIITT
4y��{ [� yCrybOy1 s T{�Y(�
f f.,D 92, J. �[ MM ] O J..�.W�Mi.�.IG
3,M) PLAN - 0,:iJTN%.t NA. PERMIT' DOLS 140-f 1NC:I.UL)Z,8l,,£'.tYaY
WALf:AICIOLt`• R 9;ttlMWl YAPPRO.A;CH
(:I331`OM CONS"CFiUC T10H VI MDo rail
PO.RCHIPA,.'f'10 320.00 ,P
CAWWF.iWWRT 804.00 SF
ESTMA:M COV Or' CONSTRIUM1.001.
W51809.20
Ct91`d51`AUC7100 FBE 101-000-418-000 SI, M
•ttU1�C.�+►tl�rlaCpry4��3dOCi9•e�+gt2.{1��Qys/7U
'
$�c�o�.'d(9ffi
��+.1
• I�. iV R.11CA a FEBS's'B
PLU AA'B4HO '"M $180.50
:i3'itONO MCi`fl`"1GH FBI, - RESI 3 A 01 ••q,F{..a3-241. -000
GRADi.'NO HE 101.000.4,23.000 830.x0
T_)LY 3.ARZR IMPACT FFZ $1,907.00
ARIr ria PUBLICPL �V - RMIR
TES- i• Ct 3'�I'�iY(�'°T1Q AbTTC°kiCT
$4,958.24
AUG. — 8 2001
TOTAL MOMS ItIMS DU'VOW
CiTY OF LA OUNTA
FIIu.AACE DEPT
RECEIPT
DATE
BY ;
DATE FINALED
INSPECTOR
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts"
Forms & Footings
/
Ducts
Slab Grade
_ _
�/ s ��
Return Air
Steel
Combustion Air
Roof Deck!09-Q
Exhaust Fans
O.K. to Wrap
Q_
F.A.U.
Framing
e �_
Compressor
Insulation
1 _�� �Z
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior lath
Drywall
Drywall -Int. Lath
9 -
Final
/
/r���/—sal_
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
Waste Lines
�,/
G7/1���
Electric Final
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
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
0000,
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
-
Al Miller & Sons ltj)oti)il;
. su-Iso sumynic Dr. 1'horie: 760/316-12X.4
Roonng ine,
Cathedral Cily. Ca 9223.1 � WX! 760/321-7097
Fci&imile
r.r(.x GaryAndy@Troll I3r dims, PGA West
Fax: 177A a%
From: Russ Miller
Date:
Re: Inspection i 3 1Z'—v P_VC=
Pages:.
Gary /-Andy,
Vie have inspected all the Roofs at PGA West (Vistas and
Reserve). All ve-nts are installed per the Q'Hagin
specifications and per your plans
Thank You,
Russ Miller
Toll brothers,GInc,
Qualify Homes by Design O `.
August 8, 2001
City of La Quinta
Building & Safety Department
P.O. Box 1504
La Quinta, CA 92253
Fax: ' 777.7011
Re: Lot # 13
Project: Vistas (Tract # 29349-1) -or- eserve2( Tact 929348-2) (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 fiirthe' r. information, please let us know.
Sincerely,
Andy Fraser
Project Manager
Toll Brothers @ PGA West
r
74-923 Hovley Lane East, Suite 2-220 Palm Desert, CA 92260 `
7Fn_r..7A-a„na rn rte„ nnc•
04/12/2002 15:32 9092920,0-q SCHMID CONTRAC"IG PAGE 07/09
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INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, California Administrative Code, Title 24; State of California, in the building at
81-670 TIBURON DRIVE, LA QUINTA, CALIFORNIA 92253
TBI 13
A
CEILINGS:
.TYPE: Fiberglass BATTS MANUFACTURER: OwenslCorning THICKNESS: R-381 >_" BLOW
WALLS.-
TYPE:
ALLS;TYPE: 'Fiberglass Batts MANUFACTURER: Owens/Coming THICKNESS:R41 5 1/2
GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE:
BY. TITLE:
SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517 C-2
BY: TITLE: PRODUCTION MANAGER DATE: 4/'2/02 s,
. J
1
L.ST:-9• :/1TL._•••_ "� _T•�•�L•��`r"^����w= •�•�i_'�"�_—r.`—r.:—._.sR7A.'S'L—."_:1017.'lfC.'l.'-:=. �:Ls�(C. Z'l._.C.YC.'0. "9.'�.:d'1 :OS!t'G.L.LI.:C.A'OXP.(S.(C1S9T.lO.(C.4.Y..'G.OY..C.'%/E4f.L'f
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 locat4 d at
81-670 TIBURON DRIVE, LA QUINTA, CALIFORNIA 92253
TBI 13
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER- Owens/Coming THICKNESS: R 3 12" BLOW
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Coming THICKNESS: R-21 5 /2"
GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE #
BY: TITLE:
SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517 C-2
_ w
TITLE: PRODUCTION MANAGER DATE: 4/12/0
d
ii
a�e�wuaudQr:rycw.i:•'rx�:wvaarROrl7r�unr��/a'sl�ur��otrrrOso�tua�.OvuaoNN14::/A+.uoi Wiper! �^➢��1�/�.W��'.'rfoq.�P�ri% .te7ovuc(ui„wrof fruFb ra tfoNr+�SiR(o.4nEm�:w�a'nr�.ir. ri
_ 'Certificatel'of
occupancy
City-ofLa
uildingBandSafet D
eartment,
laf
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: 8;1t6'70, TIBURON DRIVE
2. Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0907-256
Occupancy Group; R-3 Type of Construction: VN Land Use Zone; RL ,
Owner of Building: TOLL BROTHERS INC
Building Official
-Address: 74-923 HOVELY LANE E STE 2-220
City: PALM DESERT, CA., 92260
.By: BILL GORDON
Date: 4/17/02
POST IN A CONSPICUOUS PLACE