0009-103 (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
77'7699 }3 ,/r'�f P30/2i
Date�t'� rSignature of Contractor—
OWNER-BUILDER
ontractor 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.
tion
Ave and will maintain'workers' compensation insurance, as required by
Se tion 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 PACivic BA+IPL.01'm Policy No. WLR C43O9318
(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 Secti^ n 3700 of the Labor
Code, I shall f grit with, comply with those provisions'.
Date: / V X 112 Applicant G 14.. _ J �'tw
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.
1. Each person upon whose behalf this application is made & each person at, 1,
whose request and for whose benefit work is performed under or pursuant td •
any permit issued as a result of this applicaton agrees to, & shall, indemnify: d
& 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 J
the above-mentioned property for ins
pectiog purposes.
} '✓ !E %�
Signature (Owner/Agent) Date/
v�
PERMIT PERMIT#
`<BUILDING
0OW1_03-
�
DATE/. 1 . VALUATION LOT „ TRACT
$290.764AW 293419-2
JOB SITE__ _
ADDRESS 01,-690_maidK IW
APN
76744.30-0123
OWNER -
CONTRACTOR/ / EN INEER
TOAq L1;R l m. S Ii3C
TOLL BRarl M INC
74-923110VELY LANEEAST SUMM-220
74.823 HOWLY LAS wr sum -no
PAM DEEM CA 92260
PA}M DESEWr CA 92260
(760>674.9699 CBIA 3832
USE OF PERMIT
MNOUK FANGLY DVMLIJNG
,SYD-PI AN:SIENNA LOT 15 -PERMIT D093 Nar INCLU.03
BLOCKWALL81 JIZ.1V1;'4 AY ,A.i PR.OAt:I iPOOi.
CUSTOM CONSTRUCTION X409,00 OF
PORCH/PATIO 831.00 s
OAP,AOTUCAR.PORT (:3i) 14,151.20
=D"= COST OF CON'STRUCI: ON
290,7"GD
CONSTRUCTION FES' 101-000-418--000 51,308,00
PLAN CHECK FEE 101.000-439-319 $1,048.29
MECHANICAL G'Is•E 101-000421-000 $35.50
RLEL';TRICAL FEE 101-000-426-000 $186.26
PLUMBWO F19F. 101.000.419.000 5180.50
STR.ONQ MOTION IIEE - RE81D 101-300-241-000 $29.08
ORADINO IEE 101.00042]-000 $20,00
DEV=PER IMPACT P'LE $1,90700
ART IN PUBLIC PLACFA - F&SIE 701.000.255!,000 $226.01
�`.
S`Ut -T TAL C014fr1 tU•C1109 AMD PLAN CCK
$4,991.54
LESS PRE -PAID FEES
'TOTAL
$0.00
PMUTnOWN OW
$4,881.54
OCT 0 3' 2000 ;
iii 1 F LA OLANVI
a
' j F
RECEIPT t.
DATE
BY
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 if
Exhaust Fans
O.K. to Wrap p ((� L
F.A.U.
Framing j
Compressor
Insulation D
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath Af
4-670j-- � 6
41
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 I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines (p
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
FBQures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
I
LA QUINT#
s CITY OF LA` QUINTA
01=8G & SAFETY DEPARTMENT
Of 777-7012
FINANCE De"TION REQUEST LINE
777-7153
Owner TOLL BROTHERS INC
Contractor TOLL BROTHERS INC
Permit Number 0009-103
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 81-690 TIBURON DRIVE
SFD-PLAN!SIENNA LOT -.15 PERMIT DOES NOT
INCLUDE BLOCKWALL/POOL/DRIVEWAY
APPROACH
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL G
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTWALLA130VE, HAS B9EN SIGNED
CONCRETE SLAB J D
JOISTS & GIRDERS
ELFCTRICAL GROUNR WORK
DO NOT OUR C NCRE UNTIL ALL ABOVE HAS BEEN SFu.iHO•••
ROUGH ELECTRIC
ROUGH PLUM
ROUGH GA ,'(& GAS TES
HEATING & VEN - A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP 77-211,
`'- '
GROUT O 4' ❑ 8'
FRAMING - C>'
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR �) i [
EXTERIOR (LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEF nC TANK Da
FINALS
ELECTRICAL 0
PLUMBING
FIN" GAS TEST -G _
h- qG - A/C
HOUSE NUMBERS -1 _
JOB COMPLETED
ABOVE OVALS DO NOT IN UOE- IGHT TO
TI 1RN ON I I r i iOV RI 111 nWr-
Z0'd 96STLLL 09L 1S3M tiJd SOBS �-101
Ev:ET Z00Z-8E-onu
AUG -28-2001 TUE 11: 15 AM, AL .M I'LLER & ,SONS- ROOFING FAX NO. 3 P... 01
Mmuler's SONS,
Al Miller &Suns nodUbg
g.jUC9 cs•7GO Su�ntttlt fir. Phone: 760/346-1214
Cathedra City, Ci 93234' FAX: .760 321-7097
Fw#nlle.-
To'.
Gary u) Toll Brothffs
Tax: 771-1 S96
From: 'Russell E Ilii `ler
Date: August 27 , 2001
Re•
Pages: I, including this page
Gary :
Let this fax server as an acknowledgmen# that the cap:
metal c n lot 15 Reserve has been install. per the USC.' if you
'have any questions,. please fell freee to contact. me.
IZ;W40V
.r`�c>.Zwl S
AUG 24 2001 7:54AM SCHMID-CONTRACTORS 760 3471897 p.6
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
THE RESERVES AT PGA WESTILOT 15
PALM DESERT, CA
TYPE: Fiberglass BAITS MANUFACTURER: Owens/Corning
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/coming
GENERAL CONTRACTOR: TOLL BROTHERS, INC:
BY: TITLE.
R-30'9 1/2"
THICKNESS: R-19 6 1/2"
LICENSE:
SCHMID INSULATION CONTRACTORS, INC.
LICENSE #221517 C-2
B TITLE: PRODUCTION MANAGER DATE: 08/24/01
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
THE RESERVES AT PGA WESTILOT 15
PALLIA DESERT, CA
CEILINGS
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Coming THICKNESS: R-30 91/2"
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Coming THICKNESS: R-196 1/2"
GENERAL CONTRACTOR: TOLL BROTHERS,.INC. LICENSE #`
BY: TITLE:
SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517 C-2
BY. TITLE: PRODUCTION MANAGER DATE: 08/24/01
`doll ll:::v�®the�s, �Inc.
Quality Homes by Design®
August 8, 2001
City of La Quinta J
Building & Safety Department
P.O. Box 1504
La Quinta, CA 92253
Fax: 777.7011
Re: Lot #
Project: Vistas (Tract # 29349-1) -or- EZe Tract #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
747923 Hovley Lane East, Suite 2-220 Palm Desert, CA 92260
760-674-9699 Fax 760-674-9081
N miner & sons
Al Miller & Spas 1ic?orriP,
®��� Inc. 6$-760 Summit 11r. Phone: 760/346-121.4
Cathedral Uy, Ga 92231 Fwx! 760/321-7097
Fad
rA, Gt'y / AWjT(rc;T'OIl T32�Ui��CI's 'CTA West
From Russ Miller
Date:
Re: inspection
Pages: 1.
Gary / Andy,
We have inspected all the Roofs at PGA West (Vistas and
Reserve. All vents are installed per the O'Hagin
specifications and per your plans
Thank you,
Russ Miller