0105-063 (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
777699 B 4410102
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).
( ) 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.
( ). 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.
. F?,9i,G'IFIC. KUP'lOM VeAt C:y4MWO
(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 miner so as to�,bcome subject to the
workers' compensation laws of Cali or, iae and agree t} t if I should become
subject to the workers' compens�tion�, r`ov' 5 s o'S 2tion �7770 ofthe Labor
Code, Itshal iorthwith1comply with thos .p��oisi3nsDate: • a '7 'A'wlican/ . 1
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
z 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 stalthat the above information is
correct. I agree to comply with a01City, ands a e laws relating to the building
construction, and hereby autho'i re r �ives of this City to enter upon
the above-mentioned properly for I p�
on, p ses
r p
Signature (Owner/Agent)/ �' Date11 r
BUILDING PERMIT PERMIT #
DATE VALUATION LOT TRACT r
JOB SITE ti
ADDRESS
APN
767-450-022
OWNER
CONTRACTOR I DESIGNER / EN (NEER
TOXIL. L3RO11VIKU i1+3C
37°C� 123
a{ [�
14-923 ROVE,f.%Y.A.Ai".1.•V.L�:4.i:,�f, ff—IN �dd.fr.,+'2,420
[���I{��;' �r� p �e � �pq q�f ry p(ry
!4"723 E}.��lT,,—'d �,'EM 5fUT 'ea,vFr6+Fl� .
1-3I 1~!;: UUMICY OA 92260
PIPAM MOORT CA 92260
USE OF PERMIT
SfrD • LOT 24 PLA1d HAVARRO vA' C9u9.I:AS& WOKE lad'12MT1 ;DORS NOT
1IRMAJD9 BUCK >}' AL3 ,POOL OR. nlU'd'E11 AY APPROACH.
CL9OTOM CONIrtRUC:T1ON :�2210.fi v
PO.12.>wf%IVitTKO 339.00 SF
OAidACtWC9Att'k'0.RT (STO 14,336.00
Riy�'+"�,WATM) C091: .OF CONSTRUMON
l�yy���q9y Yy �1 2�
JE".65,1'.�48.1 JU .FS•�. 15���71
CONSTRUCTION FEE 303-000-418-000 $.1,2331 M
PLAN rHr-0K FRIF 101-000-439-318 WX 15
MISC1'1A2iWAL FEE, 101-000.4.21.000. V91.40
a P=7°91CAi. YKE 101-000.420-000 WDA3
PI,11M1:iY O FEE 101 -0 00-419-00 3115&30
.Y d'.RM,Kf MOTION ,FLE - RESI 3 ' *'v • • H- - } $37.04
OT#A1: ING F.EZ 101.„00 23a0 32Ti.00
DOVILt?SER IMPACT PKy � ,ftiil.OU
ART IN PUBLIC PLACES - 1 + 01.000-255440 ool i IM PQ
M A`f 2
CITY OF LA �UINTA
SUB-TOTAX, C ..s MOW, i0 ►. NCE DEPT E�C;�
$4,789.02
IYM YRE-loAW FFMO
$0,r3fs .
t
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
:i A '1� /,—) , /
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings`
Slab Grade � Q�
Steel
�/3 �l
��
Ducts
Return Air
Combustion Air
Roof Deck
O.K. to WrapA/10-
Framing
Insulation
9//%/
���i/��
6/`/
Exhaust Fans
F.A.U.
Compressor
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
l3/�
Final/ �4Q�Oi_t%
BLOCKWALL APPROVALS
Final
POOLS - SPAS
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
Waste Lines '/� �1/LyL
Gas Test
Electric Final
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
�f/y/0i
��
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
/-
J�/r
Final
COMMENTS:
t
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) %
rig
AUG 24 2001 7:54AM
SCHMID-CONTRACTORS
760 3471897
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 24
PALM DESERT, CA
TYPE: Fiberglass BATTS MANUF,
RSR: vwensicorning THI
1NAL S:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Coming
GENERAL CONTRACTOR: TOLL BROTHERS, INC, .
R-30 9 1/2"
THICKNESS:R-19 6 1/2-
LICENSE:—,-
BY:
12"
LICENSE:BY: TITLE.
SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517 C-2
B
TITLE:. PRODUCTION MANAGER DATE: 08/24/01
R�ti't:'1Y4.G'///`•ieC:Y6aV :r,.rrs.' �•a 1
ermrw:.....ovw.a„wscr�s�inaw..mac:y,'s��tuavaw.w`wwa,s,6vieidimmr.6xr�.c,
_..--_. _... ._.. wr.�.wry..:.:'A-.:xK.rirviivi'/ee�vrt�CtieY.dK.vr.�Y.SR3s'ALY:M:a!+Ai�ife'r4,.1J.✓.tuV�3GiLftiHmAY.'6i:3K^.r/3�4+OYili29i'ISSiA6.Yi.Yla'YLY14.iY�fl>.'W.oiir�.3'.ii}GrlpFi�'�a.eWi-Win'/.rY.iYY.7?.l.oMrY.<
INSULATI06Y CERTIFICATE
This is to certify.that insulation has beery 'instail'ed 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 24
PALM DESERT; CA
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-30 91/2"
iNALLS:
TYPE. Fiberglass Batts . MAN UFACTU RE R:.Owens/Coming THICKNESS: R-19 6 1/2"
GENERAL CONTRACTOR: TOLL BROTHERS, INC, LICENSE #
BY: TITLE.
SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517. C-2
A.
8Y: TITLE: PRODUCTION MANAGER DATE: 08/24/01
n:.:or ctc.or.;,rR.;rtytiy:w•m�.rnve�art�..an,.nrr:.va:^>mrnar :.�.:�.,..-,�,.�:............ _._ . _.
P.6 `
A �
Ca'
Toll"Bro11C.ther°s,
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 # Z 4/
Project: Vistas (Tract # 29349-1) -or- Reserve Tact #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
74-923 Hovley Lane East, Suite 2-220 Palm Desert, CA 92260
7F;n-R74-gRgQ Fav 7rn.A7A..0nQ1
i
miner sons
Al Miller ac Spm 11c)pfijip
Rouffiong Inc. ' ba -Iso Summit Dr.Phone: 760/346-121.4
Cathedral (lily, Ga 92'31 ��ti1(: 760/321-7097
FCIC§iMV
rl,(x Gary / Abdy*roll Brutl- s PC-wA West
:1C" 777 -1a%
From:
-
1=rom: Russ Miller
Date: Z 02
Re-onins ecti,
Pages: 1.
Gary /Andy,
We have inspected all the Roofs. at PGA West (Vistas and
Reserve). All v6nts, are installed per the O'Hagin
specifications and per your plans
Thank yoh►
Russ Miller
DEC. 19 01-j(WED) 12:04' t ° PAGE. 2/2
''
• FALCON FOAM
1 � A OmsrON oi'anAO00FovG coRPORAttON•
14104 Towne Ave. _ l ' -
PO. Box .SIV6 ; . Q (.' Cb' I ' s> `
' los Angeles; CA 961 `.
�.. _
3 0,53.5.7 02FAX:310.515.G849
December 19, 2001
i
To Whom it May Concern:': f
All 1.5# nominal pcf Type IIR material was shipped for the Benefit of.Thompson BIM in '
Orange, to the job site of PGA-West in La Quinta, CA, to the-attention of Wayne Smith
Plastering. The 7);pe IIR T&G foam•was manufactured by Falcon,Foam and shipped to
PGA West in La Quints, CA. This foam' rieets or exceeds ASTM C578-95 Type II•: ',i
specifications.' 1 y
In,'addition, the -.application of an additional, smooth•coat stucco' finish'will not in any way
affect. the performance of the W -Type, I1R foam:
;Sincerely; r.
Mary K: Stocker
General Manager
Falcon Foam
� n L
L;erriricare or occupancy
City of La Quinta
Buildingand 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: 81-685 TIBURON DRIVE
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0105-063
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: TOLL BROTHERS INC Address: 74-923 HOVELY LANE EAST STE 2-220
City: PALM DESERT, CA., 92260-
By:
2260By: BILL GORDON
Date: 2/8/02
Building Official
POST IN A CONSPICUOUS PLACE