0009-105 (SFD)LICENSED CONTRACTOR DECLARATION
_ CLARATION
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, E�. ,.- 04/30/2(
Date ✓� Signature of Contractor f..^-+ _
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). _::J... - . J
() I,am exempt under Section B&P.C. for this reason
Date Signature of Owner r
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
perform4an6e of the work for which this permit is issued.
, ( ')�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 PAACIFFO EMPLOYEE! Policy No. WLR C430A318
(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 thejjworkers' compensation provisions of ection 3700 of the Labor
Code slia I/fortliwl h comply with. tho 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 a1
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 inspecti purposes.
C'
Si nat Owrier/A enf) 'i� `Date%�y%--' �` `��
BUILDING PERMIT PERMIT#
DATE1 VALUATION LOT �-amTRACT
I0l = f �. .,20 �2 29348-2
JOB SITE v
ADDRESS
APN
767-K:V-021
OWNER
CONTRACTOR / DESIGNER / EN (NEER
TOLL 13RO�S WC
MLL D OTFI>±' S INC
74-923 i�0'i ELY LANE LAST BUTCE2-220
74-923 UOVELY LANE RAW �'fT 2,2«220
PAI,.�i�r1 �DESFIRT CA. 92260
PALIdL DEMT CA '9iZ60
(760)67A••9699 CX* 3832
USE OF PERMIT
11 q'GL E FAMILY D�'i� ELtD7Cs
50 -PLANT : UINTANA LOT:23 PERMIT DOES '1 OT 114Ci UDE
Fad.00KWALI.9/POOL,fDRiV CIWAY APP�tOACH
CUSTOM CONSTRUCTEON 3,412.00 3F
PORCWtt7P��/Aw IO 320.00 SF
GARA
i T' COSH' OF CO%+Tfi3.1"RUC7�ON
2 tw"
.P0nm Fn $9U e y
;
CONSTRUCTION RUCTION PEE 101.000.418«000 $1,290.50
PLAN CHUCK FIS: 101-400.439-318 $1,031.83
MUC1.1A111CAL FEE 101.000.421 w•000 $9206
E1.1't.OTklc,A.L FEE 101-000.426-000 pskoo
PLUMBING LEE 101.000.419.000 $180.50
STRONO MOTION FEL? - RESID 101-000-241-00+0 $28.58
. .
GRADiNO FET, 101-000.425-000 $X00
DEVELOPER IMPACT FE $1,907,410
ART IN PUBLIC PLAC. - FM11 701-000-255-000 $214.9;1
; L11;3-MTAL COkARUCYIOAi AND PLAN t�N�L
$4.958.93
LESS PRP-P.AIID MW
$0,00
Pyri TOM ?MW I; DVS flow
$4,` .93
OCT b 3:2000
RECEIPT
.
DATE'
BY
DATE PINALED +
INSPECTOR
i.
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings 05u,07112/00
Ducts
Slab Grade
Return Air
Steel
7
Combustion Air
Roof Deck
p
Exhaust Fans
0. K. to Wrap
/ p/
F.A.U.
Framing -
A/ 1 L
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
44,
D 11- Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
/
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer ConnectionXv
Encapsulation
Gas Piping
'
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
m miner sons .
Al Miller 8c Sous itc?oritnP
oofing
INSsu-760 Sununu Ur. phone: 760/346-1.21,4
Cathedral City, Ca 9223,1 F.0 ! 760/321-7097
Facsimile
rl'ec Gary / Andy@1611 Brothers PcrA west
Faro
777-0%
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 Q'Hagin
specifications and per your plans
Thank you,
Russ Miller
Ccroll "Brothers GInc.
Quality Homes by DesignO
1
August 8, 2001
City of La Quinta
Building & Safety Department
P.O. Box 1504
La Quinta, CA 92253
Fax: 777.7011
Re: Lot # 23
Project: Vistas (Tract # 29349-1) -o Reserve (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.
74-923 Hovley Lane East, Suite 2-220 Palm Desert, CA 92260
760-674-9699 Fax 760-674-9081
AUG 24 2001 8:I1RM
R. .
SCHM I D -00N 1 kHG I UXb '/bU U4'/ 1 tia'/
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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
p-iu
THE RESERVES AT PGA WESTILOT 23
PALM DESERT, CA
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Coming THICKNESS: R-30 91/2"
r
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Coming THICKNESS:R-19 6112"
GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE:
BY: TITLE:
SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517 C4
BY: TITLE PRODUCTION MANAGER DATE: 08/24/01
•N.CNUP�WYtlfipeRf/�R?iI�Cl0 t1I.GIFICJIdfIA:rlIgWL rY 'fU7]/YtlI.Y 'iSP6iEL3%iY.G LiR61'Vi01alYY.7/-4fW�9�'JAXtaXtl:S .WVY1 VAZWMVVA1',. AY,=—IXOYlAi9R
INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, Califomia Administrative Code, Title 24, State of California, in the building located at
THE RESERVES AT PGA WESTILOT 23
• PALM DESERT, CA
CEILINGS;-
TYPE:
EILIN -TYPE: Fiberglass BATTS MANUFACTURER: Owens/Coming THICKNESS: R-30 9112"
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning, THICKNESS: R-19 6112"
GENERAL CONTRACTOR: TOLL BROTHERS, INC. - LICENSE #
BY: TITLE:
SCHMID INSULATION CONTRACTORS, INC. LICENSE #22151.7 C-2
BY: TITLE: PRODUCTION MANAGER DATE: 08/24/01
1
Certificate of Occupancy
City of La Quinta.-
Building,
and Safety Department. .
9
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.-
2
ollowing:
BUILDING ADDRESS: 81-695 TIBURON DRIVE
Use Classification: SINGLE FAMILY DWELLING • _ Bldg. Permit No.: 0009-105
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: TOLL BROTHERS INC Address: 74-923 HOVELY LANE E STE 2-220
City: PALM DESERT, CA., 92260
By: GARY HARTMAN
Date: 11/6/01
Building Official
POST IN A CONSPICUOUS PLACE .