0009-104 (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
77769 B • , 041304V
bate -,x7/ ),Signature of Contractor 1 �
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 theproject (Sec. 7044, Business & Professionals
Code).
O 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.
(l 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 PACII+IC EMPLOYEE! Policy No. WLR C43084318 '
(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,l should become
subject to the workers' compensatiV rovisiions.o ' ection 3700 of the Labor
Code, I shall orthwith comply with,these provisions-
Date: Y4�21al) 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 at
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. 'l 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 inspection purposes.
Sig nature(Owner/Agent)' ` _0�- Date%✓ , �%
BUILDING PERMIT PERMIT#OM
04�%
DAT/E' ' VALUATION LOTTRACT
$270,35930 CYC' 29" -2
JOB SITE _�r�
ADDRESSo _� a URONDRT
7417-�.4CD 14
OWNER
CONTRACTOR/ / EN INFER
TOLL BROTHM INC
TOLL BRO'I°TMS INC'
'14-923 I10Vl <LY LANR KA" ;3i1'. rBZ-220
74.92q HOVELY LANB F f -TWI 42.220
:PALM DESM CA 92260
PAL1d DESMer CA. 92260
(760)674.9699 CBLO 3832
USE OF PERMIT
SIN OU FAhMY DVI.L:f.I WO
SPD,PLAN:N.AVARRO LOT16-PERMIT I3OM NOT.INCLUVE
BLOCKWALL8/POOUDR'VEWA.Yt' PPP,OA.CH
CUSTOM CONSTRUCTION 3,222.00 SY
PORCWPAT10 ritoo SF
QARAOE/CARPO.RT (SF) 14,356.90
F.�TFM COST OF C(i1�i�.1�.2`ixG`r.ION
270,359.30
p�g� �'�q�q+�f 9�y y�^p�p
ACi`+�iliY{a7�` A.V E 91.fl. i-EMA .Z. n
.
% CMJBTRUCTIO14 IEEE 101-000.4134000 $!,238.00
',PLAN CHECK FEE 101-000-439-318 W2.15
t: MECHANICAL FRE 101.000-421-000 b10,00
ELFFXTRICAL "M 101.000-420-000 5180.43
PLUMBING FEE 101.000.419-000 1183,30
STRONG MOTION I,1~ - MID. 101-000-241-000 $27.64
O ADINO PER 101.000.423.000 $20.00
D VELOPER IMPACT FEE $1,907.00
ART IN Pt SUId FKACE.3 - RESIE 701-000,-255.000 $175,90
a ,
SUB -Air. C0148 r' cK-117011 FLAN CIM
$4,788.02
I=SIS PRE -PPM FM
$0.00
OCT 031000 OTAL PF-r1rEKS DIRE
,
QUM
-A,
a
RECEIPT
RECEIPT
DATE i BY.
DATE FINALED
INSPECTOR
ox
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & FootingsDucts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing/
pi
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
2 / X
Drywall - 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 Plbg. 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 Connection
Encapsulation
Gas Piping
Gas Test
Ti Ol
Appliances
Final
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)
COMMENTS:
z.
r
August 10, 2001 1'
Danny: ,
Please be advised of an address change for the following structure. The structure
formerly. addressed as 81-780 Tiburon Drive, APN # 767-530-014, Lot'16, Tract 29348-
2 the construction for which building permit # 0009-104 was issued, will now be
addressed as 81-700,Tiburon Drive'
Please note,this change and contact me,directly at (760) 777=7012 if I may be of further
assistance.
Thank you.
Sincerely,
Kay Hensel '
Building & Safety Department
i
RUG.24 2001 8:14AM.- SCHMID-CONTRACTORS 760 3.471897 p.17'
W:.WtDr']I"/9rRN'd1`/t:S/lfifi6SAf.Y'A:C:OPiv1WVF'R;:i'aWfNWMN'+NYNi.NAIHff9LFiDrif.1RAVNlYdYM!9�LNOiA11Y1IP4"�1000fY.Ota1".RAJt:YfWAY. vY�IVJYJie;W.NA�MPY/.�{�N9+(aC' '
j. INSULATION CERTIFICATE
This is to certify.that insulation has been installed in oonkrrnance with the current energy
regulation, California Administrative Code, Title 24, State of California; in the building at
THE RESERVES AT PGA WEST/LOT 16
PALM DESERT, CA ,
CEILINGS:,
TYPE: Fiberglass BATTS - MANUFACTURER: Owens/Coming THICKNESS: R-30 91/7'
' WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Coming THICKNESS:R-19 6 Ili o
GENERAL''CONTRACTOR: TOLL BROTHERS, INC. LICENSE:
BY: ~ TITLE: a
SCHMID INSULATION'CONTRACTORS, INC. LICENSE #221517 C-2 e,
•1
Y: TITLE: PRODUCTION MANAGER DATE: 08124/01 e
•t
.. NCti44,RL.40PM� P(�.GOs.rK1W./ff�iW�WGfI ,Mh'WtlIG��tWN^.LR(R6c'.ffYC6dRN.(GIWR.�WIf _ ,WGJ•llmlSG.vY�..,./N J
S/eji/SlORtf!/.OVAO.1iL1•iIICJF'•?1�.0:Ozf4Vsv .iOiuI20V�RHFL130Yft YAt1tSSf4k�bW3tSR✓.GYMAIffW4HWP.KLgyitP..aCY/�'ST/I[.CffLQ"a!
' INSULATION CERTIFICATE
3
This is to certify that insulation has been installed in conformanoe with the current energy
' regulation, California Administrative Code, Title 24, State of Califomia, in the building located at
' THE RESERVES AT PGA WESTILOT 18
ti PALM DESERT, CA
CEILINGS:.
TYPE: Fiberglass BATTS , MANUFACTURER: Owens/Corning ' THICKNESS: R-30 9112"
WALLS: ;:� . •
TYPE: Fiberglass Batts MANUFACTURER: Owens/Coming. THICKNESS: R-19 6112"
b GENERAL CONTRACTOR: TOLL BROTHERS, INC... LICENSE #
BY: • TITLE:
` SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517 C-2
BY: TITLE: PRODUCTION MANAGER DATE: 08124/01
'3�.�rpausxoie..4viw.xRrc�mmvnaitis�o/mamranyis�myx!afn�:ai�.�ari:v�mBKaa��Hvbsmry^.�f►as.�uz�fsossnyo�,v®�►:s�weuntaouwvw-^��z:
m mmer &sons
Al Miticr & Spm RooCi1iP,
RooffiNInc. 68-76vSununitDr. Phone: 760/3,16-121.4
Cathedral Cily. Ca 92231 Ftix: 760/321-7097
FwiM11P
'.r(.x Qrt y / Andy(gNoll Bruthms PCTA West
Fax: 777-15%.
From: Russ Miller
r
Date:
Re:,Inspection
Pages: 1.
•
Gary / Andy,
VYe have in 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 t
'�' ,
s
Toll "Brothers Inc.
Quality Homes by Design®
August 8, 2001
City of La Quinta
Building & Safety Department
P.O. Box 1504
La Quinta, CA 92253
Fax: 777.7011
Re: Lot # l4P
Project: Vistas (Tract # 29349-1) -or-(RTract #29348-2) (circle one)
eserve
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
Certificate of Occupancy
City of. Lin
Qu . to
/ .A 0!1A1� �
Building and .Safety Department
M o>r r'►
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: 81-700 TIBURON DRIVE
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0009-104
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: GARY HARTMAN
Date: 10/16/01
POST IN A CONSPICUOUS PLACE
J