0006-394 (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
P(o?essionals Code, and my License is in full force and effect.
License # ryp yLic. Class Exp. Daatte
'' 77699 B 04/.30/2(
Date n 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).
() 1 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 haveand ;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.
(�ave 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 09HERALA(VIDEN) Policy No. W13161102-07
(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 Section 3700 of the Labor
Code; I shall forthdith comply with those provisions.
Date:�r Applicant
Warning:jFailGre 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. 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 inspection purposes.
Signature (Owner/Agent) Date ":�.�:
r !i BUILDING PERMIT PERMIT#
LOT TRACT 2930-2
D TE VALUATION $2850920
�a
JOB SITE
ADDRESS
APN
OWNER
CONTRACTOR / DESIGNER / EN (NEER --
TOLI, BRe11INC
TOIL BR01IMS INC
74.923140VELY LANE F'. SUr1'L2.220
74.92.3 HOWUY LANK EAST 3WfL, 2-220
PALIA DESMT CA.' 92260
PAI" DEW ZT Cit, 92260
(766)674.9699 CB7tA, 38x3
USE OF PERMIT
ISWCLR PALbSTLY DWE.SWO
SFU=PLAN: QUINTANA LOT: 13=i'F,WIT DO??.3 NOT INCLUDE BLOCK
WA.LI.J OR POOL
F
CUSTOM C014STRUCTION 3412100 SIS
PORCWP.Kf10 320.00 SF
0ARAOEICARPOR.T (93F) 13,' 3$,.4®
EST 17 D COSI OV CONS=-UCTdON
=,W%20
p3mmuT Vn subWARY
CONSTRUCTION ', 101.000.416.000 Si.290:94
PLAN CHECK rem 101-000-439-31.15 $1,037.93
MECHANICAL FEE 101.000-421.060 $02.00
?LF. 'TR1CA1.. FEE 101 -000-420-06 " $188.00
PLUMBiNO FEE 101-000-419-000 8130.30
STRO140 MOTIONY9E . RESID 101-000-2,41-000 $20.38
cJRADrrlc.$ FEE 141-000-423.000 870.00
DEWZi0PZRIMPAC T"MR.
AIRT.IN PUB1,1 PLA,C +F.S - R SIL 701V.000-255-400 $214.52
' r r rai:Pusrr 161 -000 4n-3)8 .$730.00
s
' AU JL12 URICPLAN Cjwf y,
$4,938.93
o�-� 0�` LE33 PM_F�A11�iwa
LA
- 750,00
10M PE10W FWN DUE NOW
`4
UAO 93
F
RECEIPT
DATE
BY
I/ /
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs 40
Forms & Footings /—/(5 —40pZ1 ��'
Underground Ducts
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap /
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath :80W05
DWwall - Int. Lath -d
1G9 -S
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 36
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection /2
Encapsulation
Gas Piping
Gas Test
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:
A r- -1 S-2001 WED � 01: 34 PM .AL MILLER & SONS ROOFING FAX NO, 3 P. 01
jumillerasons
Al Miller & Sons Rooti11PM=GRhone: 760/396-1.21.4
oWng1lics
C 760 Sununu 1Ca
Cntl�cdral city, Ca 92--m Jt''.ix: 760/311-7097
Fa.simile
`.t'{x Qiw / Am1y@Troll Bwfl ns YCyA West
Fax: 777 t.a%
From: Russ Miller
Date: August 15, 2001 41
Re: Inspection L -S
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,
Rus's Miller
1�l1
i !k
`?oll (Brothers GInc.
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 # PL—;; c-lz cU3� �'1 -� !a T JRuJ0Cr4 l )jZcV � �A Qv(.uTti
Project: Vistas (Tract # 29349-1) -or 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.
S incerely,
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
f
Certificate of Occ(lpancy,
City of La inta
BuildinDepartment .
gand
Y.
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: _ , 81-710 TIBURON DRIVE
Use Classification: SINGLE FAMILY' DWELLING Bldg. Permit No.: 0006-394
Occupancy Group: R-3 -Type of Construction: VN Land Use Zone:' RL
,Owner of Building: TOLL BROTHERS INC Address: 74-923 HOVELY LANE EAST #220
City: PALM DESERT' CA., 92260
By: RICHARD K. KIRKLAND -
Date:. 6/21 /01
Building Official
POST IN A CONSPICUOUS PLACE
y