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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisionsp%4f
Chapter19 (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
'777$ B 04/30/2(
Date 0
� tib Signature of Contractor
ty
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.
V' Lhave 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 OXNtR.AL-ACCIDEM Policy No. WC0161102-07
(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�wor ers' compensation provisions of Section 3700 of the Labor
Code, I shall ortft ith comply with those 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 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 riull and void if
work is not commenced within 180 dak 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 �f���
' PERMIT#»S 1. ••
BUILDING PERMIT
�,:�-
./,k,//'
D}1TE VALUATION $321A4iV30 LOT 22 TRACT .2930-2
�`
JOB SITE
ADDRESS��
APN
76'%530-020
OWNER y
CONTRACTOR/DESIGNER/EN INFER
TOLL BROTMRS il3C _
'i ML BR01—ARZ WC'
74.923 H:OVALY 1JM PAST SU -2211
74.923 H0V:ELY L,MWE; Of SYMIM- -220
PALM M"' r . 'CA 922E0
PALM DESMI CA 922 0
(760)6'14-9699 C13114 113832
! `
USE OF PERMIT
SPV-PL.P NN' ENNA LDT: 21-P€s:RMJl P DOSS NOT INC.LUL)? 0LOCK 'WALLS
OR POOL75% PLAN CHIrCK FEE REDUCTION N'OR. SSSUANCE OF SAME
P1.,AN TYrl9
CUSTOM CONSTRUCTION 3,772.00 SF
PORCPJPATIO 907.00 sip
CMAOR(CARPORT (SY) 13,T5Is�0
ESTMAlklD Cts"r OI+' C0HS17 tJG'n0i;
321,6 1U
CONSTRUCTION M 101.000.418-000 $1,416.50
PLAN CH'i CX =4 101-000.439418 $295.08
WCHAN1CAL ISE 101.000.421 000 3111.00
1*53,..I? .*TR.ICAL• FOE 101-000-420.000 $200.60
PL,UMBIN0 FER 101-W0419.000 $1".$0
STRONG MOTION HE - RESID 101-000-2-41-000 $12.17
J
ORADINO PEP, 1.01.000.423 -GOD $20,00
DkVZL0PZP IMPACT I°EE { �I,9tY100.
w
.ART IN PUBLIC PLACES - RESIE 701.000.25,,5.000 $304.1
SUB -1W S 109 ANSA PLAN CHECK
$4,475.00
Lisp PRE -PAM 1M
$0.00
�7--
✓ TVVi N 9
8
$4j47300
r 1+"KES DCBE NOW
n
RECEIPT
DATE
BY� /
DATE FINALED
INSPECTOR
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
/
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation5
j
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
WL
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 I
I
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
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:
AUG -15-2001 WED 01.34 PM AL MILLER & SONS ROOFING FAX N0, 3 P. 01",,
Al Miller & Sons _
Al Miner & Son; Roofing Phone: 760/346-121.4
Bong Inc. Eli 760 Summit lir.
Cathedral Cil), Ga 92234 r'.ix: 760/321-9097
Fmimik
'fix Gary / A mly@Troll Bmthem PGA West
Fax: 777-1.596
From: Russ Miller
Date: August 15,20.03.
Re: Inspection
Pages: 3.
Gary / Andy,
We have inspected all the Roofs .at PGA West (Vistas 'and
Deserve), All vents -are installed per the Q'Hagin
specifications and per your plans
Thank you,
Russ Miller
'roll '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 # 22
Project: Vistas (Tract # 29349-1) -or Resery (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 tr PGA West
74-923 Hovley Lane East, Suite 2-220 Palm Desert, CA 92260
760-674-9699 Fax 760-674-9081
RUG 2.4 2001 8:11AM SCHMID-CONTRACTORS
760 3471837 p.11
0
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 WEST/LOT 22
PALM DESERT CA
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Coming THICKNESS: R-30 91/2"
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Coming THICKNESS:R-19 6 1/2"
GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE:
BY: TITLE:
SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517 C-2
BY: TITTLE: PRODUCTION MANAGER DATE: 08/24/01
otaxm[V ar.:w�aemrwrvuaw�waraauArrw.a.:m.vafm:w•tY.^.ucaJixsswzt�nvs �ramruiemmersvmasSW�4�AA�3%fdBIXY/�J1vt?PM'rr.I/pY017Xa/.Wl
INSULATION CERTIFICATE
This is to oar" that insulation has been installed in conformance with the current energy
regulation, California Administrative Code, Title 24, State of Califomia, in the building located at
THE RESERVES AT PGA WESTILOT 22
PALM DESERT, CA
C I INGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Coming THICKNESS: R-30 91/2"
WALLS:
TYPE, Fiberglass Batts MANUFACTURER: Owens/Coming THICKNESS: R-19 61/2"
GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE #
BY. TITLE:
SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517 0-2
BY. �1.... TITLE: PRODUCTION MANAGER DATE: 08/24/01
I
Certificate ofOdc'upancyT
i f �� -
C t o La Quinto F
y
Building and Safety Department OF
,This Certificate issued pursuant to the requirements of Section 109 of the Unifoim 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: 81-705 TIBURON DRIVE
Use Classification:: ' SINGLE FAMILY DWELLING Bldg. Permit No.: 0006-399
Occupancy Group: R-3, Type of Construction: VN Land Use Zone: RL
Owner of Building:. TOLL BROTHERS INC - Address: 74-923 HOVELY LANE ESTE ~2-220
City: PALM DESERT, CA., 92260
By:, GARY HARTMAN
Date: 11 /6/01
Building Official
POST IN A CONSPICUOUS PLACE