0006-398 (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
i77 .� B 04/:30/2:
Date m " : Signature of Contractor
OWNER -BUILDER DECI4ARATION
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 Sianature 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. .
F(�) I have and will maintain workers' compensation insurance, as required by
Sectio 73n 00 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 0ENERA,IwACCIDEN1 Policy No. WC0161102-p9
(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 theeorkers' compensation provisions of Section 3700 of,the Labor
Code, I shall• ortliwith comply with those provisions.
Date: • �' raj Applicant..
Warning. Failure to secure Workers' ompensation 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, agenfs.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)
y U BUILDING PERMIT PERMIT
DTE VALUATION 23 ,691.10 LOT_I a TRACT 29$8-2
.4
c
y�
JOB SITE ve
ADDRESS CSL715 �.:I12�N.LYCi -
APN
t
OWNER
CONTRACTOR/DESIGNER/EN INEER
TOLL BROITMS INC
TOLD niM DTC
74-923 HOVELY IAA14E 357'1' ErUrrE2.224
74-923 HOV1 f,Y LANE, 1.3=1 Z-220
PALM DEMRT CA 92269
PALM D.�'SMT CA 9126Q° •1
(760)674.9699 (.'I$1.f 3S32 r
USE OOF�FyqPERMIT
7 �y y �a��{�p� t��r�
d'71[V�,7XZ, 1,�-0RP.KLu✓E DV'FJ:W,.�.d1VO
�r
VD -PLAN: C:ASTILLCI 1.,OT:21•PZRMIT TOES NOT INCLUDE BLOCK
'KA118 OR. P006115% PLAN 011ECK FEE REi5UCTION FOP, IMUANCIL OF
xAhAEPI-t'N TYPE,
CUUTOM CONSTRUCTION x,689.00 ar.
POR+,diIPATIO $51.00 SF
GAR A GEMARPORT (133) 3,427:60
7 NYHdA�'�''I.J COST OF C0T?hWWC'T 0X
223,491,10
PEFdW WE SUMMARY
C ONW11RUCTION ME 107-000-436-000 5110173.50
PLAN CHaF,L'K WE 101-000-439-31$ $219.06
I+ ICHANIC:AL� FEE 101-000-421f000 892.00
ELECTRICAL FU 101-000-420 ;0W $156.20
PLUS BWO FEE 101-000-419:000 $186.50
STRONG MOTION PEE - RESSIU 101-000-2412000 $3133
CRADING FEE , ` . ` 101 -!000-.423-6,00 120.00
Dl VELOPEk IMPACT FEE
�,,kT 19 PUBLIC PLACE - RM117Ci1d(OU�%SS�130
a911-STRTJc;L:ON AM PLA1+I'CHECY,
"IryLESS
X3,9 0.34
PRE -PAID ZnS
P-1111MOT -11-MB DUE
i
le
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
}
�,
IIR>•
INSPECTION RECORD
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
/ ,s 0
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Q
Compressor
Insulation
_
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
b
Drywall - Int. L th
D/
� ata
Final
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
Gas Test
Electric Final
Waste Lines
/'_�
�r
Heater Final
Water Piping
f
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:
Certificate of Occupancy
City of La Quinta
Building and 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: 81-715 TIBURON DRIVE
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0006-398
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
II
.,,Owner of -Building: TOLL BROTHERS;INC
&-sn
Building Official
Address: 74-923 HOVELY LANE EAST STE2-220
City: PALM DESERT, CA., 92260
By: GARY HARTMAN
Date: 10/30/01
POST IN A CONSPICUOUS PLACE
Toll Brothers, Inc.
Quality Homes by Resign°
August 8, 2001
City of La Quinta
Building & Safety Department'
P.O. Box 1504
La Quinta, CA 92253
Fax: 777.7011
Re: Lot # 2 %
Project: Vistas (Tract # 29349-1) -or-(Reser (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
MMIllemSons
Al N1111er & Spn; 1?,?ofi,,g
RoofingInt, . bu-760 Sununit lir. Phone: 760/316-123.4
CatBcdral Cily. Ga 92231 Fitz: 760/321-7097
Fmtr,,mile
'T" Gary / AWyf«T bll Brod ws PCTA West
FWx: 777-1596
From:. Russ Miller
Date:
Re: Inspection
Rages: 3.
Cary / Andy,
We have inspected all the Roofs at PCA West (Vistas and
Reserve). All vents are installed per the 4'Hagin
specifications and per your plans
Thank you,
t, l
Russ Miller