0106-262 (SFD)i LICENSED CONTRACTOR DECLARATION
I,,hereby,,affirm under penalty of perjury that I am licensed under provisions of
&apter'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
777116599 r D✓� . fes"' 04/3012(
Date 1-1 Signature Signature of Contractor y )
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. forjhisrreas6n
Date T-1 /4;_ Signature of Owner f �a'� �-•
WORKER'S COMPENSATION DECLARATION
F 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. <T_
P (,) I have and will maintain workers' compensation insurance, as required by
Ve'eUon 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 Policy No.
!'ACIFICIWP.i OYR1 a; YAXLC43RE4M—
(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 forthwith comply with thdsprgvisions.
Date: � � - n•� Applicant—
Warning:'
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 Codecinterest 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: '>r�
Signature (Owner/Agent)�� Date���
BUILDING PERMIT PERMIT#
DATE VALUATION LOT OIW-262 TRACT
JOB SITE
APN
ADDRESS p 4ty y y�f r9 yyf� 1c� �L W� c�
''`'�8� 'tfi.fkF.�'yt.J•iy S,�,l'i5d t�h�J.J4&
p ae9n ,�A n1
'167490-034
76 f7�t90-034
OWNER
CONTRACTOR / DESIGNER / EN (NEER
'T011, 7i~,12OT MK.,O WC
'u��'C1j�:i(T� , Z31�v.C3�`f1'i✓RS ��"
11-9.2 7.'1.p'¢.R:+F.'A• A.EP. `iil•'YS;i.L'/6 .1.V3 W'40.dib.sl.RQI°",6 d1W�
�p j` �g �7 7 � k
!�'I"ki23 J�7L'!d''/.1Wil LANE E .L 'i�i�M1.:�J.•I,[`r�-2 0
PAXIIADINIZERT CA 92260
PAW DEM U.' 0, A !Y2, 2, 6 0
Q60)474-9699 MR 3932
USE OF PERMIT
SW01E"FAWT.L-•Y DWEWi Uqo
4611 TL?L L2, AVE
71'D a 1rL'rT.; k'1.AN SATti', A ROSA 71,11 . P&M4' TXV3 •11fQ: [ULCUDir
BLOCK Milt POOJ-.Oil I"33 IVEWt3YAPPROACH. 75% PLAN CHrJ_-CK RE,
RET IC.1`ION ,APPL.3l,MFOR ibS'1 LTIP1. a S€AB149ITT.ALS
fv't3N'k'OM COtd 'E'Rt7t:'' ION 474,1.00 F
T-OR.CiriI'.€bflO 324.88 s^y
0ARAWCARPt>RT °YsiW O. '
Wr` :�&:.f�. -C rf lm,o'irrm31c mx _—
10
PFJMT MY guAvvy"y
CONSTRUCTION 101-000-419-00D Si M.00
O
PLAN C H CIG; FEE, $MTO
IECF 33Ln&L FFIR 101 "000-421-000 $9.50
Op]. lbCAL 7ffZ $179.56
PLUMBING FER 101.000419 -CM �S6iy,G41
u'a"i:aAim' a K1.;F;'1MV -i ME. is MT5 101.0004-241 *000 $31.06
D.l ti,r&33PM IMPACT VFZ
ARV -N PUBLIC PLA WS - '.FIS E -701-t300 55.000 $77M19
5•�3,1�1`1�P;1;`L:`C3 j6 C' k"9.OiD••��3gq5��tP�LA}wtt•�M, t,ACIt
'F.�
y32A.20
7 1 yy
"`"��,�..•.�-"' -; daTI Do 11x1:Y'..I+^L''.Y•ir3.!e� d'.':M..0
1 ` .,,-`�t'��'LF. 0�,�` Wim„-✓
, . ��,�.,\
t:y
RECEIPT
DATE
BY
DA F DDZ
INSPECTOR
�jAL
`;
INSPECTION RECORD
-.!'OPERATION
DATE
INSPECTOR
OPERATION'
DATE
INSPECTOR.
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings
Underground Ducts
Ducts
Slab Grade
_ _
v(
Return Air
Steel
Roof Deck
�l_ _
Combustion Air
Exhaust Fans
O.K. to Wrap
Framing
Insulation
Fireplace P.L.
//ate ��—(,L
F.A.U.
Compressor
Vents
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wall Firewall
Exteriorr, Lath
Drywall - Int. Lath
Final
Sr/3`�
Final r
POOLS -SPAS
BLOCKWALL
APPROVALS
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 . _
Waste Lines 8�3l.�b!
Water Piping /
Gas Test
Electric Final
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Showqr Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer- Connection
_
8/3l�DI
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
a
-
r
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.L`,I
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
. r�. MAR -22-2002 13:49 TOLL BROS PGA WEST 760 7771596 P.02
57 'tin Kp'
OF" QUINTA
- 3t�UI1MNG &;SRFETY DEPARTMENT
OF
Ali!!
- 77y-70112
` ? INSPECTION) REQUEST LINE
_ E TII-7153
Owner_
TbLt-SROTAEP.S INC.
Contractor TOLL BROTHERS INC.
Permit Nun"r 0106-262
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 81-040 KINGSTON-HEATIi"
SFD - LOT 34 PLAN SANTA ROSA 3741
PERMIT DOES NOT INCLUDE BLOCK
WALL POOL OR DRIVEWAY APPROACH.
TYPE OF INSPECTION I DATE INSP.
FOUNDATION & SETBACK 1 1 /l
MAIN
PRE-GUNITE ' I I
.
DO NOT POUR CONCRETE UNTIL ALIABl3VE HAS
CONCRETE: SLAB I 0
JOISTS & GIRDERS I
ELECTRICAL GROUND WORK I
_ I
NOT POUR CONCRETE UNTIL ALL ABOVE HAS
ROUGH ELECTRIC I
ROUGH PLUMBING j
ROUGH GAS & GAS TEST I
HEATING & VENT - A/C .
FIREPLACE I.
ROOF {
BOND BEAM I
O.K. TO WRAP
GROUT ❑ 4' 0 8'
FRAMING 'I I S ��
INSULATION
PRE -ROOF I
_ I
v
COVER NO WORK UNTIL ABOVE HAS BEEN
DRYWALL INTERIOR I
EXTERIOR LATH j D
POOL PRE PLASTER !
TANK
ELECTRICAL
ei i ih,ei.o.:
FINAL GAS TEST I -
'ATING . AIC I
.USE NUMBERS 1
JOB COMPLETED
TEMP POWER l
' l
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TOTAL P.02
I,A
•0,V1212002 15:32 9092920409 SCHMID CONTRACTTtiIG PAGE 06109
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INSULATIQN CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, California Admini strative Code, Title 24, State of California, in the building at r
81-04M KINGSTON HEATH , LA QUINTA, CALIFORNIA 92253 a
TBI 34 "
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Coming THICKNESS: R-3812" )SLOW
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNESS:R-, A 51/2"
GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE:
BY:
TITLE:
SCHMID INSULATION CON-FRACTORS, INC.
LICENSE #221517 C-2
BY* �d_ TITLE: PRODUCTION MANAGER DATE: 4112/02
---------------•--
r
INSULATION CERTIFICATE
This is to certify that insolation Pias been installed in conformance with the current energy y
regulation, California Administrative Code; Title 24, State of California, in the building local W at
81-040 KINGSTON HEATH'; LA QUINTA, CALIFORNIA 92253
"
'—T6134
; rEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Coming THICKNESS: R
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Coming THICKNESS: R-21 5
GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE #
BY: TITLE:
SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517
TI7L: - PRODUCTION MANAGER DATE: 4/921(
i,
®11 LlrotnCrS GInc.
Quality Homes by DesignO
August 8, 2001
r
City of La Quinta ,
Building & Safety Department
P.O. Box 1504
La Quinta, CA 92253
Fax: 777.7011
Re: Lot # 3
Project: istas (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.
Sincerely,
Andy Fraser
Project Manager
Toll Brothers @ PGA West
74-923 HoWey Lane East, Suite 2-220 Palm Desert, CA 92260
7Rn-R74-QRQQ F-11 -Ian Fin nno•i
Al Miller & Sons
Roofing Inc.
At Miller & Sons Roofing
6B -76u Summit Dr. 1'hohe: 760/316-121.4
C:athcdrat CjIy, Ca 9223.1 F -XV 760/321-7097
F,6rWini
'.t'tx (�ar.y / Amly@Voll Brotliej,,s PGA West
ax:
From, Rss Miller
Gate: / ,p
5, / 2._. 3 0/6 r4
Re: Inspection
Pages:.
r
a�
Gary-/ Andy,
We have inspected all the Roofs at PGA West (Vistas and
Reserve), All !vents alre installed per the a'Hagin
Specifications and per your plans
Thank you,
Puss Miller
(Certificate of Occupancy
City of La Quintal
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=040 KINGSTON HEATH
.Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0106-262
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 EAST STE 2-220
City: PALM DESERT, CA., 92260
By: DANIEL P. CRAWFORD JR.
Date: 5/3/02
POST IN A CONSPICUOUS PLACE