0106-261 (SFD)LICENSED CONTRACTOR DECLARATION
penalty ofperjury that |amlicensed under provisions o/
'Chapter 9(commencing with Section 7ono>ovDivision 3o/the Business and
Professionals Code, and myLicense ioinfull force and effect.
uuennuw uv.o/osa Exp. Date
DateSignature of Contractor
'
OWNER -BUILDER DECLARATION
| hereby affirm under penalty ofperjury that |omexempt from the Contractor's
License Law for the following reason:
( ) |, asowner ofthe property, mmyemployees with wages astheir sole
V.Cmmponsation, will Uothe work, and the structure ionot intended oroffered for
noo|o(Sov.rn44.evxinaoxapm,eouiona|oCouo).
( ) |, as owner o, the pmparty, am exclusively contracting with licensed
contractors to construct the pr9ject (Sec. 704*. ouain000 a pm*,00iona|o
Code).
(} |amexempt under Section suPo
Date Signature o,Owner
'WORKER'S COMPENSATION DECLARATION
| hereby affirm under penalty of perjury one nf.tho following declarations:
()| have and will maintain acertificate o/consent mself-insure for workers'
oomponaaxion, as pmwUou for by Section 3700 of the Labor Code, for the
performance ofthe work for which this permit ioissued. r
( ) | have and will maintain workers' compensation inoumnoo, as required by
Section 3700 of the Labor cuUo, for the performance of the work for which this
permit is issued. My wm,xom' compensation insurance uomo, & policy no. are:
Carrier , ' '- Policy No.
(This section need not be.completed if the permit valuation isfor $
( ) | certify mauinthe performance cxthe work for which this permit |oissued, '
� Shan not employ any person m*any manner ooaombecome subject mthe
Workers' compensation laws o/California, and agree that if| should become
subject
Code I shall forthwith comply with tho 2v in�p-
Warning: Failure xlsecure Workers' Compensation coverage iounlawful and .
shall subject anemployer iocriminal penalties and civil fines upm$1OO.O0U.in
addition mthe cost ofcompensation, damages aoprovided for inSection n7ns
o/the Labor Cwuo.interest and attorney's fees.
IMPORTANT Application is hereby Made to the.Director of Building and Safety
for a permit auWom to the conditions and restrictions omx forth on hi§
application.
1. Each person upon whose behalf this application ismade ueach person at
whose request ongfo,*hnoobonofitwom|upndonnodvndororpumuamm
any permit issued ooa result cxthis anpnoamnagrees to, m oxan. indemnify
& xu|U harmless the CUyof LoQuintu. its officers, agents and employees.
o.Any permit issued ouaresult of this application becomes null and.vnidif
work is not vommonoeu within 180 uoxo from umo o, issuance of such
po,mit, or cessation ofwork for 180 days will subject permit t000"oanaxiun:
| certify that |haooread this application and state that the above information ia
correct. | agree tocomply with all City, and State laws relating vothe building
construction,and hereby, m i this City to enter
PERMIT #
BUILDING PERMIT
DATE VALUATION LOT TRACT
29349-1
JOB SITE
ADDRESS
APN
'81-060 MHOSTOMMAT11
767-4904)33
OWNER
CONTRACTOR/ DESIGNER If EN INEER
IWIJ DRMT CA 92260
PAW DEW ZT CA 92260
('160>614-9699 03TA, 383'4
USE OF PERMIT
4611 ThLL-8R"Z
BLOCK WXLL, POOL OR DIUVEWAY APPROA(H; 75% PLAN CiW7K REE
CUSTO'M 1COMSTP1.001TION 4,07.00 OF
GAPMEXARYOKIT 706.00 11011
X911IMSMV, MGT 01k, CaNNUMC7,10H
3_V1714.10
MawpVT SUMMARY
CONORU0710H "-S,' 101-000-4184000 $1.469.00
MWIR&HICKLITTE 101-000-421-0-00 $92.00
ELECTRICAL1119 101-0410-420-000
PLUMOR40 PER, S16150
STR _000
ORAPMO FEE 101-000-4,25-606
MT PHI PUSIAC MAIM!! -ftSK 101-000-2-55-000
Lr= PIWPATD MS
$0,00
now
RECEIPT . .[DKTE
BY
DATE FINALED
INSPECTOR
J.
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
_
Underground Ducts
Forms & Footings
Slab Grade
_ _
G`�I
Ducts
Retum Air
Steel
Roof Deck��
O.K. to Wrap
Framing
Insulation
Fireplace P.L.
�� v_
�_ Q� (�/Sr'
�� _
Combustion Air
Exhaust Fans
F.A.U.
Compressor
Vents
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
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
_
Waste Lines �� �� =
Water Piping
Gas Test
Electric Final
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
Sewer Lateral
_ _ -
O.K. for Finish Plaster
Pool Cover
Sewer Connection
9�/�l
Encapsulation
Gas Piping
Gas Test
Appliances.
Final
COMMENTS:
���
a Z,46r, 3/114/62141
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) _ �!6'—
4 31s16A
INSULATION CERTIFICATE G�►Ti�/
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
81-060 ; KINGSTON HEATH CCA QUINTA; C—ALIFORNIA 92253
TB1�33�J
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning
GENERAL CONTRACTOR: TOLL BROTHERS, INC.
BY: TITLE:
SCHMID INSTION CONTRACTORS, INCA
r j
J�
THICKNESS: R-30 9 1/2" BLOW
THICKNESS. -R-19 6 1/2"
LICENSE:
LICENSE #221517 C-2
BY:t ° TITLE: PRODUCTION MANAGER DATE: 1/17/02
INSULATION CERTIFICATE
This is to certify that insulatiori has been installed in conformance with the current energy
regulation, California Administrative Code, Title 24, State of California, in the building located at
81-060KINGSTON HEATH, LA QUINTA, CALIFORNIA 92253
TBI 33
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-30 9 1/2" BLOW
WALL:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNESS: R-19 6 1/2"
GENERAL CONTRACTOR: 'TOLL BROTHERS, INC.
BY:
TITLE:
s
SCHMID INS�A,ITION CONTRACTORS, INC.
Al `:�}
LICENSE #
LICENSE #221517 C-2
BY: f TITLE: PRODUCTION MANAGER DATE: 1/17/02
' f •,k � � 'ki k
1 ,
1
i
mmer a sons 1,
Al Miller & Sons Rooting
Boonng in�N bu-Iso Summit;tir. phone: 760/346-12x.4
C:athe4ral Cily. Ca 92231 FWX! 760/3'21-7097
I
From: Russ Miller
Date: 411162-
R e.,
11162 -
Re: Inspection
Pages: 1.
i le
Biro lis PCwA West
33 v16rq
Gary / Andy,
We have inspected all the Roofs at PGA West (Vistas and
Reserve), All vents are installed per the 4'Hagin
specifications and per ,your plans
Thank -you,.
Russ Miller
X711 bra, tliers, GIne.
Quality Homes by Designo
August 8, 2001
City of La Quinta
Building & Safety Department
P.O. Box 1504
La Quinta, CA 92253
Fax: 777.7011
Re: Lot # 33 I
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, ple
Sincerely,
Andy Fraser
Project Manager
Toll Brothers @ PGA West
let us know.
74-923 Hovley Lane East, Suite 2-220 Palm Desert, CA 92260
7Fn-F74_()F�n Fa•: 7Fn_„�n.nna7
ri