0006-220 (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
777699 1 04130/2(
Date ' •17 crgi,natu,e of Contractors, 'T��f
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.
��/..I have and will maintain workers' compensation insurance, as required by
SetStion 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 C1E}3EFil�I. AGGII�2AI7 Policy No. i�#CU461107t
(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 Ilforth ith comply with those prowytons.
Date: (�' if JApplicant / .g r 7r-✓�
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
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 fobinspection purposes.
Signature (Owner/Agent) Date ,l
BUILDING PERMIT PERMIT#
DATE VALUATION LOTf'?x� TRACT
S.00 29'349.1
JOB SITE .��s y
ADDRESS 5 �� 5•CQDT A
APN
767490-W4
OWNER
CONTRACTOR / DESIGNER / EN INEER
TL`iLL BROrEMS INC
TOLLBROTE7.frPS WC
74 -923 HOVELY LANE Ems' SI%i'.C.E2.220
74923 !10VMY JUAN. EASrf Wl"T sa-220
PALM D&ITRRT CA 92260
PALM T717SU.T CA 92260
(760)674.9699 C ilo 3832
USE OF PERMIT
iGL;E rAMMY MOU WO
V, D. PLAN'AVP.RRO !]12 L0'P P}.RP/E1T DOES NOT INCLUDE
.
k`9# OCKWA�.�%� 3 OR. POOL.
CUSTOM CONSTRUCTION V22100 By
IP/PATIO 339.00 SP
�1�Ai�a7.CAi/ �c t p
�.ye'131.!�7.�.E/CAfRPORi (o TO 14,?N.80
COST OF Ct3NSii IXIMON
PR%MUM. i5ir11'IKARY
CONSTRUCTION FEE 101-000.41'8-000 S1,zis.00
PLAN CHECK FEE 101-000-439-318 $992.13
INISCHAVICAL F7,E 101.000.421000 mw
ELECTRICAL PE;•Ea 101-000420-000 $190.43
t' PLummoFF—E 101-000.419.0020 2163,50
STRO140 MOTION FRE - RF;2 ID 101-000-241-000 112'7.04
I
GRADING FEE 1111-000.413400 $20,00
DEVELOPED IMPACT Ii'919, $1,90700
ART ft4 PUBLIC PLAC&SS - RUE 701.000-255-000 $0511311
FEE l ZPOSI'1` 1;01-000-439-3Y>$ 4750.00
STAB T'OIAL C01-TSTIZUCX'i0A1'AND PLAU CWXK
LESS PRP. -PAID MIS
-$750,00
'r'O EAL PETI ME:SEEN DA NOW
�c4a(3
RECEIPT Y•
DATE "*BYF;
;ti w ..
DATE INALE
63
INSPEC �R
ex�
4
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts t
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
_
Exhaust Fans
O.K. to Wrap Z
_
F.A.U.
Framing
Compressor
Insulation
Vents
Grills )
_
Fireplace P.L.
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
_
DR/wall,, Int. ath
D
•
Final
3
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 2/�i�Y
Gas Test
Electric Final
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
S/
Appliances
Final
COMMENTS:
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)
12/05/2013 23:54 FAX
wiMu
.ii ii«..ai�a�..i..n.: i iii�..ui��.�. i.iw-ii•.,..viviv.vrvii.i�aiiiiuv.�i:�- i�uiiia.-.vi i i iwi i�iiw. ri�iwuiw�i�i�uuiii�:r�
I
I SU TION CERTIFICATE
f
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 located at:
81-125 Kingston Heath, Lot 4, The Reserves @ PGA West (Models), La Quinta, California
CEILINGS:
TYPE: BLOW MANUFACTURER: Certainteed Thickness: R-30
WALLS:
TYPE: SATTS MANUFACTURER: Certalnteed Thickness: R-19
GENERAL CONTRACTOR: TOLL BROThERS, INC. LICENSE #
BY: TITLE:
PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632.0-72-
B
32:072
BY: TITLE: ADMINISTRATIVE ASSISTANT DATE: 1/31/2003
t
I
f�
oll "Bra
Quality Hom
i
i
August 8, 2001
City of La Quinta
Building & Safety Department
P.O. Box 1504 '
La Quinta, CA 92253
Fax: 777.7011
Re: Lot # 4 t
Project:(!E�ract # 29349-1) -or- Re
To Whom It May Concern:
This letter serves to advise ou the O'Ha in roof v
Y g
representative. The vents are as pf,r plan to our sat
Should you require any further information, pleas
Sincerely,
r
Andy Fraser
Project Manager
Toll Brothers @ PGA West
lens, GIncm
by Designm
(Tract #29348-2) (circle one)
have been inspected by the Toll Brothers'
e let us know.
74-923 Hovley Lane East, Suite 2-220 Palm Desert, CA 92260
760-674-9699 'Fax 760-674-9081
MG JUMNIeraSions
t
r
Roofing lnc,,',
�►
Al Miller & Sons Rpptipp
till 760iSufmnit Dr.
C:aCiIY. Ca 92L3i
FcrYsi7n7*,,
Phone: 760/346-121.4
Ftlx: 760/321-7097
ri'iX 'y /AWy(�l7I'OIl BlIAlu"S, PGA West
ax: i'�7-].5.96►
From: Rus miller
Date: 11 003
Re. Inspection
Pages: '11.
Ip
'i
r
Gary And
.�I
We have inspected all the Roofs at PGA West (Vistas and
Reserve). All vents are installed per the o'Hagin
siwcificatiotis and per your plans
Thank you, �
Russ Miller
. i
i
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: 81-125 KINGSTON HEATH
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0006-220
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 E STE 2-220
City: PALM DESERT, CA 92260
By: DANIEL P. CRAWFORD JR.
Date: 2/28/03
POST IN A CONSPICUOUS PLACE