0006-221 (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
/�777 5 13 r _ 04/ 30,1(
Date�✓�rJl. r� r� (Signature of Contractor
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
�pe'Rf mance of the work for which this permit is issued.
l' /) I have 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 Policy No. r,.a.,,,,.,.,,,, —
(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' compensatiomprovisions of Section 3700 of the Labor
Code, IFsl��ll forthiwith comply with �t ose ry�Jr�lor�s.
Date:° '!1/9 L� Applicant 7d 711.'
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. r
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 propertty f r inspec to • purppoossses.
Signature (Owner/Agent) ! G+ Date 4� a
BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT
W20/20C ;321, 0.30 5 29 49.1
JOB SITE .VTlw 1
ADDRESS S.�..�,=J.°�!iC7�CJeS�FC.�W''�.�.
APN
767-490-M2
OWNER
CONTRACTOR /DESIGNER / EN (NEER
110u, BlrlarHm 114C
T Crs $1101'MRS WC
74.923 HQVai. Y LAWE E- ABT WHF2.220
74.923 I3.Ot' LY I A?31 f %yTl`I•{2�2�0
PALM D. RT C.A. 92260
PALM. DESERT CA 92260
(760)674.9699 CB140, 3832
USE OF PERMIT .
SNGLi? 1:'AMX. :D'V1K .LRA3
Mib. PL N: SIF,I+TNA ICIT5 PLR.MI'T I)OFS NOT INCLUD9 B1,OCKWALL
OR. POOL.
CUSTOM CONSTRUCTION 5V772. 00 SI'
PORClitPATIO 907.00 SIS,
GARAMICARPORT (,Y) 1:%7$2,40
RISTMATE D COW OF CO.} MITCl10H
321.1660.30
PIRMN VD! 9UNSIARY
CONSTRUCTION ITE 101,000-418-000 $1,416,50
PLAiV CHECK ",.1, 101-000-439-318
MECH"ICAL FEE 101-000.421-000 $1.11,00
ELBCTRK, AL FBI '1 01-000-420.0+06 $200A
PLLy1ulDINO PEE 101.000.419-000 SAN4.511)
STRONG MOT -TON Fa - MSID 201-000-241.-000 $32017
OMMO ME 101•000.4,23.000 $231100
DEVELOPER IMPACT FFE $1,907.00
.
ART IN PUBLIC PACES -1tI•ME ;01.000«255.000 $M4,15'
ME DEPOSIT 101-000-439-318 -$750.00
SUB -TOTAL COMSTRITMION R.Ni�r:9��F�vLA a C�1������,C�
$5,330.24,
r
C r_
RECEIPT
DATE
BY'� f
DATE FIVAL§D
SPECTOR
�
11
h
v
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
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing 4147ZL.
Compressor
Insulation
Fireplace P.L. r
_
Tr,
Vents
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall Int. ath
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
Gas Test
Electric Final
Waste Lines
// FUT
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 Q
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)
•rw!A40'/IvN'wtiprrswr.rwuwd-Jv�rw.:!w....w'.►n..vwww':i.s:.ra>ow!.w:fwv: rr.
/
f
' INSULA
7
This is to certify that insuiation has been it
regulation, California Administrative Code,
s
81.145 Kingston Heath, Lot 5, Th
CEILINGS:
TYPE: BLOW - MANUFACTUI
WALLS: j
TYPE' BATTS MANUFACTU
s
GENERAL CONTRACTOR: TOLL BROTH
BY:
d in conformance with the current energy
2-4. State of California, in the building located at-
las,@ PGA West (Models), La Quinta, California
CERTAINTEED THICKNESS: R-30
CERTAINTEED THICKNESS: R-19
S, INC. LICENSE #
TITLE:
PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072
B TITLE: ADMINISTRATIVE ASSISTANT DATE: 1/31/2003
�yicrihns^svrsivu�v.w�.v.iv;ivvx(rvvivuxi.:ry Anv�v'.ri:wvtier,r.�aprN.siv..niiiw.urir ..rii
I
t
Almmemsons
Al '!3illcr Jc S!)ns ltoptit�p
Howng ine, l 6i-760 siim,nit lir.: Phone: 760/346-121.4
Cathedral city, ca 92231. FM.' 760/321-7097
,I
Ft
/wsimi
T x GIAry / A dy(g.,Toll Br O tlua,,S IT-wA West
Fax: 777-1.a%
From; Riuss Miller
[date: 2.'( q /03
Re: lnispection 6,0r-
15'
Pagans: ! �.
Gary / Andyt
•i
We have inspected all the Roofs
at PGA West (Vistas and
Reserve). All vents are installed per the o'Hagin
sf)ecifications and per your plans
hank You
Russ Miller
4
r
a ,
To,,tl r®thers, Inc.
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 #
Project istas act # 29349-1) -or- Reserve (Tract #29348-2) (circle one)
To Whom It May Concern:
This letter serves to advise you they 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.
.i
Sincerely,
'i
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
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: 81-145 KINGSTON HEATH
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction:
Owner of Building: TOLL BROTHERS INC
--ate
Building Official
vni
Bldg. Permit No.: 0006-221
Land Use Zone: RL
Address:
74-923 HOVELY LANE E STE 2-220
City:
PALM DESERT, CA 92260
By:
DANIEL P. CRAWFORD JR.
Date:
2/6/02
POST IN A CONSPICUOUS PLACE