0106-256 (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
s7' X99 /rte 04/30/2(
Date ' "� ;u�}� Signature of Contractor / ;97 I
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 w"' Signature of Owner
WORKER'S COMPENSATION. DECLARATION r
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
'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.
(This section need not be completed if the permit valuation is for $100.00 or less).
—(=)–I-certify-th At -i n-th e-performance-of'the-work-for-wh ich-th is -pe rm it -is -issued,
i1 -"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 those provisions:
Date: ^ x ,, A` Applicant''•
Warning Failure to secure Workers' Compensation coverage is unlawful and
shall subiect an,.emplover to criminal penalties and civil fines uD 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. ' . f
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 spection purposes =
Signature (Owner/Agent) •' Date )�7 "
BUILDING PERMIT PERMIT#
—
DATE VALUATION LOT TRACT
28
JOB SITE
ADDRESS
APN
f€ �f4JGWONMAa TI
767-•45?3-028
OWNER
CONTRACTOR / DESIGNER / ENGINEER
"�f'v),•( - DR011-TERS Iffic
TOIL gRor. MRS INC
*74-913 I-TOVELY LAME, M'MATE2,420
PALM DERIERT CA 92U.50
PKLPA DMEWT CA 922160
(160)041W599 0131111 3832
USE OF PERMIT
[MAS
C E+'i31b TL.' '1� 3 Y+1C1
4611 TEL„E,M "E
SIM--Wr2Y, PIJAN SAiarAR.OSA3t41o PERMIT DOES NOT INI U13F.
.1VY�q AWA POOL VRArIVEPpA TR4ACH
C175110M Ci►L•dVrRLrCTIaN VM.00 01F
POLICHIPATIO 37,4.00 SF
C; �.A.RekC.WX1M'PCe3•i. 1.1:16.00 Sri
—C l♦lr 1'1 " I J .fJ it 3X31» €�- 1 �3� i3i} # "" A0
PLAN CHECK FEE $1,o4m
14�k•`s:�51'C°�.L.i:� �'.��-U;5�9-�4��.'•l.IESC+ 1ifI�,90
PLAW31140 FEE •F ill-00IN4.19-fW 164R( 1
ST itONQ 11010 TI OM FFX - PY41D 101 43(3 4A I -t300
01RADINO IYU 101-000-4234M $20-00
s�+i-rae�r: a�:s igx�°11�9.1i4J
kki�v"c`inrs%,usv,
P.71`br�" IN PUBLIC-PLAC:M RUSK 701-000's M,000 gii$�fi�
„`
qqA��iR�`!!rI97..C'r`.TC:FBEV
�Sa i
��2hht,;10�.,,���/�yy
'.''?9 DUE NC)w��a++.
M
JUL 3 0 2001
RECEIPT
DATE CIf'/ 11F i
kE YUKfA
BATE FINALED
INSPECTOR
DEFT
-oZ3 03
INSPECTION REC�RC�
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
_
Underground Ducts
Forms S Footings
! /bZ
Ducts
Slab Grade
_ _
Retum Air
Steel
Roof DeckExhaust
Combustion Air .
Fans
/D —
O.K. to Wrap
Framing'
may- ' (
_ _ _
F.A.U.
Compressor
Insulation `
_
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
'C d- te Lines
Party Wail Firewall
Exterior Lath
Drywall - Int. Lath
��Jly3—
Final
Final
POOLS - SPAS
MLLOCKli AI
L' APPROV//W
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
R nal
Gas Piping
PLUM I&AG APPROVA S
Gas Test
Electric Final
Waste Lines
�� r_
8 l'� 10'x-
Heater Final
Watei Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
e��i/bZ
Encapsulation
Gas Piping
Gas Test
l `J
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)
!W
To:
Greg Butler
From:
Andy Fraser
CC:
Date:
06/19/02
Re:
Expiring Permits at PGA West Vistas
'i
As per our conversation last week, I am requesting an extension on the following. permitsr81-:.16gt81-
140, 81-140, 81-120, 81-100 and 81-065 Kingston'. Heath. -As I had mentioned, these permits were paid
with the assumption that the'construction would have started much sooner
These will be the last six homes to start in the Vistas at PGA West. I greatly appreciate your help in this
request. If you have ant questions, please feel free to contact me at 777-1565.
Sincerely,
CITY OF � QUINTA
BUILDING & SAFE DEPT.
APPF�O
Andy Fraser
Project Manager DATE ' o BY
PGA West "
7� 25Ia 2
0 Page 1
0
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:
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group:
81-160 KINGSTON HEATH
R-3 Type of Construction: VN
Owner of Building: TOLL BROTHERS INC
Building Official
Bldg. Permit No.: 0106-256
Land Use Zone: RL
Address: 79-923 HOVELY LANE EAST STE 2-220
City: PALM DESERT, CA 92260
By: DANIEL P. CRAWFORD JR.
Date: 4/23/03
POST IN A CONSPICUOUS PLACE