0103-201 (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
M699 J t�30t
Date ' �" Signature of Contractor if
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
tion 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-thaYirrthe-performance-of-the-workfor 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-yrfovisions of Section 3700 of the Labor
Code, I sh 111orthwith comply with t seyr vis�oas*
*Dates '-i `/ Applicant- !� f y Z
Warni g: Failure to secure Worke S. Compensation coverage is unlawful and
shall subject an emplover..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.. 'f"
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;tor 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 authorizq representatives of this City to enter upon
the above-mentioned property foTAnspect purposes.
sTliYd4 J ,f�
Signature (Owner/Agent; /� Dater"
4 '
. r
BUILDING PERMIT PERMIT#
DATE VALUATION LOT OiW,201 TRACT .
`pyyttq�^ t A
27 2,93 9-1
JOB SITE
ADDRESS
APN
-
1-180 ]UNG^ ON IM
767-49x.027
OWNER
CONTRACTOR / DESIGNER / ENGINEER
W. _ B1ZUEARSTcsC
�4-� a2, � HOVAIA UM T �'r B'�J`ffE2.2 0
74x923 11TO T. ��a�Y�'.C: EAS � MltUR2.210
ir:'A'L; A DESERT CA 92260
$lAlltd DIORMT a.a`.& 92260
(160)674.9699 CRY14 3932
USE OF PERMIT
SYD-PLAN 1.,0T = PHIRMIT DOP—T NOT INCl.,t 02 HEXIC.'K, MrALLIPOOL/SpA �.
DPAY ''WAY APPROACH, 75% PEwANCIA CK. FEE PEDUC ION IPOR. ISSUANCE
O14:MW .PLAN TYPE.
CUSTOM CONSTRUCT 1014 4.10PIJ.jo bR
PCJR016PA-110 '14.00 e5?
+3ARAOR, IM00 13I±
TSFYM' D C:b9WT CSR'
3�. 714.10
—#-`<.'+WTl'4; CI.2Edh'- I; ---lei t3�ts 3 f� SVG i�
}LAN CCPD)C.K FEF 101-000-439-319 1VIa. t I
MCKANICAL FES: 101.000421.000 $110,00
4LEV"111CAAL 311i1. 4219.7.1
T'Ia•1MffifNO RC -9 103.000.419-000 S130.59
STP.0?00 MOTION ??'M • R=10 101-000-241-000,
x3 3>,PNa1 lC s.1 ' �? 101 -000423-000-
:aIMP
A�yy�g�v,sai,�ih PER IIMPP C T FEZ
AMHN PUDU( FLACES - RME 701 -000-255-000 403.52
` JU T a.SS M. FM
$0,00
f
' E eta'
9i4, 74-3.48
��. �Ilr1',ftCE DENT
RECEIPT
DATE` ~-Z -
BY
DATEPJNALE
INSPECTOR
c t9 4
w
,. {. .a. �.t'c•Y.IY'i._. ui.1...k�N�'Y..
INSPECTION RECORD
OPERATION j
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set B'
Underground Ducts
Farms & Footings
'lab
�j
Ducts
Grade'
Return Air
St
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
Framing
- `! 6
F.A.U.
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
'
Final`
�
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Maid Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Waste Lines
_
���/(��
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
S//
Encapsulation
Gas Piping
Gas Test
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)
G_
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: 81-180 KINGSTON HEATH,
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0103-201
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: BILL GORDON
Date: 4/12/02
POST IN A CONSPICUOUS PLACE
3T 760 7771596 P.02
CITY OF LA QUINTA
BWLDING & SAFETY DEPARTMENT
777-7012
INSPECTION:FREOLIEST LINE
777-7133
Owner TOLL BROTHERS INC
Contractor TOLL BROTHERS INC
Ammit Number 0103-201
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST -SIGN -ALL. APPLICABLE SPACES
JOS ADDRESS 811$0 KINGSTON HEATH
SM -PLAN VENTANA LOT 27- PERMIT DOES NOT
INCLUDE BLOCK WALL/POOL/SPA & DRIVEWAY
APPROACH.
TYPE OF INSPECTION DATE INSP,
FOOTING
GROUND PLUMBING--'
PRE-GUNITE
00 NOT POUR CONCRETE UNTIL ALL B VE HAS BE ,SIGNED
CONCRETE SLAB
JCWSTS & GIRDERS ..
ELECTRICAL GROUND WORK
_ .SOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
MATING & VENT - A/C -
FREPLACE
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' O 8'
FRAMING
INSULATION j
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR I ..,I / /
PRE PLASTER
•ANK
_ FINALS r
ELECTRICAL
F1 NAL GAS TEST _
'\NTING - A/C
_.JSE NUMBERS
JOB COMPLETED y
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TOTAL P.02
INSULATION CERTIFICATE
This is to certify that insulation has ueen installed in conformance with the current energy
regulation, California Administrative Code, Title 24. State of California, in the buildirg located at:
81 -180 Kingston Heath, Vistas@ PGA West, Lot 32, La Quinta California
CEILINGS:
TYPE: SLOW MANUFACTURER: CERTAINTEEO THICKNEc.;S: R-38
WALLS:
TYPE.- BATTS
MANUFACTURER: CERTAINTEaD THICKNESS: R-21
GENrFRAL CONTRACTOR: Toll Grothers, Inc. LICENSE 0
BY:
TITLE:
-01 G I
PARYAGQ SCH OSM-01 G PRODUCTS, A MASCO COMPANY LICENSE # 6Z'2072
r.
BY: L TITLE: ADMINISTRATIVE ASSISTANT DATE: 4/30/2003
L
Kir
Il
i�
AIM111eirgsom.
ROunng Inc.
Al nlillcr & Sons Hoo(inP
6ll-76b Sununit Dr. phone: 760/346-121.4
(-:a0h0c11'al C;iiy, Ca 9223,1. Fwx., 760/321-7097
g
'f
3
i�Fi �I I imiLo,
iy
r r( I. Ga�ry / y((11011 BlutheiNS PGA West
ac
Fa : 777-1596
From' Ru s''MI ler
Da,
it
Re lns.pecti+on 2-
ii
Pa;es:.
Gary / Andy,
We haV0 inspected all the Reefs at PGA West (Vistas and
Reservelj,
All vents are installeder
p the O'Hagan
specifications and per your plans
Thank yftu,
ii
Russ Miller
Toll, r ot�ier�. enc®
Qw�l�ity 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 ra,ct # 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 fin then information, please let us know.
Sincerely,
Andy Fraser
Project Manager
Toll Brothers @ PGA West " A
I
74-923 Hovley Lane East, (Suite 2-220 Palm Desert, CA 92260
760-674-96199 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: 81-180 KINGSTON HEATH
- Use -Classification: SINGLE FAMILY -DWELLING Bldg. Permit No.: 0103-201
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
I I Owner of Building: TOLL BROTHERS INC - Andress. _ 74.923 HOVE v_ ��� r nTr _ -
- ..v . -&. I L_n1tlC C 0 1 C L'LLV
City: PALM DESERT, CA., 92260
By: BILL GORDON
Building Official
Date: 4/12/02
POST IN A CONSPICUOUS PLACE