0112-064 (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"
Signature of Contractor—
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am axempt 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). t
( ) 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.
O 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 apiMMEMPLOYER
y,g ) O Policy No. VP 3/yM 3 IS
(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
s u bject-to-the_workers_compensation-provisions-of-Section-3700-of-the-L-abor—
Code, I shall forthwith comply with those provisions.
Date:" Applicant
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 ADDIICa110n is hP_.rP_.hy made to the Dir orttnr Of Fii iildting 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, indem i
& hold harmless the City of La Quinta,'its officers, agents and employe
2. Any permit issued asa result of this application becomes null and voi
work is not commenced within 180 days from date of issuance of s
permit, or cessation of work for 180 days will subject permit to cancellat
I certify that I have read this application and state that the above informatio is
correct. I agree to comply with all City, and State laws relating to the buil ng
construction, and hereby authorize representatives of this City to enter u on
the above-mentioned property for inspection purposes.
gnatu; (Owner/Agent) Date
BUILDING PERMIT PERMIT#
/
DATE / VALUATION LOTary-04 TRACT
JOB SITE
APN
ADDRESS
81,-205. R'ITFOX HFAM,j
767-4390-
OWNER
CONTyR�ACTORt�/TDESIGNER / EN IINtEER
01111 13110,11-M-9
AL CITMERS
14-923
'74-923 HOVELY IA,42EEM 0I.'I� -22,,0
TIP -J AV. DEWPT 0,A 92260J?JR�i
1� 3:C � �1td' CA 92,260
i�30;�tr74^�36P f` 1 � 3832
USE
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C7'sLY4.�I S!, Ss�ilvp,7J..i.4 .1./�•F+.d..<I.L'dR 7
VD a pXT 9 :PLAN • *'XNTA R.OS.A. PE3'MA T rJOES WOT 1W0,3JDEf
01XX', WAL-4% P004 PA, O lAWKW1t,4IAPPROACIA,
CUS'1'Cika9 1"t3NS'1'RUCTIUN V4.1.00 OF
POi;,d":HIPA/i'f"IO 924.00 Say
OLAMOVIC-ARPOTIT *11,10.00
:S.f7.i.tit'lad'A'IED OSI $0 co-VI�tS"M`+Q;fCIrl.oj`!Y
3101S50310
C014$TIVU CT1011 N! Le 101.000-4-18.000 5113 00
PLAN CHVVK FNlp p,094.79
+ w1-'F�2�IC AL FES; 101_001:1r01.000 s9s.50
X17=1}=�x�r,=C.L 173,Fi
STlwt�'i1€'� ifiYlta?i B LC W riF r13� 10).000-241-000 $31.66
Ci�'..Ab31NO FE%, 101-000-423-000 $20.00
O Nihl 1MPACT 1171r, $1,91Yulo
AWf IN PUDI.AIC PEAW - IIE Sir 270-000-44.5-000 sy% 38
MUD -I'C?f.AT , Lam. rONSeiiYUCTION AND��a��.�Sn!3'�f'-�"jHpk",��,7.¢ty.
$5,1, <�Gi�1219
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RECEIPT
DATEBY
DATE FI ALED
ra �
INSPE CT
INSPECTION RECORD'
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings"
Slab Grade
_
I/lwlo2
Ducts
Return Air
Steel
Roof Deck
O.K. to -Wrap
Framing
Insulation
Fireplace P.L.
$�jr'_p a- _ �J
3 ilZ .D'L L(� g20pr✓
4[ �d /
Combustion Air
Exhaust Fans
F.A.U.
Compressor
Vents
Vents
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
_
_
Drywall - Int. Lath
Final
� b_�S pZ.
FinaU
POOLS - SPAS
BLOCKWALL
APPROVAILS
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
Water Piping
_/
Heater Final
Final
'Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral_
Pool Cover
Sewer Connection
l /fi/Qfi
Encapsulation
Gas Piping
Gas Test
_/—'0—'44.�
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)
1+
This is to certify that'insulation has I
regulation, California Administrative
81-205
LATION CERTIFICATE
installed in conformance with the current energy
Title 24, State of California, in the building loci d'at
HEATH, LA QUINTA, CALIFORNIA 92253
TBI 8
CEILINGS: 1
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Coming THICKNESS: R-3 3 12" BLOW
WALLS: I 'r
TYPE: Fiberglass Batts MAN
GENERAL CONTRACTOR: TOLL
BY: i
'l
SCHMID INSULATION
BY�
7ER: Owens/Corning THICKNESS: R-21 6,12m
rHERS, INC. LICENSE #
TITLE:
INC. LICENSE #221517 0-2
PRODUCTION MANAGER DATE: 4/1210!
04/12/2002 15:32 9092920 SCHMID CONTRACW PAGE
04/09
1�
INSULATION CERTIFICATE
This is to certifythai; insulation has bin installed in conformance with the current energy
_
w
regulation, California Administrative Code. Title 24, State of California, in the building at
a
a
�
-
°'
{ 89=205 KINGSTON HEATH, LA
{QUINTA, CALIFORNIA 92253
— -- T1311
u
y
CEILINGS:
:.
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-381; !" BLOW
:d
WALLS:
y
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNESS:R-< 15 112"
GENERAL CONTR4CTOR: TOLL BROYHERS, INC, LICENSE:
y
BY: TITLE:
SCHMID INSULATION CONTRACTORS,
INC- LICENSE #221517 C-2
BY:TITLE: PRODUCTION MANAGER DATA;: 4/,2/02
v
- .�.�._. ._ .-.-'lftlXiT'r.'r.L.17C_Y'�.^r.9C:P:61X9C.Cl6K'Y.CF'OYOmfi�ld(RYAKy(afOF�Y'..4X2�0� fuW+trY(i.'.tnGlr�.t. /e�Y ;]I/Lh
j
.i•�.C.��.�5'S.L,.?.r.�:.:-.yT:.-.•..�._'G'w^�L'.SSX.:.P.r.Y^..LtiWi.:.T.:�._�.�:.[5:�:��..:'.�.Yd:^.isJ'Tf3LT'dR'A1l.LOi:S'S:eY.:'L•'a9S•_•-e.r.
��t�+s._.e.�.tm._.._tnxw..r._.r.nmr.�.,.xr�._�w«.... �..�.�._._...,. _.._.-.....�.�.�....�.�__
1+
This is to certify that'insulation has I
regulation, California Administrative
81-205
LATION CERTIFICATE
installed in conformance with the current energy
Title 24, State of California, in the building loci d'at
HEATH, LA QUINTA, CALIFORNIA 92253
TBI 8
CEILINGS: 1
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Coming THICKNESS: R-3 3 12" BLOW
WALLS: I 'r
TYPE: Fiberglass Batts MAN
GENERAL CONTRACTOR: TOLL
BY: i
'l
SCHMID INSULATION
BY�
7ER: Owens/Corning THICKNESS: R-21 6,12m
rHERS, INC. LICENSE #
TITLE:
INC. LICENSE #221517 0-2
PRODUCTION MANAGER DATE: 4/1210!
TOIJIPMothers, ITnc.
Quality Homes by Design -m
Au.gust 8, 2001 .
Ct'Ty of La `9111T8
Building & Safety Department
P.O. Box 1504
La Quinta, CA 92253
'Fax: 777.7011
Re: Lot
Projec : Vistas Tract # 293'19-1►) -or- Reserve (Tract #293+8-2) (circle one)
To Whom 1t 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 plali to our satisfaction.
Should you require any hn-ther information, let us know.
Sincerely;
Andy Fraser
Project Manager
Toll Brothers @ PGA West
+ �zs Fiovley Lane East. .Suite 2-220 palm Desert. CF 92760
1•
m M-111er
eons
Al miller &Sous Rc)ofii1P
Ro Oflmu Int, 68-760 sununil Dr. Phone: 760/346-121.4 '
Cathedral city, Ga 92,>3,1 Frac: 760/321-7097
Facsimile
rth G-�Y'y / A dy@Voll I3mUjms PGA'VVest
1?ax: 777-1.59
fi roni; Rus filler
Cate: 7 /g %Z
%e: Inspection �,O' 8 V/5 % /�'
Wages: 1.
Qary / Andy,
We have inspected all the Roofs at PGA West (Vistas and
Reserve), All vents are installed per the O'Hagin
specifications and per your plans
Thank you,
,j
Russ Miller
Certificate of Occupancy
City of La Quintal
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: 81-205 KINGSTON HEATH
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction
VN
Bldg. Permit No.: 0112-064
Land Use Zone: RL
Owner of Building: TOLL BROTHERS INC Address: 74-923 HOVELY LANE EAST STE 2-220
('.ity- -PALM DESERT,.CA 92260
By: DANIEL P. CRAWFORD JR.
Date: 7/18/02
Building Official
POST IN A CONSPICUOUS PLACE