0103-197 (SFD)lk .. ,
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
771/69"9 'S IIIA -13012c,
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
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.
,if the permit valuation is for $100.00 or
' J I ( ) 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 shall forthwith comply with those provisions.
!� Date: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
51`laii subject an eiTipiGyei t0 Cr iiiiiiiai penalties and Civil finesup t^ Q1 ^Q inn .
addition to the cost of compensation, tamages 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. 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'iss"ued 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
construotlon,.and hereby authorize rrepresentatives of this City to enter upon
the,above-mentioned property fo�rrihspectid1h urpossees.
Signature (Owner/Agent) Date j
BUILDING PERMIT PERMIT#
DATE /J / VALUATION LOT 0101•207 TRACT
9336,71.4.1.0 231 29349-1
JOB SITE APN
ADDRESS gyqq p,�r� p,�y �yt� g.Y h• .yy 716f} -4 ,p90^41, p� L
3
GT,f:-'.R.LK{Y..117..5. 45rd.0. ��i itl �39.i.JCR
OWNER CONTRACTOR / DESIGNER / EN (NEER
IMLY, €3iaO111T..P13 TQC 1110111 B ,4Y IM.''sVf('.".
14-923 ,1101AZY LOWEim. M'T`%"22 22t3 � � � T ,`S' �t� r ` � , ' C�!'S �•,2 trt7
PALM DLMWV CA or -2160 PKM DIUISEI-Irf CA 9,1260
(760;WA-9699 CI TE 3832
USE OF PERMIT
SIM-PLA?4 alW`3'.ANA3 LOT 73- PUMT DOES Naf 1I+iCT..UDE iLti,Ll 9
WAJ,I'JPOOV.?Pk & D�w''f' tEWAa''.E PPP,C3.ACH. FEE
CWTOM C01MAUCITION 4=0 Stu
POMiNATIO 514. or, si
0ARAGEMARPORT QMH 121,837.40
CITY 01'AV
FINA iCcl Dr'
MMUC IVE SWUNTARY
f -%A € CHECK WZ
101-000.4-ig-358
2297.53
Yu".�li.�.lr7k�°.��lu
ZC)1�t7�S43`-�2Z�Cldi�3
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FI,JM'T 1UCAL VITF
101 -000 -420 -WO
KAJUDINO RX
101-000-419-000
S162130
iRKA40M,07 ON RMID
101-000-21Al-0*0
$53.6'
ORADINORIE
$20,00
A� �I:A33�i:ii J �l'.f�s:•i' i''��!
s a,�'t`. i•r
14,33 PRE41AID M3 � 1$0,00
TQ OTA° L FBF R til ff IM0 .L 4JF. HOW I 1i4(526,11
RECEIPT DATE ,/ f I BY IE FQLSD/� ^ INSPECTOR
,r'J! i/ /�%/ l
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings Z
Slab Grade
Steel
_
j�y�0)
(p�8 p
_
�4Ai
Underground Ducts
Ducts
Return Air
Combustion Air
-
Roof Deck
O.K. to Wrap _ X
Framing zbk
Insulation
Fireplace P.L.
i��
_ y�l
f
- _
_
Exhaust Fans
F.A.U.
Compressor
Vents
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
_
_�-p"
Final
3 ��Z-
��[c- Gjb�tev�
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
a_��!
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral_
Pool Cover
Sewer Connectionv776
Encapsulation
Gas Piping
Gas Test
z1!
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 2
Utility Notice (Perm) ��/�%twv
`?oll 'Brothers 'Inc.
Quality Homes by Design'
Auglist 8, 2001
City of La Quinta 01
Building & Safety Department
P.O. Box 1504
La Quinta, CA 92253
Fax: 777.7011
r
tr fii .r
Re: Lot # 2 r
Project( Vistas ract # 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 por plan to our satisfaction.
Should you require any further information, please let us know.
Sincerely,
'i
Andy Fraser
Project Manager
Toll Brothers @ PGA West
74-923 Hovley Lane East, Suite 2-220 Palm Desert, CF, 92260
76n-F74-Q;;�M Fav ian-Fin-ana,
mmilleralSons
At Miller & spm Rppfitip
Roofinginc, ` 61 -760 surrunit lir. Phone: 760/346-121.4
Cathedral Cily, ca 9�'
223,1 .ix: 760/321-7097
I
Facsimile
GaryY B flims �TAWest
F&N: 777-0%
From: Russ jAiller
Date: `�1 QZ� 2 3 L) ST>�-
Re., Inspection ,
z
Pages: 1.
Gary'/ Andy,
We have inspected 611 the Roofs at PGA West (Vistas and
Reserve). All vents
are installed per the O'Hagin
specifications and per your plans
,I
Thank you,
Ij
4: 'Akk
Russ -Miller y
i6
Y �s16d
INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energ/MX
regulation, California Administrative Code, Title 24, State of California, in the building at
81-260 KINGSTON HEATH, LA QUINTA, CALIFORNIA 92253
('
TBI 23
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-30 9 1/2" BLOW
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNESS:R-19 6 1/2"
GENERAL CONTRACTOR: TOLL11 1BROTHERS, INC. LICENSE:
BY: l � TITLE:
SCHMID INWJ iTI CONTRACTORS, INC.' LICENSE #221517 C-2
BY: •TITLE: PRODUCTION MANAGER DATE: 1/17/02
INSULATION CERTIFICATE
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
8'1-260 KINGSTON HEATH, LA QUINTA, CALIFORNIA 92253
TBI 23
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-30 9 1/2" BLOW
WAI I S
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNESS: R-19 6 1/2"
GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE #
BY: TITLE:
SCHMID INTI CONTRACTORS, INC.
LICENSE #221517 C-2
BY: TITLE: PRODUCTION MANAGER DATE: 1/17/02
Certificate of. Occupancy
City of La Qdinta
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 bui/ding construction or use. For the following:
BUILDING ADDRESS:
Use Classification: SINGLE FAMILY DWELLING
81-260 KINGSTON HEATH
Bldg. Permit No.: 0103-197
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: 3/21/02
POST IN A CONSPICUOUS PLACE