0103-194 (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
0413012t'
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:
A
Carrier Policy No.
1I CR.FICI UNPL,OYRIP1 'tri C40094318'
(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' 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
shall -subject an employer to criminal penalties and civil fines uo 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.
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 �f inspect�p purposes.
Signature (Owner/Agent) ✓�%� Date"- R
71.1
BUILDING PERMIT PERMT#
DATE % VALUATION LOT i TRACT
` � � ✓/i �.: :�`l�.t,:2 � - - 29349-1
JOB SITE
APN
ADDRESS
X -I mawuo1q lw vrH
767-490-01
OWNER
CONTRACTOR /DESIGNER / EN (NEER
TOLL BROTHERS WC
111OLL BRaIMMOM
74-923 11OWi' LANE FAUX SUM—U-120
74.923. iZOMMY LANEENU
WM!^;2420
PALM DEIRE P'£ CA 9226E
RAL..:DE DEWRT
CA `2,2650
d�i6�jGi4��f�99
f:## 3�i�f'L
USE OF PERMIT
SPD- AM VIfN eAWA LOT I 1 - PERM I T 00F. TrOT L.3iON
ALLPR >3O)APA &,DRNEW.61Y.@PPR. ACH.
n
Gil
\
CUSTOM C(M01, IXTION 4 c�.00 S� 4� MAR
2 8 2001
POLd,C1�id'PANTO 0 Sig
I5�el14.,f�
�.W'ab'MZ'R�G4•.i'tiWPG,J RY (MD 0183I',V4�
CI
OF lA OUINTA
INANCE DEPT
dMA= OM1 +.I We CONUR 7HOPT
X.Ma714.10 '
PLA14, CHECK FES 101.000-439-319 $1,166.12
MISCHANICALFEt~ 101.000.421.000 $92,00
ELECT- AL PRE 101.000-420-000 $105.62
FxX1MMO P Y511 101-000.419.000
,.�'I'9�ON0 M'OTJMI FEE 4 RESID 101-000-241-000 �35.br7
QJRA1XIg0FKK 101 -000 -423 -WO $20.00
r'. E:VEL+6. P 19, 1P 9,NAW ME, $1,91)7:6f)
J%'Its' ro k'"usL16 P1.0kon - ftksl " ol-o81 as 5.000 9349,` 9
STIB-"("C 'rAL COMMMMION AM PLAW CRECIX`s
CR.1C?
LESS PRE- Nw PM313
$0100
TOTAL P'',RMff ERm .SUE NOW'
RECEIPT
DATE°
BY
DATE FINALED
INSPECTOR
W
INSPECTION RECORD,
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts '
Forms & Footings
Ducts
Slab Grade
_
(D( �l
Return Air
Steel
_
_
Combustion Air
Roof Deck
�
Exhaust Fans
O.K. to Wrap�7jJ-�
_
0�
F.A.U.
� (Alf, (Alf,_
�_ -
Compressor
Insulation"'T
�d/��
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
_
Drywall -Int. Lath
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/3�0
! LI,Z1�
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Seaver Connection
//3�py �j,Qlli
Encapsulation
Gas Piping
Gas Test
Gas
/ or -
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
/� 6
(Perm)
i
(., = f
mmillwasons
RO(MHU 113C..
A MIl S68-76 SummTer Spit smPhone: 760/316-121.4
Cathedral Cily, Ca 9223,1 F -ax., 760/321-7097
F.(tcsimile
Great y / Arc 3<q/ToIl I3roU"v,, PGA West
F 777-1.596
From: Russ Miller
Date: 11-7 02
Re: . Inspection
Rages: 3.
Gary / Andy,
We have,inspected all the Roofs at PGA West (Vistas and
Deserve),; 'All vents are installed per the 4'Hagin
sp6cifications and per your plans
'hank you,
,. Russ Miller
R
`?roll `.FB
Quality.
August 8, 2001
City of La Quinta
Building & Safety Department:
P.O. Box 1504
La Quinta, CA 92253
Fax: 777.7011 I
ther°s, GInc.
ies by Design
Re: Lot #
Project: eract It 29349-1) -or- Reserve (Tract #29348-2) (circle one)
To Whom It May Concern:
This letter serves to advise you the O'Ha in ro� f vents have been inspected g i p ted by the Toll Brothers
representative. The vents are as per plan to our. satisfaction.
Should you require an further information lease let us know.
Y , p � ow.
Sincerely,
Andy Fraser
Project Manager'
Toll Brothers @ ]
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 at
81-265KINGSTON HEATH, PALM DESERT
LOT 11
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning THICKNESS: R-30 9 1/2" BLOW
4
WALLS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNESS:R-19 6 1/2"
s.
GENERAL CONTRACTOR: TOLL BROTHERS
BY: TITLE:
SCHMID INSUL ION CO /ACTORS, INC.
LICENSE:
LICENSE #221517 C-2
BY: TITLE: PRODUCTION MANAGER DATE: 9/4/01
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
81-265 KINGSTON HEATH, PALM DESERT
LOT • 11
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: ' TOLL BROTHERS LICENSE #
BY: TITLE:
SCHMID INSU CONCTORS, INC.
LICENSE #221517 C-2
Dz:— _ TITLE: PRODUCTION MANAGER DATE: 9/4/01
Wj
JAN -18-2002 10:04 TOLL BROS PGA WEST
TOLL BROTHERS, INC.
PGA )WEST
Qu alit Homes By Design:
FAC
TQ:
l�>6.���
COMPANY:
FAX NUBIBBR:
��? -�--7 1
RF. . •�
LE TRANSMITTAL SHEET
FROM:
760 7771596 P.01
R r t jS u -7Z-
TOTAL NO. OF PAGES INCLUDING COVER:
Zi'
i
fi
BI -525 T.IBU ON DRIVE LA QUINTA, CA 92253
760,7 .1565 760.777.1596 (FAX)
}
JAN -18-2002 10:04 TOLL BROS PGA WEST 760 7771596 P.02
CITY QU A
�` Eh
Of � BUILDIN S ETY RT T
I 12
I PEC ONU ST LI
,71538 1�
Owner
TOLL BRO C <k/
Contractor TOLL 131tOTHE
Permft Number 0103-194
POST ON JOB IN CONSPICUOU"LACE
INSPECTOR MUST SI',GN ALL APPLICABLE PACES
J08 ADDRESS 81-265 KINGSTON RF,ATH
SM -PLAN VENTANA LOT 11- PEI MIT DOES NOT
INCLUDE BLOCK WALL/POOL/SPA & DRTVIEWAY
APPROACH. i
'TYPE OF INSPECTION i DATE IN$p.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING I i
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS 8 GIRDERS j
ELECTRICAL GROUND WORK
/aP or o/
NOT POUR CONCpETE UNT L ALL ABOVE HAS BEEN SIGN
ROUGH ELECTRIC j
ROUGH 15LUMEONG j
ROUGH GAS & GAS TEST �
HEATING 8 VENT-' MC—1
FIREPLACE C
ROOF I
BOND BEAM i
O.K. TO INRAP j
GROUT f:) 4'- 08, j
FRAMING j
INSULATION aAf
PRE -ROOF
COVER NO WORK UNTIL ABO HAS BEEN S GOICID
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER I
POOL FFENCE A GATE j
EWE SEPTIC TANK
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TESL'
TING -;VC I
AE NUMBERS
JOB COMPLETED
TEMP POWER
AE:IOVE APPROVALS DO'NOT INCLUDRIGH TO
TURN ON UTILITIES OR OCCUPY BUILDING
TOTAL P.02
Certificate of Occupan'cy
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: 81-265 KINGSTON HEATH
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0103-194
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building � TOLL -BROTHERS INC
Building Official
Address: 74-9203 HOVELY LANE E. STE 2=220
City: PALM DESERT, CA., 92260
By: RICHARD KIRKLAND
Date: 1/18/02
POST IN A CONSPICUOUS PLACE