0103-195 (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 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.
(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 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.
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 inspection-pur oses.
Signature (Owner/Agent) Date 7 7
BUILDING PERMIT PERMIT#
DATE J VALUATION LOT 01,0349S TRACT
-11
?/ ,: �''5 1 / $310.550.70 12
29A49-1
JOB SITE
APN
ADDRESS
-285 =1GS"TOMMAT
767-4051V*12
OWNER
CONTRACTOR/DESIGNER/EN (NEER
INC
TL`?X.L FIRMAMP �,T�Lp"..yr
.'*�`I;f;1pL:?C��3*.C»a'13'�1{yr�y:Sq
6 �9":+':#-.➢ �:1�9".!":r£.f 3. Rsd'►S.V.�✓.Cu•'M:1 t��7lb!°rtk'��.irV
��'�,F: u+ S�'J Y'..:clld .L.k�'"1.5Y.S"r .4�6'�:YrL t�u�iJ3�..tw�"�v.b �i
PKAd DESErel' CA 92260
PALM; DESEW
CA 92260
sa150)4574.9699
CM0 :58342
USE OF PERMIT
MtrMIT-11EA>hl,yam
. -.PLAN 141Ta4 ROSA iA)T 131 PRRMIT r)OF 140T I'#ri,VU1Dt
E L, Cts
REi7ftVTJ0X F®P.11.39UMC;l;,OF'SAME Pl—kN TYPE
�7USTOM COMi'RUC TIO:d SF'
PORVIPP..WI`N0 324.00 Sig
CITY OF LA OUINTA
C' l.&PAi(MCARF'ORT (1.13 14,8170
FINANCE DEPT
Pli"MArr Y` L9 9ETAI A;i2Y
CO N2T1iUCIIION My, 101-000-418.000 $!Xgloo
PLAN CHRICK, AM 101-000-439-318 $V3. 6
hIRCHANICUM, RM 101-090-421,000 s9s,00
9144 S2'MAI< FEZ 101-000-420-000 3.873.56
PLUMBIN0 PRE 1€71 -00CL-419.000 1, ft f!6!
:vTR-0140 Pa1iOT10-9 PIM - REM) I09 _000-2011100) MAU
C:4i31I��'� �,4➢'i vr300-�2.:�dC+(3(} $:�a.tl#3
D3] l L� 1lCiP1�k S at10 Ep E 1,9119, 00
ART i'.Idl PUBLIC PLOXI1M .. Mr. 701 $27513
OTM-WYA:.CaRNRUC.� OR AMPS ANMECK
$4,324.20
LESS PRE -PAW ]AUN',
$0.00
ITYrAL PUMMIM96 DUE NMI
$4,324.20
RECEIPT
DATE / t /ry
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE TINSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
�1�
Ducts
Slab Grade
_
ll//%l "�
Return Air
Steel
_
Combustion Air -
Roof Deck
O.K: to Wrap D
Framing_ __
Insulation D� L
�ih1�17W
Fireplace P.L.
_ _/ _
��S / a / _ _
` e _d .A� __ __
_ Q_
lD�bl _ /
Exhaust Fans
A.U.
Compressor
Vents
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
D II - Int. Lath
_.
1A
-zp/-
Final IW-0,eoo�✓
BLOCKWALL APPROVALS
Final
POOLS - SPAS -
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
_
Waste Lines ��'/Q� %
Gas Test
Electric Final
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K: for Finish Plaster
Sewer Lateral_
Sewer Connection
��jf/Q
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
~
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit ,
Rough Wiring
Low Vottage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles ,
G.F.I.
Smoke Detectors
Temp. Use of Power
Utility Notice (Perm) r— C/
a
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: 81-285 KINGSTON HEATH.
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0103-195
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: TOLL BROTHERS INC
—7 dt-x
Building Official
Address: 74-923 HOVELY LANE EAST STE 2-220
City: PALM DESERT, CA., 92260
By: BILL GORDON
Date: 1/24/02
POST IN A CONSPICUOUS PLACE
TOH `Br°other°s, IInc.
Quality Homes by DesignO
August 8; 2001
City of La Quinta
Building & Safety Department
P.O. Box 1504' _ '
La Quinta, CA 92253
Fax: 777.7011
Re: Lot # / *;X-
Project: 0 ista (Tract # 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 further information, please let us know.
A
Sincerely,
-Andy Fraser
Project Manager
Toll Brothers @ PGA West
B
74-923 Hovley Lane East, Suite 2-220 Palm Desert, CA 92260
760-674-9699 Fax 760-674-9081
mmer a sons
Al Miller & Spns ltootilll; Phone: 760/346,1214
Roofinginc,
Cath 0 Summit Dr.Cathedral Cily, Ga 92231 Fat: 760/321-7097
Facsimile
ri'(lC Gary / Andy@Toll Fimth+js YGA'West
Fax: 777-1.596
From: Russ Miller
Gate: (' t4/ I
Re: Inspection
Pages: 1.
U
Gary / Andy,
We have inspected all the Roofs at PCA West (Vistas and
Reserve). All vents are installed per the C'Hagin
specifications and per your plans
Thank you,
Russ Miller
01/17/2002 10:10 9092920499 SCHMID CONTRACTING PAGE 05/09
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
81-285 KINGSTON HEATH, LA QUINTA, CALIFORNIA 92253
TBI 12
CEILINGS
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning THICKNESS.- R-30 9 1/2" BLOW
WALLS`
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNE58:13-19 6 1/2"
GENERAL CONTRACTOR: TOLL BROTHERS, INC. LICENSE:
BY: TITLE:
SCHMID O;PON CONTRACTORS, INC:, LICENSE #221517 C-2
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
81-285 KINGSTON, HEATH,. LA QUINTA, CALIFORNIA 92253
TBI 12
CEILINGS:
TYPE: Fiberglass BATTS MANUFACTURER: Owens/Corning. THICKNESS: R-3.0. g 1/2" BLOW
WALLS:
TYPE: Fiberglass Batts MANUFACTURER:, OwenslCorning
GENERAL CONTRACTOR: TOLL BROTHERS, INC.
THICKNESS: R-19.6 1/2"
LICENSE #
BY: TITLE:
SCHMID INS TION CONTRACTORS, INC.. LICENSE #221517 C-2
BY: TITLE: PRODUCTION MANAGER DATE: 1/17/02
Certificate of Occupancy
City of La Quinta
s
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: 81-285 KINGSTON .HEATH
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0103-195
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: TOLL BROTHERS INC
&4-%
Building Official
Address: 74-923 HOVELY LANE EAST STE 2-220
City: PALM DESERT, CA., 92260 _
By: BILL GORDON
Date: 1/24/02
POST IN A CONSPICUOUS PLACE