SFD (9909-005)57128 Medinah
9909-005
LICENSED CONTRACTOR DECLARATION
I heieby 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
o
701039 B 01!'31/2(
ate—N, 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)
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. STA,I'Z FUND .. 'Policy No. 033-98-0009236
(This section need not be completed if the, permit valuation is for $100.00 or less).
O 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
Dode, I shall forthwith comply with those'provrsions
ate: - 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.
IMPORTANTApplication ishereby 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 purpo/ses.
(S/nature (Owner/Agent) .;", >,,, - % • Date
BUILDING`PERMIT PERMIT#
DATE VALUATION LOT TRACT
.e BOA 7 c
$250
JOB SITE -
APN '
ADDRESS `
71674807417'.
OWNER
CONTRACTOR/ DESIGNER/
1t-CCOWC-E" OXTOP LLC
7,RMS WEST HJ1YUMT(3 WC
750E UT; 3140
78-401 FMGHV4AY 111
SAN.f,7TF.GC CA 92101
LAQUMA CA 92253
019)557.9191 4 M7 457a
CC
USE OF PERMIT
a Ik0.L n P,A'iwliS:.'S Dt;imLw6
SFD- LOT 50a PLAN 3AR., I'& MIT WeSNOT INCLUDE BWCK WALL OR'. ,t ;
POOL ;
CUSTOM a,'NSTRUCTIOA 3,013.00 8F
PCIR( HIPA,T1O 325.110 S9; -
CSA At3FJCAR! 0RT 6000 SF
E 97'1.I"TED COSH:' OF C0N8'TRU(: 7'!ON
250,3".0 `
? ERAW FEE SUTAMARY
C-OAISTRUCTION FEE : 101-000.418.000 $1,168.00
d
PLAN CHECK FEE '101-000-439-318 $957.99
MECH"ICAL FEE 101.000^421-000 $124,00
,...
„ ' f'1 t ,
ELECTRICAL FEE 101.000.420.000 $174.916rn
s
PLUMBING FEE I01.000419-000 $191,50
s
STRONG MOTION FEE • RESID 101-000•-241-000 $25.0m
6 P,,AIJi1•IQFEE 1,41.00023^000 $20.00
aI>.✓ °'.
ART IN PUBLIC PLACES . RF.SIs 701-000-255.000 $126.98
5
s
DEVELOFC'P IMPACT,FEE $1,907,04
ti
SITS T01 CONSMUCiTON AATD PLAW CRIECIC z
$4,G9fi.`S 1
-
i'O fA1<,MOW MS DUE NOW
A
RECEIPT
DATE
BY j
DATE FINALED
INSPECTOR
fir:'''
L
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs 9 9 A
Underground Ducts
Forms & Footings A
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
- Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
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
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection /
Encapsulation
Gas Piping ol
Gas Test /
Appliances
Final
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)
COMMENTS:
r<<•
4
P
The DanDee Roofing Proposal
osal
Cw1qra><y lull% tic 732,542 P 0 Box 17..E Thnusand Palms, CA 92276
ROOFING AND CONSTRUCTIONPhone (76a) 343.33BS Fax (760) 343.3096
BIDS TO
JOB -NAME;
TRP,NS WEST HOUSING, INC P.G.A. WEST HOMES
78-401-F HWY 111 P.G.A. WEST AUGUSTA PHASE 4
LA QUINTA, CA 92253 LOTS # 1.51.5,24,49 LA QUINTA„CA 92253
PHONE 771.3363 FAX 771-9077 DATE 12=7-00 .
0-HAGIN ROOF DORMER VENTS
THE DAN DEF COMeeKr_IVC,. HASINSTAttEO THE ROOF DORMER vENjS 'CORREC-TI.Y.ANE
PER ENGINEERS SPECrIFICATIONS. -
r
HoncE
u ••oef the luacnamr..s' Lion Law (California Code of Civil Ptuwdura. Section 1161 01504. ). any Ca+!rpC10r, Sl tX onrrpCtOr !anorpr, aunplier nrngr porsnn ria helps io
iniutovv yuui piu0eity out's not Palo for his work or RuppliAR, hila a right !o enforoe a claim against your property. This nwans Ihal. uncia cuw; netuinn your ptilperty
Codd' oe so:d bn' a court ofricor and the prcrro(x!s Of the sale used to sausty ine Indebtedness 1 hLa can happen even n you nave pale your own cunlractw :n full !f Iliv
Sud16C1Lt ^Al: IADorer nr supplier remains unpaid and If legal action Z nowssary to wl!aa w unmet lite !nibs (d this cniveAr:1, the. IIfP.vAd•ng oarty snal! oe enPltec !o its
easorv+U a anoritf Y rites pin. An (Hata of still Ana Interest Brian accrue an all sums wrich are due 30 days 044jr billing at ItK+ ane. ill to % per Arnim', The Usnoee Co.
Inc. isnot responsible for deleya G8usod by weamer. fittlitP, melena! snnne96 a delay in material supplied to the ob or lo,erry otiw, uuwy t1uYC)-W iia rx::1tirl. Ine'
I)Ant7Pe CO Inc tC%AI k"Illry under this contrism or in negligence Is limited solely to the amuvnl of this Conlraet
We are fully covered by wodtdrtuU-jr,.ornoansakn and oubllk(Iabllky Insuranf:o. Carriers names and policy ILNrL 4r+4 nv iltltfla.oll
MQUO
Any aite,auon or ue.aaon hurt, Ihv it ;iWvb spepi!irsepne invnlving Axtra rear or mararnm or tailor will only of executed upon ,v ntV n w uvrti (o' san+r. ,rr••.I will n?c.o 1P
A0 aura charge over me sum mentioned in this proposal All jiyieemmus Must lit: rnnde ir+ wrdhrlp Aitd is nits” or free access to oullding for ousel, xiolixi frum p u
D(Inne.. are based on Current costs of material and labor. Increases or decraases, will be rCnectOn at Arne of signing contra[[
13e1ore and or (Imir.g rtwhng opleraPona and the compiellon of roofing, The Oanllee Co Inc, will not be responsible or gable for damagn Caused from
acts of God, such as earthquakes, thundoralornte, hall or any other weather conditions beyond moiers control.
DATE
I III. I1r1N1)I.f. T-1A
M
20'd 99L0£b£091- uLLMON LULC V9tc60 00-40—Oaa
DEC7E1-2066 1640 WESTERN INSULATION 909 686 8786 P.06i17
WW'."L ERN INSULATION, INC.
42 It Latham Stmct, Riverside, Cal, mia92503
r - Tel, (909) 886.8760 FaX (9091686-8786 - ` r
INISUI,AMH 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:.
TRACT / PHASE: PGA_ WEST - AUGUSTA
LOT # 50
• SITE ADDRESS 57-128 MEDINAH LA QUINTA, CA '
• ,-E•�ERIQRWAILS:.. ..- •--.r-,.---.. ------------------------
MANUFACTURER:
------------'- ----MANUFACTURER: JOHNS MANVILLETHICKNESS:, 3 1/2 ' R-VALUE: R-15 -
ICE LIRAS' - SABLOW A
MANUFACTURER: JO S MANVILLE THICKNESS: '�} 13" Fl-VALUE: R-38, ,
GgNERAL CONTRACTOR: TRANSWEST HOSING'
• 8Y;
TITLE:
DATE: �.
INSULATION CONTRACTOR: WESTERN INSULATION, INC. ✓
LICENSE NUMB
E 81278 ,
BY:
•
TITLE; PRODUCTION MA ER
DATE DECEMBER 1, 2000 '
07(14/2000 -07 10 9097860018.
} lns`tallation Certificate: -Residential
STEEL T
ikaoor v 3
CF -6R
Use of this torn to sanely vw requites tMngoat the AdmWOMIttwCode to 40wA bait Gw btwMdaa woo 1w P1 t,fld- and WUW-
'An in:taAuron Cerdflose Is requlrad to Ybe posted at the buI&V elle prWIM ilia dMd. ties• stat
maybe used to meet these niquIrements.' Al eppilanae iced below N d
the .fflpancy and type of the aapliartCe ingalte0 rrittq ba of bettR tltntth appiafto apaoi ad ollttte Cetdllcoe
Compitanoe (CF• 1 R). This aNticsta (or ks egttivalenq be pnpead ttltd signed by IM pueonN)0*u
reaponsibw for the appllalm Insta t ion.
I, the undersigned. verity that the aqu(pm►nt feted kl the ategory tcbvw eiQro" 10 OW e = tu+d
that the equipment m6ats or exceeds the requirements d the Applituroa qy 6isMwd1. M 1 tads i ft
the vNipme nt to aquivalant to of more e!f)clent than the eq sped> W on tlw Caed coo d C 061116 nAW m
demonstraia compliance with the Energy Ettfolenoy 8 for resWWdW bulldb+pe.
.'fi, :.HVAC 3 TEM3'
Nati: HydroniC boiler information'b entered her*. Otho hydraft or combined hydMOO pulpmed In Mesad wrier
Wats HeWnq Systems.
`:.14aJn uEt;ulp. '- cEC G f ' ' :Acwat Otstribtetlon .; Oust ew -i u*v Lood Huff
Type ( maoa. Mani: Mahe A itfktenDy typeand ftft U-000—Owl. E"Or" t _
, t.r •
i is ,lt rti.M
•i lr rl. o t '
The buiWVq d sign heat toss and design heat gain rate have boon delemtbted Main a matttOd spedied' N Seattnn 150(h) of
the EnarQy array S! ar and are two of too w%arte used for equipment sk" and aalemort
s4r4wry rw Dar HVAC Subontrww (Co, Name) er dwrwat Cies raator w Omwf.
1'601111,QA Ca Gar A=P-Pp'Y A, O e, 4.-%.
tk
• CFC C rtglad • ' ,: •
CoollrtQ Equip. } , Caatprpaaor unit ; Aetttal Distribution Did a
Type (air oond ' ° Menu1. Yaks A EHbterm Type and: it h
WAT.1:R HEATING SY1,7ElI+ r
Water Heating C'SC Certlt{ed Retails r Tenit t at TwcmaV
Systern Type a Yanuf. Yaks A Input(M Capaoltyt tttaltott
(storage gas, etc•) Yodel Number or dtuh) (astir)gftww tAsal7fr) WValw
I • For am" pas, ttwmoo (rated Inputs 75,OW 9atatth. eteaute aealatsaoe sad haat putap wader tte'We.let EneW FOW. .
For terga gas mon gs eraser has tams (fated htpNt s75,000 EtuAu), stet Rated Mp+t, RaeMtsry Elldettsy srd tltwtrby Loss•
For InaenUnnow pea %rater heatm. ret Aard LW and Reoorary Lften ff,
For InstsnUraroirs aiaswif waw hooters, let Ailed LvA s
, - FAv„ b SHOWpR
Ab f aucets and tthowerhasdti in W*d are {fated W too Cortvttflsion't►.0ltedory of CartMled FsuoMa slid Shawetlt sde
{ pursuant to Title 24, Peart 0; Subch
. vv .aptef Z. Settlors t t t,
k ' .f. .?'i {... i F ;moi t .. - • } •
Gar Plumrcry suoeMtl.a.r (Ce. t wog e►oan..t aanr.aw.r owa.r '.'
`Certificate of Occup
ancy
City.0f La' Quinta
Ouilding and Safety Department, M01
_
t
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 constructionor use. For the following:
BUILDING ADDRESS:, 57-128 MEDINAH
'Use Classification: ,"SINGLE FAMILY DWELLING Bldg. Permit No.:., 9909-005
Occupancy Group: R-3 Type of Construction: VN Land Use, Zone: RL
Owner of Building: MCCOMIC-SEOKTOP LLC" Address: 750 B ST STE 3140
City: SAN DIEGO, CA., 92101
— By: DANIEL P. CRAWFORD JR.
Date: 12/13/2000
Building Official
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