SFD (9904-187)57161 Medinah
9904-187
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'' s'
License # Lic. Class"' Exp. Date
741 39 B ` _-. - 01131/;4f
pate -;7 •`' %Signature of -Contractor f°' '- - `
OWNER -BUILDER DECLARkION
I hereby affirm under penalty of-perjurythat I am exempt from the Contractor's
License Law for the following reason:
( ) I, as owner of the property, or my employees withwages as their sole
compensation, will do the work, and the structure isnot 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.
S'rATE FUND 3)35-X14-f1Tif1
(This.section need not be completed if the permit valuation Is for $100% 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/
l shall fo)3hwith comply withthose provlslons:~- "`"
Date: % Applicant - -•
Warning: Failure to secure Workers Compensation coverage is unlawful and
shall subject an employer to criminal penalties andcivil fines up to $100,000, in
• addition to the cost of compensation, damages,as provided for in Section 3706
of the Labor Code, interest and attorney's fees..
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit- subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, an'd-hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
.Signature (Owner/Agent) t' '" "•✓ Date -_.-
BUILDING PERMIT FERMT#
1
DATE /yVALUATION LOT.990 87 ,TRACT
JOB SITE _ - " - -
APN ? -
ADDRESS
5.7_1. 1 1R .$ -'-.,.'.•"'
7 ..lO_ .
OWNER r CONTRACTOR/DESIGNER/ENGINEER
MCr_0&t.1C-SE'Ok=P LLC TRANS NEST HOUSING :INC
7_50 B S7' SIT 3140 78-401 F HilGffiVAX 1111
SAN DIEGO CA 92101 LA QUINTA CA 9223
tit;?x:57-x:191 CBL# 4972
USE OF PERMIT
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AFD LOT 5, PLAN :2BV :- PERMIT DOES NOT INCLUDE 13LRX-K WALLS 6
OR POOL ,
CUSTOM CO NST KUCTION 2,371,004'W
PORCRfP.ATIO 43100 SF
A
GARAG&CARPORT 600.00 SI.
rt
'ESTIMA'f•EdD COST Of CONST :fZUC'f IOIN
2_ 7,;S6 4.4N
PEP.Al Z• FEE. SPAIM.A RY
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CONT 1'RUCT.ION FEE, 101-000-418.'000
PLAN CHECKFa, i01-000-439-315 $861,54
MECH.kVQC'A'L .F fiE 10 f -000-421-400 $98150
g
F.LF:C:.1'RICAL'FEF 101-000-420-400 5159.52
x
PLUMBING FEE. 141-000419.000. $178.00
STRONG MOTION FEE - RES 101-006-241-000 $21.79
MW,NC1 FkE 101-0004213-000 $'20.00
Y
fNFRAS'.Ci2UC 1URE FRE 225-040-11=13-342 E4,7r2 67
ART 1N PUBL1C .PLtkC.iES - RFSM 101-000-255-000 $294.66
Slf;840 Tr1L CONSi•RUCTION,AND PLAN CNEC.K
$7,459-15
LESS ME -PAID FEES
$0.00
TOTAL PERM f' FEES DUE iNMN1
$7,459.18
RECEIPT
DATE
BY j y
I`
DATE FINALED
e
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade ,�
Return Air
Steel
Combustion Air
Roof Deck 6
Exhaust Fans
O.K. to Wrap 4
F.A.U.
Framing
Compressor
Insulation //
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 APPROV LS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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 &2TEncapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbctures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
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:
TRACT / PHASE: AUGUSTA® PGA WEST, PHASE 2
'LOT # 25 F
SITE,ADDRESS: 57-161 MEDIHAH, LA.QUINT
EXTERIOR WALLS•
MANUFACTURER: Johns-Manville THICKNESS: 3 5/8" R-VALUE: R-13 '
CEILI GS; BATTS BLOW
MANUFACTURER: Johns-Manville THICKNESS: 13" R-VALUE: R-38
GENERALCONTRACTOR: TRANSWEST HOUSING, INC.
LICENSE NUMBER:
BY: APf S 5+% Q k 2 w I A/
TITLE: 15—,, r n'r2v r.y
DATE: 3 Jot 7 140
IN5 LATI N CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY: '
TITLE: PRODUCrION MANACER
DATE: FEBRUARY 11, 2000
02l1a%2000 10:58 9397360018 STEEL T
Installation Certificate: Residential
KIM-. �--
Uao of this tone Wsetish "mquirwra tits at the Ada+Wattettw Coro til •pdenaL butt w Ih11-11,1M steal M'
151 - t to L 9 04
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PAGE 02
find poat.a�
An IntsukWn cartftMs is required to be posted stole bt� etc m E,e b8UW=d *A "W OMS T& *t
may be used to most those requirements. Ab appYnOe 1 WW bWm tNhs tit � �
the •ftidancy and type of theADQarta a,atiiledRltitltbe Wbefttl'#M#teeppdYlOe cat*Cmdfb"
0ornpUance (CF -M. r* ;on a (ot b equkellM� be prepared e114 ti}pl:.d b/ iftsi PwsOh(!i 0 �►
resporssibliby for the appliance InslatVibn.
1, the unders4nod, verity that the squtprnertt Hied In Site on" ebwm MY ttlgfid ws Ib111% arlitlsl Ifraaw and
that the equipment meets at access the tequ(retaettls d the Appllautos t�ridatitb. Ib VIOLA I� "
tete equipment is equtvalentto or more of lent%antheeq apedld�OerdlbpiedCOA tltoewbn=edm
demonstrate compliance with the Energy �ncy S for rt &—;W' -b
HVAC SYSTEM
Now Htrdronic bailor information Is ordered hon. Otfer hydRmW or awnWrA d IrydF*ft egt,tipattird M bated under
Water MoiWng Systema.
heating Equip.
CEC Candled
Actual Otstribudan o mor iiuft LAed
Type (tumsar
btanut. U&M &
Elf type end od= 0"r`tuh
M
host um atm
Wodol Number
Air AL o INes
CEO Grtifled
Coo,tnpp Equip.
"'y eek sow '
t=Unit
Lanuf. liNra i
AckW DloblibWton Dum�tor
<ZMid•ney and PIp;Y1�0
hart u et0.
Peder Nnn+bre
n �Ie1Ye
Crag
CLJ 4L•1
M --- .14,%.
The build design heat lass and design heat gals rota have boort determined tieing ■ n,etltod epen�ed h tiwWon 160(h} of
the F.A y tdoncy aro two of the Meta used for equlpmont &W* WW aeW N10M
rW=
� -0,65 %Greve. - r fg- rMc .
Signaa+n
Om WAG 3.teorw wr (Co- lilacs)ar GNrtrd CmitUW or *mW
WATER HEATING SYSTEMS
W■ter Hosting CEC Cortlited Ratsdt
Sysum,Type YantA.-Usks i Inputd
1. For smut gas swap• (rated bNmt s 75,000 9w&rL decub r"uw oa and heal ptrtap wow bnUm 1W 6n&V IFa9W
r'or targe psa atoragr wnar heaur• (need input 3,75.W* ttarrttr}, lilt listed UVUL R•ooliery atQi*N* and sOrrdw teas.
Far Instantaneous pas crater Mews, IN Raad Ir" and Reoowq EM*",
For htsunuv soca Weoato wow hestrrs, tW Rafed VVA
FAUCM & SHOWER HEADS
AN faucets and showsrhoads insWed are Acted in the Commlaicres Dire*q d CGOW Faucets tired S OWNheeAIt.
pursuam to Tdle 24, Part 6. Subchapter L Section 111.
SIOMMM
$&Vie" w%"" 1$a
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rtwt MM SWNW reelortoo. M.we)oi perterirrrert�.s+.r
r-16-00 07:52A TOM. WHITE
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5 7 -1161 Vvi A- t
Roofing Proposal
P.O. Box 277 ThOUS. id Arims, CA 92276
Phone (760) 343-3385 Fax (760) 343-3096
BIDS TO: JOB NAME;
TRANS WEST HOUSING, INC P.G.A. WEST HOMES
78-401-F HWY 111 . P.G.A. WEST (PHASE 2-B)
LA QUINTA, CA 92253. LA QUINTA, CA 92253
PHONE 771.3363 FAX 771-8077 ' DATE 2.15-00
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.ONJ DEE COMPANY INC. HAS-INSTAL490-ME.ROOF„Q9$MR.VENTS- CORRECTLY, ANG
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eguNGINEERS SPEMCAVONS.
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'undo, an mochamCB: I Ian I,iw fCdldorm Coda of Cavil PtnrMuro 81:uhan 11111 at Req I any oonbador, Bubnnntntptl;r. IOuutur, supplier ntner person tea: hotps to
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Improve your Piumity but is not paid mr 144 work of supplies, has a right to entotec d claim against your prowl: ily. This rias" trent. ortoi a noun hearing
yn,Er timoo(ty
CONI of. gold by a mum amen, raid 1119 Wocseds of the Bala used to Wall, the indshiadn"ee ihi$ van happen "van d ymu hove paid your own n nntam tut In Ns. If me
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Subeomramcir. Inrwt?f of auppter remajno unpaid and ,f lopal action is nacessety In WIVO u, ardoro" the farm%$ of this contract. thin prltv$antp party shail bre entitled to Itti
reaeonool0 idlolney feat plus all (tuna Id Guo and Inluresl shall armia an oil plans, which are dua 30 d0vs ulter bilin At the rat0 at 19 % par enmn%% Tho Danoea Co.
Imr. id not reaponuhle tr r nslayll wutwd by W"thW, 11,1210. dnllarBd shortage or delay ,n mAlmwl tyoplied to the Ihh mr to Wit, other delay beyrnvt a$ ventral The
DamDN Ca ImC lMmi ttny,hly under this contract or in ftR0t W,G9IG Ilmhsd Soley M Ina v%rounl of this contract
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We e fulry•covered by workmen's coMpitipsatlon and pub;lc Ilap111tir InGuranco. Carfior* names and policy,pwmbers ovellable on
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Any aperet,nn oil juvlation from ha a afmva AWifitadt9us Involvingextra nodal Irudcrial ortabrlr will nn l,y csmuled upon written vrilva for same and wd1 Ir;t ptry .
t,fj uxtta eh ►ga rner In" Burn nr, nliw%W In this prnpaael All nlllelr%enb must ba mm" In with' $•1d 1 heead nn 1.
"%V W evvess to Wilding In# aLYA kwWng horn ow
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am based on current Costs M ataildriat and labor. Increases m decreases, will he rMinrrtod at dole of signing contract *
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potrne and or outing raonnN njorallons and tree COmptntion or coating. The DSItDon Co Inc, will not be resportatbig or liable for daEnall ca%ysd from
anis of God, such AS varlhgYalies, thtlndafltonna, hall or any nihar wevIharcandldons beyond roofers cWtol.
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ROOF ATTIC -EUNTILATION REQUIREMENTS.
r ROOF ATTIC 2,203 SQ. FT.
..OF VENTILATION AREA REQUIRED
(1) I8" DIAME7E 4 DORMER VENT +..69 $Q. FT. OF VENTILATION
•n , ' %'p p ' ,• 5'de' "i-.. yi i r Yr+ it, °„Y^ r t .?ha t ,«3''_'` .rt: .. t. ,., rl. /' • •.
.00.- * 066 PROVIDE A MINIMUM OP1,11 DORMER VENTS.
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ROOF ATTIC, ENTILATION REQUIREMENTS
< RQOF ATTIC, kREA=,. 2, 572 SQ.FT.
3000 Ii './i /I) a •: +,r't r+ k. '!, t'1 { 1 `yly '': 6 _7... . '. `:..
T r'f r '. t r .• , ;s,fM' •• .57 SQ.FT. OF,VENTIATION AREA •REQUIRED
DIAA, .M ,:DOR ERMENT w .69 SQ. FT. OF VENTILATION
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f a •Psi l t .'F T ' :: l°fi} h.; P •+ .. + 1 ..r' : ,: ' f ` + • .
J DORMER VENTS.
' ' .68 .f . 2.42 PROVIDE A MINIMUM OFi i'
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F'ATtrIC ENTILATIONREQUIREMENTS
ROOF ATTIC REAs- 3,013 SQ. FT
Ty tt i n' t •t' fa 1f114
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0.04 80. FT. OF.YENTILATION AREA REQUIRED
(1) .18?DIAMET DORMER VENT .W SQ. FT. VENTILATION
tt£t t•'.,.y r p ,,mFrrar ill + 4'y h i; ,::, • :. .,., , . ., . , ? RMERS
4.56 PROVIDE A MINIMUM 0NVENTS
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This Certificate iss*uedpursuant,td,lhe.requiremefits, of Sectio' n - .09'of the Uniform Building Code;
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certifying that, at the time of issuane,4this structure -was in compfiqnde with the vadou's'ordinances
of theCity,regul F
Oting buildin ',co "s&dbtJbn.or.use.., or the tb&v'ing.,
BUILDING ADDRESS: 5T-1 61 MEDINAH.
Use Classification: SINGLE FAMILYDWELLING Bldg. Permit No.: -9904-187
Occupancy Group:' R-3 Type of Construction: .VN Land Use Zone: RL
Owner of Building: MCCOMIC-SEOI(TOt.11-C Address:, -750-13 STSTE 3140
City:,. fSAN DIEGO CA 92101
By: DANIEL' P.,CRAWFORD JR.
Date: 3/.29/2000.
Building Ofticial...,-;--i{
POST IN A CONSPICUOUS PLACE