SFD (9909-010)57178 Medinah
9909-010
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
7010.39 B ' 01fr l/,2
ate•+- Sig nature of Contractor f A-11
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
SMtion 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 SPATE FUND. Policy No. 035 98 000!635
(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„rnanner 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,provlsions.,% -
Date: - Applicant
Warning: Failure to secure Workers,Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to .the conditions. and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
Whose request and for whose benefit work is performed, under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from'date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application -and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction,'and hereby. authorize representatives of this City to _enter upon
the above-mentioned property for inspectio jourposes.
Sig ature (Owner/Agent) /1 a/ !/" - Date
i BUILDING PERMIT PERMIT# t
'DATE- VALUATION LOT{g TRACT
;1.x,1 x.70 5S 28410-2/1
JOB SITE APN
ADDRESS .}i: 7164W,011OWNER CONTRACTOR /DESIGNER /ENGINEER
WCOWC-SEO:I:POP lip_
750BS'TSTE,3140
SAN DIP QCT CA 92101
USE OF PERMIT
SIWGIL? FAMMY DV EL IN'0
TRANS VEST H0-JS1Kiq INC
78-4017 111011WAY 111
LA CA 92153
I(193551-9191 CBS .4972
SFD- WT 5$, PLAN 1C, PERMIT LLCM NOT INCLUDi? BLOCK 1A'AU OR
POOL, 75% REDUCTION ON PLAN CHECK TEE OR MULTIPLE ISSUP.ANCrr
OF UI ME PLAN TYPE,
CUSTOM CONSTRUCTION 243,00 .SF
PORCHIPATIO
40E.00 SP
QARA0E/CARPORT
566,00 SF
ES111VIATED COST OF CC3mmL1mon
PERhm FEE WIV045C
CONSTRUCTIO14 FEE
101-000-418-000
PLAN CHECK FEE
101-000-4.39-318
$193.24
MECHANICAL FEE
101-000-421-000
$60.00
t_j
ELECTRICAL FEE
101-000-420-000
t
$145.93
h
PLUMBRIC FELE
101-000-419.000
x
STROP O MOTION FEE - R.FSID
101-000-24.1-000
$18.31
ORADING FER
i 01.0010-423.000
$20,00
I)WELOPE R IMPACT FEL
$1,907.00
SCTR OTAL CONMUCT O)q,AND*P1_,AX CHECK $3,461.96
>. I.SSS PIS;-PAIf?VES $0.00
TOTAL F-ERMUISS DUE NOW $3,461 .
RECEIPT I DATE
DATE FINALED I INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
(p / b -p
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
fit
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
-
Exterior Lath
Drywall - Int. Lath
Final
Final / /
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I
I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
^4
Neater Final
Water Piping
7
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
-
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
TheDanDee
G,: Wmy bx% l is 732542
ROOF/NG AND CONSTRUCT/ON
.Roof ing p Pro osal -
-
P.O. Box 277 Thousand Pa/ms, CA .92276
Phone (760) 343.3385 Fax (760) 343.3096
BIDS TO : JOB NAME:
TRANS WEST HOUSING; INC P.G.A. WEST HOMES
78-401-F HWY 111 - P.G.A. WEST -AUGUSTA PHASE 4
LA QUINTA, CA 92253 LOTS # 1.51.5,24,49 LA QUINTA, CA 92253
PHONE 771-3363 FAX 771-9077, DATE 12-7-00
O-HAOUV ROOF DORMER VENTQ
• y
THE DAN DEE CO -PAIV INC,. HAS INSTALLED THE ROOF DORMER 1' VENT, CORREC
(✓ER ENGINEER$ $PEGiEICATIONS. •
AM
110, Ina MACnANCt t len Law (California Code of Civil PtucuOCt
duro. S10n 1161-oE
1. ), any con!rpolor, llto--tultrattor !ahorer. pus"fir nfhe) penin" he helps to
+Aiv;i:va your o ooeny owls not pi,d for his Work or euppliAt, has a righl !o enforce a claim against your.properry. This "all thal. 06 a Mull "coon( you( p(nRerty
could 0o 60e0 b1' s Coen dtrk:or and Ific pfLK=fju of Ire sole used to sallsry the lnaeblednAsl InIACan,nlppM.eVQrLd you "aye palC yOUt*sfM WriffaClW.rhlUll. U,llq•-
IADorat lir supplier remains unpald and It tegai action is niocessary to coll: ,1 W urlWiGt l+Ke rW1t13-ld,tMsCOr1IlArs, tnq.IlfeyAlh Qg•uaflY.lhet, -p! elitist/C'!0411
;01301100! 011W.39111011 r,3 plus All TbW
lq lit gill And +nierest small accrue an ail. Sums ' Nch are dtla 90 dOYli 0491 6"rny ul IIxµ rilte ;if its Sh.11Ar arC-11m, rho usnoef CO
Inc. is not reeponsipie fol delaya cMwsed yY weaA+itt. Nr1Ar:, melena! shmage or d" in materiel sudplled to the :ob of to oily OLhW vw'1ly. cuy'Xid do winfiN' the"
)Ani ice Cn JAC -tdA1 I,Aanlry under this contract or In negligence is limited solely to elle amwnl wt this Conlrott '
A
We are fully covered by wariuP.uc".ornoansatlen and nubllc llabl% Insuranco. Carriors names'and polit;y mvmgar; rvyilpmv.pit '.
MQUEiL -
Any alror0on vi hurn Inc ilahovil tnyniving Artra mitt of material or labor will only DO eYYCUted UDOn.'M. Rll•11 0dcry.(0' 6011111 deq Will TACOMA
J" asua charge over the tum menlloned in thii DrL1p0aAl All HUletmel113 rowel lir tria0e in wrAnnig And is nAW On free access t0'oullolry OlrttCl ppryryj "urn i}ir,•
r prlrns are based on current costs of material and labor. Inrraoses ordecrsasas, wlfi be rpngctcn at untoorsigning contract, ,
ee!ore and or during ruonng ovoratlons and the completion of roofing, The DanDse Co Inc, will not be rnponsible or flsbfv for damage coursed from
acro ol Ood, ouch as earthpuases, thunderstorms, hall or any Other weather conditions beyond roofers control.
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06/26/2000 1$:30 9097360018 STEEL T PAGE 01
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DEC -01-2000 16.:42 WESTERN INSULATIOI ,;t 909 686 8786 ,P.11i17
i
VESTERYINSULATIONt INC.
42 L t Latham $tiscC,.Riv=s'ide, California 92501 ,
Tel. 1909I,aa"i8 Q ; FBx 1909) 686.8786 ,
' 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: PGA WEST - AUGUSTA
LOT # 55
SITE ADDRESS 67-178 MEDINAH LA 4UINTA, CA-
--------------------------------------------------------------
WICB10A WALLS:
MANUFACTURER: JOHNS MANVILLE THICKNESS:' 3.1/2 'R -VALUE: R-15
09111 INGS: TTS BLOW
MANUFACTURER: JO 4S MANVILLE THICKNESS: 18" R- VALUE: R-38
1
GENERAL CONTRACTOR: TRANSWEST HOSING.
BY: '
TITLE:
t
DATE:
INSULATION C®NTMCTCR: WESTERN INSULATION, INC.
LICENSE NUMB 1278 ,
BY:
TITLE:'' PRODUCTMON MA AGER
DATE DECEMBER 1, 2000
,J' tc
WCertificate 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, of the time of issuance, this structure was in compliance with the various ordinances
of the City'regu/ating building construction or use. For the following.-
BUILDING
o/%wing:BUILDING ADDRESS: 57-178 MEDINAH
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9909-010
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building:, MCCOMIC-SEOKTOP LLC
Building Official
Address: 750 B ST STE 3140
City: SAN DIEGO, CA., 92101
By: DANIEL P. CRAWFORD JR.
Date: 1/19/01
POST IN A CONSPICUOUS PLACE