SFD (9904-184)57191 Medinah
9904-184
LICENSED CONTRACTOR DECLARATION
1 -.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
7011139 B P3.1/01
/ ate . 1 t Signature of Contractor `-=A
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).
O 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 worker`s'
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
bpermit is issued. My workers' Compensation insurance carrier & policy no. are:
Carrier•: • Policy No.
S'A FE FiJib1 Oa5-9fi-titlp.123ra
(This section need not be completed ifthepermit valuation is for $100.00 or less).
(' ). I certify that inthe`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 hall forthwith comply with those provisions.
Date: r.l i . f 4Applicant/Warning: Failure to secure Workers' Dpensation coverage is unlawful and
shall subject art employer to criminal penalties and civil fines up to $100,000, in
additionto 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. fi
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 ..r.
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
r.pe,rmit, or cessation of work for 180 days will subject permit to cancellation.
I ceitify 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
const(uction,'and hereby authorize representatives of this City to enter upon.
the above-mentioned property for inspection purposes., _
Si nature (Owner/A ent) 0'- •-• Date
BUILDING PERMIT PERMT#•-
DATE VALUATION S217,8".40 LOT 1728-. -f TRACT -9110-2
JOB SITE'
ADDRESS '• f 9C i4
D
APN 76.1-4WI80
OWNER
CONTRACTOR/DESIGNER/ENGINEER
N4CCOMIC-SEOKTOP LLC
'i'P_NS NVEST ROUSING .INC
7_508 ST M-. 3140
79401 F HIGMVA. ' 1 1 1
SAN .D1E00 CA 92.10.1
LA QUINZA6 CA 92353
(6'1N)5 ' 9191 C'BL0 4972
USE O(F[[PERMIT-
SISV6J1•E. '.A.M1.1a
SF'13 LOT 28, Pi:A31'2PEIRAliT DOES NOT Ci.C1DE i LOC : it 11.1.5
OR .POOL
CUS' ONICIONI STRUC"1'IO`N 2,57100 SP
POK 1IiPATiO 432:,06 SF
GARAGWCARPO.RT 600.00 SF
i10STMIXf ED COST OF C ONSYI'€ U C.°"t I.ON
21 7,864.40
PERMIT HE 8UN11W%RY
CONST RUCT'.IOPIFEE 101.-000419-000 $.1,052.50
Pi.iW OMCK 1~ Ek 101-000-=139.318 $861.54
IV.ItsCHANICA1. KE 101 -NO -421.-000 $98.50
IaLEC RICA'L! EE 101-000.42()-000 5159.52.
PLUMBINGFFE 101-000419-000 $139.00
STRONG NICI ION Fr4E - RESID 101.-000-241-000 $21.79
GRADING F.is& 101-000-422"00 $20.00
1.NFRA3TRUCn'0RE F'E'E 225410f1-443-342 $4;772.6
ART IN PUBLIC PLACES - RF—M701-000-05-000 $29=1.66
,¢ r
c
SVB-'fOTA,L CONftlJC' iCdN AND PI.JVi CHECK
$7,459.1$
LESS :PRE -PAID FEES
ti I .
$0.00
TOTAL PERMIT FEES DUE NOW
SUN 1 1999
57,459.:48
ter, NTI
,
RECEIPT
DATEBY
" "y'
fl
DATE FINALED
INSPECTOR
A
i,
ti
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings s
Ducts
Slab Grade S
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O. K. to Wrap X /
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L. lo
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines /
Neater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Ma:c^-16-00 07:52A TOM WHITE t--- dC7 ✓ ' 1 P.O1
r
The"anDee Roof n Proposal
g
C01t1 >fy h1[•e L %C 732542 P.O. Box 277 ThoflSdnd Palms, C A 92276
ROOF/NG AND CONSTRUCTION Phone (760) 343-3385 Fax (760) 343-3096
BIDS TO: JOB NAME;
TRANS WEST HOUSING, INC P,G.A. WEST HOMES
;. 78-401-F HWY 111. P.G.A. WEST (PHASE 2-B)
,,T 1•
to QUINTA, CA 92253' LA QUINTA. CA 92253
r' PHONE 771-3363 FAX 771-9077 DATE 2.15-00
-HAGIN ROOF DORMER Vf=
Tf'"A&.OEE COMPANY INC. HAS- INSTAL49Q, JjE.ROOF,.•Q ..VENT$ CORRECTLY, A
PER ENGINEER . SPECIFICATIONS.
y,+2 4 ani - + ` •,. .. ,.
r issr,
' NOTICE
* ' ° 'Undoi itis Machaniew I ion Law (cdldumia Code of Civil Pmr:Anveo Suction 11a I M Req I nay conhaefor, subnnrttmax. lDow. supplier omw por.yprt Irc helps to
Improve but is not paid for hie wort or supplies, has A right to entorec a Beim against your provoly. This rnnarte rant. (trio( a court hearing ynur p(owty
Mild be sold by a noun ontcar nrat the proceeds of the *Ala tread to 68lrsly the indshtodnoas t his can happen even n you havc paid your w. n cnnt;nr;tui In NII. If ma
Subeomraw. moony op supplier remains tmpaid and it lopol action is neceaaary to G)ltuut ar enforce the terata of this contract. the pryevpdnrp party shell be entitled to its
realnnottio ouvney fees plus all wig iii Sul•, and inturest shall atyrde an all stirs. which are nus 10 Coy* atter billing at the roto at 18 ti per annum Tho DanDee Co.
Inc, tl not m3pdnsinle tnr riwayu citvwd by Weather, Mo. mmorad yhcntage or oelay in mAtorru uuoplied to the Inh nr to any other delay beynrwi Its control The
DanDee Cn Int.• tnbN bobrlrty under this contract nr to nnpliflr ntco 16 limped Soley to the nntpunt of this contract
We ars fully.pavered by workmen's Goftllponsatlon and pub,le Ilapipit r Irteuranco. Carriers names and policy +umbers available on
nia41KtiliL
Any alteration of Juv aeon from ma A above 4W.11radwns involving e►1ra Gnat nr rncttcrial or labor will only IM cr'cwted upon written urdc,s tot same and will tv: r; prrK
wr uxtia charge over the surd nrprgiur*d In this prnpriml All arpoumcnis mu*t ba mine in writhing and is hAeed nil hw access to bivirtmfl ter Ji,W kading from nor
trunca
Prices Am based on current coats nt rnatnelet and labor. Increase* of decreases, will he (Minted at time of algniny rnntract
Ootbre and or during roaring uprrstlons and the complMlnn of Hoofing. The DntDnn Co Inc, will not be reapnnribes or liable for damayrr tietrried from
arae of God, such as eanhquetes, thunderstorms, hall or env rdher weather Conditions beyond roofers control.
DA 1`I'
DEQ707-98 MON 09:.21 2 FAX NO, 4550212
x.
i
0
P, 02
PLAN 1:
ROOF ATTIC
ENTILATION REQUIREMENTS
ROOF ATTIC
kREA • 2,203 $Q. FT.
300 8.1
.34 SG. Fr. OF VENTILATION AREA REQUIRED
(1).18" DIAMETE
DORMER VENT • .69 SO. FT. OF VENTILATION
r fir. ' ,,...7,34
10.68
•' .. ;.
PROVIDE A MINIMUM 0F1,11VENTS.
.6991.
DORMER
; .
PLAN 2:
L
ROOF ATTIC
VENTILATION REQUIREMENTS
x .ROOF ATTIC
AREAm 2, S72 SQ.FT.
3009. f • 1.67
s._
SOFT: OF VENTIATION AREA REQUIRED
(1)18" DIAMETE
I DORMER VENT., .69 SO. FT. OF VENTILATION
1F
•.8.57 f . .? .
s.i 12A2
:, .-j
PROVIDE'A MINIMUM OFi13iD0RMER VENTS.
.69
PLAN
"
ROOF ATTIC
,ENTILATION REQUIREMENTS.
R ATTIC
REA= 3,013. SQ.FT.
3019 e.L' ;
A
30081.--
0.04 SO. FT. OF VENTILATION AREA REQUIRED
.
(1)18` DIAMETE
R DORMER VENT a .69 SO. FT. VENTILATION
89 s.t. _
i` -
4.55 PROVIDE A MINIMUM Obi .; RMERS VENTS
y
0
P, 02
JAN -10-00 WED .12:40 2 '
,. FAX N0. 4550212 I
P. 04/05
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{42/10%2000 10:58 90973E001Q STEEL T PAGE 02
Installation Certificata: Residential
Lloe of this Porro to satla►y"rsqulrwrtmw of the Admioldre0ftCello to opUaetsf. but ow wars" wW be1 t '
01i ox
o -t- - A` 0 r --
She Addy u y
An IumRalion carted-.&@ is requlmd to be pasted adtM btaMV Gila 110 b5Utft0609Iua=lp i is t]ttd
may bo used to most these roqukam-mnta. A9 app8anea baled 40 ww wwam iPttl> od.
the aliiciancy and" of thea ptIane lrtsWed Mw4bs ad arbestert lfJte Qa eltate
Compilance (CF -t R), Tftla eePt Csae (ar ,aN. Pad be ttif;f d D st i1tp et►oerldi
responsibliity for the appliance IndaWbA.
1, the undem4 nod, verity that the ag*%er4 tamed in the cdOM above RT ZOOMS Ib 9% MCW 0001110d%mm and
that the equipment meets ar exceeds the requka mGM ad ft Apolame Effilbla 8121WIfft (fl I hire VOMW
the eauiprnent is equivalam to or mole ofiderd therm the egtalpmwtt apeaed M Q09*00 =WnKW In
demorotrata compliance with ilia Energy Eifidency shr4sid4 for r"werowbuudktgL
HVAC SYSTEM
Nwe: Hydronai boiler inlcnnaibn to entered here. Ctha hydroma of 05rhblnW hydrants egUOWAgl to tltlted wider
Weser 1491WAQ Systems. .
Floating Equip. CEC Candied AcbW clstrlbUdon DuM or ldreaaft L"II
Type (Itimaw, Benin. UsM & Eff TV" and wase ♦' w.
host sumo, etc.) Uadal Nutrtbw ld E l1 tbes*ffi N -belie 09101111MM fti
CEC CartMled
Coaling Equip. Ceuproa4ar unit kw" alatribatlen mor
Type (*kf Gond.. Uanuf. Malts sr t;lpflelarsay t
heat u eta Model Numkmw n
C C L 41--1
1
V u
The buildinq design hear bas and design heal gain rom hags been defermbted using a madod specNed In t3esa N 150(h) of
trio Energy 4ancy ar s, and are two of the witett€s used for equIpmettt aWrr® and aoWdlan.
2- /,5 -0D $ MCC- — r A&— V9C- .
54aan,ro omr WAC 23 (Co. Ham) w Get" 6e WOM w
WATER HEA71N0 SYSTEMS
water HeatinS CEC Certified Pabdt Tank F54wer Taaait all
System Type IOanuf.l6rtelua& Input (kW CPmprr t . Et ll ton
(storage gena ate) Updal Number2E JIUM(gallons) oftemw LM -1la1Uo
1. Far small gas storage {rated input 5 75.009 btu 4 e160ty realstanes and haat pump w 4w butent U EnerU Farr.
For largo gas atarsga waw hesteas lrsted t qM 3PMW9 BaNtlr 1111 Pfd inpuL INAMMY 05*rt* wd lwratby t-oas.
For Instantaneous pa breast hsstem, flat FLOW IrW and P4=wq E"J*w y,
For lnstsntanooua siaetrter warm hosier®, gist Faced VVA
FAUCET'S & SH01AR HEADS
AD faucets and showwhaads installed are Ind In tato Qmiwian's Directory of CePtlllod Ftal mb VW Sh ww8fh0iide.
pursuant to Title 24, Pari 6. Subchalrter L Section 111.
517maturs fiats
a.%A--r,iW%NWV ren
N wrhlrq 86609 calor fco.11aa4et ar darr+etd Oeree ►ar r
02/10/2900 10:53 9997360213
Installation Certificate: Residential
STEEL T
k *&j I.
PAGE 03
PIP
6 R
Use of this form tom®dlstythefsquiremanisofdwAdfaWstred"Code is*pttat4ttA60 atualbtiptomlOadfi11Acasae:'
to Add"&&
An insmUlion corigicate is required lobe ptsatbd at 1M +0 t a m 1@71► 16®Qif t4 1 Pp f1 per• ° ern
may ba used to meet thesa.rtiguIremaritA. A>bW 42
!
CompNabsiokl tilllM IOp-
the efticiency and typ+a of the appilartt b rfu t be afant orbattitrtlha thf fippliafta aOffloCae iran
naa (CF -1 R).ie, drtllkodo (or bvgtt rafant) ba prOpsf+ed and dry by fetes arsOtt rj avafall
responsfbirdy for the appliance Installsilast.
1. the undersigned, vgttity alai the oqulpmerd fisted In the C96M aboYs illy 41FIRUM laf+ltaa Now and
that the equipment meats or utcoeds the requ nments of is A01ance ft9dit & at 9 ho t psi
the equipment is equNalentto or more efticiertthanthf+vquort ett3p-medcgs Of C490IND 2111MAW0
demonstrwe cornplianco with the Energy mercy Standards for ra"O it buftlgil.
HVAC SYSTEMS
144we: Hydronic boiler infarmasion is entered here. Other hydivala or combWW hydhO ft aquOofl M Is bw t
Weser Beating Symerm,
Mating Equip. CSC Ca died AcUml INSUibstrtltrn Djafw PAaft Lead No*
h ouu o. atc: Uadal Numbee rAFU 9 Too a 11 Vkhhm Balm
MWh1 eAM
fs err `% 14-2
CEC Certified
Caollna Equip. Compresaor /Unit Ack-1
iPo leis smnA.._ klanud.lAttJte & t1liltis etery
u v 6r
Did w
The bultding dssign haat loan and design heat gain tato hams been determirld LWN a fReijwd spedfod In seckbm 190(h) o!
the Enww EffkJancy St and are twx of the a teff used for equipnom mt atm atw as
OPJ.r— l®•ems f`(' L` T C.
Oast MVAC &"nira= (OL Harm) *r t$wmd 0wWiwWW0Nw
WATER HEATING SYSTEMS
W®ter 6leattng CEC Cartttted
Sysurn Type Manuf. Make i
(atonga as a. str) geodes Number
anulle
Tank Fhm&w
i . For ornsil gas storage (mad Irvut s 75.004 i3sar A efawk reslauhm and had primp szWg (t=%v , 11AFidw.
FW WV gss alar W valor tteaUes (MM input )-79.004 VAIs Ilaf Ftatsd lrVA FSwtairy 42dwtq wW Bandbl Las.
For inatuntnrte m W wouw hes tnfa, flet Rg%d UWNW p oft" Eftl ww-
For instanw-A aua eireota wet" heatrsfe, oil Add tnpvt.
FAUCM & SHOWER HEADS
A111111 and shi werhvada Installed are Rated In the Commission's Dinfdory at c4no d Fala to sw shw4whawls.
purauard to Title 24, Part ff. SubahWer 2. SacWn 111,
Si r4 cats Pfwrolsinga40poaradeeee/Ca®-Ndeoywaee+wai6 reat as uev+mr
Rpri .faneary son
4
WESTERN INSULATION, INC'
4711 Latham 8t wt, Rivm-id&, California 92501
Tal. (909) 696-8760 Fox (909) 686-8786
INSULATION CERTIFICATE-
THIS 15 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 gib: 28.`:
SITE ADDRESS: L57191 MEDIHAH,-LA.QUINTA,,CA
.' a ..
EXTERIOR WALLS .
MANUFACTURER: lohns•Manville THICKNESS: 3 5/B" R -VALUE: R-13 r
•CEILI OBATTTrS BLOW
MANUFACTURER: Johns -Manville THICKNESS: 13" R•VALUE: R-38
__. ---------------------- ------ -
GENERAL CONTRACTOR: TRANSWEST HOUSING, INC.
LICENSE NUMBER: —10 101 -
BY: i z✓ 2 w i r / .
TITLE:
r. DATE: 3 1
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER; 481278
BY:
TITLE: PRODU ION MANAMR ,
DATE: FEBRUARY 11, 2000
$0. 50 •. 98J 8 989 506 NOI1.N1!lSNI' N'S?1S3fy! tq- :60 0007—T-t—E13--j
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*-Certificate-of Occupa
ncy
City oafLa'Ouinta F Z
Building. and Safety Department Of
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.
ollowing:BUILDING. ADDRESS: 57-191 MEDINAH
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9904-184
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: 3/16/2000
Building Official
POST IN A CONSPICUOUS PLACE
1 I