SFD (9909-012)57198 Medinah
9909-012
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
701039 - Pa ; 91131p,
ate `- % Signature of Contractor
OWNER -BUILDER DECLAR TION e!
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
S on 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 STATE F"D Policy No. J3S 93-!1001236
(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„ifel should become
subject to the workers' compensation provisions of Section 3700 of the Labor
de, I shall forthwith comply with those`provisions /`
Vat
e:: Applicant 6i
Warning: Failure to secure Workers'(C-ompensation 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, indemnity
& 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 purposes.
Signature (Owner/Agent) ' e_4 /A, %r. Date
`."(1”) 66 BUILDING PERMIT PERMIT#
•?'ATE VALUATION LOT 55-01!_2 TRACT
1 i,1 o ltJ 57 ;t8410 -2f1
JOB SITE
ADDRESS
APN
716-480-017
OWNER
CONTRACTOR / DESIGNER / ENGINEER
1 9'iCCOMIC-SUOKTOP UIC•'
Tmis VTEST I-10'UMNG DIC'
75013 8T USM 3140
78-401 F0,011W.e Y 111
SANDIEC:C) CA 92101
LA QUINTA CA 92.253
.(619)557.9191 CBTA X Sr12
USE OF PERMIT
9WO..T-E FAId2'IT..Y I3`WELLWO
SFD. LOT 5% PLADt 1811 PERMIT DOES NOT INC;LUDF BiOCK'WALL OR
PCCT 7.9% REDUCTION ON PIAN CHECK FEE OR MULDPIA ISSURA1dCE
OF SAME PLAN TYPE.
CUUTOb/I CONSTRUCTION 2,203.00 SF
PORCH/PATIO 409.00 5F
GARAi1 CARPORT 566.00 3F
EnrudAm C°Osi m 0C31!ts.iNJa1' on
PEST M. SUPIMMRY
C 1
CONSTRUCTION FEE 101-000418.000 $951.00
PLAN CHECK FEE 101-000-439-318 $193.24
r
MECHANICALFEI? 101-000-421-000 $60,00
-
ELECTRICAL FEE 101-000.420-000 $145.93
PLUMBING FER 201.000.419.000 $165.00
STRONG MOTION FEE - RESI D 101-000-241-000 $18.131
GRAD NO FFE_ 101-000.423.000 S20,00
,DEVELOPER IMPACT FEE $1,907.00
SUB -TOTAL CO:NMI:TC014 AND PY. AAT CHECK
$3,461.9£3
LE30 MRB-PAW FM
$0,00
'ITOT'AL .I'FRMff IMS VVE ,NOW
$3,461.98
RECEIPT
DATE
BY j
DATE FINALED .
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
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
f Da
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
161 fIn
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVAIIS
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
77
Encapsulation
Gas Piping
Gas Test
D
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:
DEC -01-2000 16:45 WESTERN INSULATION 909 686 8786 P.'_7/17
WmESTERN INSULATION,
RerON INC.
y 4s 11 lAtham Str=t, ivside, CoMbimia 92501 •
Tel. (909) 686-8760 Fax.(909) 686.8786
bisULATION 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 # •57
SITE ADDRESS 57.196 MEDINAH LA CUINTA, CA
• EXl-ERIORVUALLB: -- ... -
----------------- .......----- --
MANUFACTURER: JOHNS MANV/U.E THICKNESS: 3 1/2 R -VALUE: R•15
CEILINGS: BAITS BLOW .
MANUFACTURER: JO ILLE THICKNESS: 13" ""R- VALUE: R-38
GENERAL CONTRACTOR' TRANSWEST HOSING
BY:
TITLE:
DATE:
INSULATION :> WESTERN INSULATION, INC.
LICENS MBE 1278
BY:
TITLE: PRODU TION MAN
DATE DECEM9ER 1, 2000.
TOTAL P.i7
•
j
The DanDee
Cka- aw my bx-. t is 732542
ROOFING AND CONSTRUCTION
a.
it
,
t -
',Roo'fin'g Proplo al'.,,,,.
. osr
P.O. Box 277 Thousand Pa/mfr, CA 92276
Phone (760) 343-3365 Fax (760) 343.3096
4
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 7.71.3363 FAX 771-9077 DATE 12-7-00
e
Me MAMANCi(WI Law (Ca'iforma Code of Civil tauwtluro. 9oction t tet of Sop.}, any cao!racar.
Dat,br;onnactor !Ahorer. "st'npnar nmol person ne halps Io
^'u'rvi",uur G'00enY Dul ib not 044 fpr MS work nr auppliea, nae a right !o infofce a claim AgainstAgainstyour property. This tnPans ftlal. uflvt a. uuui; hCurn,9 your property
co td Do 50:0 ,• a coon otricor and Inc plcrwj: of the sale used 10 WIVY it* !ndeblean"s t hii can happen even n you nave palc your own wrllriiGtrjr :n full !I dq•
`irlklb:v.1^.Ina la0orer nr supplier rvma •ls unpaid and d legal action is nowsaary to coll';ct or unfUltm pee !du119 tit IMS Gn'itrAr7, InA 11fevAIP119 Davy snalr De enunec !o in
cant+' ary .,annnlr l filen of -J... An MAIA of Sial Ara interest small accrue an ail sums wr,'ch are due 90 dDys nwi bdluiq Ill 11V ';Ar al 15 7. 0e.( arrvot The uen0ee Co.
Inc. is not reepo,,si0le for oelays cMused by weamnr, strike. material stxxtnge rx delay in material wdphed 10 the ob of to any othu' uv!uy uuYu, t'Ia,^rultrCl the
aAnl t".. Co lnC IntAI uAndiry under this cantreol or In negligence Is limited solely to the aauxrul of this cD.11roct
We a%e fully covered by wofKfrjuiLs.omoensatlon and nubllk-(labillfy jnsuranco. Carrioro names and polir;y fLtJm
jam uvyilgtflq.on
fal1NE5L
Any allerauon pi 7ev.al'Vn hurts Inc• ;i etX-vn Involving extra rani of fnatorial or woof will only De executed upon Nrnlvrl w uots iw e•;;par. ,u -.I will B'?Gt1Me `
.1"+ ,ua cNrge o•,er ma sum fnanuoned in this DrPpOaAI Allytbieenienly mwl liC made In wrdllrng Ands OAaed Oft free aciass t0 DUIl01n9 10! Odrt•(;t'ODdnxj from tea.
Inn.:
ortr.na ire eased on cturent costs of material and labor. Incrwses or decreases, will be rertoetorf at limo or signing contract
Before and or during ruc;nng overavons and the completion of roofing, The DanDea Co Inc; will not be responsible or liable for damayn caused from
acts of Ood, such as earthquakes, thunderslor'nia, nail or any other weetner conditions beyond roofers control. '
i
-------........ DATE, M..'
L70 cd 98L0£1YEO9L ul.LMON WLV b'Sift c6Of 00—LO-Z)ao
00/20/2400 13:30 9097360a18
installation Certificate:' Roside•ntlal
STEEL T PAGE 01
Uoo t( Ihta lore b aGunly aw •.qu4.n.osu d to A&Vwd tmtoe Coda Is p tart lbe Ia1MaePgl:!t! b! ,:• , .. !! '.
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maybe uaedtomeet the&@tWi.nt.r L As exam ttwdbefowenattwttttt etplt tent oadleCers a
the eMbenay and type d the eppltwM @tat" vines be otb fllWldM eppiieA04tp d
Cornp4anoa (CF -1 R). This anriaale (or b egWV> WM be pcep&ded sad *.W bF dW Wlii*) W**
reaponalblky for the appllanoe Inatalation.
1, the underi4nod. verity aw the egwpmerd toted In ft waM ebnem- eowle"Diel tt Md end
thm the equpment meets or &%=G a the requkeMMU d die Appihwul ,d albinited Iat
the equipmern is uivalent to of =M GHWOM 0M. til. ipeC ed
d efrww ato oom Bance with the Ene Eff far reilderltW bulidirgi.
-HVAC SYSTVAS
Now Hydronie bolt' Warmadbn is entered hen, 011ier W►idraft-or Combined RydroMo e411pmed I. {Med wrier
Wrier Heating Systema.
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er (APUL eml LLbbatlon -- Yat3 4sef 111!1 Cad
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the Energy MW SlwWMd&, are two d the arlterie wed for equWnM $Wf4 et(td
41:
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WATER HEATING SYSTEMS
Water Muting CEC Cenifled
Sysum Type ManuL Yalu i
(siorsae aoa. •ta) Yi did Numbee
Tank flrusor ar
1. For un" pea otonp a (mad !+put 176.00 B&ktA veins te.leta^oe and bed Few.
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Fa taaunun.ow ye +rstr 11e616M frit Waal Input and Rem" EMUM.
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FAUC rs a SKOWMJ40A15
f.
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pursuant to title U. Pan 11, tubytapt.r Z. 60don 111.
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the Energy MW SlwWMd&, are two d the arlterie wed for equWnM $Wf4 et(td
41:
saw+ lues HVAC Buhenlftr W (" Nerlle) a40ee1e1 Corte.ator of awrw ir
WATER HEATING SYSTEMS
Water Muting CEC Cenifled
Sysum Type ManuL Yalu i
(siorsae aoa. •ta) Yi did Numbee
Tank flrusor ar
1. For un" pea otonp a (mad !+put 176.00 B&ktA veins te.leta^oe and bed Few.
For tinge gu atorepe crater heaun (rind kwb7L= tk:trr), ides Rshd hwA 11.0011.ty IN 1j ertd t tan.
Fa taaunun.ow ye +rstr 11e616M frit Waal Input and Rem" EMUM.
Fee Inotsnta^eoro oi•e0te rreW heetari, Gq Kafiri Input.
FAUC rs a SKOWMJ40A15
f.
M WAste acid shpworhoada fl~ata(lod are MW 41 the Cllmnliuiw% OA=y d Coded ftaft Std sftowee NWA.
pursuant to title U. Pan 11, tubytapt.r Z. 60don 111.
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Certificate ofoccupancy, -
City of La Quintci,,J
Buildin and SafetyDepartment MoFg_
ThisCertificate 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: 57-198 MEDINAH
" Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9909-012 .
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: 1/10/01
Building Official
POST IN A CONSPICUOUS PLACE
jT
Notice
The follow sketch and calculations represent a field fix for each of the
following addresses:
80-105 Cedar Crest
80-225 Cedar Crest
57-108 Medinah
57-138 Medinah
57-168 Medinah
.57-178 Medinah
7-198 Medin4h-
57-141 Medinah
Greg Butler
Building & Safety Nanager
City of La Quinta
of 2, 00
SWANSON & ASSOCIATES 3914 MURPHY CANYON RD.. SUITE pA130 SAN DIEGO, CA 92123 (619) 576-3260
PLAN -
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APPROVED
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FOR CONSTRUCTION
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DATE I BY
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CyIL P*
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REVISIONS
DESCRIPTION
DATE
DESCRIPTION DATE
ITEM NO.
CLIENT:7h w./S r
ITEM TITLE
PROJECT:
AT TN TO: 7-`i4
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6B4
PHONE:
//Am I dAG< TRUSS SUPRr_
DATE:Wu( -
SHEET
/
FA/76006/75
,
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SCALE:
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SWANSON & ASSOCIATES 3914 MURPHY CANYON RD. SUITE NA130. SAN DIEGO, CA 92123. (619) 57673260
CHECK FoST LOAD AT EA •
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REVISIONS
DESCRIPTION DATE
DESCRIPTION
DATE
ITEM NO.
CLIENT:
ITEM TITLE
PROJECT:
AT TN TO: -
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P& W�
PHONE�w
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FAx:
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SCALE:
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%ffL� ¢�� �3%Z hef� CoNC/z�TE 64413 /S 44FW366
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REVISIONS DESCRIPTION DATE DESCRIPTION DATE ITEM NO. '
CLIENT: ITEM TITLE PROJECT:
AT TN TO: /� W&W 97
PHONE: / •�Cac DATE: / SHEET
l/ (� -
FAX. .
SCALE: Sof 3