SFD (9904-183)57201 Medinah
9904-183
LICENSED CONTRACTOR DECLARATION
I lierL3by 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
Q Signature of C
te.
,3a' ;ontractor
OWNER -BUILDER -DECLARATION
1. hereby affirm 'under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
1; as owner of the property, or rT,iy employees with wages as their sole.
compensation, will do the work, and the structure ure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
1, as owner of the property,am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Busi n*esg &' Professionals
Code).
)..I amexempt under Section B&P.C. f6r'this reason
Date' 1. Signature of Owner
., t4
','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
perf6emance of the work for which this permit is issued.
(YY 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.:
' ' : I I Policy No.
Carriei
31'ATC FUND
(This section ,need not becompletedif the permit valuation is for $100.00 or less).
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
Codeql Sball forthwith comply with those provisions.
Applicant .... . --T-S
Warning: Failurejo secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
additi6n.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.
J,..r Each person upon whose behalf. this application is made & each person at
whose request and for whose benefit Work isperformed under Or pursuant to
-a.ny,permit issued as a result of this applicaton agrees to, & shall" indemnify
h ` id harmless mless the City of,La Quinta, its officers, agents and employees.
2.An
Any permit issued as a result of.this application becomes null and void if.
til work is not commenced within 180 days from date of issuance of such
p
ermit,"'or cessation of work for 180 day's 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'pr6l5erty for inspection purposes.
Oignatur6 Date...
J,
PERMIT#
BUILDING PERMIT1, 99ig-193
DATE VALUATION $11101,133.70 LOT F-1-9 TRACT 2810 ^21
4 -
JO§SITE k '57-201MEMAH
ADDRESS
76.14WIN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
MCCOMIC-SEOKTOP LLC
TRANS wrmr Housyw INC
750'B gr STE 3140
78401 F RIaRWAY 111.
SAM DIEGO CA 92 101
LA QUINTA CA 92253
(619)557-91
191 CU -0 72.
49
USE OF PERMIT
MNGLEVAMILY DVKL,Lriqc-,
I
MUI.,T1PLE1SUANCE OF SAME PLAN TYPE - PERMIT DOES NOT
ENCLI IDE 13LOCK WALLS OR POOL
CUSTOM CONITCRUcr [ON 2.203.00 SF
PORCWATIO 408.00 SF
GARAGE/CARPORT MA -00 SF
'CSTIMNYED COST Oir, COMM RUCTION
188,133.74)
PERMIT FU SUMMARY
CONS1:RUC-1710N, FEE- 10.1-000-418-000 6951.00
PLAN CRE CK FEE 101-000-439- 318
MECHANICAL FEE 101-000-421-000
ELECTIUCAL FU $145.93
'PIXTMBING FEE, 101-000-419-000 $W_00
STRONOMUDONFEE - ft. -SU) 101-000-241-000 $181.81
MADINGFEE 101-000-423-00 $20.0
WrRASTRU CURF FEE' 225-000-443342 $4,110.91
ART W.PUBLIC PLAM - RBSIL.' 01 -000-2-5.5-060 5220,33
x.
SUB -TOT -Al, COASTRUCT10N AND PLAN CRECK
$5,88611
-PAID F BE 8
LESS PRE
PAIS.
TOTAL PER FEFS WE NOAV
JUN 161999
IN.
RECEIPT DATE
IR
BY
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
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 APPROVA S
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
Gas Test �f
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:
WESTERN INSULATION, INC.
4211 Latham Street, Riverside, Callfurnfa 92501
Tel. (909)686-8760 FaX (909) 686-8786
INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSUL4tTION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACT I PHASE:AUGUSTA (g? PGA WEST, PHASE 2
LOT' 1: y 24
SITE ADDRESS: 57-201 `MEDIHAH, LA QUINTA; CAk
EXTERIOR WALLS: '
MANUFACTURER: Johns-Manville THICKNESS: 3 5/8" R-VALUE: R-13
CEILINGS: BATTS BLOW `
MANUFACTURER: Johns-Manville THICKNESS: 13" R-VALUE: R-38
GENERAL 021VTRACT Ri . TRANSWEST HOUSING, INC,
LICENSE NUMBER: -70k,0-31
TITLE:i 7.2..
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278.
BY:
TITLE; PRoDTjcriON MANAGER
DATE: FEBRUARY 11, 2000
02/10/2000 10:58 9097360018 STEEL T PAGE 01
i
Installation Certificate: Residential 04
U•e al this lorm sq satisfy " requl emmts el &A AdowWoredsra Cotta is *001" b4tt b1forwillA 1113,
%to Addm*4
An inets W1on cerVlwtm to raqulmd to be posted 11W bt NIN sate WWI* OW lfzStlt M tall tft'1101tlifp a w that
maybe used to meet these rsquitentsM& Al �p;wma a 1lstmd bdosr � t� �% ofthe efllcimncy end type of the appllar= inatalaAd ffwN ba Orbd*Via ft ��
Compllanoo (CF. t R). This c*naa=a (er its squMilsrs) than be prepwW w d Welod ' ilia pates) tavww
responsibMty for the apptlaws Irtatalirdlon.
i, the undersigned, verity that the equipment Il ded in Oris c d*M ebm lily sWOn btu e w d b"tanad crtd
that the equipment .1noets or escoWs the regUiramrss d the AppWU= GUIrIldwiL In b I lti x vaned talat
the equipmert Is equivalent to or more efi16mnt thait the nett Ment! spaWW 0400 COMMM9 Of CWOWM GUbffAW to
demonstratecompliance with the EnsrgyEf itis ryStandardsfarrsticlmlilbull hqL
HVAC SYSTEMS
Nwe: Hydropic boiler W.ormallon Is cr ared here. War hydranic or combined hydro* trquorrtortl 12 dated lr Wwr
Wager Flooring Systems,
beating Equip. CFO Csrtillsd Act W i06odt bcojan 0k* or P m*q Lwd • NW
Te�aso.N ��NOW
houete1 Mcdlbet Ul E. 1 Loop••tlahw ownetft—hi
4A t. L(
The building dasign haat bsa and design heal grin tffia have been dstermbted vekv 8 etatw In t3setion 18o(h) tel
�e & WW Eftkian * Seam ars two of the ptteris used for equiptmM aWrig =W
�� 2 -0e&- 06 -5=t rt'• rel.+-,
Sion=m 0" NVAc si,>tmrtftclior (" ►orae) m Offael COOMW of taerrew
WATER HEATING SYSTEMS
Water Heating CEC Cartif led Rawds
Symons Type Manut. Biala A Input
fatoraeo can. DIC -1 Model Nurnbe► er Raul
1. For am.0 gas among* (rased input S 76.000 Gift okouils resleteusms arrd hod p"p "dWhemlomfidFOW.
For targe vu etoreapo water haaws (raiad insert 3,7$000 Sut4 list PA&d lnpA P=WW MkWW and Billroft Lapr.
For tmmnunecii a prs anter haaretr, Asa tined (rpm Led aeoavwry Mildenmp,
Fat laatanuitwoua viac&iQ wtuw Matm, Pat timed trout
FAUCETS & SHOWER HEADS
M latrreta and ahowwheads insmiled aro dated In the Commblabn's birectwy of CadW Fatlmb and $;ft01rvt=41&
purauam to Trtla 24, Part 6. Sulachapter g, Section 111,
� ro thou PtrmWrq 86Awongwoor fa. Nwm) or Q49wW CAWWWWWCW wr
RAFiMm Jw%"wy i#K
CEC Cirtlllsd
Casting Equip.
Contpres3aw Unit
Ac"
IDteofbutlon L99dw
Yyps lair oond-
1lanul. Mss& iv
i3iftlal•euli
Typit and �flink m
healpump, ate=)
Model Number
(081EMMLecvtl®p
t4 C600
Cti jjro-/
r�• b
Sfy% IL
�
The building dasign haat bsa and design heal grin tffia have been dstermbted vekv 8 etatw In t3setion 18o(h) tel
�e & WW Eftkian * Seam ars two of the ptteris used for equiptmM aWrig =W
�� 2 -0e&- 06 -5=t rt'• rel.+-,
Sion=m 0" NVAc si,>tmrtftclior (" ►orae) m Offael COOMW of taerrew
WATER HEATING SYSTEMS
Water Heating CEC Cartif led Rawds
Symons Type Manut. Biala A Input
fatoraeo can. DIC -1 Model Nurnbe► er Raul
1. For am.0 gas among* (rased input S 76.000 Gift okouils resleteusms arrd hod p"p "dWhemlomfidFOW.
For targe vu etoreapo water haaws (raiad insert 3,7$000 Sut4 list PA&d lnpA P=WW MkWW and Billroft Lapr.
For tmmnunecii a prs anter haaretr, Asa tined (rpm Led aeoavwry Mildenmp,
Fat laatanuitwoua viac&iQ wtuw Matm, Pat timed trout
FAUCETS & SHOWER HEADS
M latrreta and ahowwheads insmiled aro dated In the Commblabn's birectwy of CadW Fatlmb and $;ft01rvt=41&
purauam to Trtla 24, Part 6. Sulachapter g, Section 111,
� ro thou PtrmWrq 86Awongwoor fa. Nwm) or Q49wW CAWWWWWCW wr
RAFiMm Jw%"wy i#K
u
Feb -,15100 OB:33A TOM WHITE P.02
TOP. l'o Roofing' Proposal _
C l,'. ble. L /C 732542 P.O. Box 271 r' h' ou.iiiand Palms, CA 92276
ROOFING AND `CONSTRUCTION Phone (760)3'43-3385 Fax (760) 343-3096
BIDS TO: JOB NAME:
TRANS WEST HOUSING, INC P.G.A. WEST HOMES
78-401-F HWY 111 P G A WFST'(PHASF 2-R)
LA OUINTA. CA 92253 LA.QUINTA, CA 92253
PHONE 771-3.363 FAX 771-9077 DATE 2.15.00
r 0- GIN ROOF DOd4MERPENT$
THE DAN DEE COMPANY INC. HAS INSTALL90 ER VENI—C-ONtREICTLY•, AN
PER ENGINEERS SPECIFICATIONS.
A
'Under the Macranics' Lien .aw t.C7atc(;rniA Cride of nivo hrox.adura F:Arhnn 1181 nt 5no 1. ally v nlwdor. sutcon!ractcr, !ahbrer, srnr!ier ")Ir*Ar nrr rtn ht;, h,,Ip;. l•:
improvA your property Nil rA npt prop ir}r his work 6r suppl,bs. I;•as a. right io vnfor v a Bairn acatnst your prilinArty' 1 hip. rne0os,h it. 0r10r a wull twaring your pioperty
cutild ho Ad by imur! offlicer and the oraceeds of the sale used In salisfy thA in hteAnn2s I h,s can hotwon evert if you have paid your own contractor n+ toil {r U e
8Bh'OntRv.,nr. Itindfhr nr Suppl,pt n-,ttlilt4$ unbind Enlo if 100! duliun is necessary to collect or enfor^e the terms of lhrs (Uhtipct the ptr+uill:+p oar?y shall oa erY,iIIto its
lwsongble attorney fees plus all W5is of suit and Interev snal! acr.rllp. an All Auma. whinn Arp. Au^ 3n liiW: uric, billing al the rate at IB % per annum The DanDee. Cn.
hw. h nv; rebliwamwe fur ut•.tays t:auvw: uy wr.,nur.:, nmr.• unten;u wnnnnlle (11pr,,Ety IFIntitlr:ni4i aupp,teo to the Joo or !o any otnpr sway newiA tl5 miltro! I nC
Nrillnr. Cn Inn.. IOSII hili>,idy inittr;, ll t• cunt,. act (n c, rni7Iv:,r1w is limited sully to the amouni of this contract
We are fully ccvered by workmen's compensation and public Iiablllty Ina uran!;.e•.Carriers names and policy numbers available on
req oast.
Any ,111taltPua to t iw-d)Iltm Dorn N' it aibuvc svccigcatiorls involving extra cost or mAtprial cr Iaborwo only hr, excC.tity i upori written ordars'lor sama, ano :v,u ntlr!nrna
an extra cnarge over the stat•! mF.nhortm ,n,irlis nropA9Al All agre?5,`4ttiiR nttr; t I,,h ,nygk; In wijth,nu and is oased an free acceia to htuldnlo Iqt ihtrtli iorttrinp Dim nn!
. r
Prigelt".ire bill Vn current 6QBta gf material and lat{nr. Initimmes nr d9nYAAWi. will lip rpfiprtpd At tlmf of v(punf{ rprrtn:: t.
ttoforo and or during roofing opeiahonp, and tree completion of roelinq, TIM DimDev Co Inc, Mll not be responsible or liable far damage catrilted from
We, Af Obit, Aildh AS F.31gM,,A64A, 111,,.,.1.,, etv. me, 1 ll v, vrry vile, "caller uvndItivim hayimd ninlmn cnnfrol.
DA IE /C10
11 It: t)Atvt)F.F. .(r. INC.
WED. 12:38 2 - rA NO, 4550212
- F. 02/05
yJAN-19-00
PLAN 1.
ROOF ATTIC VENTILATION REQUIREMENTS
'
ROOF ATTIC AREA = 2,203 SO. FT.
30 0 sJ O 7.34 SQ. FT. OF VENTILATION AREA REQUIRED .
(1) 18° DIAMETER DORMER VENT .69 SO. FT, OF, VENTILATION
.69 s.1. m 10.68 PROVIDE A MINIMUM OF 11 DORMER VENTS.
PLAN 2:
ROOF ATTIC VENTILATION REQUIREMENTS
-
ROOF ATTIC AREA= 2, 572 SQ.FT.
2572 s'f'
300 s1 = 8.57 SOFT. OF VENTIATION AREA REQUIRED "
« .
(1) 18" DIAMETER DORMER VENT= .69 SQ. FT. OF VENTILATION
8.5
.59 s.f 12.42 PROVIDE A MINIMUM OF 13 DORMER VENTS.
PLAN 3:
ROOF ATTIC VENTILATION REQUIREMENTS
ROOF ATTIC AREA= 3,013 SQ,FT.
30 0 }. v 10.04 SO. FT. OF VENTILATION AREA REQUIRED
(1) 16" DIAMETER DORMER VENT = .69 SO. FT. OF VENTILATION
.889 s.f. m .14.55 PROVIDE A MINIMUM OF 15 DORMERS VENTS +
9 OF CPQ
j" AN
rd rica to : 0...
ccupa-v c
of
city.®f`La V Quints
6 `vim
Building -and SOety,Department MOF
_ _
This Certificate issued pursuantto the requirements of Section .109-of. the Uniform Bui/ding Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building consfruction or use. For the following;.
BUILDING ADDRESS 57-201 IVIEDINAH-
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: '9904-183
Occupancy Group: R-3 .' Type of Construction: VN Land, Use _Zone: RL
Owner of Building: MCCOMIC-SEOKTOP LLC Address:. 750 BST STE 3140
City: LA QUINTA, CA., 92253
Building Official
By: DANIEL P. CRAWFORD JR.
Date: 3%8/2000
'POST IN A CONSPICUOUS PLACE