SFD (9904-181)57221 Medinah
9904-181
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 B 1/31/01
D e r S's t t Signature of Contractors-w -
r
OWNER -BUILDER DECLARATION
I`hereby affirm, under penalty of perjury that I am exempt from the Contractor's
License Law. for the following reason:
( .)_ 1, 'as' wner. 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)..
am exempt under Section B&P.C. for this reason
Date,.' Signature of'Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirms under penalty of perjury one of'. the following declarations:
z~{) .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.
a I have and will maintain workers' compensation insurance, .as required by
Section 3,700 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.
STA!` FUND 035-98-0001236
(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 if I should become
subject to, the workers' compensation provisions of Section 3700 of the Labor
Code I shall forthwith comply with those provisibns.
gate ` tnj i G f 4 r Applicant ( 1 i . Ci t ^l.t .•.. 1. •_
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 Applicatiop,is hereby made to the Director of. Building and Safety
for a' permit subject to the conditions and restrictions .set forth on his
application: i .. r..
]. Each person upon whose behalf this application is made & each person atr
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 authoriie representatives of this •City to enter upon
the aKoye- mentioned. property for inspection purposes.
Lignature (Owner/Agent).r `' A-lr -e_..•. DateC • S1 / r
BUILDING PERMIT PERM a
.".
D1t
VALUATION $88,1..3,3.70 LOT L31 TRACT 284,10-2
//ATE
JOB ADDRESS 1`1'11 t
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
tV1CCOMIC-SE0kMP LLC:.
TRANS WEST HOUSING, INC
'750 B ST STE 3140
78-401 F HIGHWAY 111
SAN DIEGO CA 92101
LA QU 1NTA CA. 92253
`
(619),557-9191 CBL'# 4972
USE OF PERMIT'
s1'Nt:'rIr[ 'i Alt 1:1.LY:17V1/:i.:1 ;1,11at(;I '-
3:1; PLAN 1A P:f:P- bU7' .DOES NOT ilvt i:eTC )? BLOCK WALLS aR.
8F D
*LOT
ttW
f"O.l. I
CUSTOM CONS` TRCTIONf 242113.04) ,S,1'
MPATIO 408,00,, 9F
PORO
GARAGWARPO T 566.00 SE
f?;S'i"1't0!iA FEE 0 COST OF CO NST RUC7,11Oitit
1<sBS,.11 :70
PERMIT ft SiiMA/iARY
i rON S t/'vRLIC `71. fON FFE :161-00041F,006
/}p 959
.PLAN CflECK FFM 1 V ,L i/Vl/: 7i' .7 :9 $ d 2.93
NIECHAMCAL FFX101.000-423-000 $60.00
01ECTi21CAL FE 101<OOf)-X20.000 $145.93
PLUNISINC, Fri .101-000.4 9-000 $.166.00
STRONG MO's RYNf? rs' - :R;ES Ill .1.01-000-:241-000 $18.31
ORAi ING FM $20J)o
i.NFRAS`1'R17C CURE PEF 22.5-000-443-342 $4,1.,1,(?..91.
Aklf :W 1't7BLIC PLACES -.RMIT... 01.-000-255-000 $220.33
.: IsLr.E1- lVi'.&.1<C'E.NS"fkLIC-110N.AND PL k ! C14EC1
56,405.93
LESS PRSPk10FECS
$0.00
rr
1 D .TOTAL
i'FHN11T FEES DUE NOW
$6,465.93
JUN 16.1999
rt AiTi "
RECEIPT
DATE
BY ! JDATE
FINALED
INSPECTOR
T'
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 APPROVAL
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 ConnectionEncapsulation
Gas Piping
Gas Test i
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:
ti
FROM : HorneCen iersInc PHONE NO. : 750+772+3557 Feb. 23 2800 09:41AM P8
HOME CENTERS, INC.
Real 0111w 11839 6o4reroo Vdey Road • &an Dlaaa, Caltornls2211tt
(8118) 7556537 1 6813.1214 9 FAX (819) 755 01 a Contractor License 4281673
ibange County: 22343 Lo Palma Avenue #111 • Yorba Unda, California 98887 Projeot
(714).822.1270 s FAk (714) 692.187A /
PNm Desert: 77.922 Country Club Drive, Bunte H • Palm Desert, California 82211 Lot ! Phase
(612) 772.9656.4 FAX (819) 772.8657
Las Vegas! 8070 South ArvBre Stink, Suite d s Las Vag", Nevada Nt 18 Buy6i
(702) 871.7575 s FAX (702) 871.7292'
S orpmeMoo 8480 Surdles ANd. • Rancho Cordova, Calltornia 98742 CASH ORt%AJ2f ADD TO LOAN ❑ f1F'NrHAR(y d
(916) 835.3389 FAX 01101:35.6172 .
WINDOW COVERING ORDER CONDITIONS
ht,0.l, to proumd with measure Immediatoly, Homebuyer Is responsible for all measure charges, Cancelled rxders'wlll be
subject to a fifty (850) dollar processing fee. Addltional charges may appy. Seo terms and oonditions Owtomonto,
I understand my ordor Is placed on hold until home loam approval; Shouldl cancal after loan approval, I am rosprmslhlo for any
and ani cast's Incurred with regard to the processing of my order. (This. condition applies to all ordero'regand1less of deposit or
7woWd
t plan.)
like my order processod as quickly as posalble prior to home loan approval, I understand that should I cfrneal or r►at
receive home loan approval, I an responsible for any and all casts incurred with regard to the processing of my order, (This
condition apples to all orders that include a minimum 50% deposit)
If uslnti customero measuroments, H,C.I. will not be responsible for meataxemam accuracy, and Ii.C.I, will. nol Install
twoducts ordered from these measures. , No change orders will be accoptod rogarding installation,
KlnW material and Installation charges ina3y vary based at actual on site MerarX011nonts.
Ks tsalllval
aoustan window treatment order. No change orders will be accepted after receipt of deposit. Balance is due prlor to
lon unless other financial arrangemonts have been made. ,
APPROXIMATE DELIVERY TIME
BUNDS 4.8 WEEKS FROM PROCESS DATE as defined above. r
E] SHUTTERS 10.12 WEEK6 FROM PROCESS DATE ae defined above.
DRAPERIES 0.10 WEEKS FROM PROCESS DATE as defined above,
WINDOWS TO BE COVERED IN YOUR HOME INCLUDE:
WINDOW COVERING PAYMENT PLANSALES ORDER(S) 0
a
9P'QQIAL INSTRUCTIONS
SUBTOTAL
MEASURE CHARGE
SALES TAX
INSTALLATION CHARGES
2
OTHER
TOTAL SALES PRICE
4
DEPOSIT AMOUNT L- _f42 % S l 9F• "
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F►b— 15100 013:33A TOM WHITE,
The-BanBee',
%npmiy bK*.. L is 732542
' ROOFING AND CONSTRUCTION
s- G
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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 WFST (PHASF ?-R)
LA OUINTA, CA 92253. LA QUINTA, CA 92253
PHONE. 771.3363 FAX 771.9077 DATE 2.15.00
O-HAGIN ROOF DORMER-YENTS
THE DAN . DEE COMPANY INC. HAS INSTALL
Q_ THE ROOF DORMER VJyIs CpRRECTLY., AN
PER ENGINEERS SPECIFICATIONS.
e A 306
!lL T.!GE
'Under the Macnanics' Lion Law (CalrornI,R Cndq Ot: ivo IrronadwA 6iAF I tel At SM ), Uny CQnbatior. subwn!ractCl, !aoomr, hunpligr Jlrw pli.Wff) IIA.Iu;lp l7
Impmvn your prnparty hill Is not poll UN his work or .uppi,es. his a lig!It to 0111,10 :a a daim agalnat your prnpArty 1 hip medns toil. oftor a Wutt bearing you, property
r uuld be wAd by a court offer and the eraceeds of the sale used to lwllgty thg lnawtltednngs I his can h'rupen evert if you have paid your nwn nontinoor u+ hlil it vx.
S,th;.ontr.v,,!nr. onnrer nr SU4lDller roaltnl,S unubld Jnd If logDl aclwn Is necessary io Collect or enforce thq lem1R hf 1hIR M. )WICt INC Pmvaillr,g oar*/ snail oe entitled to its
rwsonable attorney fees plus all costs of suit and Intefes: snail accrue an all Rlifttq, whlrn are dug in dtws u41.v bl!ling at the rate at 18 % per annum The DanDee Ca
tut.. Is nut lebliw multi fel uwaya Imummr uy YYnnllle:, +,unlit, nyir.Iml suulu111ft or pr .ty nl 111MVIB, SUDPlif.1) io lne too Or!0 any Utnor delay n( -Vona rra r:nrilrn! Illrl
r)hm[)Ae CA Inn. lot.11 hrti),i ly tutgtar tht. eonNuct (e wr nvpl uurlat is limited solely to the amount of tnis eontrtm
YVe are fully ccvcred by workmen's compensation and public liablllty Insuranf,.q Carrier$ narnes and policy numbers available on
fequisi
Any :111ort11't1:1 r.11 duYiollpn frUrtl the Y above soCCl¶Catlons :flyolving extra cost of mdrarial Or Wmr wdl Only hi: exectl9i(i umirl written orders top sanw, ann .wdl niir!nnlp
an extra enarge over me sum mo loonlSd in MIR nrnpORAt Ail ggrti'rttPltilq mlNl tlkt rrriUkt In wllthrnU a^d is basad On (fee ACCf,,s j til hluldlna I'M ihrrltl laalttinrl frn,ll nut
fnrr.M
Fries are based Dn current Galata al(material and labor, Inctnaara nr ner. nga!a. will hp rPBprrnd at rima nl sltytinp 1,rinfract.
eoh+ro and or during roofing operations and the Completion of reeling, TIM Dnnnnn Co Inc, will not be responsible or liable far aamsgo caugnd tram
alta M 064, aedh ds 6arehr4„6A6A, th,..l..,Aw vlv, poll vl only vlilvr weather uvaditivlls tmyund nrutr.ra cnnirol.
I'I Iii 1 ANI)FF. CO. INC.
M
l A'I'k
JW -19-00 WED .12:38 2 FAX N0, 4550212
P. 02/05
*F<L:
.PLAN 1;
ROOF ATTIC'VENTILATION REQUIREMENTS
ROOF ATTIC AREA _ 2,203 SQ. FT.
2203..6.L
300 s.i 7.34 So. FT. OF VENTILATION AREA REQUIRED
•
(1)18'•DIAMETER DORMER VENT + .69 S0. FT. OF VENTILATION
7
10.88 PROVIDE A MINIMUM OF 11 DORMER VENTS,
PLAN 2;
ROOF'ATTIC VENTILATION REQUIREMENTS
.
ROOF ATTIC AREA- 2,.572 SQ.FT.
2572 sl. .
.300 cf m 8.57 SO.FT. OF VENTIATION AREA REQUIRED
(1)18" DIAMETER DORMER VENT n .69 SO. FT. OF VENTILATION
8.57 9.1 '
.69 6.1 12:42 PROVIDE A MINIMUM OF 1S DORMER VENTS.
PLAN.3: '
ROOFATTIC VENTILATION REQUIREMENTS
ROOF ATTIC AREA-' 3,013 SOFT.
s°t_ .
300 $A. 10.04 SQ. FT. OF.VENTILATION AREA REQUIRED
-,(1)1S- DIAMETER DORMER VENT a .69 SO. FT. OF VENTILATION
.69 s.f. 14.55 PROVIDE A MINIMUM OF 15 DORMERS VENTS
p,ACy r
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02/10/2000 10:56 9357360018
Installation Certificate: Residential
STEEL T L S —7
Xo4 Ai ,.
' .. .,11.••H• . 1. ., 1 '.4 r fit'
Use sl Chia lernl vo asttsty uw requirwwnlu at>sl. AdallrlisesftnC de V apUe Nuttre iMallwstaolttanutf p+ Y iiwtl!!
L. ' 3t `i - : d 1 Q r 1- H X19 0 •'Y s9:
to Adam" "`-'-•••,-•-'•• •-
An inal"ion oeruf ka s Ie required to be posted d the binding site prior to tJte iia Mna M ft t1no pMlhk T1rr ftten
may be used to moot those regulrsmoatL AlVIA s Udell beiow Weft ndud bWd1s Mop that
the offlclenq and type of the applattoe ti30drtgpibrt6q prbNtK1ha111M tpr011idOQI}taOsf d
CompWma (CF• t R), Thle conMims (arks equty kM tthaa k» ptepwW and aiprdd lby tyle vM fol +0 oreraU
responsibility tar the appilanoe InstaAation.
1, the undersigned, verily that the equipmerd Aded in the adep y a)otn Iy boo aioatN egt plltelit atda sd amd
that the equipment rneots or exceeds the ngI*aMwft d the Appila= $lesldllt I in 1116illia 1 Mw vow lftat
the equipment r equeraisnt to or more effideM than the equlpnterd spe0it4d I-Im c wdl wl d Colttat um euftrrdmw to
damonstruo aompilartco wr:h the Energy Efficiency ShwWards for resider410NEWMI1911.
' HVAC SYSTV 4c
Note: HyEronie bol►or Informasion is entered hare, 00w hydropic or oomWned hydro* equomit is Wed Ilttder
Water Hsoting Systema,
Heating Equip. CEC Codified Aosta! OlstSf icitittA Omer *MV Load Mead
Type (turn&=, Manuf. Maio d Etllaletwry and " '4i"'' lklm Ow.so
haat Pump. str 11oda1 Number IAPUIL .eat t .• .r .. d .a. au. ..rew.rt
CEC Cent! lad
Cooling Equip. CanWsaaalr Unit
Yyps (sir wnd, Mimi. Make i
Ave Cite CIL iA64
T-- 1%
a
-: • .,... t %/frog.
The building design heat baa and design hostQsin rOa have been datmined using s In Bodied w(h) of
the &ow ENldwo an
Std are two of tyre G*wW used far equipn" sktk j WW se 0066
06 La
e Oatr NVAO Subat*sear (Co. Mama) er tllerlar ConOreagr etr Owner
WATER HEATING SYSTEMS
Water Heating c1c Certified
System Type Manut. Males i
(storae;o qss, stet Model Nurnhsr
t. Far swaJi ipso owr■Qo (load inputs 716,000 suit okei is reektorloe snd had fart Pwwb4ow%54 Pow.
Far WV poo stonpe water hsetm (plod input *74000 IlUt4 Irl Rosrd Impel; Paaowrf► BAiOfs w ww f Len.
For huunurwous 1ps waw hesua, tla pjwd frVA and p4anty Idgdorloy,
For lnotantarleoua decvW wear hestlye, Irl Retell VVA
FAUCETS & SHOWER HEADS
AU falx ots and showorheads inswod are Astod in the Commkasbn's birecdory d Oerstlled Fasiosb ttrtd b'ltotlrerheude,
pursuant to Tdio 24, Part d. Subchapter 2, Section 111,
m"a"r els ttlurnld„e @o+tMarNl M tisrwst Caar/M QM71e1
e.rlssr inwov It #I
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WESTERN INSULATION, INC.
4211 Latham Street, Riverside. Cdifornia 92501
.
' TO. "9) 1568-8760 Fax (904) 886-8786
INSULATION CERTIFICATE
THIS 15 TO CERTIFY,THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORMA ADMINISTRATIVE CODE, TITLE 24,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACT / PHASE: AUGUSTA 0 PCA WEST, PHASE 2
LOT #: 31
SITE ADDRESS: 57-221 MEDIHAH, LA QUINTA, CA
.._.
--------- .... .............................................
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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 L CONTRACTOR: TRANSWEST HOUSING, INC.
' O9
LICENSE NUMBER: `7 oBY:
f5Q
TITLE:
,.
DATE: cD 1 3 r aC -
INSULATIC)N CONTRACTOR WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
`
TITLE: PRODucrfUN MANACER
'
DATE: FEBRUARY 11, 2000
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^^n . aM "`w •Y-fi"'*, "' '.'*'"S?t° "e'...-.... . tee...... _ .p„Ly..:. .-.+:.-.yts7^,•, o-tv.r ... ..... - r„ 'S -r. .+...- w. yµ 'L a1 r.F... .. y .... ,,,.,,..-..... .,.. L r " ' . sT
"' .r '. 'e y rr. '` .7 ' .x" 4•„ _s - y.,•'' sC .r.;¢/ `_- .'.r, , . . "{r Ir ,
a ; y :._y 7++»._.ni 7 i N'r L ,'• w .`,• `f s L . t ` ' ' ( t "x. ,.., . ! }.• r: + 'r L.` , 4 M t f
- ._- 1 9A :•4 .. 1 4 .. ' 1 r*'. l ' - , n S t * 7r V [P
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of , Quinta
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Buildirig;4-atid S-6fety,- Depart en_t OF
This Certificate issued pursuant -,to, the'requirements"of Section 109 of the Uniform Building Code,
;certifying that, at, the.'.tirrie:of issuance, this structure was in compliance with the various ordinances
of the'-City'regu/adgg bui/ding, construction or use. For the fo/%wing:
BUILDING ADDRESS:' _"'`r;,: , -6 r:` 57-221 MEDINAH
Use Classification:' SINGLE FAMILY DWELLINGg:
Bld , Permit No.: 9904-181
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: 2/24/2000
Building Official
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POST IN A CONSPICUOUS PLACE`
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