SFD (9904-180)57231 Medinah
9904-180
LICENSED CONTRACTOR DECLARATION
Lhereby 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
I r•
701039 F 1/31101 '
Signature of Contractor> -!
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
r 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 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
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:
Carrier Policy No.
S A1T FUND ' ` 03 98-0001'•.,3. 6
(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,
!;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, t shall forthwith comply with those provisions.
Dater:. ! ; Applicant 0 s, _ _ r
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 inspection purposes..,.
/Signature (Owner/Agent) t - Date t j
PERMIT# t
BUILDING PERMIT ,-
s►,:go
DATE VALUATION SM,791.%.aQ LOT 32 TRACT 28410-2
t
JOB SITE y q 1^"' —"`—
ADDRESS ?={3 MEIDINAH
APN ,
76:1114 U -.t80
OWNER
CONTRACTOR / DESIGNER / ENGINEER
A/1CCOmic-swKTOP ux
TRANS WEST HOUSING INC
750 R S.T SIT 3140
75-40.1 F EiIG /WAY 111
SAN' -D030 CA 92101
L A t;,3UI1 rA CA 922'53
(619)557-9193 CBL# 4972
USE OF PERMIT
SINGLE :PAMILY DW81,.LfN:.(i -
SYD LOT ` RiiAv3#24iX iCiLl`; li1
PC?Gi,e~{ir, rv f tl
1
CUSTOM L'014STkUC'I'ION 3,013.00 SF
PORCH: PATIO 325.00 SF
GARAGIVCARPOWf 000.00 SF,
l SfINIt►1'1 D COST OF C`,OPNNFRUCT'tON
2511,795.21D
PERAUT FEE S9JM11r11ZARY
CONSTRUCTION rEO: 10.1-0110-11.8-000 S.I.,k i13.Ur3
PLAN CHECK FE`I3 101-000-439-315 S957.V9
MKWANICAL FFE 101-00042.1-001 $124,00
EI,FCTP.tCtkL FEE 110.1.000-4220-000 $17 k.96
PLUNF, INC,.F'EE 101.000-419-000 S19w. U
STRONG MOTION FEE - RRESID 1,01-000-241-000
GRAIX.ING FTE 101.000-423-000 20.at1
1*-R..kSTRUCr.Cr12E:SEE 2'2S -W0-"3-342
t►Wf 1N PUBLIC 1 PLACES - R'ES 70IAGO-:3.55-000 $376,99
OR
F• ' r71.'.1.DTbJ iP\L CViYU A L tOl. tdtJdY -AND PLAN CHECK
ti,385..1C
LESS PkF-PAID FEES
$0,00
6
I
.•tel TOTAL I'ERINY1<T FEES:DIIE.NOiY
S0,385.I6
JUN 161999
RECEIPT
D E a .a ;'•
BY"jl
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs oe
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck XAVW
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 6
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
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 /
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:
Feb=15-00 08:33A TOM WHITE P.02'
of
The ]DanDee Roofang Proposal s
y.1hKeCAunpook.. : L /C 1732542 P.O. Box 277 rhtsuoarrd Pa/ms, CA 92276
ROOF/NG AND CONSTRUCTION Phone (760) 343.3 385 Fax (760) 343-3096
BIDS TO: ,JOB NAME:
TRANS WEST HOUSING, INC P.G.A. WEST HOMES -
76-401-F HWY 1,11 P C A WFST (PHASF 2-11)
LA OUINTA,-CA 92253 LA QUINTA, CA 92253 n
PHONE 771-3363 FAX 771-9077. DATE 2.15.00
O-HAGIN ROOF DORMER..YENTS
THE DAN DEE COMPANY INC. HAS INSFALLEQ_ ROOF DORMER V11TS CORRECTLY,
PER ENGINEERS SPECIFICATIONS.
t
+eL4.T.!GE
Under the Mecnanics'tien Caw rCalromia r ode of ^IViI (4rx.AAU.'n :i1MhOn I Ifl1 At Seg ).:1nV ollttaG1or. SOtKOnlriGlGr, !socia,, scnnher,llMrr p: rain h,} n,;10n t.r
InrI your prmmny hill is nnl poll kx his work or aupplioa. his a rigid to enkirce a daim against your prnpoortv 1 his mol ns th, l. Ortor a wu,t hearing your p,operty
cuuld be Wold by it court. officer and the Oroceeds of the sale used in gatlgfv the in<!Rhlennwaa I his can haPuen even it you have paid your own rontraetor :n iia it N;•
SwicOnrrx!pf. onnf'r nr suL10hi;r ruttlihna u0u0ld 010 If 10901 Octiun is necessay to collect or enforce the IAMIg of this M)tr0Ct 111Cprevaill"y Par?"/ shall tw entitled to itt
ruesonable altorney fees plus al! toss of I?uit and Intens; snail accrue an all fitlmg. whim are nuR :1n d:wail. s Uric, billing at the rate at 1d pw armum Thr OanOee C&
1116. ID IIV; rtnxyprtrtu,r ful urrdyti cmlater uy mimlM, nose. a H:M.nnl. tiunolgit•. (v nriyy In rrlinencl- suDPiteu to the loo or!0 any otnor m,Ay nF-Vt) n dR fn11Vn! I Gf,:
Nrloote Gn Inn. lot -V hgbihly kintlrr lh:t• is ti7gl,WC-rl u ib llinitud solely to the a410unt of INS contram +
We are fully covered by workmerrs compensation and public liability Insurantie.Cpfrlel; names and policy numbers available on
req wet
Any illlei_llt'tri coo ry v-01itin frurn the Ili abum smul!lcations ;nVolvin0 extra cost of material 6r IAMr'wol Only hie Axecte.mi Upt?rl Writtan Orders for Lanae, ann wdl nernrnN
.an axva 0narcte Over the SUM mk^IIOnA0 in irim 11 OpOBAI All Agr0F.-,1 U8 n1101.tltt miit,k, In wlithrrtg rd is oasad on tie flcrfflg to hluminn fol ihtrltl In;litllltl ff Gin ill li
thmh!
Prices are based on current coats of materiel and labor. IncfVAR('A or rtervaePs, will hp rpflprfpd et rima nt V(plinn N.tnfmr: t.
laohno end or during roofmg operations ana the completlon of rooting, Tit* Dnnnnr. Co Inc, will not be responsible or liable lar damago cauern from
AM AI cad, Allah as 6a11hy,taAAA, flti,, .ln,vty ote, hall vi viol vtlmi wtrathar 6vunJ1tivrts trtxyund mnrfrra control.
l A'Il'.
t)n Ili
I I II: I ANDFF. CO. INC.
r
J W-19-00 WED 12: 38 2 FAX K0. 4550212 P. 02/05
4a l t ,
,.
PLAN r1.
• .
ROOF ATTIC VENTILATION REQUIREMENTS `
w ROOF ATTIC AREA = „ 2,203 SQ—FT:
2203 al
300 s.f . • 7.34 SO. FT. OF VENTILATION AREA' REQUIRED
DIAMETER DORMER VENT + .69 SO. FT. OF VENTILATION
'.6981. 10.68 PROVIDE A MINIMUM OF 11 DORMER VENTS., .
PLAN 2'
ROOF ATTIC VENTILATION REQUIREMENTS
ROOF ATTIC AREA= . 2, 572 SQ.FT.
'300 s.i m 8.57 SO.FT.' OF VENTIATION AREA REQUIRED
r ((1)18" DIAMETER DORMER VENT a .69 SO. FT. OF VENTILATION
8
•r 'r ei C 7p, ..57 8.f ,r 'j•
..
69 8.1 ' m 12.42 PROVIDE A MINIMUM OF 13 DORMER VENTS.
.
PLAN 3: r
Vis.'' : ; ,, " •
ROOF ATTIC VENTILATION REQUIREMENTS.
y ROOF ATTIC AREA= 3,013 SQ.FT.
3013 s f _
3009.1. .10.04 $O. FT. OF VENTILATION AREA REQUIRED -
(1)18" DIAMETER DORMER VENT - .69 SO. FT. OF VENTILATION
89
.
.69 s.f.L • 14.55 PROVIDE A MINIMUM OF 15 DORMERS VENTS
.. ..
PRcly/? c
q OF CPJ
PLA1 13
GadL '•
ul"
01/10/2000 10:59 9097360018
Installation Certificate: Residential
STEEL T 6
9
% PAGA 4
C.r4R "
Uta of this form to asushe etw esqukaRIA ns N the AdedNeasthraC"O la eplleea6 bma tt» btfanaa*0 Carel M }h+rl/oi so>i Pam
L.®:± 44-- 3 '1, _ 9010 i Bum -
t• aa
An installation aarti love is required to be posted at the bui *V tits pt10t b taw I:it d !M PMLL Nota m
may be used to moot those raetuiramarrta. A! app6mm $I bibiM ih 1!M a) tp1all
too etfidency and typo of Ma appga++a In;sWbd roust be ra or bWW thae do -p1ft t pt d mom Cermet of
Corn*nee (CF -1 R). This os4k ta (or b wAdvsifant) bo pmpwad fattd &OW as&VIIIN CAPITA
responsibitfty for ttte appllarwe installation.
l the and a ra fined, verity the the agtriprnsett Ided In *0 OWgwy above m)► alprM= It Ow Now d
that the equipment meets or axceeds the rsqukernw t d the Appq M ETN" SIVAt FOIL In hm tirellsd startled anStat
rho oquipmem w equivalent to or more effWsrtttttatt tato equipment apodllsd cm Oan!lactda of Cernpalaftoeaubmiktd to
demonstrate aampliance rwdh the Energy Efttdency $W4srds for residemW bulldklgL
HVAC SYSTEMS
date: Nyomnio boiler informaylon b entered hum, OMw hrdmrtk or oo nWned hydemlbegtripmsrtt m IWrad wwdaf
Water Hsating Systems.
K"ting Lquip. CEC Carttlled AdtW Oturowtaon O"w LOW Nw
Type (furnace. Manut. Make i EJttotartotr Tvioeand pbsm aeloraovr• . &P
u
CEC C.rtttied
Cooling Equip. Qwnpresaw Unit Aldred awribs can Dim w
hiyp/ (au mid.. Mode •Hun bN EM Lbbodan APM
Ate- CLSAH rLo .
• t
it r
Tho building "n host lass and design hest pain rate have been deasnelnrd using a ntarhod spsrd6ad In eeetlon 150(h) Of
the t:nMw ^sy St v and are two of the triterfs used for squipmerd sking and selso ion.
toe S ird ' we •
ti+pnaain Dan HVAC Sulwnaor (W. Astmm) er t3WWW Gw m=r Owner
WATER HEATING SYSTEMS
st—I Rtttafnal
Water Heating CEC Cartif led P.Swd/ Tsnk ;=wt Tank
Systam Typa Yanut. Make i InWwt(kW Capselh Illenibv vmwmn
(stooge get, etc.) Yodel Number or Otuh) (gallons) ®ttmae t►s Ids_ f I kVdus
1. For small gas storsaa (ritwd inputs 75,000 BW. dnwio rwaiartoe srd hast ptrmtp aster kestem !bt betw Fatal .
For WV gas atorega vtretar hwtan (rated hput s7ti = Bk tr), list hated Input AMY BIIlalenq rid ftwhy Loss.
For Ins oftnewo gas wauw hasims, let Raid Input and Rma V lif Aishay.
For Ina artwoows elevate water hasten, Get Rated kW^
FAUCETS & SHOWER HEADS
AI taunts and showrrheads installed are Gslad in the Commitaion's Direclaq of CoAlled Fwa tt ani Shorwrhaads.
pursuant to This 24. Part 0. Subchapter 2 section 111.
r"Onewf*
Owwa" Jr.w,'rn
osis
trtwnelp euitoan*.der ter. Mavis) arawww Cee unw er owes
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: AUGUSTA @ PGA WEST, PHASE 2
LOT #: 32
SITE ADDRESS: 57.231 MEDIHAH, LA QUINTA, CA
. EXTERIOR WALLS: ,
MANUFACTURER: Johns -Manville THICKNESS: 35/8" RVALUE: R-13
CEILINGS: BA7T5 BLOW A
MANUFACTURER: Johns -Manville THICKNESS: 13" R -VALUE: R-38
GENERAL CONTRACTOR: TRANSWEST HOUSING, INC. .
LICENSE NUMBER: —70)0,39
BY:
' e an Aj
: 9 K—
TITLE: S es i o► Q.: a
' DATE: X
INSULATION CONTRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481276
TITLE: PRODUCTION MA AGER
DATE: FEBRUARY 11, 2000
•
-an
uertinca
fflw lff
6 f Occu p
City. ®f La Quin'ta,•y
end .Saet . ®epatnentoButiaing
This Certificate issued pursuant tolthe requirements.of Section=:-,1'09rof, 'the• Uniform Building Code,
certifying that, at the time of issuance, this structure was inompl. ciance. with the various ordinances
of the City regulating building construction or use. For the 'fo/%wing:
BUILDING ADDRESS: i': 57-231 MEDINAH
Use Classification: SINGLE FAMILY DWELLING, Bld 6' ;Permit No.: 9904-180
Occupancy Group: R-3 Type of Construction:. VN Zone:.'., RL `
-.. - • • r •!t _ . Thr' • 1`' ' ,
Owner of Building: MCCOMIC=SEOKTOP'LLC . Address: 750 B;ST,STE 3140 {
'' _ • . ' City:SAN DIEGO, 'CA.,, 92101:
By _ DANIEL P CRAWFORD JR.
Date: 2/23/2000
Building Official+ 3',..,; :, x•= '
POST IN'A ,CONSPICUOUS. PLACE
,_ f 1 d 4 '' .. + , . ,• .. , ri _..I' . G1s 4t]hd t t «..s.. .. -1 ti.. `i
r :s.-.,.-:.Liti.+ .isrri;:..:i..•.+...`. .::.:.irs.. - ..,Wtr..,..t. »,.r:Ys s.S: ._« ... :.;i...n•.4+..s a:.:+l.