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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
70 10339 11 G161i2( i
Date ' 4� 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
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).
( ) Lam 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 ) 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.
1 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 T Policy No.
f►i } 1'1: t tJiV1� iii 1•.s�l••�iff(i���,,�ii}
(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 provisions.'
Date: ) Applicant j - a- _`
r 1
Warning: Failure to secure Workers' Co4ensation 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) I P., Date
BUILDING PERMIT PERMIT#
J 99u.4.22a
4I(}
DATE VALUATION ^99.20 LOT TRACT IIiJOB
SITE
ADDRESS &"25 CCDAR �.,TZ�°J1v I
\..
APN
71".".6 15
OWNER
CONTRACTOR/DESIGNER/ENGINEER
Ih ,1CCO1�ITC- C�"/1KILIP 1 1 C
1{i 4J{ t 1, p. A a.l{ 1. mar
'. f" • NIS WF."T�Y/'li S1 ATG Tc
t ♦Ill\{f {..• ,l,/.11 11• , 1
1-10 a 5'I' 9VE 3't -i0
7'3-401 F IIIG11WAY t I i
SAN 011-610 CA 9.2101
LAQUINTA CA 422'53
(tii+•�iSS?-1)Ii){ (111.0 4972
USE OF PERMIT
ii NQUI, l7A14141,1" I.)�V I..F.1tV�
S1Tu - PLAN 12. LOT x, - iota &Tf TX CS.140T ll-Mu%i 11 P11K WA. S
+,.{K P _4Jt.. PLAN 0I6(X 1K.4CCION OF FE1? tckilXt A-1) 7 w: FQX A401.'I'1P1.is
I iSUANi.'1 OF SAN16, KAN 'rV PIi.
CJ 1 _14,01M CIONSTIRU`1 1111014 3.013.(10 ISS
ilGttLii,4'A'1'iu 3w5.t�u f
ti}i1tA{7ka� +�f'f iltl' 61K1.tfts .`.+1•.
\'w�{.�ftfl •A NIL \.i.��,Y- • �.?'!I` i..VL't {ll f k4t.'l. 0 JM.►t�
%CA -Ina yin
l 1'.1���'11' � il.�i ♦7 Lt lY1L�����Y
CONSI'MA7110NFUH IUI-(>ll(?-dii�-U(!(i 5f,1t18•t►t1
PI, NN E IF1-' 9 F PF: 1011-("-439_119 1239. CA)
NI CfIAl"41CA1JI1 , I0I-00)0-421-000 3124.00
lUX-CTRICAL FEM 101.1100-11204)00 S174.94
PLL►M ING HAt 101-U()U-•tty-(}(x) 5E+'2.:w)
11Mc')td1'1 N1 10PON FE;F? - R!7S1{:1 ! O1-cifN1-?,a ).n{xI gF s (18
';%TUU)ING V111 101.000-42:1.0110 3::00)
INr'€ AN-I'RUt 1U12EHIM 2Z3-1140- d:�-3d2 55, �i .64
AWr IN Ai! 3LIC PLACPS - I(ESII'l 701-000.2_5+-000 3:S7G!A9
• rr�
ST 1 i -'ISI A}.�,f)NCTI:UGTIC)N AND PT AN (:'HECK
$7.96667
I.EStl PRII-PAM FEES
V),00
TMA1.1PKIRlt IT FERS DIJI, NOW
$7,866.47
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
C
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Combustion Air
Roo k
Exhaust Fans
O rap
F.A.U.
Framing A
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
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
Gas Piping
PLUMBING APP OVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans J
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection 677177
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
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)
�4f p:+/ 2080 15:14 5097360018 STEEL T PAGE 04
Installation Cartificate: Residsnttal A,AIj 3 CF414 .
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M h MA"n nrtiticus is ngwmd to oe pasted a s the
M" ar +0 olle to the bstwta d f!q t tftla bnn
mbe wed to mmol there MCFArerttetlb, Alttrto� bbd b*w w fhtl so w e�ulptstatt fM tttia
wpid
eenry end type of the appGarlp ind.Md m; h� w bMgrti ate �pp1�11o� �p b- aft cowim" of
Comolam IGF-I - This =dim* (a Mp v(b 04*W wW end 4IWW bj i jii" mUFft owrd
raeponaibiaty for tha tappUartoe Inald-
>, the wwomipnpd, carry OW %# rat Mod In dw casm sbm asEnkplrl► bvw ttraf+Itl egttlpntNt fyt�afbd and
tl+st IN evvoment meets or atow�ngnbentetltk d #6 AppIW� RN
b sd�lon, t Moan tMflMd that
the equipment b squivaWto to or more ellldertt iltart yq eqy opoaMiad OA CMMedC011�bf104 twbat�dd 1e
46monttrsts Cornvliance with the Ewa UWmW Stnndvda for rerlidettlW bdldiltps.
...
Nile: Hrdt4nq bt>♦ler wormobn is enterod here. Wer *mnb or oo MWW hydrorda eqt* wt N Med under
WNW He" sya.m&
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•Type (fWnW, _ ' U4nvL MW* 4 UlmlYmr tVMA"
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the i:i+erpy rwy St rand ara two d Uw eteke" ""for Ntiptnant a1�i p a "W" M �IOA ISO(h) of
Dm MVAC ftitioa! mm (Ce. Nfiw* er tf I MM O R ism er o*w
_ + :,. � '+'` ••, W4TEii��1EATIN±� SYSTEMS • �,�. ' , -
<z"�16
Rebdt Tank wear
SyatertlYjtpa Yanul.IAUce ktmlkW Canal Itaa�raee
t. For &"a 94 slenpe (tow'•rt!>utt hi.000 @kft deetr s nwoWroe and heat puwp WNW bwW%ld&WmlFow
Fw bnR flea trtwmw enter heetere pard mpg *M fie% a il�d ;;; it @mmy "Glow and away IBs.
eo
Far W"Maw PS WNW hft&@M 161 PAW
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for'AMM GAMS eteeMe waw k"W$, IM AWd kWA
FAUNS i S"QWF.R HUM.
AD tatraoct v4 &?Morh"" i OWW am Mad N tea Commi"W'o Dirsdoy of QS Mod Fwxd, and 8howerhead:.
PUM" t to TNIe 24, Put d, SubomispW �. wagon I 11.
• ' ttbnra+re . tiw • N�q Mi►ee+MeYa►(Qw t'1rM�e►dwrw.t arr,eet««ANrw
' , .�. M�Nr�MMiwr �aR � •
M&-r.-1G-QO Q.7:52A TOM WHITE
lY f The'"'."banDee
G� any Am% iic 732.542
ROOFING ANO G-ONSTRUMON
P.O1
Roofing Proposal
P.O. BOX 277 ThMI&Wd lea/ms, C'A 91276
Phone (760) 343-3385 Fax (760) 343-3096
BI,STO : J0R NAME;
TRANS WEST HOUSING, INC P.G.A. WEST HOMES
70.401-F HWY 111 . P.G.A. WEST (PHASE 2-8)
LA QUINTA, CA 92253 LA QUINTA, CA 92253
PHONE 771.3363 � FAX 771-9077 DATE 2.15-00
T1i"Bi UEE COMPANY INC. HAS.1NSTAL49Q- 9.R00F,,.,IQQgM VENTS CORRECTLY, Ad
PER EjyGINEERJV-E E1WJONS.
l i
NOTICE
Undo? 1►te Mechanics, I ion t,aw (i yllrwnra Cods nl GiNI PmneAvro 5cetion 1181 M Fon 1 any Conoactor, euberuamcbu. ipUwut. tuppllM nmttr pdrserl Irc odor to
Improve mut aouaity but is riot paid W n4 wwk a support, hart a right to WWI: a calm against your prour:ity. This maaror thnt. Mot a court Ixanng your prcperty
nlxld bi: Wb by a awn nntnM rMq bw Wocssda of the AaM uAen to aAbsty the indsttleMess Ins Can happen even n ynu heft paid your ?ran r nnu:a;?w hr full . If Ina
Subeorararnrv. ImWo?r a oupploat re?riems unpaid and if Waal action is naMaaary in dr)IIVGt of enforce the rerey of this, Contract, the prMvndwo party shall he arUelen to $6
IrRawillolviol(ioiney feet plus au ems i)I suk and interest shag armw no all owns, which are dim 10dove urter billing at ton rirto at 191A, per annum Tho DenDss Co.
Ino, it not reapontrblo Inr nniayy feuded by weatner, solus. InAtArsd shonapa or delay in malKrui supplied to iris ph rd lu w?y otherdolay beyn,ri its Control The
DanDes Cut Ins rnl,H Iuiti,YN under ins convaq M m nf+OiKMsiriw 14 UrnGad splay,n Ins ptiuunt of n+u cororarr
We era fully,poverod by workman's CoMpbnsati0n and publlc flappity Insuranco. Carrylr* names and policy,pumbers available on
f�ultttL
Any alwalrnn or dgvration from fro A strove ,tpsoMqthwu involving extra emslM,natenal or lobar will only bu crcoured upon wntlen vrdc,s tar sarna and will tv.-conic
Ion utthit chlrgl (lyrtr Inlr surf? ?ty.,nUoned In this pro" All "iquinunts meq be r1LtnA in w'10'k?g end Is hoed nn f,qc across to hudderp low dkty t kwding from oia
trtiaei
PWeAa Am based an urrrent Coeur at ramadvol and labor, Ihoreeaee M ,lesassss, will he Mfkrried at ttn?e of siyniny contrail
taefury And or during roonny "proration and Ore ConlpiMktn of mallinp. The Da11Den Cc Inc, will not be rempnridble or liable for asir mflorrcaiyed from
or•'ts of God, aWh as sarUlqutdras, thundefetorms, boa of any other wWhor condi lona beyond MOWS wital.
Ili ANl?ItL �;p�
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DA 1'I'
DA'11
JAN-I9-OO.WED 12:41 2
FAX NO, 4550212
U7`1
ft
P. 05/05
APR -06-2000 16:19 WESTERN INSULATION 909 686 8786 P.01i01
IMTERN INSULATION t INC.
4211 IBtho= ebwt, Rivmido, oa&rWuL 92301
TCL (9I 696.8760 FaX (909) 686-8786
SM ION IFICATE
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24,
SPATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
TRACT / PHASE: AUGUSTA- TRACT # 28410-2
LOT# g
SITE ADDRESS: 80-426 CEDAR CREST.
EXTERIOR WA"S
MANUFACTURER: Johns -Manville THICKNESS: 3 1/2" R -VALUE: R-15
EdU ® ( WATTS BLOW
MANUFACTURER: . Johns-ManvlNe THICKNESS: 13" R -VALUE: R-38
OWERAL �OINTRAC'TOR' TRANS WEST HOUSING ' _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _
LICENSE NUMBER:
BY:
TITLE:
DATE:
INSlBLA'TIOIN CO TRACTOR: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PRODUStIONMANA ER
DATE ADM S. 2000
TOTAL P.01
1. Apr -11-00 12:34P HOME CENTERS INC
HomE'CENTE1R8jNC.0
Corporate 0fte: 11839 Sorrento Valley Road • San Diego, Calffomia - 92121
(858) 755.6838 a FAX (658) 755.0801 - Contractor License #291673
Orange County: 22343 La Palma Avenue #111 - Yorba Linda, California 92687
(714) 692-1270 - FAX (714) 692.1576
Palen Desert: 77-682 Country Club Drive, Suite D - Palm Desert, California 92211
(760) 772.3555 - FAX (760) 7,12.3557
Las Vegas: 5070 South Arvlde Street, Suite 4 - Las Vegas, Nevada 89118
(7C2) 971-7575 - FAX (702) 971.7992
858 755-1246
. = F !L:.,i/iii
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P.
08
CASH ORDER ❑ ADD TO LOAN ❑ BENCHARGE1 ❑
WINDOW COVERING ORDER CONDITIONS
H.C.I. to Proceed with measure immediately. Homebuyer is responsible for all measure charges. Cancelled orders wig be
subject to a tiny ($5q dollar processing Ue. Additional charges may apply. See terms and conditions statements.
aI understand my order is placed on hold until home loan approval. Should I cancel atter loan approval, I am responsible formy
and ail costs fairred with regard to the prooessing of my order. (This condition applies to all orders regardless of del or
plan.)payP•)
®I would Nke my order processed as quickly as possible prior to home loan approval. I understand that should I cancel or
MM" (home loan approval, I am responsible for any and all were incurred With regard to the processing of my order.
condition applies to all orders that Include a mirtimum 50% deposit.)
DIf to tg custorttera meesuremertts, H.C.I. wOl not be responsible for measurement accuracy, and H.C.I. will not
producta ordered from these measures. No change orders will be accepted regarding installation.
Final material and r4tWation Olwges may vary based on actual on site measurements.
Thio Is a custom w(ndow reatment order. No change orders will be accepted after receipt of deposit. Balance Is due
Inotallatkm unless other Inanciel arrangements have been made.
APPROXIMATE DELIVERY TIME
BUNDS — 4 - 6 WEM FROM PROCESS DATE as defined above.
SHUTTERS — 10.12 WEEKS FROM PROCESS DATE as detlned above.
® DRAPERIES — a -10 WEEKS FROM PROCESS DATE as defined above.
WINDOWS TO BE COVERED IN YOUR HOME INCLUDE:
M-- RIP&MIN,
WINDOW COVERING PAYMENT PLAN
SALES ORDERS) e $
0
OPWAL INSTRUCTIOM
SUBTOTAL $
MEASURE CHARGE
SALES TAX $
INSTALLATION CHARGES $
OTHER CHARGES S
TOTAL SALES PRICE
DEPOSIT AMOUNT %
$ 1724,-sn
/-7 -1/— ,C, i
12
BALANCE DUE BEFORE INSTAL0AWN $
4
METHOD OF PAYMENT: DEPOSIT BALANCE
I helve rwW Wl of the 'Statement of Terms and C ondldons" and I wderstarW and accept them. The above order conditions, charges
and payrrw t terms are eceepted by buyer.
BUYER 6A1E—!LLz /
SALESPERSON
t2��—
CMTF#WJTVN; WKW .1LOOVO4 ME C"4W • ORNVAY FU R—NK CUeTOMER COPY AEV IQM
rtiflocate of .Occupancy
City of La Quinta
Building and Safety Department
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 ADDRESS:
80-425 CEDAR CREST
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction: VN
Owner of Building: MCCOMIC SEOKTOP LLC
J
Building Official
Bldg. Permit No.:. 9905-225
Land Use Zone: RL
Address: 750 B ST STE 3140
City: SAN DIEGO, CA., 92101
By: DANIEL P. CRAWFORD JR.
Date: 6/8/00
POST IN A CONSPICUOUS PLACE