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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
iv1039 13 01; 31;Mi
Date'" 2 .1-1 r 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).
( ) 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
ruction 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.
a):i 771.7, l3 of I,J}'y}/ n�,.f 1!)•y,�Jf13.� 1
(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 r'I
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) l r f- fn Date- `f
BUILDING PERMIT PERMIT#
'�3t05-222
DATE VALUATION t o� !„3 LOT TRACT 28410.2
JOB SITE
ADDRESS'
APN 7.j.tar-�.�►
OWNER
CONTRACTOR/DESIGNER/ENGINEER
till,
I OUK"INO WC
75013 Hyl` "if 3 14
rb-401 V Hls;iIMW Ji 1.
KAN 13180) CA 92101
l.,A Qt.JiNTA CA 1.42253 .
{f1)�1tSi's"��3iEj3 MA' A' 4072
USE OF PERMIT
Si!>3i3t,f]t Hj'�Nlij..v174r1
4471D - KW4 10R, LOT it, - ..110WIT'1;JtJ!«S NOT !?tiC ILJOH-13LO1: K
Vs+srl.t:.LS OR P(X)L. PLAN C HkC K f'loJit'i ION C1! H,:E 10i0Uu3!1) 761"d 110t2
14fiJ3..'J:'!k't1.43.3:t`,,s"tTA;iJCR OF SAMts V1 !tN T Pr3.
teV0 ' N l,.`JLM.3.t�4iJl...l.f:1�1'VS .i Z3.f DtJ S
11,0_KC1VPA.t10 408.110 ,F
R� � A1�7.i.�'�d•.Y. 6 Bi 1..+'LY>5i F� .,49.'� •itjlVc9" .'YiisC,,rd aJ}V
1 as, 1J I.'II 1
j �j j �� y iq /�
PERM�1 A.i EE SUAI )7I.l RY
GUNS T'i7.tlrC TION V34,F 101.4x313-4183 ow $951.00
PLAN CI-it»CiC, t:'t-T i(8Y tNH9;�4�0-i1S 1<PV';'7d
;tfrt't1Ai�tt A,. i"f 3 7703 WO -1121. 7710 5160 full
fttEkrfRI AL FIX- 77(1.1-(W4210.00 S14;*.a3
Pt I I I ANIB I X(1 t_HC 114-f1fJO $166.00
q'Ti 0140% M(YrVONN 41 _ R afto {.t)1-1177111_').1{ tit►(! 5 tsa fit
(;.12,11 INC MU: lti1. fit?Q =iF3'C1tTi) twft.tifl
HOA.AsTituoi)klt i'iB 22.5.00443'34 N3,I.)i3.J1
jR3aT JN PILIkt(AC P1.,MA,-'S - 3ik;Y3113 771.13 -W)-M,000
iii 1k3 -TOTMr C'r,)NK'C1Ci.{l'"f701I-t�' MOP) .t -NC OI! K
I't"Yf};AL ii'VMMIT FKM 0111+: NOW
:55,06.22
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
I
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs Af
Underground Ducts "
Forms & Footings if I
Ducts
Slab Grade 4,1
Return Air
Steel Ay
Combustion Air
Roof Deck jf
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
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PI . Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines yHeater
Final
Water Piping 7
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
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)
Av-11-00 12:30P HOME CENTERS INC
r..
0
HomE-CENTED16, INC.
Corporate Office: 11838 Sorrento Valley Road • San Diego, California • 92121
(858) 755.6636 • FAX (858) 755.0801 • Contractor License 11291673
Orange County: 22343 La Palma Avenue 0111 • Yorba Linda, Calkmia 92687
(714) 692-1270 • FAX (714) 692-1578
Palm Desert: 77-582 Country Club Drive, Suite D • Falm Desert, California 92211
(760) 772.3555 • FAX (760) 772-3557
Las Vegas: 5070 South Arville Street, Sults 4 • Las Vegas, Nevada 89118
(702) 871.7575 • FAX (702) 871.7992
858 755-1246 P.05
3104 '
CASH ORDER ❑ ADD TO LOAN ❑ BENCHARGE ❑
WINDOW COVERING ORDER CONDITIONS
M.C.I. to proceed wffh measure immediately. Homebuyer is responsible for all measure charges. Cancelled orders will be
subject to a tlRy (U) dollar proem" tics. Additional charges may apply. See terms and conditions sutsments.
I understand my order Is placed an hold until home loan approval. Should 1 cancel atter loan approval, I am responsible for any
and all costs incurred with regard to the processing of my order. (This condition applies to all orders regardless of deposit or
payntartt plan.)
®I would like my order processed as quOty as possible prior to home loan approval. I understand that should I cartcel or not
receive home loan approval, I am respor ible tar any and all costs incurred with regard to the processing of my order. (This
oorxftn applies to all orders that include a minimum 50% deposit.)
®it using wsfomers rneaaurentents, KQI. will not be responsible for measurement accuracy, and H.C.I. will not install
products ordered from these measures. No change orders wdl be accepted regarding installation.
Final metartal and installation charges may vary based on actual on site measurements.
aThle Is a ctstom window.ftatment order. No change orders will be accepted after receipt of deposit, Balance is due prior to
Installaltlon union other Inanclal arrangements have been made.
APPROXIMATE DELIVERY TIME
BLINDS — 4 - e WEEK$ FROM PROCESS DATE as defined above.
SHUTTERS — 10 -1$ WEEKS FROM PROCESS DATE as defined above.
DRAPERIES — 8.10 WEEKS FROM.PROCESS DATE as defined above.
WINDOWS TO BE COVERED IN YOUR HOME INCLUDE:
9
WIN®OW COVERING PAYMENT PLAN
SALES ORDERS) 0
of $
0.
$11PEOIAL I NSTRUCTIONS
SUBTOTAL $
MEASURE CHARGE $t—
SALES TAX
INSTALLATION CHARGES
$
OTHER CHARGES
$
TOTAL SALES PRICE
$
DEPOSIT AMOUNT
% $
i/ -% / <'n
BALANCE DUE BEFORE INSTALLATION 3 l T cm"f i oLci
METHOD OF PAYMENT: DEPOSIT BALANCE
I have read all of the'Statement of Terms and Conditions' and I understand and accept ftm. The above order conditions; charges
and payment imms aro acted by buyer.
BUYER DATE
f
SALESPERSON
M3TRPWn0N: V*M • FLOORING FILE CHARY - DRAPERY FUZ NK • CUSTOMER DOPY REV 10!99
04/05/2000 15:14 9097360016 STEEL T
PAGE.01
Instailation Certificate: Reeldentlal
Us@ of We term to satisfy Um mqwjrM ui of do AdMIMSbat"C'"o I$ epti&u4b"00
Me Addr*"
AA Wirtallation cortftsto is roqWrad tabsp*lWjdftbUiiftd0MWf*ftWVLM-d
::jIVj;ALN* rAjj9Qrj*8 IldW bl" We
m" 156 used to Meet those requiromords. AN
the offidancy and " at the %)pUanos lIMtW 6WM"wb6WV= a it
Compliance (CF -1 A). This c*rWjc&w (or its oqWv2kM &W tle pMpM acid dpi Oman
reapoftsibility for the appdanft KMaHWjQ&
t, the
thid the equipment ingots or exceeds the MqWM44M Cift Apel{ = SWINWIdL in' v4r6d OW
the DquiPmOnt is OQUIVaWrg 10 Or more student Ow the squipmrd 134"Mmed. ItAOX4410
dimionstrata cKwmpUncovAh the Energy Ok"ney Slowsids Ear r* $nWbWjdkM
Few ZAW C am
HVAC SYSTF-JAS
Note: H"ranir. bolter informMion is ordered her*. Mor homoc or cowbhW hydMtjc spowt ieuw . utwor
Wicof Heating Systems.
Hastint; Equip. CEC C-ortiflood Av" DlowmatIon
Type (lumace, MoW. Make &
7 L TM
7'
Srd- L To. 400
w I Z. vQ*,w30
CIC Certified
Cioollng Equip. Campiviamw Unit Ago— Distitibutlan Dud or
Type (ait Gand- Manul'. Make L 011011"" raw and
h*&I punto, str-I Model Nurnbw 0wh
Im. C,6?4 Ct JA-'
1.%.& •S6 IL
The building daisigj heat loss and doWan hold 94M raw Imwe been determined using a maMoci iWocillied In'soolkim IsNh)'Cd
the EAOM two of the cirkerin umd for equipment sitting wW sebudzu
-els'
Ob -r!
Dow WAG &WwnncW(ft Hittllts) wGwwW Cwwww womw
WATER HEATING SYSTSMS
Water Heart 'tg CLECCoriffied RaWl Tank go -gar
Byrum roe Manut. Usk& i IRWA fkw Cat omw asagnon
1. Foram" gas stomps (wed Nuts For 7g.ogg RA". WeWb MWtAngo, arid hW pap --@W hoofts. bt&Mk* Psclii.
Far inwanuwAww sais waw hestm, fat PAbd kox wd PAcwoq eadwdy.
For knotanwomw decblo wow beetwa, %I pAsd bp&
FA UCVM & 5140WP-R HEADS
AJ lawsts and showorhoods Instail6d are Wad In the C4mmj"jw-j DWOW f
,d C&RMW pufosta WW WWWL*qa".
pursuard to Title 24. Part 0. Subehamer 2. Section 111.
Paw 114unt" arms wdMwow too. "ww) w Gorlwal 0 1-- or awow
Rwrie"44"
APR -06-2000 15:45 WESTERN INSULATION 909 666 8786 P.O6.'08
410N INSULATION, INC
4211 Latham Street, RiV=Me, CdifbMia 92501
'ISL P909) 686-8760 Fmx (909) tt86.8786
d
YNS T N U z
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- TRACT # 28419-2
LOT# 11
SITE ADDRESS: 80.545 CEDAR CREST.
MANUFACTURER: Johns -Manville THICKNESS: 3 1/2" R -VALUE: R-15
CRILIN98, BATT SLOW
MANUFACTURER: Johns -Manville THICKNESS: 13" R -VALUE: R-38
+GENERAL CONT ACTOR: TRANS WEST HOUSING
LICENSE NUMBER:
BY:
TITLE:
DATE:
IRSULATI®i� QQbjTTO8: WESTERN INSULATION, INC.
LICENSE NUMBER: 481278
BY:
TITLE: PROD C ION MANAGEFV
DATE Aoril B, 2000
Certificate 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: 80-545 CEDAR CREST
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9905-222
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: MCCOMIC-SEOKTOP LLC
Building Official
Address: 750 B ST STE 3140
City: SAN DIEGO, CA., 92101
By: DANIEL P. CRAWFORD JR.
Date: 5/30/00
POST IN A CONSPICUOUS PLACE