9907-322 (SFD)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 Busiress and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
Date 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
perf_once 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.
ti; )Vt1i..,�,'I1-(It's Vr.'.ty01.WIi,7
(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 proves '
, ons of Section 3700 of the Labor
Code, I shat forthwith comply with those -0 rs..
Date: 490 Applicant—
Warning:
pplicant 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 R permit Sruhject to the conditions• and restrictio* Set forth Qp 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 i sppjection purposes.
Signature (Owner/Agent) s` - Date p
,PERMIT #
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RECEIPT I DATE I BY i DATE FINALED i INSPECTOR
VA 041 X#
s.IJ,Ss�m—Glh.3
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
0. K. to Wrap
f
F.A.U.
Framing
�-
Compressor
Insulation
/, 6
/
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
�
Drywall -Int. Lath
C. en
-s19
Final B/
Final
—.� —o/
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
Gas Piping
PLUMBING APPROVALS
Gas Test
Waste lines
�`2O
Electric Final
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
%— - O ( /1
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)
�j
WESTERN INSULATION, L.P.
4211 Latham Street, Riverside, California 92501
Tel. (909) 686-8760 Fax (909) 686-8786
INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CGDE, TITLE 24,
STATE OF CALIFORNIA, 1N THE BUILDING LOCATED AT:
TRACT/PHASE:
MIRAFLORES/PHASE 2
LOT #:
47
SITE ADDRESS: C_a:«
;__ 900RO.SEMAR_Y_ST-LA-QUINTA,-CA
----------------------------------------.---------------------------
EXTERIOR WALLS:
MANUFACTURER:
JOHNS MANVILLE THICKNESS: 3 5/8 " FI -VALUE: R-13
CEILINGS:
BATTS BLOW
MANUFACTURER:
GREENF/BER THICKNESS: 10.3 " F -VALUE: R-38
CEILINGS:BATTS�
BLOW
MANUFACTURER:
JOHNS MANVILLE THICKNESS: 13 " F -VALUE: R-38
GENERAL CONTRACTOR: DESERT CITIES DEVELOPMENT
BY:
TITLE:
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, L.P.
LICENSE NUMBER: 94484
�/
BY: .
TITLE: PRO U ION MANAGER
DATEMBER 16, 2001
i
WOOD DESTROYING PESTS AND ORGANISMS INSPECTION REPORT
s - - This is an inspection report only -- not a Notice of Completion
ADDRESS OF PROPERTY INSPECTED
IBUILDING NO STREETT T
47-900 Rosemary Street, La Quinta, CA, 92253
:UDE INSPECTION IPA
33 04/30/01 3
BUILDER'S TERMITE & PEST CONTROL, INC. Affix_ stamp here on Board copy only
3305 E. Miraloma Avenue, Suite 173 A LICENSED PEST CONTROL
Anaheim, CA 92$06 OPERATOR IS AN EXPERT IN
(714) 985-963$ (619) 574-0990 (714) 985-9639 FAX HIS/ HER FIELD. ANY QUESTIONS
RELATIVE TO THIS REPORT SHOULD
BE REFERRED TO HIM/HER.
REGISTRATION # PR 3509 REPORT # 2192 STAMP # ESCROW #
ORDERED BY: DCD Development Inc. 78-600 Highway III La QUinta CA 92253
REPORT SENT TO:
PROPERTY OWNER:
PARTY IN INTEREST:
ORIGINAL REPORT ® LIMITED REPORT C3 SUPPLEMENTAL REPORT 0* REINSPECTION REPORT 0
*Stampnjl Date
GENERAL DESCRIPTION: SLAB ON GRADE
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INSPECTION TAG POSTED: ELECTRICAL PIPES
-
OTHER INSPECTION TAGS:
.-
1,. SUBSTRUCTURE AREA Pre -Const. Soil Treatment See 1A
X
X
2. STALL SHOWER
X
X
3. FOUNDATIONS
X
X
4. PORCHES -- STEPS
X
X
5. VENTILATION
XX
6. ABUTMENTS
X
X
7. ATTIC SPACES
X1
X
8. GARAGES
X
X
9. DECKS -- PATIOS
X
X
10. OTHER INTERIOR
X
X
11. OTHER -- EXTERIOR
X
X
DIAGRAM AND EXPLANATION OF FINDINGS (This report is limited to structure or structures shown on diagram)
SLAB ON GRADE
n
Inspected by 'Richard A. Lemerand License No. OPR 9721 Signature
NOTE: Questions or problems concerning the above report should be directed to the manager of the company U -wed, qt estions or problems with
services performed may be directed to the Structural Pest Control Board at (91 6) 263-2533, or (800) 737-8188. f�
You are entitled to obtain copies of all reports and completion notices on this property filed with the Board duringg the preceeding two years upon
payment of a $2.00 search fee to: The Structural Pest Control Board, 1418 Howe Ave., Ste. 18, Sacramento, California 95825-3204.
JUL 2 0 2001
2nd
PAGE OF STANDARD INSPECTION REPORT ON PROPERTY AT:
47-900 Rosemary Street, La Quinta
BLDG. NO. STREET CITY
04/30/2001 2192
STAMP NO.. DATE OF INSPECTION CO. REPORT NO.
THE EXTERIOR SURFACE OF THE ROOF. WILL NOT BE .1NSPEC EI). 17 YOU WANT THE
WATER TIGHTNESS OF THE ROOF DIrTERiUMED, YOU SHOULD CONTACT A' ROOFING
CONTRACTOR WHO IS LICENSED BY THE (7mTRACTOR, S STATE LI BOARD.
"NOTICE: Reports on this structure prepared by various registered companies
should list the same`findings (i.e. termite infestations, termite damage,
fungus damage, etc.). However recommendations to correct these findings may
vary from company to company. You have a right to seek a second opinion from
.anther company".
NOTICE TO PROPERTYOWNERS-(section 7018 of the California contractors
license law, business &professional code Div. 3, chapter 9) Provides
under the Mechanic's Lien Law any contractor, subcontractor, laborer,
supplier.or other persons who helps to improve your property but is not
paid -for his work or supplies has a right to enforce a claim_ against your
property. This means that, after a court hearing, your property could be
sold by,the,court officer and the -proceeds of the sale used to satisfy the
indebtedness, This can happen even if you have paid your own contractor
in.full', if the subcontractor, laborer, or supplier remains unpaid.
'Notice: The charge for service that this company subcontracts to anther
person or entity may include the' company's charges for arranging and
administering such services that are -in addition to the direct costs
' associated woth paying the subcontractor."
Fume Company:
Fume Address:
Fume Phone #:
THIS IS A "STRUCTURAL PEST .CONTROL". INSPECTION REPORT: NOT A BUILDING
INSPECTION REPORT, THEREFORE NO OPINION IS BEING RENDERED REGARDING THE
STRUCTURAL INTEGRITY OF THE BUILDING.
THE. FOLLOWING AREAS WERE NOT INSPECTED, AS INDICATED IN SECTION #1990,
PARAGRAPH (j) OF THE STRUCTURAL PEST CONRTOL ACT AND RULES AND REGULATIONS:
FURNISHED INTERIORS, INACCESSIBLE. ATTICS, INSULATED ATTICS; AND PORTIONS
THE20F; THE INTERIOR OF HOLLOW WALLS: SPACES BETWEEN A FLOOR OR PORCH DECK
AND THE CEILING OR SOFFIT BELOW: STALL SHOWERS OVER FINISHED BUTTRESSES AND
SIMILAR AREAS TO WHICi THERE IS NO ACCESS WITHOUT DEFACING CR TEARING OUT
LUMBER, MASONRY.AND FINISHED WORK, BUILT-IN CABINET WORK: FLOOR BENEATH
SINGS, AREAS WHERE STORAGE CONDITIONS OR LOCKS MADS INSPECTION
IMPRACTICAL.
SUBSTRUCTURE AREAS:
Item 1A: Soil to be treated with chemical toxic for subterranean termites, chemical
registered with the State of California Division of Chemistry approved for
termite control.
WARRANTY -ALL WORK PERFORMED BY BUILDERS TERMITE &PEST CONTROL' IS WARRANTED
FOR A PERIOD OF ONE YEAR.
THIS PROPERTY WILL SLY WITH THE.STANDARDS OF THE STRUCTURAL PEST CONTROL;
ACT OF CALIFORNIA.
' COST BREAKDOWN
1A:
BUILDER'S TERMITE & PEST[GONT�RO� IYC. ---'License No. PR 3509
3rd PAGE OF STANDARD INSPECTION REPORT ON PROPERTY AT:
47-900 Rosemary Street, La Quinta
BLDG. NO. STREET CITY
04/30/2001 2192
STAMP NO. DATE OF INSPECTION CO. REPORT NO.
OCCUPANTS CHI-IICAL NOTICE
Builders Termite & Pest Control, Inc. will use pesticide chemical(s) specified
below for the control of wood destorying pests or organisms in locations
identified in the Structural Pest Control report as indicated above.
(1)e pest(s) to be controlled:
SUBTERRANEAN TERMITES FUNGUS or DRY ROT
BEETLES ». DRY -WOOD TERMITES DIS
(2) The pesticides) proposed to be used and the -active ingredient's).
A• DURSBAN TC: Active ingredients: Chlorpyrifos'
(0,0 -diethyl 0-(3,5,6-trichloro-2-pryidinyl) phosphorothioate) 44.0%.,
B» TDABOR: Active ingredients: Disodium Octaborate Tetrahydrate
.(Na2-B8-013-.- 4H2-0) 99.0%.
C. TALSTAR: Active Ingredients: Bifenthrin 7.9%.
D. VIKANE: Active Ingredients: Sulfuryl Flouride in conjunction with
Chloropicrin.
- E. PREVAIL FT: Active ingredients: Cypermethrin 24.8% Inert ingredients
75.2%
(3) "State Law requires that you be given the following -information:
CAUTION -PESTICIDES ARE 'TOXIC CHEMICALS. Structural Pest Control C.oerators are
licensed and regulated by the Structural Pest Control Board., and apply
pesticides. which are registered and approved for use by th= California
Department of Food and Agriculture and the United States Ehvironmental
Protection Agency. Registration is granted when the State finds that based on
existing scientific evidence there are no appreciable risks if proper use
conditions are followed or that the risks are outweighed by the benefits. The
degree of risk depends upon the degree of exposure, so exposure should be
minimized.
"If within, 24 hours following application you experience sympn_oms similar
to common seasonal illness comparable to the flu, contact your physician or
poison control center and your pest operator immediately. (This statement shall
be modified to include any other symptoms of over exposure wh_ch are not
typical of influenza.)"
For further information, contact any of the following:'
Builders.Termite &.Pest Control,.Inc................... (714) 985-9638`
County Health Department - Imperial 760-355-1741, Los Angeles 213-240-8203,
Orange 714-834-7700, Riverside 909-791-2200, San Bernardino 909--87-6280,
San Diego 619-515-6770, Ventura 805-652-5916
County Agriculture Commissioner- Imperial 760-339-4314, Los Angeles
626-575-5466, Orange 714=447-7100, Riverside 909-275-3012,, Sari Bernardino
909-387-2105, San Diego 619-694-2778, Ventura 805-933-3165
Poison Control Center ................................ (800) 876-4766
Structural Pest Control
1418 Howe Avenue, Suite 18, Sacramento, CA 95825 .. , (800) 737-5188
Persons with respiratory or allergic conditions, or others who may be
concerned about .their health relative to this chemical treatment,.should
contact their physician concerning occupancy during and after chemical
treatment prior to signing this NOTICE.
NO CHEMICAL APPLICATION WILL BE PERFORMED UNTIL SUCH TIM[E THAT THIS NOTICE IS
RETURNED. HAVING READ
THE INSTRUCTIONS, I, THE UNDERSIGNED, WILL ACCEPT
RESPONSIBILITY FOR ALL THE AFOREMENTIONED.
BUILDER'S TERMITE & PEST CONTROL, INC. --- License No. PR 3509
JUL 2 0 2001
STANDARD NOTICE OF WORK COMPLETED AND NOT COMPLETE& '
NOTICE - All recommendations may not have been completed. - See below - Recommendations not completed. This form is„prescribed
by the Stuctural Pest Control Board, with whom a copy must be filed by company within 5 working days after completion of work under
a contract.
THIS IS A NOTICE OF COMPLETION ONLY, NOT AN INSPECTION REPORT.
BUIL NG • ,
ZIP
�8 r ATE OF COMPLETION
79-780 Miraflores Blvd., La Quinta, CA, 92253
3:3 06/22/2001:
BUILDER'S TERMITE & PEST CONTROL, INC. AFFIX STAMP TO
3305 E. Miraloma Avenue, Suite 173 BOARD COPY, ONLY
Anaheim, CA 92806
(714) 985-9638 (619) 574-0990 (714) 985-9639 FAX i
REGISTRATION # PR 3509 REPORT # 2448 STAMP # ESCROW #
Notice of DCD Development Inc. 78-600 Highway III La Quinta CA 92253
Completion
Sent to:
Property Owner:
This is to certify that the following recommendations on the above designated property, as outlined in Wood Destroying Pests and
Organisms Inspection Report .No. 2448 dated 06/22/2001 Stamp No.
Organisms Inspection Report No. dated Stamp No.
Organisms Inspection Report No. dated Stamp No.
have been and/or have not been completed. '
Recommendations completed by this firm that'are in accordahce with the Structural Pest Control Board's (Rules and Regulati
1A ons:
Recommendations completed by this firm that are considered secondary and substandard measures under Section 1992 of the Structural
Pest Control Board's Rules and Regulations:
Person requesting secondary measure:
Recommendations not completed by this firm:
.Remarks-'
Cost: $ 0.00
Inspection Fee: $ 0.00
Other: $ 0.00
Total: $ 0.00
Estimated Cost:$
NOTE: Questions or problems concerning the above report should be directed to the managgr oft company. Unresolved questions or problems
with services performed may be directed to the Structural Pest Control Board at (916) 263.4533, or (800) 737-8188.
You are entitled to obtain copies of all reports and completion notices on this property filed with the Board during the preceeding two years upon
payment of a $2.00 search fee to: The Structural Pest Control Board, 1418 Howe Ave., Ste. 18, Sacramento, Californie 95825-3204.
JUL 2 0 2001
WOOD DESTROYING PESTS AND ORGANISMS INSPECTION REPORT
This is an inspection report only -- not a Notice of Completion
ADDRESS OF PROPERTY INSPECTED
79-780 Miraflores Blvd., La Quinta, CA, 92253
BUILDER'S TERMITE & PEST CONTROL, INC.
3305 E. Miraloma Avenue, Suite 173
Anaheim, CA 92806
(714) 985-9638 (619) 574-0990 (714) 985-9639 FAX
REGISTRATION #
ORDERED BY:
REPORT SENT TO:
PROPERTY OWNER:
CODS• TWELtION PXG� R yr
33 05/15/01 1 3
Affix stamp here on Board copy only
A _ICENSED PEST CONTROL
OPERATOR IS AN EXPERT IN
HIE,/HER FIELD. ANY QUESTIONS
RELATIVE TO THIS REPORT SHOULD
BE REFERRED TO HIM/HER.
PR 3509 I REPORT # 2448 STAMP # ESCROW #
DCD Development Inc. 78-600 Highway III La Quinta CA 92253
PARTY IN INTEREST:
- jj jj.� lcNvrt is nmiteo to structure or Structuresshown on diagram)
SLAB ON GRADE
1
Inspected by Richard A. Lemerand OPR 9721 t
License No. Signature f
NOTE: Questions or problems concerning the above report should be directed to the manager of the company. Unres red /estions or problems with
services performed may be directed to the Structural Pest Control Board at (916) 263-2533, or (800) 737an I
all
rts
and
payment of You are galed $2t00 seain cohoeie to as f The Stoructural PestpCont of Boanotices
rd, 14 8 Howe Ave., Ste. is, Sacled with the ra enton alifoniac9582g-two3204.ears upon
f
Inspected by Richard A. Lemerand OPR 9721 t
License No. Signature f
NOTE: Questions or problems concerning the above report should be directed to the manager of the company. Unres red /estions or problems with
services performed may be directed to the Structural Pest Control Board at (916) 263-2533, or (800) 737an I
all
rts
and
payment of You are galed $2t00 seain cohoeie to as f The Stoructural PestpCont of Boanotices
rd, 14 8 Howe Ave., Ste. is, Sacled with the ra enton alifoniac9582g-two3204.ears upon
f
2nd
PAGE OF STANDARD INSPECTION REPORT ON PROPERTY AT:
79-780 Miraflores Blvd., La Quinta
BLDG. NO. STREET
05/15/2001
STAMP NO. DATE OF INSPECTION
CITY
2448
CO. REPORT NO.
THE EXTERIOR SURFACE OF THE ROOF WILL NOT BE INSPECTED. IF YOU WANT THE
WATER TIGHTNESS OF THE ROOF DETEj;dyW D, YOU SHOULD 03NTACT A ROOFING
CWTRACTCR WHO IS LIGINSED By THE CMTRAC,TCR' S STATE LICENSE B01pjRD,
'70TICE: Reports on this structure Prepared by various istered
should list the same f' � companies
endings (i.e. termite infestations, termite damage
fungus damage, etc.). However reconmendations.to correct these findings may
� her �„• to c�any. You have a right to seek a second opinion from
NOTICE TO PROPERTY OWNERS -(section 7018 of the California contractors
license'law, business.& professional code Div. 3, chapter 9) Provides
under the Mechanic's Lien Law any contractor, subcontractor, laborer,
supplier or other persons who helps to improve your property but is not
paid for his work or supplies has a right to enforce a claim against your
Property. This means that, after a court hearing, your pro�:.erty could be
sold by the court officer and the proceeds of the sale used to satisfy the
indebtedness, This can happen even if you have paid your own contractor
in full, if the subcontractor, laborer, or supplier remains unpaid.
"Notice: The charge for service that this company subcontracts to another
person or entity may include the company's charges for arranging and
administering such services that are in addition to the direct costs
associated woth Paying the subcontractor.”
FLXne Company:.
Fume Address
Fume Phone #:
THIS IS A "STRUCTURAL PEST CONTROL" INSPECTION REPORT: NOT A BUILDING
INSPECTION REPORT, THEREFORE NO OPINION IS: BEING RENDERED- REGARDING THE
STRUCTURAL INTEGRITY OF THE, BUILDING.
THE FOLLOWING AREAS WERE NOT INSPECTED, AS INDICATED IN SECTION #1990,
PARAGRAPH (j) OF THE STRUCTURAL PEST CONRTOL ACT AND RULES AND REGULATIONS:
FURNISHED INTERIORS, INACCESSIBLE ATTICS, INSULATED ATTICS, AND PORTIONS
THEROF; THE INTERIOR OF HOLLOW WALLS: SPACES BETWEEN A FIOOF OR PORCH DECK
AND THE CEILING OR SOFFIT BELOW: STAU SHOWERS OVER FINISF=, BUTTRESSES AND
SIMILAR AREAS TO WHICH THERE IS NO ACCESS WITHOUT DEFACING OR TEARING OUT
LUMBER, MASONRY AND FINISHED WORK, BUILT-IN CABINET WORK:: FLOOR BENEATH
COVERINGS, AREAS WHERE STORAGE CONDITIONS OR. LOCKS MA
IMPRACTICAL. SS INSPECTION
SUBSTRUCTURE AREAS:
Item 1A: Soil to be treated with chemical toxic for subterranean termites, chemical
registered with the State of California Division of Chemistry approved for
termite control.
►o
WARRANTY -ALL WORK PERFORMED BY
BUILDERS E- PEST CONTROL IS WARRANTED
FOR A PERIOD OF ONE YEAR.
THIS PROPERTY WILL COMPLY WITH THE STANDARDS OF THE STRUCTURAL PEST CONTROL
ACT OF CALIFORNIA.
3rd PAGE OF STANDARD INSPECTION REPORT ON PROPERTY AT:
79-780 Miraflores Blvd., La Quinta
BLDG. NO. STREET
CITY
h
05/15/2001 2448
STAMP NO. DATE OF INSPECTION CO. REPORT NO.
OCCUPANTS CHEMICAL NOTICE .r
Builders Termite & Pest Control, Inc. will use pesticide chemicals) specified
below for the control of wood destorying-pests or organisms in.locations
identified in the Structural Pest Control report as indicated above.
(1) The pest(s) to be controlled:
SUBTERRANEAN TERMITES FUNGUS or DRY
ROT
(2) The pesticide(s) proposed to be used and the active ingredient(s).
A. DURSBAN TC: Active ingredients: Chlorpyrifos
(0,0 -diethyl 0-(3,5,6-trichloro-2-pryidinyl) phosphorothioate) 44.0%.
B. TIlvJBOR: Active ingredients: Disodium Octab orate Tetrahydrate
(Na2-B8-013-.- 4H2-0) 99.0%.
C. TALSTAR: Active Ingredients: Bifenthrin 7.9%.
D. VIKANE: Active Ingredients: Sulfuryl Flouride in conjunction with
Chloropicrin.
--- E. PREVAIL FT: Active ingredients: C�Ypermethrin 24.8% Inert ingredients
75.2%
(3) "State Law requires that you be given 'ithe following information. -
CAUTION -PESTICIDES ARE TCXIC CHE[aCALS. Structural Pest Control Operators are
licensed and regulated by the Structural Pest Control Board., and apply
Pesticides which are registered and approved .for use by th✓ California
Department of Food and Agriculture and the United States Eivironmental
Protection Agency. Registration is granted when the State finds that based on
existing scientific evidence there are no appreciable risks if proper use
conditions are followed or that the risks are outweighed by the benefits. The
degree of risk depends upon the degree of exposure, so exposure should be
minimized.
"If within 24 hours following application you experience symptoms similar
to common seasonal illness comparable to the flu, contact your physician or
poison control center and your pest operator immediately. (This statement shall
be modified to include any other symptoms of over exposure wh=ch are not
typical of influenza.)"
For further information, contact any of the following:
Builders Termite & Pest Control, Inc ................... (714) 985-9E38
County Health Department - Imperial 760-355-1741, Los Angeles 213-240-8203,
Orange 714-834-7700, Riverside 909-791-2200, San Bernardino 909-�87-6280,
San Diego 619-515-6770, Ventura 805-652-5916
County Agriculture Commissioner- Imperial 760-339-4314, Los Angeles
626-575-5466, Orange 714-447-7100, Riverside 909-275-3012, San Bernardino
909-387-2105, San Diego 619-694-2778, Ventura 805-933-3165
Poison Control Center (800) 876-4756
Structural Pest Control
1418 Howe Avenue, Suite 18, Sacramento, CA 95825 �.... (800) 737-8188.
Persons with respiratory allergic sp' ry or eller c conditions, or others who may be
concerned about their health relative to this. chemical treatment, should
contact their physician concerning occupancy during and after chemical
treatment prior to signing this NOTICE,
NO Gov'ECAL APPLICATION WILL BE PERFORMED UNTIL SUCH TIME THAT THIS NOTICE IS
RETURNED. HAVING READ THE INSTRUCTIONS, I, THS UNDERSIGNED, WILL ACCEPT
RESPONSIBILITY FOR ALL THE AFOREMENTIONED.
BUILDER'S TERMITE & PEST CONTROL, INC. --- License No. PR 3.509
New Construction Subterranean Termite Soil Treatment Record'
This form is completed by the licensed Pest Control Company.
This report is submitted for informational purposes to the builder on proposed (new) construction cases when soil treatment for prevention of
subtetraneen termite infestation is specified by the builder, architect, or required by the lender, architect, FHA, or JA.
All contracts for services are between the Pest Control Operator and builder, unless stated otherwise.
Section 1: General Information (Treating Company Information)
Company Name: BUILDERS 'TERMITE & PEST CONTROL, INC.
Company Address: 3305 E. Miraloma Avenue, Suite 17aty: Anaheim Stete: CA Zip: 92806
Company Business License No.: PR 3509 Company Phone No.- (714) 985-9638
FHA/VA Case No. (if any):
Section 2:' Builder Information
Company Name: DCD Development Inc.
Phone No.: 78-600 Highway 111, La Quinta CA 92253 760-771-5049
Section 3: Property Information
Location of Structure(s) Treated (Street Address, or Legal Description, City, State and Zip): L#: 58 T#:
79-780 Miraflores Blvd., La Quinta CA 92253
Type of. Construction: [XI Slab
(more than one box may be checked)
Outside.
Approximate Depth of Footing:
Inside:
[ ) Basement [ 1 Crawl [ 'I Other
1 Foot
1 Foot
Type of Fill: Earth
Section 4:. Treatment Information
- Date(s) of Treatment(s): 06/22/2001
Brand Name of Products) Used: Prevail FT EPA Registration No.: ?79-3082
Approximate Final Mix Solution %: "25 s
Approximate Size of Treatment Area: I
Sq. ft.: 2400 Linear ft:: 0None Noted
Linear fl. of Masonry Voids:
Approximate Total Gallons of Solution Applied: 240.00 Gallons
Was treatment completed on exterior? [ I YES [XI NO
Service Agreement Available: [ I YES [XI NO
Note: Some state laws require service agreements to be issued. This form does not preempt state law.
Attachments(List):
Comments:
Name of Applicator(s): Rigobert0 Reye.Certification No. (IF REQUIRED BY STATE: LAW): RA 11338
The applicator has used a product In accor c hh the product label and state requirements. All treatment materials and methods used comply with state
and federal regulations. /
Authorized Signature: Date: 06/26/2001
Warning: HUD will prosecute falffare
and THIS FORM MAY NOT BE ALTERED. statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001Form NPCA-99b, ' 010, 1012; 31 U.S.C. 3729, 3802)
Form VA -26-8375 and HUD-920solete ,
(2/97)
JUL 2 0 2001
Subterranean Termite Treatment Builder's Certification and Guarantee
This -form is completed by the builder.
This form is submitted for proposed (new) construction cases when treatment for prevention of sub-erranean termite infestation is
specified by the builder or architect, or required by the lender, FHA, or VA. Treatment for the purposes of this form means
application of soil termiticide, and/or wood treatment, and/or installation of bait systems. Any treatment must be done in accordance
with applicable federal and state requirements.
This form is to be completed and issued by the builder to the buyer. It is not to be considered as a waiver of, or in place
of, any legal rights or remedies that the buyer may have against the builder.
FHA/VA Case No.:
Location of Structure(s) (Street Address, or Legal Description, City, State and zip): L#: 58 T# :
79-780 Miraflores Blvd., La Quinta CA 92253
Buyer's Name:
The undersigned builder hereby certifies that .a state licensed or otherwise authorized pest control company (Where required by state law) was
contracted to treat the property at the location referenced above for subterranean termites. The builder further certifies that the contract with
the pest control company required the treatment materials and methods used to be in conformance with 311 applicable state and federal
requirements. All work required by the contract has been completed. Where not prohibited by applicable state trequirements, the buyer, for an
additional fee payable to the pest control company, may extend the protection against subterranean termites. Contact the pest control
listed_ on the attachment for further information. company
The builder hereby guarantees that, if subterranean termite infestation should occur within one year from the Cate of final closing, the builder
will ensure that a licensed or otherwise state authorized pest control company .(where required by state law) or other qualified licensed pest
control company will further treat as necessary in the infested area to control infestations in the structure. This 'urther treatment will be without
cost to the buyer. If permitted by state law, the buyer may contract directly, at the buyer's expense, with a pest control company to inspect the
property on a periodic basis and/or use EPA registered products to control the infestation. The builder will not be responsible for guaranteeing
such additional treatment. The builder further agrees to repair all damage by subterranean termites within tie one year builder's warranty
period. This guarantee does not apply to additions or alterations that are made by the buyer which affect the the original structure or treatment.
Examples include, but not limited to, landscape and mulch alterations which distrub the treated area and create new subterranean termite
hazards, or interfere with the control measures:
If within the guarantee period the builder questions the validity of a claim by the • buyer, the claim will be investigated by an unbiased expert
mutually agreeable to the buyer and builder. The report of the expert will be accelpted as the basis for disposition of the case. The non -
prevailing party will pay the cost of any inspections made to investigate the claim. For further information contact your state structural pest
control regulatory agency.
Type of Treatment [ ) Bait System [ ) Wood [X) Soil (NPCA-99b required)
Note: Appropriate treatment record must be attached and listed
Attachments:
Builder's Company Name: DCA Development Inc.
Authorized Signature:
Phone No.: 760-771-5049
Dater 060/26/2001
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012, 31 U.S.C. 3729, 3802)
Consumer Maintenance Advisory regarding Integrated Pest Management for Prevention of Wood Destroying Insects
Information regarding prevention of wood destroying insect infestation is helpful to any property owner interested in protecting the structure
from infestation. Any structure can be attacked by wood destroying insects. Periodic maintenance should irclude measures to minimize
possibilities of infestation in and around a structure. Factors which may lead to infestation from wood destroying insects include foam
insulation at foundation, earth -wood contact, faulty grade, firewood against structure, insufficient ventilation, moisture, wood debris in crawl
space, wood mulch, tree branches touching structures, landscape timbers, and wood rot. Should these or other such conditions exist,
corrective measures should be taken by the owner in order to reduce the chances of infestations by wood destroying insects, and the need
for treatment.
An original and one copy of this guarantee are to be prepared by the builder and sent to the lender. The lender
es one copy to the
at closing and includes a copy in the VA loan package or HUD insurance case binder. The builder sends one cop �olthe licensed pest control buyer
company which performed the treatment.
Attached is a copy of the state authorized pest control company's service record
THIS FORM MAY NOT BE ALTERED. Form NPCA-99a
Form VA -26-8375 and HUD -92062 are obsolete after 5/31/97.
(1/99)
STANDARD NOTICE OF WORK COMPLETED AND NOT COMPLETLDJ
NOTICE.- All recommendations may not have been completed. - See below - Recommendations not completed. This form is prescribed
by the Stuctural Pest Control Board, with whom a copy must be filed by company within 5 working days after completion of work under
a contract.
THIS IS A NOTICE OF COMPLETION ONLY, NOT AN INSPECTION REPORT.
,
ZIP
79-770 Miraflores Blvd., La Quinta, CA, 92253 "3 106/22/2001
WELDER'S TERMITE & PEST CONTROL, INC. AFFIX STAMP TO
3305 E. Miraloma Avenue, Suite 173 BOARD COPY ONLY
Anaheim, CA 92806
(714) 985-9638 (619) 574-0990 (714) 985-9639 FAX
REGISTRATION # PR 3509 REPORT # 2449 STAMP # ESCROW #
Notice of DCD Development Inc. 78-600 Highway III La Quinta CA 92253
Completion
Sent to:
Property Owner:
This is to certify that the following recommendations on the above designated property, as outlined in Wood Destroying Pests and
Organisms Inspection Report No. 2449 dated 06/22/2001 Stamp No.
Organisms Inspection Report No. dated Stamp No.
Organisms Inspection Report No. dated Stamp No.
have been and/or have not been completed.
Recommendations completed by this firm that are in accordance with the Structural Pest Control Board's Rules and Regulations:
1A
Recommendations completed by this firm that are considered secondary and substandard measures under Scction 1992 of the Structural
Pest Control Board's Rules and Regulations:
Person requesting secondary measure:
Recommendations not completed by this firm:
Remarks:
Cosi:: $ 0.00
Inspection Fee: $ 0.00
Other: $ 0.00
Total: $ 0.00
Estimated Cost: $
Signature
vim--- ..
NOTE: Questions or problems concerning the above report should be directed to the manager of the corn nyy Unreso ved questions or problems
with services performed may be directed to the Structural Pest Control Board at (916) 2632533, or (8 ) 737-8188_
You are entitled to obtain copies of all reports and completion notices on this property filed with the Board during the preceeding two years upon
payment of a $2.00 search fee to: The Structural Pest Control Board, 1418 Howe Ave., Ste. 18, Sacramento, California 95825-3204.
JUL 2 0 2001
Certificate of Occupancy
City of La Q,uinta
Building and Safety Department.
�E
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 t,
of the City regulating building construction or use. For the following: '
BUILDING ADDRESS: 47-900 ROSEMARY STREET
Use Classification: SINGLE FAMILY .DWELLING Bldg. Permit No.: 9907-322
tk
Occupancy Group: R-3 Type of Construction: VN Land Use. Zone: CR
Owner of Building: CATELLUS RESIDENTIAL Address: 5 PARK PLAZA, STE. 400
COMMUNITIES
City: IRVINE, CA 92614
Building Official'
By: GARY SHOWALTER
Date: NOVEMBER 29, 2001