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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
A ��5� QJQS
,pate T i t^' 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
() 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 foi 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 NATIONAL UNION Policy No. 71638V
(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 toIthe workers' compensation�erovisionsto�ection 3700 of the Labor
Codeyhs all fo�f hwith comply withrhose provisions.
Date: 11 �� p Applicant'J` "
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 prone forinspection purposes. ?,I
) i1
Signature (Owner/Agent) , . Date
BUILDING PERMIT PERMIT# 10
DATE VALUATION LOT t3QI-041 TRACT
48 30023
JOB SITE
APN
ADDRESS 81-567 VEST °,}VMX,O'1lt DJ.ZYV.IM
7(4-270-017
OWNER k,
CONTRACTOR / DESIGNER / ENGINEER
F A LA QUIRTA I.LC
SHWA LA QUINTA LLC
83 260 AVENU'.L 62
81260 AM41-ILi62
LikQM. T.A. CA 92253
LAQLWA C.A. 92253
;moi F'y0rm-6005 Mill *MD
USE OF PERMIT
SIS -LOT 43, PLAN 6430. PER.MIT r30M^ NOT INCLODE 01,OCK
WALLS, S, P001, SPA OR. DRIVF'WAYAPi'ROACH
CUSTOM CONSTRUCTION 2,769,00 SF
PORCM;A.TIO 214,00 S?
O.ARA13L+/ -A-RPOPT 710,00
XN'1:M1'rKID C"0;7T OF CO.NSIRUC'IIMM
ZM643,70
CCMT1?UC TION YEE 101-000-418-000 s3)Ji1 x.00
PLAN! CHECK Pipe. 101-000-439-316 088.15
MECrHM11C.Al.1FEE 101-000.421.0010 831.0
Pr1.'F.CTIZJCAL FEE 101-000-420.000
PLUMBB40 FRE 101-000.419-000 _ 81GG 40
STRZO OMOTION FEE- PES1Ce 101400-241-000 823,a&
ORAM 0.FIEZ? 101X10-423-000 f15.00
K) VELOPEtd M4PACT PES' $Z,40.00
.ART 1N PUBLIC PLA<;M - R 01 270-000.445--000
1101q 'AM px..w Ci3F'.CK
;ESS PIC* "PAID MES
$4,910.32
$0.00
F73 ® 4 L TOT PKIMIT1KE5 Dljm: NOW
$4,910,242
li
CITY O;T LA aulPsTt'
RECEIPT
DATE /
BY
DAT FI ALED
INSPE9
,U
J
i.' • .:,�
OPERATION
a
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
p
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
9L
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath114
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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
FBQures O
Main Service {
Sub Panels
Exterior. Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final .
Utility Notice (Perm)
COMMENTS:
I
STRUCTURAL JOB SITE OBSERVATION
Project Name:
Observer:
A visit to the project site was. made on the above date to:
gs i''-'sINC.'
S4.ulctlir,al t.figineer,
Project Number:
Date of Observation: 116, /C
0 Address specific elements of the work.
N i)?
CI Assist the field personnel with complying.with the intent of the construction4ocuments.
0 Assist the fieldpersonnel with -.complying with the findings, in a previous structural job site observation.
C Fp4yn C,
At the time. of our visit; work had progressed to the point of Phase:
Address:
Bldg: / Lot Number:
Bldg. / Plan Type-& Elevation:
V
Foundation Trenched
Foundation Poured
Roof SheathinIg-Covered
.0
Roofing Material Stacked and -Loaded
0
Extcrioi Walls Covered.
L;
0
Interior Wall Covered
C.
C
0
Insulation Installed
0
1.",o
Electrical, Mechanical, Plumbing Completet
,
Fin4l FramingPick-ups,Completed .
Building Complete
Based upon our visit:
Refer to the attached fiel¬cvto'.Fa addressed ,;by-th'e: coins* u"i -'1--J" I'
trucpqpgrsonne
0 Additional informaii on'will- be sent from
our office which will need.' i'0"16'iddies ',by'i'he'con.struction personnel.
0 It is our opinion that this building is being constructed in-,gineralicaftfor-ri ance-with-.:the intent of the construction
documents prepared by
our office.
Q Site ObseiVition: teased, framingwas not at a stage:of c6mpIetift"in whichsite observation could be performed.
U Concerns-brbukhtto
Comments:
Please note: XAB��LVALA=
Our findings
rigs sand:-mcommendations. rr
cons
lneqi4--,approv`M
tivaMori"documents
construed as authorizing the 6xPqr1,4#W
Site Observation was made only tode;
portions of the work which would best
did not include review, approval or obs
addressed.
A-) I
other than }structural ramtficat�ons which we .have not addressed. Be advised that changes to the
tildmg. official:.0ur;fiin'is not authorized.to act as ;the Owner's agent. Our findings shall not be
Observatidn,,,was made of those
t the intent .......... observation
. . . . . . . . . . . . . crit of the work. Site
1. The contractors safety L precautions, proce
2. Any -shoring, scaffolding, underpinning,.1
Any soils at the site,their adequacy.to su
4. Any drainage courses or devises of a ten
.s, or any other erection methods or temporary bracing.
, or any other soilrelated. conditions.
part of the structure, including roof and floor slopes, drains and
pipes.
The findings ofthis observation are.understood to beane ssibiidf-proifcssional opinion by the.engineer based on his or her best knowledge,
.,
information and belief. As such,. it consists ofteither a. gu, ir4ktiOor. avarriiitee expressed or implie
Field Superintendent (third copy).fC. Z
If FT
—Date:
Client (second -copy via mail)
Field 6jiktir (hirst-copy) Z-2 gg�2= - - —Date:—
If you have any -questions please contact our
STA MESA, CALIFORNIA
ROSEVILLE, CALIFORNIA
SAN RAMON, CALIFORNIA
LAS VEGAS, NEVADA
Phone: 7.14-513-7500
Phone: 946-71445.97
Phone: 925-242-107
Phone: 702-740*.5427'
Fax: 714;513-7555
Fax: 9167t].74-7599
Fax: 925-242-2961
Tax:'702 -74071-543,1
4:,
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i
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 at
81-567 DESERT WILLOW DRIVE LOT 11 048, LA QUINTA CA
CEILINGS:
TYPE: BLOW MAUNFACTURER: Certainteed THICKNESS: R-38
WALLS:
TYPE: BLOW MANUFACTURER: Certainteed THICKNESS: R-13
GENERAL CONTRACTOR: SHEA HOMES LICENSE #
BY: TITLE:
PARAG N SCHMID BU LDING PRODUCTS A MASCO Company LICENSE # 221 17
NT REPRESENTIVE DATE: I
BY; TITLE: ACCOU -
. � .�..�:-.�v:.�r.r�r..�...i�•�.•.•.....i:..:i•sir:•.:....rr..s•�.•..��.:-i�iii:ri.y�n;r.:i f. �,i.r...�v:i:.,•viror•iin• rrrr: ...:r., .. ....•�•,.., ... ..
Installation Certificate: Residential CF -6R
Site Address PERMIT #
81-567, .Desert..Willo' rive'
1. BUILDER INFORMATION SUBDIVISION: Trilogy P, La Quinta
Shea Homes - Trilogy - LaQuinta CITY: La Quinta
60311 Trilogy Pkwy COUNTY: Riverside
La Quinta, CA 92253-7642
INSTALLING CONTRACTOR: WEST PAC AIR CONDITIONING
2. PROJECT INFORMATION
b1(.�1�f:7i:3T111�[�r1
TYPE
Flexible Ductwork
in Attic and
Between Floors
DUCT OR PIPING R -
VALUE
Flexible Ductwork
Will have a R -Value
of 4.2 or Better
I, the undersigned, verify that the equipment listed in the category above my signature is the actual equipment
installed and that the equipment meets or exceeds the requirements of the Appliance Efficiency Standards. In
addition, Ihave verified that the equipment is equivalent to or more efficient than the equipment specified on the
Certificate of Compliance submitted to demonstrate compliance with the Energy Efficiency Standards for
residential buildings.
3. HEATING INFORMATION
HEATING MANUFACT HEATING UNIT ACTUAL EFF. HEATING EQUIP HEATING
EQUIP. MAKE MODEL # AFUE CAPACITY LOAD
Furnace Lennox G40UH48B-090X 80% 88000
G40UH36A-070X 80%
4. COOLING INFORMATION
COOLING MANUFACT COMPRESSOR ACTUAL EFF. COOLING EQUIP COOLING
EQUIP. MAKE MODEL # SEER CAPACITY LOAD
A/C Lennox 13ACC-048 12
13ACC-036
The building design heat loss and design heat gain rate have been determined using a method specified in Section
150(h) of the Energy Efficiency Standards, and are two of the criteria used for equipment sizing and selection.
6.THERMOSTATIC EXPANSION VALVE (TXV):
Thermostatic Expansion Valve (or Commision approved equivalent) is installed and access is provided for inspection.
Yes ❑ No ❑ N/A ❑
• 6. SUBMITTED BY
Signature Installing HVAC Contractor
DATE: S — 2-0-- q
JCM Inspections
1 39725 Garand Lane Suite F
J Palm Desert, CA 92211
INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS
• COMPRESSION STRENGTH TEST RESULTS
Client: Shea La Quinta, LLC Date: 4/18104
Project: Trilogy @ La Quinta - Shea Homes Project No: 02-1109
81-260 Avenue 62
La Quinta, CA 92274
Set ID Structure Age of Test Compression Strength
JCM ID Location Date Cast Cylinder ID (days) (psi)
Set -A Phase 5A - Lot #1048 :. Slab on Grade 2-27-04 Concrete
273-205 Kitchen t Required psi: 4000
6116 7 3180
6117 28 4590
6118 28 4580
Set A Phase 5A - Lot # 1048 Slab on Grade 3-1-04 Concrete
273-206 Garage Required psi: 4000
6120 7 2990
6121 28 4420
6122 28 4380
L?% 56 7 CERTIFIED:%UL
nspections supplies the service
• of compression strength test results only.
Per ASTMC39
•
Page 1 of 1
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Copy 1 JCM ections Copy 2 Project Superintendent Copy 3 Governing Agency Page + of(-
JCM Inspections
39725 Garand Lane Suite F
1r:
Palm Desert, CA 92211 1
I
INSPECTIONS
Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS
- PRESTRESSED CONCRETE INSPECTION REPORT Date:
Project Name:
Project No:
Trilogy @ La Quinta - Shea Homes
02-1109
Project Address:
City:
Title 24 AWS F,71 UBC Other:
81-260 Avenue 62
La Quinta, CA
File # ❑ D 1.1
App# F] D 1.4
Client:
Sub -Contractor:
Shea La Quinta, LLC
Sun Coast Tensioning
❑ Other
General Contractor:
Architect: Structural Engineer:
Shea Homes
Bassenian Lagoni Borm & Assoc,lnc/Suncoast Post Tension LP
.�._ E
Size and Type of Tendons: '
Weather:
�M� �
� r rk ^�1 Ah� c rv"s C�.Cv �� 1l'AAP"A
Jack Machine Cali bration:9,,.Q•..\),-A _&tl s'C 'Ct ,SII Con _ ?11,0 --�,<,USucn ; r
Unreso Items:
�o i+%c►kg'% NC
r\ 04, 4- 3, � �� � ZZ 1 nod'�.
M.None
-� `
Calibration Date:\n `,'� n - C
❑ See Below
o ok kA 3�\�n,, G43o2, ZzA r,\,\,)
Description of Work Inspected:
Specified
Lot # Location
Tendons Elongation (in) Actual Elongation (in)
4V%
J
3
}"�
1 3 3
t, ,,
3
1
AM
a
y
0
i
,,+, - ,, ' 3
PO r,
r•i n r- �+ r
I hereby certify that I have inspected all of the above work, unless otherwise noted, and to the best of my ability I have found this work to comply with the approved
plans, specifications _applicable building laws. Final report issued at project completion.
Inspector: Jack C. Millin ICBO Cert' ' a on No: 0842216-89
Contractor' Representative:
,11 1/ )._
,�
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Copy 1 JCM ections Copy 2 Project Superintendent Copy 3 Governing Agency Page + of(-