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0401-042 (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 Business anis Prol'assionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 6 ZVS B/ V301 }S ,Date,. o Sjgnature of Contractee' f� v ^^" 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 Q Date 1 Signature of Owner C 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 Se6fion 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: Lamer NATIONAL UNION No. (This section need not be completed if the permit valuation is for $100.00 or les"§). () 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,.l•shall fort th with comply wit ��}}''o a provlslonsi Date: i1�9pplicant �1 , a✓�''"" `^�. 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 pr 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 N6 & 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-inspectio4urposes. Signature (Owner/Age"nt) � � Date r' BUILDING PERMIT PERMIT# to ' 0401-U2 DATE VALUATION LOT TRACT JOB SITE ADDRESS 81.-lur, DErSKU14/91aliOWDRNE APN 764-270-017 OWNER CONTRACTOR•/ DESIGNER / ENGINEER €11260 AVMTUE 62 81260101EWt1.L 62 LAt,i}W.FA CA 9IZ253 LA QT.M4TA. C!'~ 92253 {?6iY� lii �4s()C�3 Ci3L�t 3�3U USE OF PERMIT 0Ifi3'C�3.� ;�AI��..Y T;'Vi►�L.1�7C� ,• SPO - LOT 47 PIAN 5503A. PERMIT DOES NOT iNCLUDE BLOCK WALl,A1064 SPA OR DRIVEWAY MPROAC H Z € STOM CONSTRUCTION 1,841000F Pv22OWPATIO 357.60 SF fi O.AkA.OICYCA13:FORT 539,00 V X45T: .d�.'!7D COST Or, CONvl::RMMON 1611V37.' rtRVA (T "sj'rrE 6r(Th U'Y CC7143T'Trk1I'CTIQr0 171M s 101.000.418.000 $856.50 PLAN CI!1:`.0 'IC It`%t<IN 101-00"39-31181 $692.26 MEC,E1.l NX-1.AL FEE 101-CIOO- 21-000 SHM }LECTM CAL 9'r~E 101-000-420-000 $108.9.3 PLUM UrNti Z 1,, 101.000.413.000 $124,00 STRO'140 MOTION YZE • 13BSID 101.000-241-000 $16.0 C;b".ADIN13 FrRIE 101-000.425.000 1100 DF1VMX.1 E_R IM-PAICT ME, $4405.00 S1w3'.f3-TC):,"AL. C01MMTE;PI.1'CN MWPUN %ii+.,Cl. * $4,304.33 I2Sa`3M-PAID 1±�Y`" $Cl.k?i) yWAL TOTALFITZAKC MOG9sNOW $4x304.3 3 I F`B 04 7% 't CITY OF !A C%I A -1 A RECEIPT DATE BYg�7 AL p INSPE , `!lam 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 Deckril ExhaustFans O.K to Wrap Z F.A.U. FramingCompressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final SLOCKWALL 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 APPROVAL 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 _ , ' v 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: 40 OC TES,yINC. ;( Structural'Engmeers. STRUCTURAL 1011 SITE OBSERVATION . y( Project Name: l CA" Observer: A visit to the project site was made on the above date toi ❑ Address specific elements of the work. v 3\I Project Number: Date of Observation: e,/ 6, e ❑ Assist the -field, personnel with .complying with the intent of the construction,documents. O Assist the field.personnel,with complying with the findings:in a.previous structural'jogliiii e'observation. At the time of our visit; work had progressed to the point of : Phase: Address: _ Bldg. / Lot Number: �-(� ­:_ - _- Bldg- / Plan yp T e-& Elevation: � U- � �1G. Foundation Trenched: Foundation Poured Roof Sheathing Covered Roofing Material Stacked and•Loaded Q. 0 Exterior Walls Covered G .`^°C G" = 0 Interior Wall Covered C i C .a C G. 0 Insulation InstalledG ❑ 0 Electrical, Mechanical, Plumbing Complete Final Framing:Pick-.ups Completed Building Complete Based upon.our visit: Refer to the attached field:notes to.'6e addressed by time constiucUor'Lpe?sonnelt O Additional information will be sent from:our office which will need W.he add essedby-the'construction personnel. O It is our opinion that this building is being constructed in:.general-coriforinane-ewith:the intent of the construction documents prepared by our office. Cl Site Observation: ceased, framing was not at a stage>of cotiipleriowin-which site observation could be performed. O Concerns brought to the tion offie ;- rsonnel,based'onyrevtousslte.observattoA tnad -op,�, haveyet.to be addressed. Comments: tow,x V 5 � ` r , ; lc� ��Maiff-Y �- t `f I Please note: Our findings �and;recommendattons may have other than structural ramtficattgns wtitch we have noi'addressed. Be advised that changes to the constn"ie£jondocuments need:;approval�of theibuildtngofficial: Our;fiim is not authorized.to act as the Owner's agent. Our findings shall not be construed as authorizing the expenditureofla-& iuonal:funds. Site Observation was made only to determine general;; conformance: the intent of the construction documents Observatidw-was made of those portions of the work which would best represent the intent of thecoristructiondocuments, not etch and every,element of the -work. Site observation did not include review, approval or observation of amoitg`otheriitems: 1. The contractors safety precautions;, procedures, destgn's, methods ortechniques. - x 2. Any.shoring, scaffolding, underpinning';,,temporary refammg of excavations, or any other erection methods or temporary bracing. ;::•;3e ° Any soils at the siie,,their adequacy.to support the biiildmg, expansiveness, orany other soil related: conditions. L ; 4. Any drainage courses•or.devises of a temporary nature oras a:permanent part of the structure, including roof and floor slopes, drains and pipes. The findings of this observation are understood to be.:an expression�of professional opinion by the. engineer based on his or her best knowledge, information and belief. As such,:it consists of neither.a.guarantee nor a;warrantee expressed or implied. (If FT Field Superintendent (third copy)' �4.rC.' . (Z Date: Client (secon&copy via mail) Field Eng ii�er{firstcopy) Date: t. C r If you -have any questions please contact our of ice COSTA MESA, CALIFORNIA Phone:7.14-513-7500 Fax: 714=593-7555 f ROSEVILLE, CALIFORNIA Phone: 916-7147597 Fax: 9167:74-7599 SAN RAMON, CALIFORNIA Phone: 925-242-2577 Fax: 925-2.42-2961 �: -" "' • - ;i ?;' LAS VEGAS, NEVADA Phone: 702-740=5427 Fax: 7.02-740-5431 -:.::.r�.r:n•�:•ryr..ri�-.,,..-;:-f-:...yrrrr:ern::-r!�!:.•..;rw.�,�ry�:"'•�.Tr-rrr.r->•r-r-if:•::r!i.rr:•r.v.•c-.i-.,..•.r•:......-r-........•rrrr.•..;.,...r-,,.,..,.:...., 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 81-579 DESERT WILLOW DRIVE LOT 1-047, l_A QUINTA CA CEILINGS: TYPE: BLOW MAUNFACTURER: Certainteed THICKNESS: R-38 WALLS: TYPE: BLOW MAUNFACTURER: Certainteed THICKNESS: R-13 GENERAL CONTRACTOR: SHEA HOMES LICENSE # BY: TITLE: PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517 BY: JPJTITLE: ACCOUNT REPRESENTIVE DATE: �7 rr.. r. r�rr-rr iv.��.., ii tr�•:.�.r.�...��i•r.�ii rvroiivir,•iriiri iilr..ii�,.�.iri�-ririi i.i iirrrir. i��v.��i,.,:ii�ii.r�.,.:v�r.•rrr.•r.•: r.•. �i •ir.•rr..� in:�v.•r. •r. i.: �.. ri••. r... . • • Installation Certificate: Residential CF -6R Site Address 85-71 ':Desert Willow Dri e 1. BUILDER INFORMATION Shea Homes - Trilogy - LaQuinta 60311 Trilogy Pkwy La Quinta, CA 92253-7642 INSTALLING CONTRACTOR: 2. PROJECT INFORMATION DISTRIBUTION 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 PERMIT # ty-07 SUBDIVISION: Trilogy na, La Quinta CITY: La Quinta COUNTY: Riverside WEST PAC AIR CONDITIONING 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 80UHG4/5X-100 80% 100000 80% 4. COOLING INFORMATION COOLING MANUFACT COMPRESSOR ACTUAL EFF. COOLING EQUIP COOLING EQUIP. MAKE MODEL # SEER CAPACITY LOAD A/C Lennox 13ACC-060 12 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. &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 7�1SG FMVQ -Q- ( � &-� DATE: 3 Signature Installing HVAC Contractor i JCM Inspections 39725 Garand Lane Suite F Palm Desert, CA 92211 INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS • COMPRESSION STRENGTH TEST RESULTS Client: Shea La Quinta, LLC Date: 4/18/04 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 #/1047 Slab on Grade 3-1-04 Concrete 273207 Master Bedroom�� Required psi: 4000 6123 7 3780 6124 28 5320 6125 28 5370 CERTIFIED: C, JCVr inspections supplies the service (�V of compression strength test results only. \ Per ASTMC39 �1 l G JCM Inspections _ 39725 Garand Lane Suite F - Palm Desert, CA 92211 INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS - PRESTRESSED CONCRETE INSPECTION REPORT Date: 3—/0— 04 — 0 -- Project Project Name: Project No: Trilogy @ La Quinta - Shea Homes 02-1109 Project Address: City: Title 24 AWS O UBC Other: 81-260 Avenue 62 La Quinta, CA File # D 1.1 App# ❑ D 1.4 Client: Sub -Contractor: Shea La Quinta, LLC Sun Coast Tensioning E] Other General Contractor: Architect: Structural Engineer: Shea Homes Bassenian Lagoni Borm & Assoc,lnc/Suncoast Post Tension LP Size and Type of Tendons: to tci d Sev-e Weather: �•e.� n S t^(it r, S' t esS—. s.cvQ .,Z C•rr nJ�`'� Machine CalibrationcT eee�e �1cel�t Vvj on yr UnreusJack terns: hoc e n.n Q o a n ,�, oab ' �' 1K t�S(54vo pig"o 0� ,, I ®None \ Calibration Date: IMOIi �lllets E] see Below Description of Work Inspected: Specified Lot # Location Tendons Elongation (in) Actual Elongation (in) T ex G wl�Fnsio - .. 8 . � 32 A >Z C' CL C* Gu ra�'�y 3 3 R 3+ 3 3— " Q74 y 4 Vn r'r6 o n'3 Y'4 — Q n L4 y lib w VJ\v`A,o �� 14 14i y �. 3 VS.I 114'Zs J'_' 1 c Pa &r3orwnjade✓ �(of'N C;Z 3 - 3 3 c A r A I vn � r .31► 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 Certt'ift ion No: 0842216-89 Co tract is Rnepresentative: ® C \ ... ( 1/ A � t Copy 1 JCs)ections Copy 2 Project Superintendent Copy 3 Governing Agency Page _+ of�