0401-046 (SFD)I LICENSED CONTRACTOR DECLARATION
I heel; affirm under penalty of perjury that I am licensed under provisions of
H : ' Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
C?I W -.Professionals Code, and my License is in full force and effect.
M License # Lic. Class Exp. Date
W x2 � f ilJ05
oZ r- -Date `'-Signature of Contractof
to 0. rl- /
J U C:) OWNER -BUILDER DECLARATION
W W r— I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z ( ) I, as owner of the property, or my employees with wages as their sole
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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
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 WATICINAL UNION Policy No. 1161833
(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 agreelthat if I should become
subject to the workers' compensation ptovisib s of Section 3700 of the Labor
Code, I s alliforthwith comply with tse provlslons.�i
bate: T*`Applicant � J S
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 µ
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 fotr inspection p_�urpos�es.� "
Signature (Owner/Agent)(' a - Date!
l
BUILDING PERMIT PERMIT#
0401-046
DATEVALUATION LOT TRACT
`.. < f $I „OI .3tt 52 30023
JOB SITE
APN
ADDRESS 81-6m DE.Y.E.. vii low DRIVE
1&k27"17
OWNER
CONTRACTOR/DESIGNER/EN (NEER
SIM AL& QUNI—A 11,C
RHEA, L& Q MITA UP,
81760 Ai%ENiT.E 62
81260 MENUS 62
I.A QL''W T& CA 92233
i.A QL]ii+l A CA 92253
(760)777-6005 MU3 MD
USE OF PERMIT
81WKx:1 E 1'1�213w.Y I�i7ifEi T:T�t3f
SFL) . LOT 5e,, PLAN .1333 PERMIT DOES NOT 114CLUDE SUCK
"J/AS.LA P094 SPA OR DRIV9WAY APPROACH
CUSTOM CONUTRUCTION M1100 SF
11011Cl /PATIO, 134.00 SF
C+AR.AOW.ARPOWr S.00 SF
11CSI li t 1ED 0019 ov CONE'I.' UC' ION
C0113TR.UCTION FIM 101.000.418.000 $81.6.00
PLAN CHECK F..99 101-000.,439-318 $649.36
MW1•IIANICAL FEE 101-000-421-000 $55.50
BLECfiliXAL F99 101-000-420-000 $105.62
P LUMLI IN0 FFX 101-000.419-000 $116,75
aTR.O140 MOT1014 P9,31 - msm 101-000-741-000 $14.90
GWWO LEE 101-000-423-000 $15.00
rJLVEL PF,R IMPAC IT FEE $x,405.110
C3TA fEXO 7��+.i1CM7014 AND tyLAaT C_%WCb'..
$4,173.00
�`ttZ C N T, S PRE -PAW FMS
$0,00
�. Q �, inj.:s9.`�0,M!, rE1?JlrC!XFKEA S DUE NOW
&4.373A.10
V
RECEIPT
DATE f i
BY f
DAT F� LES
INSPF,6TQtA
4/7 lr/'
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
19 t'
Exhaust Fans
O.K. to Wrap
/ o'tg
F.A.U.
Framing
G
Compressor
InsulationZ2
�Ij
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
6
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
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
m S
Encapsulation
Gas Piping
Gas Test
D
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)
NC.
W -RA SSOCIS; I
Structural Engineers
STRUCTURALJOBSITE OBSERVATION r. / l/
Project Name: 1 (� CJ�� ( . %,i �T Project Number: �f
7' yn
Observer: Ci Date of Observation: ,/ C
A visit to -the project site was made on the above.dateto;
O Address specific elements.of the work.. ...
❑ Assist the field personnel with complying:with the intent ofthe construction•documents.
O Assist the field personnel with complying with.the findings. from a,previous�structural job site observation.
(-c,t.. c �-rl,: ✓cam
At the time of -our visit, work had progressed to-the;point-of : Phase:
Address:
Bidg.J Lot -Number:
Bl.d . / Plan T e & Elevation: `+ l�A
g yp ` :v Caa r� Ar
Foundation Trenched ;2r r ' 0
Foundation Poured:, '
�i x � 0
Roof Sheathin Covered J 0
RoofingzMatini l Stacked-:and,Loaded
Exterior Walls: Covered C x C* F u = 0
1,7
Interior. Wall Covered C > k C. „ r 0
Insulation .Insialled
Electrical, Mechanical; Plumbing Complete 7 0 0 C
Final Framing Pick -ups -Completed C'
Building Complete C _
Based upon:our visit:
' kefer:to the attached field notes to•..be;add'`ressed,�by�the:constructiorxpersonnei:
❑ Additional information will .bevsentffrom our ce which will need.to'be addressed Dywthe construction personnel.
O Itis. our opinion that. thislbuilding'is being.tonstructed in general conformance-Wi%ith-the intent of the construction documents prepared by
out -office.
O Site.Observation.ceased, framing was nouat a stage of completion in which..site.observation could be performed.
❑ Concerns°brough,_ ' en d rso tre sed reeiaussite observationim adeon hareiye�Gto be addressed.
Continents: R li � � (( i krAry "moi - -
Please -note
y
�� .„o
Otic findings. and. recommendations may hate otlier' than structucal'ramrfications which we have not :addressed." Be advised that changes to the
construction.docurrients need approva} of;t}ie burldmg:offictal:. Our firm is not.auihorizedsto act as,' the Owner's agent. Our findings shall not be
constriied'as:auth'origi.h the: expenditure of:additrona}'lunds..
Site Observation was_ made onlyto determine general conformance;with the intent of the construction documents. Observation was made of those
portions -of the work which would best represent the, intent of the. coristrucUon-,A cure snot each. and. -every. element of the work. Site. observation
did not include review., approval or observation of among other rtemsc
1. The contractors safety precautions; procedures,:des gns,:. iethods;or. techniques:
2. Any shoring, scaffolding, underpinning, temporary retarnmg cf excavations:,or-anyother erection methods or temporary bracing.
3. Any.soils at the site, tlieiradequacyto support the tiui]dtng;'.expansrveness, orany.other,soil related conditions.
4. Any drainage courses or devises of a temporary nature or as a permanenYparvof 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:warrante Aexpiessed or implied': .
Field Su erintendent: third co e:
Client (second copy via mail) �
. 4 Field Engineer(tirst copy) ..l z� Date:
If you have any -questions please contaour ofr
CfQSTA MESA, CALIFORNIA P " " 744-513-7500 Fax: 714-513-7555
''IOS:EVILLE, CALIFORNIA Phone: 916-774-7597 Fax: 91¢-774-7599
SAN.RAMON, CALIFORNIA Phone: 925-242-2577 Fax: 925-2.42=2961 xC
LAS VEGAS, NEVADA Phone.: 702-740=5427 Fax 702 740 543:1' t� '
L___.------- n.inr"ry •.n rs�„• nL__-f'c 1T n[M C..... 10 k6z.A4no " y:
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
81-634 DESERT WILLOW DRIVE LOT kfO62� C�QLIINTA CA
CEILINGS, THICKNESS'R-38
TYPE: SLOW MALINFACTURER: Certainteed
WALLS:
TYPE: SLOW MANUFACTURER: Certainteed THICKNESS: R-13
GENERAL CONTRACTOR: SHEA HOMES LICENSE#
BY: TITLE:
DUCTS A MASCO PARAGON SCHMID BUIL91N 0 0 Company LICENSE # 221517
ov
BY: L TITLE: ACCOUNT REPRESENTIVE DATE
Installation Certificate: Residential
Site Address
'81-634 .Deser W o Drive-,,-,
• 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
CF -6R
PERMIT #
SUBDIVISION: Trilogy @ 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.
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
aZc.0 &r' --a 'e�V-/ DATE:
Signature Installing HVAC Contractor
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: 4/18104
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 #,;;1,0.62`r Slab on Grade 3-4-04 Concrete
273-211 Bedroom 2 Required psi: 4000
8/63y
rte,
•
Page 1 of 1
6160 7 3260
6161 28 5140
6162 28 5190
`CERTIFIED: e,
Inspections supplies the service
of compression strength test results only.
Per ASTMC39
'
JCM Inspections
.39.725.^Garrand Lane:Suite F
Palm Desert, CA 92211
INSPECTIONS •
Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS
PRESTRESSED CONCRETE INSPECTION REPORT Date: 3_1D_
Project Name:
Project No:
Trilogy @ La Quinta - Shea Homes
02-1109
Project Address:
City:
Title 24 AWS UBC Other:
81-260 Avenue. 62
La Quinta, CA
File # F_� D 1.1
App# D 1.4
Client:
x'
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
Size and Type of Tendons: ��n��s
' /�, p
`� A. -i n ne
Weather:
Jack Machine Calibration: G CQ'w C �„
�. S �-_ �-
es(�'� co r� c larve A �. a e: o �D(c ��.�, rt '� n �'�'>, c�
Unresolve Items:
j. 1
r3�+
�•
None
CalibrationDate:ac�
E] See Below
��noue.s�La logia ����. _LR\nYj y!Z3a 4
Description of Work Inspected:
Specified
Lot # Location
Tendons Elongation (in) Actual Elongation (in)
L *
t
w r n (> @ ra C-1.,
, I f ,
S: s4 S:
l}.
l\ C' A � ✓1 - S. 1 fiCL
11--, 4+.
y .1—
G Q
PQ n n A Ok
t
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l
G1 .P09_ ar3 _ t 11<Z_J
h I•'
a'700
'
-r
A A
3
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PGT; o
H
3k
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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. MillinO Certification No: 0842216-89
f
Contrac o{/rsReprese/(IJpJ t/i/ve/J):
/�
• , I r
Copy 1 JCM Inspections Copy 2 Project Superintendent Copy I Governing Agency Page of