04-5737 (ELEC)4
BUILDING & SAFETY DEPARTMENT
P.O. BOX 1504 (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPE ION R -tJ' uTS-(•76 •- 77-7153
BUILDING PERMIT ID [� 11
JUL 2 7 2004
Application Number
' 04__00-Q05737 R —
7/27/
04
CITY O
Property Address 60106 ALOE C
FINANCE DEPT.
APN: 764-270-999-182 -300233-
Application description ELECTRICAL
Property Zoning . . . . . . . MEDIUM HIGH DENSITY RES
Application valuation . . . . 3500
Owner Contractor
SHEA LA QUINTA SHEA HOMES, INC.
81260 AVE 62 81260 AVENUE 62
LA QUINTA CA 92253 LA QUINTA CA 92253
(760) 777-6005
WCC: NTL UNION INS
WC: 7165833 08/01/04
•CSLB: 672285 06/30/05
CCC: B
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Permit . . . . ELEC-MISCELLANEOUS
Additional desc
Permit Fee. 3.3.50 Plan Check Fee .00
Issue Date Valuation 0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 18.5000 EA ELEC_SVC <=600V/<=200A". 18.50
Special Notes and Comments
200 AW PEDESTAL FOR COMMON IRRIGATION
AND STREET LIGHTS
Fee summary Charged Paid Credited Due
----------------------------------------•-----------------
Permit Fee Total33.50 .00 .00 33.50
Plan Check Total .00 .00 .00 .00
Grand Total 33.50 .00 .00 33.50
P.O. Box 1504•4 �G/ VOICE (760) 777-7012
78-495 CALLE TAMPICO �I
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
�Y) 1Ll
Date:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under enalty 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 in full force and effect. (147
License Class License No.
Date Contractor x
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of.Division 3 of the Business
and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.).
U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Date
WORKERS' 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
issue y workers om n insurance carrier and policy umper ars��
Carier� t PolicyNumber '7 �� J 3
_ I certify tha , in the performance of the work for which this pe it 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 CO Applicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this 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 application, the owner, and the applicant, each agrees to, and shall, defend, indemnity and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.
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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to enter upo above -me ed property for inspection purposes.
Date Signature (Applicant or Agent):
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INSULATION CERTIFICATE V
Thls 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
60-151 ALOE CIRCLE, LOT 3168, PHASE 9A, LA QUINTA, CA
CEILINGS:
TYPE: BLOW MAUNFACTURER: Certainteed THICKNESS: R-38
WALLS:
TYPE: BLOW MANUFACTURER: Owens Corning THICKNESS: R-19
GENERAL CONTRACTOR: SHEA HOMES LICENSE #
BY: TITLE:
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517
BY: C.L'L TITLE: ACCOUNT REPRESENTIVE DATE:
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INSULATION CERTIFICATE
This is to certify that insulation has been Installed in conformance with the current energy
regulation, California Administrative Code, Title 241 State of Califomia, in the building located at
60-121 AL"OECIRCLE LOT 3167, PHASE',9A, LA QUINTA, CA
CEILINGS:
TYPE: BLOW MAUNFACTURER: Certainteed THICKNESS: R-38
WALLS:
TYPE: BLOW MAUNFACTURER: Owens Coming THICKNESS: R-19
' GENERAL CONTRACTOR: SHEA HOMES LICENSE #
BY: TITLE:
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517
B Y.Cay ITLE: ACCOUNT REPRESENTIVE DATE:���_
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90 SJad QINHOS N09VNid b0EZ9bE09L L0:60 500Z/E0/90
JCM Inspections
39725 Garand Lane Suite F
LP
Palm Desert, CA 92211�L]—E
NS Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS
COMPRESSION STRENGTH TEST RESULTS
Client: Shea La Quinta, LLC Date: 5110105
Project: Trilogy @ La Quinta - Shea Homes Project No: 02-1109
81-260 Avenue 62
La Quinta, CA 92274
Set ID Structure
JCM ID Locadon
Age of Test Compression Strength
Date Cast Cylinder ID (days) (psi)
Set A Phase 9A - Lot # 3167 Slab on Grade 3-17-05
273466 Kitchen
Page 1 of 1
Concrete
Required psi: 4000
9342 7 2990
9343 28 4350
9344 28 43A00'-\
CERTIFIED: �� � c_" AULI
JCM Inspections supplies the service
of compression strength test results only.
Per ASTMC39
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF -4R
TRILOGY @ LA QUINTA- PH- 9A (Partial)
Project Title
60121 Aloe Circle, La Quinta, CA 92253
Projectoeinor 760-535-2192
Builde�fgntac�t Henson (CCN #CC2004076) 7M -eft -e7022
HERS
Firm: BCI Testing
Street Address: PO Box 50575
Copies to: Builder, HERS Provider
Date
SHEA HOMES
Builder Name
Plan 4520 Box Bay @ Mbr
P1an�iA ber
Telephone Sample Group�-Number
o --Z9 — o S 167 (ph 9A)
Date Sample House Number
HERS Provider: CALCERTS
City/State/Zip:
Phoenix, AZ 85076
HERS RATE COMPLIANCE STATEMENT
The house was: Tested ❑ Approved as part of sample testing, but was not tested
As the .HERS rater pro iding diagnostic testing and field verification, I certify that the houses identified on this form comply
wi a diagnostic tested compliance requirements as checked on this form.
The installer has provided a copy of CF -6R (Installation Certificate.
Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts)
Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth
backed, rubber adhesive duct tape to seal leaks at duct connections.
AIMMINUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
t Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
Measured
Duct Pressurization Test Results (CFM @ 25 Pa) values
Test Leakage Flow in CFM L
If fan flow is calculated as 400cfin/ton x number of tons enter calculated
value here g00 ( O0
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) =
Check Box for Pass or Fail (Pass=6% or less) ❑
P ss Fail
galffERMOSTATIC EXPANSION VALVE (TXV)
p"Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection
Yes is a pass
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1. ❑ Yes ❑ No ACCA Manual D Design requirements have been met (rater has
verified that actual installation matches values in CF -1R and
design on plan.
2. ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV,
verified fan flow matches design from CF -1R.
Measured Fan Flow =
Yes for both 1 and 2 is a Pass
❑
Pass Fail
❑ ❑
Pass Fail
Compliance Forms August 2001 . A-16