0402-331 (SFD)79843 Amora Dr
0402-331
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
7281 fix B 13110 91334
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
performance of the work for which this permit is issued.
( )° I have and will maintain workers' compensation insurance, as required by
Sgcction 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 C S. La REpUDj,,I,:'+1SII Policy No. icie 0?
(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 provisions of Section 3700 of the Labor
Code, I phall forthwith comply withth se provisi ns.a. .
,Date: 3` 23 °4f Applicant ala/ "
_ e
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set- forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request:and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
iSignature (Owner/Agent)
/1-P 2- >: Date :✓• , > r
BUILDING PERMIT PERMIT#
04M-3-51
DATE.f ' + VALUATION . 6. 7 . LOT Z TRACT 2r'3
5
JOB SITE
ADDRESS
APN
OWNER
CONTRACTOR/[ / EN INFER
L61WAR le01M OF CALNO k}i. A.
1..1rl iHAR F101YMS Cid' CALTIADIRi .
7$-401 CHIGHWM 111
78.401 C13IC' H4 AY 111 %
Lei. Q3[TTIr A Ch., cri-25a
Lk gZTlsrm CA 9.225 3
(?6op,77-0131 031X 3434
USE OF PERMIT
KATOU FAIM,Y L+WYt.;1:.T14(3-
SFP0 - WT 7, PLAN 3:'K8. PERMIT DOM- VOT UNC 1,f )D E HL CK WALLS,
f 004 ?3PA, 011`DRIV'kMAY .b1.PF't2OAC
TRPXT CONSTRUCTION Z376.00 OF
S1:
,
/Pµrpa .1.11 ry1p1' . QrI'[O'(+ [9e s ,g4 a:;p,.00
•TfT '5: `aY/:if nJh`SiiL-OR 44100 8F .. /
C -
EM, CO3Tr OF CORMIA :tION
yyaa77yy,, --jj gga yy,, app ,gp
y.Y1.1:[.l9Zi . .ID iL lLl 'LLYJIOSY.6:C
CONO'P1tUOTION FEE 101.000.418.000 ?S,eItF
M9CHAINICAL FEE 101.000-X121-0,,,00 V72150
RL,IECTRIC AL, FFJr 101-fBQi3-d2cj- 10t? $125.00
PLf1I ti4INO ME 101.000-4194000
STROND MOTION IYEE s RluSID 10)-000-241-000
ORADAHO R% 1011.000423.000
DOVE'LDPE12IMPACT P'!: Z
It -POTAL CON,s'IMMMON AND PDW CIMIC
$,219.81
LOS P1ZR-P 1DnM
$0,00
L.1 Y' add411T S'.Y.mYSL9 R✓47 .Lq0Lr1
C' I+v . e X
MAR 2 4 2004
22
OF LA QISI TA
CITY V/IE
DEFT.
RECEIPT pE 'BY
DATE FIN LED
INSPECTJOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
I INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
-Underground Ducts
Forms & Footings
h_
Ducts
_
Slab Grade
Return Air
Steel
_
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
Framing
, _
F.A.U.
Compressor
Insulation
/
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - IM. Lath
r—
Final
Final
BLOCKWALL APPROVALS
steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
-
Final
Gas Piping
PLUMBING APPROVA S
Gas Test
Electric Final
Waste Lines
Water Piping
_ _
Heater Final
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 Conduft
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) 7d 2J-4 dy
COMMENTS:
AUG -19-2004 THU 06:44 AM TEAM HEATING & A/C
FAX N0. 9096943803 P. 04
HVAC INSTALLATION CERTIFICATE for Tested Dud Leakage & TXV Page 1 of 2 CF -6R
Site Address: 79-843 Amora Drive Permit Number
Tract Number.
Lot Number: 2 Project. Esplanade Builder. Cornerstone Dev.
An installation certmcate is required to pe posted at the building site or made avahbie for all appropriate inspections.
Atter completion of final inspection, a copy must be provided to the klwldmg Department (upon request) and the building
owner at occupancy, per Section 10-1 mb),
29323
Plan #: 37.r Phase:
HVAC SYSTEMS:
Heabng Equipment
Model Name
.. C... ,:w 4.
Identicle I (AFUE, etc.)l Location Duct Load
Svstems I (>= CF -1 R) I (attic. etc.) I R -Value I (BTU ! H
.......,. ,Z y
o Efficiency
Equip. CFEQ Certified.MlirName Identicle (SEER, eta)
Type and Model Number Systems (>=CFA R)
o0 in
u Cooling s
Location Duct Load Capacity
(attic, eta) R -value (BTU / Hr) (BTU / Hr)
US Air
a c
Ub Air 663CNX018
affic
i, the unuerslgrlea, venry knat equipmcra unrna duuvV w• 1J r3 um a uar wiw,r....— sJ oy..........
.....• ........
efficient than that specified i e certificate of compliance (Form CF -1 R) submitted for compliance with the Energy
Efficiency Standards for res de i ull n and eqFlint that meets or exceeds the appropriate requirements for
manufactured devices (from the A is ce ffici c ans or Part 6), where applicable.
• .G, Team Mechanical
igna ure, Date Installing SubcontractorName
OR General Contractor (Co_ Name) OR Owner
MINIMUM REQUIREMENTS FOR DUCT LEAKAGE COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Ma)imum 6% Duct Leakage)
CFA:
System M of
Indicate the mawmum Lille le Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
x 400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flout
DUE Pressurization Test Results
100 x Test Leakage / Fan Flow = % leakage
Check Box for Pass or Fall (Pass = 6% or Less)
=T-24 C -o-m `p-li ance Credit was Taken for TXV
Sym ' ` a of
Indicate the maxunum al of viable Duct Leakage and the'calculation used:
0.7 x.Floor Area x (0.06) for Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
x 400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity In Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
DUa Pressurization Test Results
100 x Test Leakage i Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
QT -24 Compliance Credit was Taken for TXV
x.06
X.06
TXV was
IPA-WT7
PAGE 1
F2001.01 (4-02) Action Now T-24CF6-RTD&TXV macro
-,
AUG -19-2004 THU 06:44 AM TEAM HEATING & A/C
FAX N0. 9096943803 P. 05
AC INSTALLATION CERTIFICATE for Tested .Duct Leakage & TXV
Tract Number. 29323
Lot Number 2
4 -
2 of 2 CF -6R
Plan #: 3Zr Phase:
Project: Esplanade Builder: Cornerstone Dev.
System of
Indicate the max um EZ la Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone 8 through 16
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0,06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
Ma Pressurization Test Resu
100 x Test leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
T-24 Com (lance Credit was Taken for TXV
—Vsindicate
of ["^
Indicate the maximum a owe le Duct Leakage and the calculation used:
0.7 x Floor Area x (0,05) for Climate Zone 6 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0,06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
D -u -d Pressurization Test Results
1 DO x Test Leakage / Fan Flow = % Leakage'
Check Box for Pass or Fail (Pass = 5% or Less)
;^ aT-24 Compliance Credit was Taken for TXV
ys = of
aw
Indicate the mmum a owe le Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
DUR Pressurization Test RmIts (CFM la 25 PA)
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
I'T1T-24 Compliance Credit was Taken for TXV
ys m = of
Indicate the maximum a owa le Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
400 X (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
DO Pressurization Test Results
100 x Test Leakage / Fan Flow c % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
[-'7T-24 Compliance Credit was Taken for TXV
X.06
x .06
X.06
TXV wa:
TXV wa!
TXV was
TXV wa:
I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the tests) is
In conformance with the requ remeAs for compliance credit, (The builder shall provide the HERS provider a copy of the
CF -6R signed by the builder emp y e or n rs certifying that diagnostic testing and Installation meet the
requirements for compliance cred t.)
'Le 104f, Team Mechanical
To—sig— Signatult, Dat Installing subcontractor o. Name
Performed OR General Contractor (Co. Name) OR Owner
COPY TO: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy
PAGE 2
F2001.01 (4.02) Action Now T-24CF6-RTC&TXV macro
Certificate of Insulation
Your Horne has been insulated with CertainTeed Fiberglass Insulation products, which are designed
for today's safety standards and tomorrows energy requirements.
Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated
with fire -retardant chemicals that will likely lose their effectiveness over time. It has not been treated
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
settle overtime as may other insulation materials.
This also certifies that CertainTeed Fiber Glass Insulation has been professionally installed in this home y
to provide the following thermal performance:
Job Name: Tapestry at Esplanade Tract: 29323-2 Phase: 4
Lot #.: 2 Plan: 3ZR Address: 79-843 Amora Dr., La Quinta, CA
Ceiling Area: R-38 Blown Garage Ceiling: Interior Walls:
Overhangs: Exterior Wails: R-13 Unfaced Batts
With LiAng Above
Ceiling: Garage WA: CandIevered
Inaccessible to Blow Floors NVILi-ving Above
SUft-SICem,
tractoK.. OJln su tion Co., .Inc.
60s a 91702 6Z j,2-6070 Lteeusell465709
Signed
-[ Conchita Ortiz, SecretappTreasurer --oi' R. Scott Jenkins, President--or--
Lou Merola, Director of Operations Officer
R- means resistance to heat flow. The higher the R- value, the greater the insulating power.
Ask your builder for the fact sheet on R- values. Keep this certificate with your other
valued papers. If you ever sell this home, this certificate should be passed on to the buyer.
T