0402-330 (SFD)79859 Amora Dr
0402-330
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 # Lica Class Exp. Date
7i" 102 B ICCr 9 0/G•4
Signature of Contractor e
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
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 U1.•L' 11.1:F'UDL1G 11,1:111 Policy No. MWW0$77600
(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, I1hall forthwith comply witht. ose provisions.
Date: „ ? 7. • r Applicant 72/1
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. /l
F
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. l/
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.
Signature (Owner/Agent) /C f.s' l /l r /5d Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 040Z'% TRACT
1; . -,.i f . 9120,292.40 1 2y323
JOB SITE
ADDRESS ^W AMt7M DKIV
APN
a 0!X-3WJS 024
OWNER
CONTRACTOR / DESIGNER /EN 1NEER
OF witT70P.NIY
yWAR HONl 0tylL1VAHA
78.101 C', ITIGHWAY 111
78.403 C MC3HWAY 11 I
LA. Q1.!13?I'3'.f•1. CA 92253
LA (ZIM4TA CA 92253
0)M-0131 C Vf 3434
USE OF PERMIT
Slrx) • LOT 1, t?I.,AT4 I'A'A. PIRMIT' DOES N0T;N'-1.UDP Ba.)Cr, ``FALLS;
:'Cif sL, j'A Ci};17tUMMAYARPTWACTi
ti
TRACT CONS- T I:IG"P ON 2,041,00 SP
PCIR :Hm"A'no 33.04 3F
CAKMOEICA.RPORT 447.00 Sit?
ENTIMIATIM C01.7f OF CS3NS"3"£!> r,710M
120,292A0
t30NSTI.'UC-TIC`OFB : TH. 101,000438-000 $B13,00
PI..A_IN CHECK IEEE 101-000-139-319 $501.3:,
MECHANICAL AL FEB 101.000.421.000 $53.50
9L&CTItICAL IFER 101-00()420-0050 $113m
P1r1lTAD NC PRE 101-000-419-000 $152.75
STPON10 MOT1014 PEE a 8010. 101.000-241-000
s .E?fllifi lC1 ' 101-000-4234000 $jS.Qp
17EVF.LOALR IMPACT FFE $2,405.00
RB -`01' . w COW&M TCT[ON .AND PIAN CHECK
$4,062.49
D & % SS P-Rlt•PAIU PITZ s
L9
50100
1`I1 X iln X37'1' ` `ns x rTow
MAR 2 4 2004
CITY OF EA FIQUtNTA I IIIIIIIIIIIIII IIIIIIII
2FINANCEDCPZ
J
IE
RECEIPT
DATE
BY,
DA E INAL D
INSP C
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• .I sh./ fi
h i I
.f
INSPECTION RECORD
OPERATION
DATE
INSPECTOR OPERATION
DATE
INSPECTOR
BUILDING
APPROV
LS
MECHANICAL APPROVALS
Set Backs
Forms & Footings
Underground Ducts
Ducts
_
Slab Grade
Retum Air
p
Steel
Combustion Air
_
Roof Deck
_ _
_
_
_ Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
_
.
Compressor
Insulation .
_ _
_
Vents
Fireplace P.L.
_/
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
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 A PROVA S
Gas Test
Electric Final
Waste Lines
_
v _
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
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)
7Z2. 1,0 V I
t
i
AUG -19-2014 T4k6:44 AM TEAM HEATING & A/C FAX N0. 9096943803
P. 03
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 2 of 2 CF -6R
i i ww.wu u i rmu
Site Address: 79-859 Amora Drive Permit Number 0
Tract Number: 29323
Lot Number. 1
Plan #: 1Y Phase:
Project: Esplanade Builder: Cornerstone Dev.
System of
Indicate the manmum al ble 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 STU per hour) x (0.06)
Measured Fan Flow
TrU7 Pressurization Test Resu
—Its(ET—Ma 25
100 x Test Leakage / Fan Flow = % Leakage
Check Sox for Pass or Fail (Pass = 6% or Less)
T-24 Compliance Credit was Taken for TXV
ystem = of r"
Indicate the maximum al 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 Tones t 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
Mu Pressurization Test Results
10o x Test Leakage I Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or less)
T-24 Compliance Credit was Taken for TXV
ys em = of
'Indicate the maximum a owa Is 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
u Pressurization Test Results (CFM 9 25 -PAY
100 x Test Leakage ! Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
RT;T-24 Compliance Credit was Taken for TXV
= of I—I
Indicate the maximum a a1—wa'-bte 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 (0.08) 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
Muff Pressurization Test Results
100 x Test Leakage I Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
=T-24 Compliance Credit was Taken for TXV
X.06
x .06
x.06
X.06
TXV was
1t:1W7
TXV wa:
TXV was
I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is
in conformance with the requirements for compliance credit. (The builder shall provide the HERS provider a copy of the
CF -6R signed by the builder emp or n certifying that diagnostic testing and installation meet the
requirements for compliance kxe it.)
. Team Mechenical
e5fs igna re, ns a ng Subcont—raToTrIUY 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-RTD&TXV macro
e
AUG -19-2004 TFIU 06 44 AM TEAM HEATING & A/C FAX N0, 9096943803
P. 02
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 1 of 2 CF -6R
Site Address: 79-859 Amora Drive Permit Number
Tract Number.
Lot Number. 1 Project: Esplanade Builder Cornerstone Dev.
An installation certificate is required to be posted at the building site or made avallble for all appropriate Inspections.
Atter completion of final Inspection, a copy must be provided to the Building Department (upon request) and the building
owner at occupancy, per Section 10-103(b).
29323
Plan #: 1Y Phase:
HVAC SYSTEMS:
, ,00uny Murp, na-. ••
o iencyu FA ng Heating
Equip, e r Name Identicle (All etc.) Location Dud Load Capacity
Type and Model Name Systems (>= CF -1R) (attic etc.) R -value (BTU / Hr) (BTU / Hr)
USAir 7TO=a c4.2
rr,,. Hr A I ---
-.y _.T ..r.. , ......
o Efficiency Duct Goofing Cooling
Equip. CEC CertifiiedName (denticle (SEER, etc.) Location Duct Load Capacity
Type and Model Number Systems (=CFA R) (attic, etc.) R -value (BTU / Hr) (BTU I Hr)
RF— US Air a c
I, Me URUerSIgR50, Verily 1JUH UgUIPrrIC11L IISLCu tlUUVC la. IJ L's Ulu tlaaual fi W-1 i/
efficient than that spec fl the ' to of compliance (Form CF -1 R) submitted for compliance with the Energy
Efficiency Standards for es ial bull ' gs, an ipment that meets or exceeds the appropriate requirements for
manufactured devi t e p lian E lency Re ulabons or Part 6), where applicable.
Z$. Team Mechanical
Igna ure,a installingSubcontractor(Co. Name
OR General Contractor (Co. Name) OR Owner
MINIMUM REQUIREMENTS FOR DUCT LEAKAGE COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
CFA-
System
FASystem • M of Q
indicate the mawmum a o)wable Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone B 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
u Pressurizatlon Test Results (GIFIVI U 25 PA)
100 x Test Leakage / Fan Flow = % Leakage
Check Sox for Pass or Fail (Pass = 6% or Less)
WT -24 Compliance Credit was Taken for TXV
ys em of
Indicate the maximum a owa le Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone B 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 L—
TFu-d Pressurization Test Results (CFM is 25 PA)
100 x Test Leakage I Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
r -7T-24 Compliance Credit was Taken for TXV
X.06
X.015
TXV wa:
TXV was
PAGE 1
F2001-01 (4.02) Action Now T-24CF6-RTD&TXV macro
i
Certificate of Insulation
Your Home has been insulated with CertainTeed Fiberglass insulation products, which are designed
for today's safety standards and tomorrow's 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 over time as may other insulation materials.
This also certifies that CertainTeed Fiber Glass Insulation has been professionally installed in this home
to provide the following thermal performance:
Job ]Fame: Tapestry at Esplanade Tract: 29323-2 Phase: 4
Lot il.: I Plan: 1y Address: 79-859 Amora Dr., La Quinta, CA
Ceiling Area: R-38 Blown Garage Ceiling: . Interior Walls:
Overhangs: Exterior Walls: R-13 Unfaced Batts'
With Living Above
Ceiling: Garage Wall:
Inaccessible to Blow
600
Signed
Cantilevered :
Floors NVILNing Above
:. OJInsulation Co., Inc.
a 9I7071 (626) 42-6070 Li eeme #465709
Conchita Ortiz,. Secretary/Treasurer --or-9 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. 1f you ever sell this home, this certificate should be passed on to the buyer.
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