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RPL (12-1136)51060 Mandarina 12-1136 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: S 12-00001136 \' Property Address: 51060 MANDARINA APN: 776 -210 -012 - Application description: POOL - RESIDENTIAL Property Zoning:. LOW DENSITY RESIDENTIAL Application valuation: 24000 T-it!t .4 4 Q" Architect or Engineer: PJa UCEN$ED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that I Ii ns under provisions of Chapter 9 (commencing with Section 70001 of gqivision 3 of the Business a ofessionaIs Code, and my License is in full force and effect. License Class: 8 10 27,2 License No.: 656128 ate: / 0 Z ntractor: Ji OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).: (_ 11, 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 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.). (_ 1 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.). (_ 1 I am exempt under Sec. , BAP.C. for this reason Date: Owner: 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: LQPERMIT VOICE (760j -70 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/26/12 Owner: CITRUS 18 GROUP, LLC 30875 DATE PALM DRIVE STE. C CATHEDRAL CITY, CA 92234 Contractor: 2012 TESERRA P.O. BOX 1280 TA COACHELLA, CA 92236 CI -Ty OFLAQuI (760) 398-9222 FlNAT1mDVT. Lic. No.: 656128 ------------------ 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` 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 and policy number are: Carrier EVEREST NATL IN Policy Number 7600006481121 I certify that, in the performance f the work for which this permit is issued, I shall not employ any person in any manner so as t ec me subject to the workers' compensation laws of California, an agree that, if I should be subject to the workers' compensation provisions of Section 0 of tforthwith hh abor Code, I scomply with those provisions. Date: 44K (plicant 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 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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, indemnify 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 thAbuildinstruction, information is correct. I agree to comply with all city and county ordin nces and state laws relating to and hereby authorize representatives of thiscounty o e r upo -the above-mentioned prpection purposes. o 4e: / ignature (Applicant or Agent):' Application Number 12-00001136 " Permit . . BLDG POOL PERMIT Additional desc " Permit Fee . . 243.00 Plan Check Fee 157.95 Issue Date . . . . Valuation . . . . 24000 Expiration Date 3/25/13 . Qty Unit Charge Per Extension BASE FEE .45.00 22.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 198.00 Permit . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date : . . . Valuation . . . . 0 Expiration Date 3/25/13 "Qty Unit„Charge Per Extension • BASE FEE 15.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 Permit ELEC POOL PERMIT -RES. ' Additional desc . Permit Fee 45.00 Plan Check Fee 11.25 Issue Date . . Valuation 10 Expiration Date 3/25/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 Permit . . . PLUMBING Additional desc. Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/25/13 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP, 3.00 . 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA. ALARMS/BARRIERS SHALL BE IN LQPERMIT Application Number . . . . . 12-00001136 y ---------------------- Special Notes and Comments ------------- -------------- -------- PLACE AT PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED. 2010 - CODES. -----------------_------------------------------------ Other Fees . ... . . . . I --- BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due r Permit Fee Total 347.00 .00 .00 347.00 Plan Check Total 183.95 .00 .00 183.95 Other Fee Total 1.00 .00 .00 1.00 Grand Total. 531.95 .00 .00 531.95 1 s LQPERMIT I r MAIN HOUSE 200 AMP ELECTRICAL PANEL ELECTRIC CONDUIT 93' - It POLYPROPYLENE GAS PIPE POOL STEPS WITH TANNING SHELF AND ONE UMBRELLA SLEEVE RAISED SPA AT +18" WITH TILE FACE, STACKED STONE SPILLWAYS, 4 FLUSH MOUNT DIRECTIONAL HYDROTHERAPY JETS, CATEGORY I PEBBLE TEC NTERIOR AND 8" TILE WATERLINE, CAP BY OTHERS, ALTERNATE JET HEIGHTS 100 WATT SPA LIGHT POOL WITH CATEGORY 1 PEBBLE TEC INTERIOR AND 8" TILE WATERLINE POOL SPLIT MAIN DRAIN SUCTION MINIMUM W APART. ANTI -COVERS IVASME IANSI APPROVED 300 WATT POOL LIGHT POOL I SPA LIGHT JUNCTION BOX POOL I SPA LIGHT ON GROUND FAULT CIRCUIT INTERRUPTER POOL EQUIPMENT: 250,000 BTU HEATER *ALL EQUIPMENT SHALL BE SEISMICALLY ANCHORED POOL EQUIPMENT 50 AMP SUBPANEL WITH 30" CLEARANCE AT FRONT AND SIDE AlLA"RMMROOmt VRWMLATWNMM MOMWWOMMOFTHEAIIOCJW WONWAORTIN WAIDMATNWNOltTMMIm1OINMMMOFtOMYWMOMI NWO 121110 CALIFORNIA BUILDING CODE (GAMONX01BC) 2010 CALIFORNIA MECHANICAL CODE (1ASEDo"mouR:) 201 O CALIFORNIA PLUMBING CODE(EAIWON2101LFC)- 201 O CALIFORNIA ELECTRICAL CODE (11"WON2IBNEC) 20111 CALIFORNIA ENERGY EFFICIENCY STANDARDS WLI E FBDETIM IT NBOR OATS GATE REMBAL _ FARKM A RBN(q RR. W PLR110". COP110 OTHER R&L.Mwlt APAAT+1r OWNER RESPONSIBILITIES oVNleNm (11 WM Mwlm AFFRMWMMOMN WIOFI'OOLdINMATIAYMMMOAr6EWAVAMM M TOCK moyM NMT POOLA1N ArIOUPIEM LOCM MARRE TOAOM"AICE OF P)11EroOAN/GONCARRNRLLAT tEAef1WC8 DALY FOR 61VBl MYtAARIItlit NRA1LID. (N=A -1 1MTT RIA M MDT AEMOItRA1POR U16ROR-OgMRtlR/0R06RC1A AIOAM'DAMAOE 10 GMB1110EVNIL(1. DRIVErAlr1I/RATl4 dt OTIEII nPIM NTIEACOEFI AA ( N!l, TILL FB1gW OA==QWMD0 1tR1 MOSS MN AP 2NCWPW P To PRRPIARTRN MI FRLpOOLRRA®P1TarAFl91 RA\TEIt N1 (FCLWW TtCTtM-00 ROP tM teMIt NDE ) ... -uR wrmi wTwr,r ,rn iAM AOII WIOPttROf IEEANAANDITMTAMY 1! WATgIR QWIMMING POOL PLAN FOR: E THE GROVE LOT 18 J*- 1 1 09-26-12 1 JT. I GRAHAM B. im` I R EV I S 10 N S ami iii E9:4l - - J _ 1 _ L _ _ _ _ _I _1 PL PL TON 114 -MANDATORY REQUIREMENTS ILLATION OF POOL SYSTEMS AND EQUIPMENT YNLL COMPLY WITH MANDARINA ALARMS TO BE INSTALLED ON ALL DOORS WITH DIRECT ACCESS 4E POOL HEATERS I PUMP EQUIPMENT SHALL BE INSTALLED PER MANU FACTURER'S WI )MMENDATIONS AND IN ACCORDANCE NTH LOCAL REGULATIONS IECKING EXPANSION JOINTS FOR REPRESENTAION ONLY, 1 LAYOUT WILL VARY B/rAILATION/oTX;WZ'11EMDF.ROROINOFACN1TIFiONF1EDONOPERAlED1YTHE EXCAVATOR AND m MCIMIL DRjgG1VATO%,Z DEIINMTE MIT WDE PAJ14 OR OTNBIWTAME MANIM IHE ARETO EE lXGVA7ID SELECTION S w _ ~ CONSTRUCTION AUTHORIZATION STONE DARK CHARCOAL SPILLWAY SALES FIELD SPECIFICATION 8 BOULDERS N/A n MISTING LANDSCAPE LIGHTING IN REAR YARD PRE-GUNITE JANDY HAYWARD E COMMAND WITH 6 BUTTON REMOTE UNDERGROUND PEBBIPLAS DOLPHIN BLUE MASONRY SIGNATURE DECK , DrEURI,.,nd wrb&t*n (Or PWvbm MTd Doll, by 010 DRAINAGE NOTE: _ V `•'I°'/ ar`°E""' now. nN o MISTING OVERHEAD UTILITY LINES IN REAR YARD TYPE nnnp ( u x SUE SURFACE AREA OF POOL ONLY N M p 0 FURNITURE FOR ILLUSTRATION PURPOSES ONLY PMWAETat Ta LN. FT. DEPTHS Ma rArMAX t m a` POOL A SPA COMBINED XI In- FT 120 I_N.FT, p BPA SPECIFICATIONS TILEuErim TxC yrd M-r-W-xJW-sm. FT._O_LIS. rr RwTeu+E_]IF =1U (42 WADAMMLLYAM NmoFmm u0mr T1ITIRM /(rlRaRolRO — Rea t<t n n a SPA CAP AND POOL COPING BY 1FLL2wr VMr ""' ' '"W _ _ _ —BS' — _ PL 1F10111LNOIB DECKING RIO j OTHERS AND ARE SHOWN FOR EXCAVATION / STEEL TYN G G U LLUSTRATION PURPOSES ONLY E. A_ i _ ACCIISSM011 STREET L - lXFAIEIONADHii O m IS caNcmMRBWPL= ua1Om1R — woRMOVAL — 7Rff TIM It L1r MRMTON REIR7NKmT— — arm 118 NICE 7meMeL N(-` J' r MIDATIDNRmMIN WDAIOMEOIIEBI BEDROOM 3 BEDROOM 2 I we I Ir — Nea SPA rowerw WIC I I Ir Rea 1I Rea - - L > WRaa — — MASONRY BA gj 2 v 0 RON(PPOO(ors OENVI m caFno 7rFE NSA FACM HALL MBA m-uRwrTYFeF+I F m PLUMBING ' _ - ,LTQ( HAV VAM _ M 32.5 . FT. FODLFIRiIjAyBIlISM VANIAILE 1P[ED FROP. EXT. MRU — RANIIIN 1 — NOOK VEST EDDEIaFum-1111!— ADOLRIIP= M FF If — AODLFIIUM — i 1MImlIIAY111ARD M 250 000 STU MAY MASTER 7mB 17OCl(HAY tD HAND MpMa WITH/ ON REMOTE BEDROOM ADDLOUnEM— DUALPORr FLLLM AUTO EBBL P STER r MAIN HOUSE 200 AMP ELECTRICAL PANEL ELECTRIC CONDUIT 93' - It POLYPROPYLENE GAS PIPE POOL STEPS WITH TANNING SHELF AND ONE UMBRELLA SLEEVE RAISED SPA AT +18" WITH TILE FACE, STACKED STONE SPILLWAYS, 4 FLUSH MOUNT DIRECTIONAL HYDROTHERAPY JETS, CATEGORY I PEBBLE TEC NTERIOR AND 8" TILE WATERLINE, CAP BY OTHERS, ALTERNATE JET HEIGHTS 100 WATT SPA LIGHT POOL WITH CATEGORY 1 PEBBLE TEC INTERIOR AND 8" TILE WATERLINE POOL SPLIT MAIN DRAIN SUCTION MINIMUM W APART. ANTI -COVERS IVASME IANSI APPROVED 300 WATT POOL LIGHT POOL I SPA LIGHT JUNCTION BOX POOL I SPA LIGHT ON GROUND FAULT CIRCUIT INTERRUPTER POOL EQUIPMENT: 250,000 BTU HEATER *ALL EQUIPMENT SHALL BE SEISMICALLY ANCHORED POOL EQUIPMENT 50 AMP SUBPANEL WITH 30" CLEARANCE AT FRONT AND SIDE AlLA"RMMROOmt VRWMLATWNMM MOMWWOMMOFTHEAIIOCJW WONWAORTIN WAIDMATNWNOltTMMIm1OINMMMOFtOMYWMOMI NWO 121110 CALIFORNIA BUILDING CODE (GAMONX01BC) 2010 CALIFORNIA MECHANICAL CODE (1ASEDo"mouR:) 201 O CALIFORNIA PLUMBING CODE(EAIWON2101LFC)- 201 O CALIFORNIA ELECTRICAL CODE (11"WON2IBNEC) 20111 CALIFORNIA ENERGY EFFICIENCY STANDARDS WLI E FBDETIM IT NBOR OATS GATE REMBAL _ FARKM A RBN(q RR. W PLR110". COP110 OTHER R&L.Mwlt APAAT+1r OWNER RESPONSIBILITIES oVNleNm (11 WM Mwlm AFFRMWMMOMN WIOFI'OOLdINMATIAYMMMOAr6EWAVAMM M TOCK moyM NMT POOLA1N ArIOUPIEM LOCM MARRE TOAOM"AICE OF P)11EroOAN/GONCARRNRLLAT tEAef1WC8 DALY FOR 61VBl MYtAARIItlit NRA1LID. (N=A -1 1MTT RIA M MDT AEMOItRA1POR U16ROR-OgMRtlR/0R06RC1A AIOAM'DAMAOE 10 GMB1110EVNIL(1. DRIVErAlr1I/RATl4 dt OTIEII nPIM NTIEACOEFI AA ( N!l, TILL FB1gW OA==QWMD0 1tR1 MOSS MN AP 2NCWPW P To PRRPIARTRN MI FRLpOOLRRA®P1TarAFl91 RA\TEIt N1 (FCLWW TtCTtM-00 ROP tM teMIt NDE ) ... -uR wrmi wTwr,r ,rn iAM AOII WIOPttROf IEEANAANDITMTAMY 1! WATgIR QWIMMING POOL PLAN FOR: E THE GROVE LOT 18 J*- 1 1 09-26-12 1 JT. I GRAHAM B. im` I R EV I S 10 N S ami iii E9:4l - - J _ 1 _ L _ _ _ _ _I _1 PL PL TON 114 -MANDATORY REQUIREMENTS ILLATION OF POOL SYSTEMS AND EQUIPMENT YNLL COMPLY WITH MANDARINA ALARMS TO BE INSTALLED ON ALL DOORS WITH DIRECT ACCESS 4E POOL HEATERS I PUMP EQUIPMENT SHALL BE INSTALLED PER MANU FACTURER'S WI )MMENDATIONS AND IN ACCORDANCE NTH LOCAL REGULATIONS IECKING EXPANSION JOINTS FOR REPRESENTAION ONLY, 1 LAYOUT WILL VARY B/rAILATION/oTX;WZ'11EMDF.ROROINOFACN1TIFiONF1EDONOPERAlED1YTHE EXCAVATOR AND m MCIMIL DRjgG1VATO%,Z DEIINMTE MIT WDE PAJ14 OR OTNBIWTAME MANIM IHE ARETO EE lXGVA7ID SELECTION S w _ ~ CONSTRUCTION AUTHORIZATION STONE DARK CHARCOAL SPILLWAY SALES FIELD TILE SST RUST BOULDERS N/A DIG DECK COLOR BY OTHERS PRE-GUNITE JANDY HAYWARD E COMMAND WITH 6 BUTTON REMOTE UNDERGROUND PEBBIPLAS DOLPHIN BLUE MASONRY SIGNATURE DECK , DrEURI,.,nd wrb&t*n (Or PWvbm MTd Doll, by 010 DRAINAGE NOTE: _ V `•'I°'/ ar`°E""' now. PRE -PEBBLE I i i : . Bin.# ' CIof La Q Uinta tY. Building a Safety Division Permit # P.O. Box 1504,78-495 Calle Tampico 17' La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet - Project Address:O O 1 Owner's Name:. y — o Li A P. Number. Address: S/06O qN 2)A/4- . Legal Description: City, ST, Zip: 1_4 0,4,1' r CA 7-S-7. Contractor: 2 Telephone:,♦sst' . Address: g 6 /p VE: Sy Project Description: V— 0C_ City, ST, Zip: i - Telephone: ?f/ C9zz3 AdD /32f0 75' 14S<t- 1A State Lia 4: 6S C / 2_'8 City Lic. #; Arch., Engr., Designer Address: City,, ST, Zip: Telephoner State Lic. #: Construction Type:. Occupancy: ' w u Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: v(.+E9 1 Sq. Ft : #Stories: #Units: Telephone # of Contact Person: 76 0 .2 9 1-2 Estimated Value of Projects ® 0 APPLICANT: DO NOT WRITE BELOW THIS UNE # SubmittalReq'd Recd TRACKING PERMrr FEES Plan Sets Plan Check submitted Item Amount Strydural Ca[cs Reviewed, ready for corrections Plan Check Deposit. Truss Calcs. Called Contact Person Plan Check Balance_ Title 24 Calci. Pians picked up Construction Flood plalu plan— --- dans-resubmitted-- —.—=. - --- -Mechanical— . Grading plan r' Review, ready for correctionsfiissue Electrical " -Subeontactor List Called Contact Person Plumbing - - ---` - Grant Deed Pians picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review; ready for corrections/issuc Developer Impact Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wks. Apps ' Date of permit issue School Fees Total Permit Fees fNSTALLAT'ION CERT -1 FICATE foal Arid Spa li{eatirtg asteE tc CF-6 -ivLEC i-03 'site Address: 'nforcenentF;ency:Q Permit Number: Pool and Spa HEafing Systertt te i et eetts §I 14(a): Systertts snd Equipment. Cf E. Heater has a thermal efficiency that complies with the Appliance Efficiency Regulations. 2. Hasa readily accessible on-off switch mounted outside of the heater. 3. Weatherproof plate or card containing operating instructions for the pool or spa heater. 0' 4. 'No electric resistance heating except for listed package units that has fully insulated enclosures and tight firtin covers that are insulated to at least R-6. Or if documentation is provided that at lease annual heating t 60 % of the energy is from site solar energy or recovered energy. g Q S. Heating system has no pilot light_ § 114(b): Installation. 0 I . Systern is installed with at least 36" of pipe between the filter and heater, or dedicated Suction 13 or. built-in or built-up connections for future solar heating. coon and return lines, 2: A Coverre pools or spas that have heat pump or gas heater. 3. Pool system has directional inlets to adequately mix the pool water 4. Time switch which will allow the pump to be set or programmed to run duringoff-peak p periods only §ISQ(p) Purnp Sizing and flow rate specification 1 1. The pump specified is listed in the CEC database of certified pool pumps. 2- The Pump flow rate shall be calculated based on pool sizing table below. [3 3. The Pump is capable of operating at 2 or more speeds (not applicable if pump is less than I horsepower). 4- Each auxiliary pool load is served by either a separate pump, or.the system is seried by a multi -speed pump. Pool sizin aloes tsr b e ased ¢n it eraperrtuarz all Pool owable turnover roe of 6- hours' Max Volurne Min Pipe D or Greater inches allons) _ _l_Ain Filter Area or.more Maz Pump ReturnSuction t 3,000 15 s uare feet e Sand C! DE Flow m 17,000 1.5 2 2 00aruid 2.4 20 36 21,000 2 2 130, 3.1 25 47 213,0002 2.5 160 3.9 3Q 5$ 42,000 2.5 3 210 5.2. 40 .7$ 49;000 3 3 320 7.8 60 117 Note: For urrr P ps greeter than ! h p. 360 g.9 70 133 rhe maximum Pump Floiv is 5. the lowest rc7 speed default frliratioae Calculated volume of pool 0 (gallons). 'T 6. Ret6 ' pi . pe Diameter ' S (inches). 7. Suction Pipe Diameter_ S $. Filter Type (inches)_ /7 . 9. Filter Surface Area l Age^(0Cartridge, Sand, DE). e C'110. Ma.i Pump Flow-z"g S zs- (m). (gp 2008 Residential Compliance Forrns August 2009 i i. v a]NSTALLATFFjCATE col weld S a F3eatin stentsF3- 03 • I Site Address: . 'a e i of 2) ° Enforcement Agency: Permit [Number: I1 N System Piping Un1iT/t The suction side pipe is straight for at least 4 pipe diameters before entering the pump (See table below required straight run lengths for various pipe sizes). for the !2_ The design uses low pressure drop fittings (swee 90' S) P ) Pipe Diameter Required Pipe Length inch [eaditi into um inch i I.5 6 : 2.5 10 Filtr,aiiioon Equipment I . If a backwash valve is used_ The diameter of the backwash circulation pipe, whichever is greater multi -port valve is 2 inches Of large as the DECLARATION STATEMENT certify under penalty of perjury, ry, under the laws of the State of California,'the information provided orithis Form is we and correct. I am eligible under Division 3 of the Business and Professions Code to accept-responsibilityfor construction, or an authorized - representative of the person responsible for conshvction (responsible person). C I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation ) enforcement agency. conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the . © (reviewed a copy of the Certificate of Compliance (CF -1 R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. t will ensure [flat a completed, si ned co ficate shall be po2ted, ormade Permit(s) issued for the building acid inade avpy tailable to the enforcement ragency f'or all appli abit (nspecto s le ItH the aderstandg that s signed copy of this Instaoccupancy. lesion Certificate is required to be included with the docurnectatitin the builder provides to the building owner at occupancy. Com ame: t ing Subcontractor or General Contractor or BuildedQwn r} Responsi a P erson, rJ.mo. 8 (/ \ Responsibl erson's Signature: CSLB License: — Date Sgned• Positio zgs h Company (Title): 2008 Residentiol Compliance Forms August 2009