The URL can be used to link to this page

SFD (0311-100)55255 Medallist Dr 0311-100 Fla 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 f?roSessionals Code, and my License is in full force.and effect. . +' License # Lic. Class Exp. Date ' 4820,36 Dafen- `; 4" Signature of ContractorG w 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). (Z) .I, as owner of the property, am exclusively contracting' with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code): O 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. Sec(;) I' have and will maintain'workers' compensation insurance, as required by tion 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 Policy No. VTRF1.5iID '(This section need not be completed if the permit valuatio"n 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 shall forthwith comply with thh sseoprovisions.' lcr te.,/7 Applicant,, Warning: Failure to secure Workers' Compensation coverage is'unlawful and shall subject an employer to criminal penalties and civil fines up to $1.00,000, 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 permif''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 dateof 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'inspe ction purposes. Datece = Sig"nature (Owner/Agent).-''' r¢ ''' /'1' Z"°':s BUILDING PERMITPERMT# . DATE VALUATION LOT: TRACT S:h• JOB SITE - APN ADDRESS - r1 les 7Z26.W1. OWNER CONTRACTOR /DESIGNER / EN (NEER 10701RD* 81 095NATE.44ALlu.76 ;"A,, 33t) XQ-10WA CA. - "R LA's C t USE OF PERMIT : t'j+7'1"? ;it''t7.h?\rtTF * [ kAJ1z:( :Y f 1• ' SIM lk PFT.tMITd 1pM IZOT iNc.t:VWF .81rQCic WA--A-L4 4 11004 SPAT; R 17f{3'is AW'AY AP.9?jR0; kCH . CVST()V ONSTAUC71014 301G<t)S% F t ` ' CA! .dti i70i.AaRPOu F lk IMI Sp F;ST..GAA11.VCUM 7`R. immmir me Sum wvy C: s°ri RiJ A 1{J x t . 1 t?; gar -yid S -O4?. rv Y. 1ii PLAN r;I'3.fYCK, F8Jk Cs ;-4):J +- r:3 > %fi i,r ¢ •. i„ F 1':21C"d4.i.,• FrF 0, , I &47 STROMO VOTJrAkl R.I`31D '101 -000 :l4I !a^c 'LC sErxC: pis t`Ss` r i iliif ? 1Wi t l6"TQ "Chip ;' 4 s1'I,69 SUB i,CAAL V)i i C,.q dp ' q77 X?QQ!J rpH qpyycc d.R4:32 K67:`+d:.r'PA"du:. iC 223 o D ".11M nn pp yy' '{ ay 7: 7/ " 1ry1J. .A ! :Ld.1':r. MY .'...' Ci .I W'.L's B` W DEC 1 `7. 1003 CITY OF LA QUINTA FINANCE DEPT, RECEIPT DArE r BY D FI ALE/ INSPECT INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs_Underground Ducts Forms & Footings U Ducts Slab Grade Return Air. Steel Combustion Air Roof Deck Exhaust Fans OX to Wrap /( p F.A.U. Framing Compressor Insulation /6 Vents n _ Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath p Drywall - Int. Lath S Final Final BLOCKWALL APPROVALS POOLS - SPAS 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 Encapsulation Gas Piping - Gas Test / Appliances Final 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) COMMENTS: _ - i� LATIOW C1=RT'IFI#%AT0 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 55=255-tM UAi��IS7 eRIVE_LOT-2.-LA dUiNTA CA-` r QEL LINGS: TYPE: BATTS MAUNFACTURER: Csrlainteed THICKNESS: R-38 WALLS: TYPlw: BATTS MANUFACTURER: Owens Corning THICKNESS: R-19 r GENERAL CONTRACTOR: r=HLINE CO BUILDERS LICENSE � BY: TITLE: PARAGON SCHMID BUILDING PRO UC TS A MASCO Company LICENSE 221517 ! Y: TITLE: ACCOUNT REPRESENTIVE DATE: "H'/%n'J!I/%'Ji.;/I."!.•!!//NI'./i"/JJrf.elr•IJf:A'/r./r.riil'ArIJJ,::/l,.l:ii!••:.CrIJ/rlrl.rwr.Jlr 1./•L A.'::JArf.'�r.i:.•Jr.: �� !. / NJI:.•'i.l..'.E�lrwrli4/•!:!,'✓/!.•I�NJ:'✓rulJ✓'J:'r�l.Ilvit.:l�'eJJJ.v//Jr l,•.�r:�•� rMnliult 760 636 0856 p.2 R F STRUCTURAL CONSULTANTS, INC. 44-1 oc MONTEREY Ave. SUITE 201-.C, PALM DESERT, -CA-. 9.2260 PHONE 17150) 836-1000 FAX (760) 838-01955 E-MAIL R. FRAN GIC@VERIZON.NET APRIL. 8, 2004 EHLWE COMP. DUILDERS AND DEVELOPERS 81-480 NATIONAL DRIVE LA Q=. A; -CA. 92253 Ann.: MR. LARRY NELSON Re.: MEDALLIST DEVELOPMEI-;T. THE NORMAN ESTATES AT PGA WEST LA QUINTA; CA. FOLLOW-UP TO WALK THROUGH JOB NO, 4092, PLAN 2 DEAR LARRY .THIS LETTER ADVISES THAT WE HAVE OBSERVED THE STRUCTURAL REQUIREMENTS THAT ARE VISIBLE DURING CONSTRUCTION AT THE TIME OF OUR SITE VISIT. A LIST OF REQUESTED CORRECTIONS WAS PROVIDED TO THE OWNER'S REPRESENTATIVE. WITH THE EXCEPTION OF THE REQUESTED CORRECTIONS, WE BELIEVE THAT TBE AS-BUTLT CONSTRUCTION AT THE TIME OF OUR VISIT IS IN GENERAL CONFORMANCE WITH OUR STRUCTURAL PLANS AND RELEVANT CORRESPONDENCE ISSUED BY OUR OFFICE. WE OBSERVED THE BUILDING INTITS FRAMED CONDITION PRIOR TO INSTALLATION OF DRYWALL AND STUCCO. WE OBSERVED THE VISUAL AND ACCESSIBLE STRUCTURAL REQUIREMENTS. (EXCLUSIONS ARE ITEMS SUCH AS: FOOTING SIZE AND REINFORCEIVMNT,.TOP PLATE SPLICES, ROOF SHEATHING, AND ANY. STRAPS ABOVE THE ROOF SHEATHING.). RESPECTFULLY SUBMITTED i Desen- - ENERGY erC Alf E C Services PO. Box 621 Ph/Fax (760) 564-2044 . Rancho Mirage, CA 92270 Cell: (760] 250=1852 Email: DESNRG C&AOL.COM CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R GREG NORMAN ESTATES PH 1 Project Title ` 55-255 — MEDALLIST. DRIVE LA QUNTA CA. 92253 Project Address GILBERT LEVZA 760-578301 DATE TESTED 11-8-04 Date EHLINE CO. Builder Name PLAN 2 3 UNITS Builder Contact Telephone Plan Number ALAN WEAVER 760-880-5504 GROUP .1 HERS ter Telephone Sample Group Number -a+- #CCNAW183266 11-09-04 LOT 2 1 OF 3 Certifying Signature Date Sample Lot Number Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS Street Address: P.O. BOX 621 City/State/Zip: RANCHO MIRAGE, CA. 92270 Copies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: ® Tested ❑ Approved as part of sample testing but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form comply with the 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.. ® MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6%Duct Leakage) Measured Duct Pressurization. Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM 32 If.fan flow is calculated as 400cfm/ton x number of tons enter calculated value here 800 If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) = 4 Check Box for Pass or Fail (Pass=6% or less) ® ❑ Pass Fail ® THERMOSTATIC EXPANSION VALVE (TXV) ® Yes ❑ No Thermostatic Expansion Valve is installed and Access is ® ❑ provided for inspection ENERGY �� -- C A d E C N -Aces P0. Box 621 Ph/Fax (760) 564-2044 Rancho Mirage, CA 92270 Cell: (7601250-1852 Email: DESNRG MAOL.COM i CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R GREG NORMAN ESTATES PH 1 DATE TESTED 11-8-04 Project Title Date 55-255 MEDALLIST DRIVE LA QUNTA CA. 92253 EHLINE CO. Project Address 760-578 301 Builder Name GILBERT LEVZA PLAN 2 3 UNITS Builder Contact Telephone Plan Number ALAN WEAVER 760-880-0504 GROUP 1 HERS Telephone Sample Group Number .#CCNAW183266 11-09-04 LOT 2 2 OF 3 Certifying Signature Date Sample Lot Number Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS Street Address: P.O. BOX 621 City/State/Zip: rwNUnv MIKAUM, %.A. VAciu Copies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: ® Tested ❑ Approved as part of sample testing but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form comply with the diagnostic tested compliance requirements as checked on this forma ® 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. ® MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) , Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM 70 ' If fan flow is calculated as 400cfm/ton x number of tons enter calculated. value here 1400 If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) = 5 Check Box for Pass or Fail (Pass=6% or less) 91 ❑ Pass Fail ® THERMOSTATIC EXPANSION VALVE (TXV) ® Yes ❑ No Thermostatic Expansion Valve is installed and Access is ® ❑ -provided for inspection " 1 Damn - ENERGY CADE S P0. Box 621 Ph/Fax (760) 564-2044 Rancho Mirage, CA 92270 Cell: (760] 250-1852 _ Email: DESNRG MAOL.COM f° CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R GREG NORMAN ESTATES PHI DATE TESTED 11-8-04 Project Title Date 55-255 MEDALLIST DRIVE LA QUNTA CA. 92253 EHLINE CO. Project Address 760-578 301 Builder Name GILBERT LEVZA PLAN 2 3 UNITS Builder Contact Telephone Plan Number ALAN WEAVER 760-880-6504 GROUP 1 HERS er '1 Telephone Sample Group Number #CCNAW183266 11-09-04 LOT 2 3 OF 3 Certifying Signature Date Sample Lot Number , Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS Street Address: P.O. BOX 621 City/State/Zip: RANCHO MIRAGE, CA. 92270 Copies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: ® Tested ❑ Approved as part of sample testing but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified_ on this form comply with the 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. ® MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM 82 If fan flow is calculated as 400cfm/ton x number of tons enter calculated value here 1600 If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) _ 5.125 Check Box for Pass or Fail (Pass=6% or less) ® ❑ Pass Fail ® THERMOSTATIC EXPANSION VALVE,(TXV) ® Yes ❑ No Thermostatic Expansion Valve -,is installed and Access is provided for inspection 0 ❑