SFD (06-2646)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
06-00002646
81545 MONARCH CT
764-280-999-5 -300237-
DWELLING - SINGLE FAMILY
MEDIUM-HIGH DENSITY RES
218593
Ti . ht 4 4Q*rw
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
DETACHED 8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
rchitect or Engineer:
�-- h, Corte
rLcE_ _Le -40
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 00q) of Division 3 of the as' s and Profes�inaL�Is Codeand my License is in full force and effect.
�Ial-
672285
ntractor: cax
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).:
1 _ 1 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 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 _ 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.).
I—) I am exempt under Sec. , B.&P.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: pip
LQPERNIIT
Contractor:
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: i 7/12/06
AUG o 21006
CITY OF LAA QUINTA
WORKER'S COMPENSATION DECLARATION
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 and policy number are:
Carrier AMERICAN HOME Policy Number 1247619
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any man so as to become subjeotao workers' compensation laws of California,
and agree that, ' eco a subject to the rkers' compensation provisions of Section
3700 oft L or de I shat for with co ' h those provisions.
Date: ' Applic
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.
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 Ouinta, 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 th t I h ve read this application and state othee informatt
s correct. I a ee to comply with all
city and c unty r ' n sand state laws relating cood eby au representatives
of t tj t e e o he above-mentioned p tionoses
Date: Signature (Applicant or Agent
Application Number . . . . . 06-00002646
------ Structure Information SFD PLAN 6420C W/MBR BAY
-----
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . .
. . . DWELLG/LODGING/LONG <=10
Other struct info . .
. . . CODE EDITION
2001
# BEDROOMS
4.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
615.00
PATIO SQ FTG
323.00
NUMBER OF UNITS
1.00
------------------------------
.1ST FLOOR SQUARE FOOTAGE
---------------------------------------------
2503.00
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
1056.00 Plan Check Fee
686.40
Issue Date . . . .
Valuation . .
. . 218593
Expiration Date
1/08/07
Qty Unit Charge
Per
Extension
BASE FEE
639.50
119.00 3.5000
-------------------------------
THOU BLDG 100,001-500,000
--------------------------------------------
416.50
.Permit . . .
MECHANICAL
Additional desc .
Permit Fee• . . . .
83.50 Plan Check Fee
20.88
Issue Date
Valuation . .
. . 0
Expiration Date
1/08/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE -<=100K
18.00
2.00 9.0000
EA MECH B/C <=3HP/100K BTU
18.00
4.00 6.5000
EA MECH VENT FAN
26.00
1.00 6.5000
----------------------------=-----------------------------
EA MECH EXHAUST HOOD
------------------
6.50
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date
Expiration Date .
ELEC-NEW RESIDENTIAL
114.91 Plan Check Fee . . 28.73
Valuation . . . . 0
1/08/07
Qty Unit Charge Per Extension
BASE FEE 15.00
2503.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 87.61
615.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.30
LQPERAIIT
0
Application Number . . . . . 06-00002646
---------------=---------------------------2----------------=------------•---
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
PLUMBING
153.00 Plan Check Fee . . 38.25'
Valuation . . . . 0
1/08/07
Qty
Unit Charge
Per
Extension
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes
BASE FEE
15.00
14.00
6.0000
EA
PLB
FIXTURE
84.00
1.00
15.0000
EA
PLB
BUILDING SEWER
15.00
1.00
7.5000
EA
PLB
WATER HEATER/VENT
7.50
1.00
3.0000
EA
PLB
WATER INST/ALT/REP
3.00
1.00
9.0000
EA
PLB
LAWN SPRINKLER SYSTEM
9.00
6.00
.7500
EA
PLB
GAS PIPE >=5
4.50
1.00
----------------------------------------------------------------------------
15.0000
EA
PLB
GAS "7ETER
15.00
Permit . . . GRADING PERMIT
Additional desc .
Permit Fee 15.00
Issue Date . . . .
Expiration Date . . - 1/08/07
Plan Check Fee .
Valuation . . .
00
0
Qty Unit
Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes
and Comments
SFD - Lot 5 Plan
6420C (2503
sqft)
w/MBR Box Bay
(26 sqft). Permit.does not
include block
wall, pool or
driveway
approach. 2001
CBC, CMC, CPC,
2004 CEC,
2005 ENERGY CODES
---------------------------------------
Other Fees .
. . . . .
------------------------------------
. ART IN PUBLIC PLACES -RES
46.48
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
480.00
ENERGY REVIEW FEE
68.64
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI) - RES
21.85
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1666.00
Fee summary
Charged
Paid Credited
Due
LQPERMIT
Application Number
. . .
06-00002646
-- - - - - - - - - - - - - - ---
Permit Fee Total
--- - - - - --
1422.41•
---- - - - - - -
.00
Plan Check Total
774.26
.00
Other Fee Total
3832.97
.00
Grand Total
6029.64
.00
LQPERMIT
.00
.00
.00
.00
1422.41
774.26
3832.97
6029.64
JCM Inspections
- 139725 Garand Lane Suite F
Palm Desert, CA 92211
INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS
COMPRESSION STRENGTH TEST RESULTS
Client: Shea La Quinta, LLC
Date: 11115106
Project: Trilogy @ La Quinta - Shea Homes
Project No: 02-1109
60-800 Triolgy Parkway
La Quinta, CA 92253
Set ID Structure
Age of Test
Compression Strength
JCM ID Location
Date Cast Cylinder ID
(days)
(psi)
Set A Phase 16A - Lot # 7005 Slab on Grade
8-15-06
Concrete
273-760 Guest Suite
Required psi: 4000
4457
7
3470
4458
28
4940
4459
28
4980
•
Page 1 of 1
CERTIFIED:
st 54f 6 Ino N
0
JCM Inspections supplies the service
of compression strength test results only.
Per ASTMC39
w_
JCM Inspections
39725 Garand Lane Suite F
Palm Desert, CA 92211
INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS
REINFORCED CONCRETE INSPECTION REPORT Dates: Noted Below
Project Name: Project No:
Trilogy @ La Quinta - Shea Homes 02-1109
Project Address: City:
Z IBC
60-800 Triolgy Parkway La Quinta, CA
F—] Title 24
Client: Sub -Contractor:
Shea La Quinta, LLC DCCCC
Other:
General Contractor: Architect: Structural Engineer:
Shea Homes for Active Adults Bassenian Lagoni Borm & Associates, Inc./ Suncoast Post Tensi
Slump (inches): Supplier: Superior
Weather:
Time Sampled: b n Mix Design: D83625P
Time in Mixer (min.): Specified Strength (PSI): 4000
Unresolved Items:
Water Added @ Jobsite (gals.): 0.1R— Addmixture: POZZ 322N
Concrete Temperature (F): c 3 Truck #: —3 Ticket #: 1309
® None
Ambient Air Temperature (F): Field ID Marking: Set A - 4 cylinders
❑ See Below
Location of Sample: SI rNz. On L? t n'Je — U ., rz+
❑ No Samples Taken
Dau&rmotion of Work Inspected: Phase Lot# Product Ian �( L,� QC,
J
t� CEJ rn0,1c�f�\1 iOt r
FN -\y -n(D
1) Received mill certifications for rebar and tendons placed.
2) Typical exterior Footings including Garage Footings/Door (11,12,13/SD-1), Tie Beams (20/SD-1), Typical Interior Footings/Rib including step (15,18/SD-1),
Seven Strand Tendons (4,10,12,13,16/SD-1), Simpson Strong Walls (24/SD-1), Anchor Bolts and Holdowns (6,7,8/SD-1), Pad Footings and additional
rebar placed as per these details and as noted on Itv 1r% � � j 5 d'5 Q, W 1h P 0 W 0—
Also,
Also, typical details 2, 3/SD-1 and Notes on SN -1 apply. Checked rebar for grade, size, placement, coverage and splices. Rebar and tendons were
securely tied and supported off the earth. Accepted for concrete placement.
F - Is - h(o
1) The placement of concrete for areas noted above except Garage Interior Footing and Slab on Grade. Total cubic yards placed: approx l O
A mechanical vibrator was used to consolidate the concrete. Approved #4 rebar slab dowels were placed @ 18" o.c.
2) Molded 4 cylinders for compression tests with breaks at 7 days (1), 28 days (2) and one for holding purposes.
R- \6- o(.c>
1) The placement of concrete for Garage Interior Footings and Slab on Grade Total cubic yards placed: approx Verified correct mix design.
i
I certify that I have inspected all of the above work, unless otherwise noted, and to the best of my ability I have found this work to comply with the approved
pecifications applicable building laws. Final report issued at project completion.
Inspector: Jack C. Millin ICC Certification.rN 216-80
Contracta'r's Representative: //
Copy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency Page of
JCM Inspections
39725 Garand Lane Suite F
Palm Desert, CA 92211
INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895
INSPECTIONS
PRESTRESSED CONCRETE INSPECTION REPORT
Date:
Project Name:
Trilogy @ La Quinta - Shea Homes
Project No: 02-1109
Project Address:
60-800 Triolgy Parkway
City:
La Quinta, CA
Client: Sub -Contractor:
Shea La Quinta, LLC Sun Coast Tensioning
General Contractor: Architect:
Shea Homes for Active Adults Bassenian Lagoni
Structural Engineer:
Borm & Associates, Inc./ Suncoast Post Tensi
Size and Type of Tendons: 1/2" Diameter Seven Strand Stress -Related Tendons
Jack Machine Calibration: Received Sheet from Sun Coast -Gage Pressure in psi to Machine Load in kips
S ticx> psi to 33.04 kips/33,000 lbs
Calibration Date: Machine # Wa In _ 1-7 _oto
Phase \(D N Lot# —1ppkr ; Product Plan LI_ioC. cJ Sym nnn s (
❑✓ IBC
❑ Title 24
Other:
Unresolved Items:
Q'None
❑ See Below
Description of Work Inspected: SpecifiedN
Lot # Location Tendons Elongation (in)
�,C.+.� ���• w\� ,
Actual Elongation (in) t + �'
�0 .
/e`
11 C C_
R
a_ \n' r _7L"3
(�
V
a; o .i
3
✓
1b �C C1, ft . -t -- � :
Icertify that I have inspected all of the above work, unless otherwise noted, and to the best of my ability I have found this work to comply with the approved
pl ecifications _applicable building laws. Final report issued at project completion.
Inspector: Jack C. Millin ICC Certificatton`�No: 0842216-89
Contractor's Representative:
Copy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency Page l of I
Nov 07
2006 3:43PM HP LASERJET FAX p.5
t
/:':: I'i%y/J:.//./•..(1,:.%l/✓.':ri//,✓/fJ:fl✓%
/!:'/w. FJu✓.::1,.::1t YI%/YIiS///:ll.'I/l/A'%%itAj/SnN•!.!I/I/'//I/.G/l.Cl.•w..i%//'✓/O/ 1%J/i.4/•IIYIJI.//.✓%%l:r/�'LYJ%I/J/ r.:/JJ.•!///r/IlI/w,.•%•!.'I///!./I••l. ll/: r/.yli/:%..r
✓:.`
INSULATION CERTIFICATE
This is to certify that insulation in conformance with the current energy
regulation, Catlfomia AdminlstrState of California, In the building located at:
&b-
81-545 Monarch ose 16A, Trilogy Project, La Quinta, California
s
CEILINGS:
r,
TYPE: SLOW MANUFACTURER: CERTAINTEED Thickness: R-38
n
WALLS:
TYPE: BLOW MANUFACTURER: CERTAINTEED Thickness: R-13
;
j
GENERAL CONTRACTOR: SHEA HOMES LICENSE #
BY: TITLE:
f
PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072
s
BY: TITLE: OFFICE MANAGER DATE: 11/7/2006
/
f
•:v.: ../v: .:.✓r.-:,
r.:•r.-:n/;r.•.r•xU.n::n/t'✓.:o'.,:t:✓..r/a....:.:'1. ../...:.•::.. s. .'. r.,. .r vr: r•
f
•
9
NO.' 14,2006 12:04 BCI*TESTING,ri1
•
E
000-000-00000
1-1
CERTIF ERIEI_CATION & DIAGNOSTIC TESTING (Page 1 of B Cf -4R
dress Builder Name
1545 Monarch Court - La Uinta CA 92253 Shea Homes, Inc.
Bui er
mommoo0IOW Telephone Plan Number
HERS Rater Telephon O mple Group Number- t # (lf applicable)
William Henson 760-772-29 °459n7 /7ons
Certifying Signature
Firm: BCI Testing
Street Address: 77-760 Country Club Drive Ste I
L3, 2006 CC3-1798386489
HERS Provider. CaICERTS
City/State/Zip: Palm Desert / CA / 92211
Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT
The house was R 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 house identified on this form complies with the
dlagnostic tested compliance requirements as chocked on this form. The HERS rater must check and verify that the new distribution
system is fully ducted and correct tape is used before a CF -411 may be released on every tested building. The HERS rater must not
release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested buildings.
The installer has provided a copy of the CF -611 (Installation Certificate).
New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns In lieu of ducts).
New systems where cloth backed, rubber adheslve duct tape Is Installed, mastic and drawbands are used in combination with doth
backed rubber adhesive dud tape to seal leaks at dud connections.
INIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT: Main 5 stem
NEW CONSTRUCTION
Duct Pressurization Test Results (CFM ® 25 Pa)
Measured
Values
1
Enter Tested Leakage How in CFM:
62
1400
2
Measured - +�
Fan Flow: Calculated (Nominal (,'..Cooling i..) Heating) or Measured
Enter Total Fan Flow in CFM;
3
Pass if Leakage Percentage < 6% [ 100 x ( Line 1 / Line 2 )): y
4.43%
Q Pass ❑ Fail
ALTERATIONS: Duct System and/or HVAC Equipment Change -Out
4
Enter Tested Leakage Flow In CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct
System Alteration and/or Equipment Change -Out.
5
Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Dud
System Alteration and/or Equipment Change -Out.
6
Enter Reduction in Leakage for Altered Duct System
[Line 4 - Line 5] - (Only If Applicable)
7
F.ntar TestsA Leakage Flow in CFM to Outside (Only if Applicable)
8
Entire New Duct System - Pass If Leakage Percentage : 6% [ 100 x ( Line 5 / Line 2 )):
(� Pass ❑ Fail
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC
Equipment Change -Out, use one of the following four Test or Verification
Standards for compliance:
9
Pass if Leakage Percentage •=- 15% [ 100 x ( Line 5 / Line 2 )j:
❑ Pass ❑ Fall
10
Pass if Leakage to Outside Percentage <= 10% [ 10T. (Line 7 /Line 2 ));
❑ Pass n Fail
11
Pass if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )]
and Verification by Smoke Test and Visual Inspection
❑ Pass ❑ Fail
12
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
❑Pass ElFail
Pass if One of Llnes fig through R1T pass
IR
Pass FJFail
Page 2
. NOV 14,2006 12:05 BCI*TESTING,ri1 000-000-00000
•
0
CERTIFICATE OF FIELD VERIFICATION A DIAGNOSTIC TESTING (Page 1 of 8) CF -4R
Project Address Builder Name
81545 Monarch Court - La Quinta, CA 92253 Shea Homes, Inc.
Builder Contact Telephone Plan Number
6420 STD
HERS Rater Telephone SampleGroup NumberI Lot # (if applicable)
Compliance Method (Prescriptive) i �nCGmate Zone'l3
Certifying Signature,) t (Y Date Certificate Number
%'_ •4/-� November 13, 2006 CC3-1798386489
Firm: BW Testing HERS Provider:CAICERTS
Street Address: 77-760 Country Club Drive ste I City/State/Zip:Palm Desert / CA / 92211
Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT
The house was R 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 house identified on this form complies with the
diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution
system is fully ducted and correct tape is used before a CF -4R may be released on every tested building. The HERS rater must not
release the CF -411 until a properly completed and signed CF -6R has been received for the sample and tested buildings.
The installer has provided a copy of the Cf -6R (Installation Cerlifiwte).
Now Distribution system Is fully ducted (i.e., does not use building cavities as plenums or platform returns In lieu of ducts).
New systems 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: New System
NEW CONSTRUCTION
Duct Pressurization Test Results (CFM 0 25 Pa)
Measured
Values
I
Enter Tested Leakage Flow In CFM:
49
2
Fan Flow: Calculated (Nominal',"" Cooling'... Heating) or'_ Measured
Enter Total Fan Flow in CFM:
1200
3
Pass d Leakage Percentage < 6% ( 100 x ( Line 1 / Line 2 )]:
4,0a to
Q past ❑Fay
ALTERATIONS: Duct System and/or HVAC Equipment Change -Out
4
Enter Tested Leakage Row in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct
System Alteration and/or Equipment Change -Out.
S
Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct
System Alteration and/or Equipment Chahge-Out.
6
7
Enter Reduction in Leakage for Altered Duct System
[Line 4 - Line 5]- (Only if Applicable)
Enter Tested Leakage Flow in CFM to Oulsidr, (Only If Applic>ble) ++
S
Entire New Duct System - Pass if Leakage Percentage < 6% [ 100 x ( Line S / Line 2 )j:
❑ Pass ❑ Fail
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC
Equipment Change -Out, use one of the following four Test or Verification
Standards for compliance:
9
Pass if Leakage Percentage <.= 1S% [ 100 x ( Line 5 / Line 2 )]:❑
Pass ❑ Fail
10
Pass if Leakage to Outside Percentage - - 10% [ 100 x ( Line 7 / Line 2 )J:
`., nf Pass ❑ Fail
11
Pass if Leakage Reduction Percentage >= 601/n [ 100 x ( Line 6 / Line 4 )1
and Verification by Smoke Test and Visual Inspection
❑ Pass ❑ Fail
❑ Pass ❑ Fail
12
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
Pass if One of Lines #9 through #12 pass❑pass
❑Fail
Page 3
NOV 14,2006 12:05 BCI*TESTING,ril 000-000-00000 Page 4
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 6) CF -4_ R
•Project Address �tludder Name
81345 Monarch Court - La Quints, CA 92253 Shea Homes, Inc.
Builder Contact Telephone Plan Number
6420 STD
HERS Rater Telephone Sac»ple WR6up Nilmber / Int # (if applicable)
William Henson 760-172-2954 N59d7= 460.5;_
(Compliance Method (Prescriptive) Climate Zone 15
Certifying Signature �� _/ Date Certificate Number
November 13 2006 CC3-1798386489
Firm: BCI Testing: HERS Provider;CalCERTS
Street Address: 77-760 Country Club Drive Ste I City/State/Zip:Pdlm Desert/ CA/ 92211
CODles to: BUILDER. HERS PROVIDER AND BUILDING DEPARTMENT
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 house identified on this form complies with the
diagnostic tested compliance requirements as checked on this form.
The installer has provided a copy of the CF -6R (Installation Certificate).
HERMOSTATIC EXPANSION VALVE TXV : Main System
Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed
on the system and installation of the specific equipment shall be verified.
Main System HVAC System TXVI M Pass LI Fail
•
•
NO�7 14,2006 12:05 BCI*TESTING,ri1 000-000-00000 Page 5
CERTIFICATE OF FIELD VERIFICATION R DIAGNOSTIC TESTING (Page 3-4 of 8) CF -4R
Project Address Builder Name
91545 Monarch Court - La Quinta, CA 9.2253 Shea Homes, Inc.
Builder Contact Telephone Plan Number
6420 STD
HERS Rater Tolephone Sa mple.Group Number/ Lot dt (if applicable)
William Henson „^ 760-772-2954 45.907}i.�7005;�,' �^
Com lianee Method Prescri tive CFinat`e Zone 15
Certifying Signature Date Certificate Number
November 13 2006 CC3-1798386489
Firm: M BCI Testing HERS Provider:CalCEMTS _
Street Address: 77-760 Country Club Drive ste i City/State/Zip:Palm Desert / CA/ 922117
Copies to: BUILDER. HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT
The house was R 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 house identified on this form complies with the
diagnostic tested compliance requirements as checked on this form.
le The installer has provided a copy of the CF -6R (Installation Certificate).
MrHERMOSTATIC EXPANSION VALVE TXV : New System
Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed
on the system and installation of the specific equipment shall be verified.
New System HVAC System TXV Pass n Fail
0
HOv 14,2006 12:05 BCI*TESTING,ri1 000-000-00000
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TIESTING (Page 5 of 8) CF -4R
•Project Addm =
Builder Name
91545_ Monarch Court - La Quints, CA 92253_
Shea Homes Inc.
Builder Contact
Telephone Plan Number
6420 STD
_
HERS Rater
Telephone Sample-GmupWufnberI Lot S (if applicable)
William Henson
760-772-2954 45907,x 1' 005' ,'
Compliance Method Prescri ti
Climate Zone 15
Certifying Signature if i� z'�X OyA-__j
Date Certificate Number
November 13, 2006 CC3-1798386489
Firm: BCI Testing
HERS Provider:CaICERTS
Street Address: 77-760 Country Club Drive ste I
City/State/Zip: Palm Desert / CA 192211
•
•
Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT
The house was RTested ❑ Approved as part of sample testing, but was not tested.
As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the
diagnostic tested compliance requirements as checked on this form.
The installer has provided a copy of the CF -611 (Installation Certificate).
L, -NIGH EER AIR CONDITIONER: Main System
Procedures for verification ars avallable In RACM, Appendix RI.
Yes {J No I EER values of installed systems match the CF -1R
Yes ❑ No For split systems, indoor coil is matched to outdoor coil
Yes ❑ No Time Delay Relay Verified (If Required)
Yes to I. and 2; and 3 (If Required) is a
EER AIR CONDITIONER: New System
procedures for verification are available in RACM, Appendix RI.
1 IR Yes I._I No EER values of installed systems match the CF -1R
1z 0 Yes El No For split systems, indoor coil is matched to outdoor coil
3 ❑ Yes I_..1 No Time Delay Relay Verged (If Required) Y . _Y M
Yes to 1 and 2; and 3 (If Required) is a pa pass 1.J Fail
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