0202-185 (SFD)LICENSED CONTRACTOR. DECLARATION
I hereby affirm under penalty of perjury that 1,6;m 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.
t License # Lic. Class Exp. Date
714188 S I Ar.
Date - 9 ,7 '2 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
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 Policy No.
BUILDING PERMIT PERMIT#r
DATE VALUATION LOT 020.2,Y05 TRACT
"t.., - $%5-6, 8400 :34. 24297.4
JOB SITE APN
ADDRESS 44-TX5 X' .1TffC. IZ0 AV'EMr
OWNER CONTRACTOR/DESIGNER/EN (NEER
C<;fERTU Y C'3e..OWM.L CC3.lVk' {T3:MI, %f1 !`t7RY MOWELL CO�wAAbr4tlIRC2`NS'
J r535 so, Ta MXW , SIM 4200 1535 STUD T. 5: .'�'`i'B Ta`�'�, 0200
&AX BMWARDING CA gum tVAI DERN,4'dRMTO -CA 92A00
USE OF PERMIT
SFn -1.0T X PJ AN4F.r,IC3iEV. f??"IT 170ES NOT INCLUDE BLOCK
WALYL% 2'00 1 M>' . OR. iD, RlMMAY APPIROAC',". 75% REWU : e TON 1'0 Pldvlff
CHECK FRI'#ORM143111`12 IS9,iANCK OF S.t'~MY, PI;,.,AIN'`I Y11Z.
1'
T.R11CT (X-14STRUCTX0N 3V
PORCHIPA.`T IO ; 62.00.13
0A:RA.P4MA"ORT 604.00 OF
(This section need not be completed if the permit valuation is for $100.00 or less).
'gc NVfR0C7),0)4)tE
201.0000-478_000
213 91
(.) I certify that in the performance of the work for which this permit is issued,
PLAN CH&I'I' din
101 000f 4,49-319
$172
I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
MECHANIC.ALFUT$
101- f00-4ZI•000
Sd
subject to the workers' compensation provisions of Section 3700 of the Labor
F?L,C 9'4'.IA2.IrIr'I!
Code, I shall forthwith comply with those provisions.
' '�
PLUIt~Ik l90 ra,
101-i�fSi�•�I,'1'9„000
$14
Date _. f f- _ Applicant j J� ,
,r IL., //+r-
� D
S 19+R N6 D {I Grp N �y E OM
1} 1, E1:S.�,[Y.Li IAiPd�(. L�bi i'iJ (.� n'%l.C.�/I {:J
000 24 0 )
� �� �`L{Ya�i}"4%�P � "'F:TI.•4f
$[
$
✓,/� ,1�.
Warning: Failure to secure Workers' Compensation coverage is unlawful and
43�r�L�1.NO FEE
'101-000-423.000
U�
shall subject an employer to criminal penalties and civil fines up to $100,000, in
dd' ' t th t f t' d 'd d f S t' 3706
1�?`'V�LDP1!,�t IMPACT P�4�
$.i,P
a Iton o e cos 0 compensa Ion, amages aS F" a Or In eC Ion
of the Labor Code, interest and attorney's fees.
e
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 theiabove 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.?' \ Rec
Signature (Owner/Agent)r�.t / + .' Date,
EIPT DATE
y
M1MUr
M.1014 AAD ]MLAN
,
: MOD PME PAIt"9 PTsE3
rumf 1(traus Brix lif(m
DATE FINA D INSPECTOR
_ CJ
$3,3116.08
$0.00
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
I INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
—
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
_, v
Combustion Air
Roof Deck
C
Exhaust Fans
O.K. to Wrap
_ Z
F.A.U.
Framing
_
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wail Firewall
Exterior Lath
_ Z
Drywall - Int. Lath
�p—
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
_0
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) V—!,
COMMENTS:
,
Jan 29 02 11:37a Richard Simpson 661 947-6889• p.4
INST'ALLA'TION CERTIFICATE (Page 3 of 8) CF -6R
vasa: Avul C.l) LfLl i /7 S � (/I c{ \
"uua launucO' ,
I�✓E'N�L
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
OWCT LEAKAGE REDUCTION
—Pnwquriralion
Tcst Rc%UIIN ((:I,'M 67125 PA)
Tcn9 l.cakagc (CFM)
Fan flow
If Vnit Flow is Cnloulatod a. 400 olm/ton x aximbcr of Ions, or as 21.7 x Ifearing Capaoity
in Thousands of Btu/br. enter oaloulated value byre
If fan flow is mumsunxl, ea►lcr inuasn" value hen: o �
l,caltagc Fraotiou = 'best I.oakngc/(Mvavurod or (:aloulated 1'an Flow)
Pa.il'leakage fraeticiu S 0,06
Pdss Dail
❑ For AEROSOL TYPE SEALANTS ONLY -The follow Ing diagnostic testing was completed:
Duel Fan Prumurizalion at rough -in awasunxl leakage (CFM)
CHECK AFTER FINISHING WALL:
❑ YcN ❑ No ❑ Pru'.4cury pan kka or I lou. -4 piv Nurrration test :
❑ Ycs ❑ No ❑ Vi4ual ln.Teution of Duct Connections
❑ ❑ .
•
Past rail
THERMOSTATIC EXPANSION VALVE (TXV)
J Yv.. ®No 1'1►to.latio liXpan�ion Valve (oar Cottumissivre approved
l \ equivalent) is installed and Acut-44 i-; provided for inVmlion❑
Yes is a pabs
/11,81. bail
❑ DUCT DESIGN
1 ❑ Yea ❑ No AC( -'A Manual 1) Dr -coign oaloulations have been complawd, .
Duct Design is on the plans and duct installation matches
plank.
2. ® yes ❑ No TXV is inslallcd Ur Fan flow ha;c bmi verified. If adv TXV,
verified fan flow matches: divip from CF=1]Z
Nlonsumd Fan Flow =
❑ ❑
Ycs for both I and 2 it; a Pan.
Pass Fall
I, lho uridarsignul, verily (hilt the above diagnostic ta`gt roautth *Ad rho work I perturrnet.mociatcd with the tcKt(s) is in
eoidumlanee with the mquircments lbr compliance credit. ITho builder shall provide die I HiRS provider a copv of dio Cl, -GR
siguW by the builder etuployecs or sub -contractor.; ccdKving that diagnustie to ting and in:%tallation movtl dto regpirernea►tx Ibr
compliance crudil_I
TCsts Sigoaluru•, Uatcrronncd l IlL.lalling tiAbconrtra010f O. NemC) ORPc(ie�uoral Contractor (Co. Name)
COPY TO: 13aelding Depnrhnont
1113114 Prmidar (il'applicabic)
Buildinq Owner ut. OCCvPAnCy
January 4, 2001 !
Installation Certificate: Residential CF -6R
Site Address
44-735 Monticello Avenue
1. BUILDER INFORMATION
Century Homes
1535 South D St. #200
San Bernardino, CA 92408
INSTALLING CONTRACTOR:
2. PROJECT INFORMATION
PERMIT #
SUBDIVISION: Heritage
CITY: La Quinta
COUNTY: Riverside
WEST PAC AIR CONDITIONING
DISTRIBUTION DUCT OR PIPING R -
TYPE VALUE
Flexible Ductwork Flexible Ductwork
in Attic and Will have a R -Value
Between Floors of 4.2 or Better
I, the undersigned, verify that the equipment listed in the category above my signature is the actual equipment
installed and that the equipment meets or exceeds the requirements of the Appliance Efficiency Standards. In
addition, Ihave verified that the equipment is equivalent to or more efficient than the equipment specified on the
Certificate of Compliance submitted to demonstrate compliance with the Energy Efficiency Standards for
residential buildings.
3. HEATING INFORMATION
HEATING MANUFACT HEATING UNIT ACTUAL EFF. HEATING EQUIP HEATING
EQUIP. • MAKE MODEL # AFUE CAPACITY LOAD
Furnace Lennox G40UH-48B-090X 80% 88000
G40UH-36A-070X 80% 66000
4. COOLING INFORMATION
COOLING MANUFACT COMPRESSOR ACTUAL EFF. COOLING EQUIP COOLING
EQUIP. MAKE MODEL # SEER CAPACITY LOAD
A/C Lennox 12ACB42 12
12ACB36 12
The building design heat loss and design heat gain rate have been determined using a method specified in Section
150(h) of the Energy Efficiency Standards, and are two of.the criteria used for equipment sizing and selection.
5. SUBMITTED BY
l.f�eLt� DATE: 2.�
Signature Installing HVAC Contractor
10;"17/20'13 02:36 FAX
[a 002
• v.:r.:es�r ar,y.uvr. �r:.r r�.ri ;.viiiw.w.vr r+c.•rnr�rn�ir.mar r....::., a..... :.iirr..xrvo<i� ir. fiirrsi z✓iriii �i�inas�,vs.r rr,:y,...r:.✓•✓ii n•....:..si r.•.vrow.•✓..:.,.a :.+i.•r, ..
INSULATION CERTIFICATE
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 located at:
44-735 Monticello Avenue, Lot 34 Monticello -Heritage, La Quinta, California `
s CEILINGS:
TYPE: BLOW MANUFACTURER: Certainteed
Thickness: R-38
WALLS:
TYPE: BATTS MANUFACTURER: Certainteed
Thickness: R-13
GENERAL CONTRACTOR: CENTURY CROWELL COMMUNITITES
LICENSE #71
;. BY: rc✓ TITLE:_ del;. ScJj2Q�
PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY
LICENSE # 632072
BY: TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/12/2002
f(Certificate of Occupancy
City of La Quinta
Building and Safety Department OF.�
This. Certificate issued pursuant to the .requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in comp/lance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 44-735 MONTICELLO AVENUE
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0202-185
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: CENTURY CROWELL COMM.
o-t_t
Building Official
Address:. -1535 SO. "D" STREET #200
City: SAN.BERNARDINO, CA -92408
By: STEVE TRAXEL
Date: 10-31-2002
POST IN A CONSPICUOUS PLACE