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0202-073 (SFD)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 # Lic. Class Exp. Date Dater`.., d'?'r,'`'=Signature of Contractor -Y 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. �k j I have and will maintain workers' compensation insurance, as required by Sec ion 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: Cattier Policy No. GOLDEN{II F.tr48. NWC_94%8•e3 (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, I shall forthwith comply with those.provlsions. x'7 Date:, ^��/ �_�'' Applicant Warning! Failure to secure Workers' Compensation coverage is unlawful and r 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. 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 upowoose 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) fy {-fr.•' Date p '� %�"� fro BUILDING PERMIT PERMIT# DATEVALUATION LOT.' j TRACT JOB SITE ADDRESS APN OWNER CONTRACTOR/DESIGNER/ENGINEER d • MAW, CROWS LL COMMMITAM IGS i°t:.tRY'~''};�,iVEM 00I.7.�NL`i`MIS '4115 5115 A%l1: ID1114MM A MT; 9200 15ce 5 sa 0D° m'• u., �n, "120 1 SAW RMMR.:�. 3901' CA '92408 SAU NEP,Nl.SRD190 CA. 92404 (909)381�4007 C 1ig X120 USE OF PERMIT i 111•'f - I.X 6. MONTICri.LL0 kdLA)1'AWE—K,,A!N $A1tEV, PERMIT D0E NOT 11~fC;;,UM 81=K WA€E�X,'Pi7OMP,A.OI DAIV'EWKITAPPROA.Cm, -� 'I°I1ACT CC31;FOTRUCTIO14 V12.00 OF • IaC312.G°3�!`r°�%`YO ;a4.Dp a;� 0A`Et, OUC> RTIOR X40.04 8F r.-MRAUT-rD C .0 r Off` Ct?��' ;�:1`G"�OV ' i �P�t��s.lo j' �,q��y x• �1•�y��y'y � .F, :AiP.6.d.AF FU R7l�,�y1l.CY.:v1RY CONSTRUCTION M, 10144=416-000 $1"100 PLKH CHECK rEM 101-000,439-31.1 MUMAWICAL Flaw 101.000.421.000 101-000- 420-000 1.166M, PU.&X:Ia�1ACt'1 RZY IM -00"19-000 $161125 SYRDING MOTION FEE RESID 01 -000-241 �000 $17.0 1131.000.4234000 120.00 l FEB 14 2002 ...�y�y /�_ �/1, p+y.�/ /��rQy.-�4y�p �*�+ p � *g p CHECK �y MAO i �FINpp��lpe�Gy`a $Yy�OTAT 13aL�t�38.LCM1�U�,101�1 AND S'f�0.,rl: ECK PUN { r i OW s RECEIPT DA .E !! / 0 BY `f " DATE FINALED /� CJ INSPECT INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs -LUnderground Ducts Forms &Footings - , _;-7 Ducts Slab Grade - Return Air ' Steel - Combustion Air Roof Deck - (a -Z_ Exhaust Fans O.K. to Wrap - y _ Z F.A.U. Framing Compressor Insulation - Z Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath _-20 _ 2 Final - Final — —6Z 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 APPROVALS Gas Test Electric Final Waste Lines 2— _ Heater Final Water Piping Plumbing Final Equipment Enclosure Plumbing Top Out Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test �� i4za Appliances Final COMMENTS: �� /S oj9 .� 8�/ j Ute, dG [t�iQ-/ J 1= ops/ • lv�j �C� `/L'` Final Utility Notice (Gas) �. v 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) Installation Certificate: Residential CF -6R Site Address 44-750 Monticello Avenue 1. BUILDER INFORMATION Century Homes 1535 South D St. #200 San Bernardino, CA 92408 INSTALLING CONTRACTOR: 2. PROJECT INFORMATION DISTRIBUTION TYPE Flexible Ductwork in Attic and Between Floors DUCT OR PIPING R - VALUE Flexible Ductwork Will have a R -Value of 4.2 or Better PERMIT # SUBDIVISION: Heritage CITY: La Quinta COUNTY: Riverside WEST PAC AIR CONDITIONING 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-48B-090X 80% 88000 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 DATE: Signature Installing HVAC Contractor 1 �j A:R/YJ/w(!.-.'w•n•:va:A,A'WYrYYfYYJA•YIb'N:'n:R/�iPHJ7::V%I:/YV1..9NYY�'V.Y/A/fNiWf/L'iA:N�iY�..Y%nM.N.✓•tN.h"ania n:t: ��l 1 W."�.%Y.//.Y/t:t: JiS: /J i�:d.rvaN•i•:stW'W'Win:v.vW'.wY✓r-iMiYVY!Nrn i�.uir.:v «i•,: • INSULATION CERTIFICATE This is to vertify that insulation has been Installed In conformance with fhe current energy regulation, California Administrative Code, Title 24. State of California, In the building located at: 44.750 Monticello Avenue, Lot 36, Monticello -Heritage, La Quinta, California CEILINGS; TYPE: BLOW MANUFACTURER: CERTAINTEED THICKNESS: R-38 WALLS TYPE: BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-13 GENE CONT CTOR: CENTURY CROWELL COMMUNITIES LICENSE # 7e�/l BY: TITLE: �t26e s PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 B� TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/12/2002 Jan 29 02 11:37a Richard Simpson 661 947-6889 p.4. INSTALLATION CERTIFICATE (Page 3 of 8) CF -611 Ro 2zf-Z iteAUUMs„7� MO�j C((o Avtr. Permit umber DUCT LEAKAGE AND DESIGN DIAGNOSTICS DUCT LEAKAGE REDUGMON ' rc%suritalion Text Results (CFM (u125 PA) 'fent Leakage (CFM)7 Nan Nlow If fan blow is Calculated as 01 cfw/ton s number of tont, or as 21.7 x I loafing Capaoity I in Thouttand:t of litu/bt', other caloulatod valuo boyo If fan flow is measured, enter measurod value hum Lookago fraction = •fast Lcakago!(Mc:asurcd or Culoulated fau flow) n 6,04 Ya ififloakagu fraotiou 50.06 ❑ , Pass Dail ❑ For AEROSOL TYPE SEALANTS ONLY -The following diagnosde tasting was completed.- Dual ompleted:Dual Fan Prummiiation at rough -in mcaxuFW leakage (CI M) CHECK AFTER FINISHING WALL: ❑ Yes ❑ No ❑ ]Texture pad 1W or ILOW proaurrralion tc d ❑ Yes ❑ No 0 Visual Inspcution of Duct Connuetiow; ❑ ❑ r Pass ' Fail. THFRIMOSTA71C EXPANSION VALVE (M) —__ — _•_.. .- _-. _—•-• _-._�.. C9 Y N ❑ No '1'h"Moriatic l%panrion Valve (or Commission approved ” oquivaloat) is installed and Accc.is is providad for mwpoction' ❑ Yw i. a pas; ]'ass ]'ilii ❑ DUCT DESIGN 1. ❑ Y,_1 0 No ACCA Manual D lksign calculations have been complelud, Mot Da -sign is on the plans and dual installation matchoK plans. 2. ❑ Yost [3 No f]{V it ia.�lalh;tl or l im flow hap been vuriliod. If no TXV, ved iud fan Dow nuttehtmc deign from CIL IIL Mamumd Fan Flow =' . Yes lbr both 1 and 2 u a Pans Pass Fail ❑ 1, !hu undmigncd, Ywily that the abovo diaguo•liV fust ppmlls bind thr, wore I performcd associated with the tcrt(s) is in euntonnanw with the mquiim6ants ditr comphanoe erudit. ITho builder shall provide lhu I MRS provider a wpy of iho CF -GR siguod by tho buildor eutploypen or sub -contractors c:crtifying that diagaw-lio Iustiug and installation nowt Iho rutloirerne,uls Iter, compliance: c"it.i jt ,,,. , g 2002 -A C Tests 3r frnatum, Datu lactallidg Subcontractor (Co. ME* t)R Performed Gonera) Contractor (Co. Name) COPY TO: Building Depaitmout III3R5 Provider (irapplicablc) Building Owner at Occupa»cy January 4, 2001 MI Tract'# Duct Testing;. lot # ..•. Certifk ati©'n Form ;. .,System of Z (One form per system)` . �,"" Builder.Name: C�yV,� Project Name: Ley t Builder Field Contact:. ` Tele hone No. HVAC Company Name: W -4 Y F Q 73�I%Sr HVAC Installer:. _Telephone No. SelfmCertifier° Results ,• ,° ' / Duct Leakage Measured @ 25 RA • , - . •, ;,, ' - / _�'� CFM ' Indicate the maximum allowable Duct Leakage' and the calculation method used., ° ❑.. 0.7.-.x Afloor x (0.06) for Climate Zone 8 through 15.r - ' CFM ❑ .. 0.5 x Afloor x (0.06) for Climate Zone 1 through 7,& 16 CFM 400 x (Cooling Capacity in Tons) x (0.06) l Zi CFM ❑ 21.7 x(Heating Capacity in ThP.,usands of output BTU per hour)x (0.06) CFM. Print Name Signature Date OccupancyCertificato of a. City of La Quinta GrLaAfw . 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 compliance with the various ordinances of the City regulating budding construction or use. For the following: BUILDING ADDRESS: 44-750 MONTICELLO AVE. Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 03202-073 Occupancy Group: R/3 Type of Construction: V/N Land Use Zone: R/L Owner of Building: CENTURY CROWELL COMM. Address: 1535 SO. -"D" STREET, STE # 200 Building Official City: SAN BERNARDINO CA.92408 By: GARY SHOWALTER Date: 08/15/02 POST IN A CONSPICUOUS PLACE