BMCH2014-1012Building Permit
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PERMIT NO
-BMCH2O14-1012
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21T4
STRAIGHT ARROW INC DBA BRAZIL
STRAIGHT ARROW INQDB
BRflt
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49101 BRALEY COURA
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OF IL QUINTA
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78-495 CALLE TAMPICO D 1 Qu&rcu VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/30/2014
Application Number: BMCH2O14-1012 Owner:
Property Address: 56100 MUIRFIELD VILLAGE NANCY FREEZE
APN: 762400004 56100 MURFIELD VILLAGE
Application Description: HVAC CHANGE OUT LA QUINTA, CA 92253 �I V li��__
Property Zoning:
Application Valuation: $8,000.00
Applicant:
Contractor:
21T4
STRAIGHT ARROW INC DBA BRAZIL
STRAIGHT ARROW INQDB
BRflt
49101 BRALEY COURT
49101 BRALEY COURA
INDIO, CA 92201
INDIO, CA 92201
OF IL QUINTA
=FIN04
DEPT.
(760)342-3700
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Llc. No.: 697225
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C36, C20 License No.: 66,9,72225 /���
4T e: 0 / Contractor '�'�A A&Z- �
+� OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($S00).:
(� 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 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 contractors) licensed pursuant to
the Contractors' State License Law.).
(_) 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
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
perfo ante of the work for which this permit is issued.
.I
have and will maintain workers' compensation insurance, as required by
S on"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:_ Polity Number: _
_ 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 provisions.
11--7-10- `J.
Date:
'Applicant: J
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 Building Official fora 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 certifythat I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above-mentioned property for inspection purposes.
"Da -7 Sig u IICa[It or
Agent
http://laquinta.crw.comltrakit9lDocumentV iewer.aspx?&report=/DocumentsIPERMITSB... 7/10/2014
INSTALLATION CERTIFICATE
CF-6R-MECH-2I-HERS
Duct Leakage Test — Existing Duct System
(Page 1 of 2)
Site Address:
56100 Muirfield Village, La Quinta CA 92253 (System
Enforcement Agency:
Permit Number:
1)
City of La Quinta
14-00000921
Enter the Duct System Name or Identification/Tag: System 1
Enter the Duct System Location or Area Served: Whole House
Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the
dwelling.
This installation certificate is required for compliance for alterations and additions in existing dwellings to
space conditioning systems and duct systems.
Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of
the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible
and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling,
use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. "
Duct Leakage Diagnostic Test - existing duct system
Select one compliance method from the following four choices.
® 1. Measured leakage less than 15% of fan flow
❑ 2. Measured leakage to outside less than 10% of Fan Flow
0 3. Reduce leakage by 60% and conduct smoke and fix all leaks
o 4. Fix all accessible leaks using smoke and HERS rater verify
Note: (One of Options 1, 2 or 3 must be attempted_ before utilizing,Option,4.)_
Determine nominal Fan Flow using one of the'following three calculation methods.t
✓ ® Cooling:system method: Size of condenser in Tons f 3•Sx 400 1400- •• CFMf
i'
✓ O z `in
Heating system method .21.7 z Output Capacity Thoyusanbs of Btu/hr = CFM
''• Y',•. J'P � '4 •�:. l ` K �
✓ ❑ 'CFM•'
,.'.r � ra ,y
Measured system airflow using RA3 3 airflow test procedures: -�
Option i used then:
1
Allowed leakage = Fan Airflow 1400 x 0.15 = 210 CFM
Actual Leakage = 159 CFM
Pass if Actual Leakage is less than Allowed leakage
® Pass [3 Fail
Option 2 used then: -
2
Allowed leakage = Fan Airflow _ x 0.10 = _ CFM
Actual Leakage to outside = _ CFM
Pass if Actual leakage to outside is less than Allowed leakage
Pass 0 Fail
Option 3 used then:
Initial leakage prior to start of work = _ CFM
Final leakage after sealing all accessible leaks using smoke test = CFM
3
Initial leakage _ - Final leakage _ = Leakage reduction _ CFM
((Leakage reduction _-/ Initial leakage x 100% _ % Reduction
Pass if % Reduction >= 60%
c3 Pass Fail
Option 4 used then:
4
All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling).
Pass if all accessible leaks have been repaired using smoke
0 Pass r7l Fail
Reg: 214-A0047732B-M2100001A-0000 Registration Date/Time: 2014/07/09 06:24:39 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE
CF-6R-MECH-2I-HERS
Duct Leakage Test — Existing Duct System
(Page 2 of 2)
Site Address:
56100 Muirfield Village, La Quinta CA 92253 (System
Enforcement Agency:
Permit Number:
1)
City of La Quinta
14-00000921
® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off
during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA
ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may
be configured to the closed position during duct leakage testing.
® All supply and return register boots must be sealed to the drywall if smoke testis utilized for 'compliance
— applies'to duct leakage compliance option 3 (leakage reduction by 60%0) and option 4,(fix alf'accessible
leaks) described above ;:.. -
® New duct installations" cannot utilize building cavities as -plenums or platform returns in lieu of ducts.'
® Mastic and draw bands must be used in combination with cloth backed rubber adhesive ducttape to seal
leaks at all new duct connections
DECLARATION STATEMENT
• I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized
representative of the person responsible for construction (responsible person).
. I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation)
conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the
enforcement agency.
• I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am
required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also
perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS
raterand if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and
additional checking/testing of other installations in that HERS sample group will be performed at my expense.
• I reviewed a copy of the Certificate of Compliance (CF -1R) 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.
. I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the
building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I
understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder
provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data
registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings.
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
STRAIGHT ARROW INC
Responsible Person's Name:
Responsible Person's Signature:
Randy Scott
Randy Scott
CSLB License:Date
697225
Signed:
6/25/2014
Position With Company (Title):
Is this installation monitored by a Third Party Quality
Name of TPQCP (if applicable):
Control Program (TPQCP)? ❑ Yes ❑ No
Reg: 214-A0047732B-M2100001A-0000 Registration Date/Time: 2014/07/09 06:24:39 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
Bin # \ City of La Quinta
Building &r Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
P� t Address: S(o��(' l///��� 'Owner's NameA-AfG SZ_r_-
A. P. Number:
:Address:.j��OQUJ���LIiQ
Legal Description:
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Contractor: CJ�/Z�ot�� �t4Z�l� ,��(J �-r�
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Telephone:
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St�atc Lic. # : t9g 722
City Lic.+#,l
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
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Construction Type: Occupancy
State Lic. #:o'
i w Add'n Alter Project type (circle one): New r Repair Demo
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Name of Contact Person:'�/
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Sq. Ft.:
# Stories:
# Units:
Teltphone #,ofContact Person: 7(PO SZ 7-5 S 7t "
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for correctionsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN 11OUSE:-
Jrd Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees