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10-0092 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&-ty/ 4 4 Q" BUILDING & SAFETY. DEPARTMENT BUILDING PERMIT IU Application Number: 10-00000092 Property Address: 53710 AVENIDA CARRANZA APN: 774-121-010-15 -000000- Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: COVE RESIDENTIAL Application valuation: 104459 Applicant: Architect or Engineer: Low-Tc� z>e-4 sG 1 e rfthi, v - LICENSED CONTRACTO DECLARATION I hereby affirm under penalty of perjury that I tensed and p pter 9 (commencing with, Section 7000) of Division 3 of the Busines n rofessional C ,and my Li nse is in full force and effect. License Class: B c No.: 8 583 Date:ontractor: ®v// v OWNER- UILDE RATION I hereby affirm under penalty of pe lury 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 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 contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 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: LQPERMIT Owner: ROJER R.J. LACRC 53710 AVENIDA C LA QUINTA, CA 9�2 ( 2010 I CITY OF ! A QUINTA Contractor: MORRIS CONSTRUCTION INC, ROPER 51200 CALLE PALOMA LA QUINTA, CA 92253 (760)272-9292 Lic. No.: 867583 VOICE (760) 777-7012 FAX (760) 777-7011 ,SONS (760) 777-7153 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 and policy number are: Carrier EXEMPT Policy Number EXEMPT I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any m2W0RK;ERS'COMPE<USATION come sa to a workers' compensation laws of California, and agree that, e subje t orkers' compensation provisions of Section ol 3700 /o/f/tty�ee Laorth ply with those provisions. Date:6-11. 010,/Applicant: WARNING: FAILURE TO SECU 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 a4 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 cekofr 180 days will subject permit to cancellation. I certify that I have read this application and state that the abo i ormagree to comply with all qty and county, ordinad state laws relating to buildin c structioorize representatives cifthis county to enter n the above-mentioned propert o nspect'on Date: Signature (Applicant or Agent): Application Number 10-00000092,. ------ Structure Information 1618 SF SFD ----.- Other struct info . . . . CODE EDITION 2007/2008 # BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 476.00 PATIO SQ FTG 194.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 1618.00 ---------------------------------------------------------------------------- 2ND FLOOR SQUARE FOOTAGE .00 Permit . . . BUILDING PERMIT Additional desc 1618 SF SFD Permit Fee 657.00 Plan Check Fee 427.05 Issue Date . . . . Valuation . . . . 104459 Expiration Date 11/07/10 Qty Unit Charge Per Extension BASE FEE 639.50 5.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,00.1-500,000 17.50 Permit . . . ELEC-NEW RESIDENTIAL Additional-desc . Permit Fee 96.13 Plan Check Fee 24.03 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/07/10 Qty Unit Charge Per Extension BASE FEE 15.00 1618.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 56.63 475.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.50 1.00 15.0000 ---------------------------------------------------------------------------- EA ELEC TEMPORARY POWER POLE 15.00 Permit . . . GRADING PERMIT Additional desc. Permit Fee . . 15.00. Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date 11/07/10 Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Permit . . . MECHANICAL Additional desc.. . LQPERIMIT Application Number . . . . . 10-00000092 Permit . . . . ... MECHANICAL Permit Fee 52.50 Plan Check Fee 13.13 Issue Date Valuation . . . . 0 Expiration Date 11/07/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 2.00 6.5000 EA MECH VENT FAN 13.00 1.00 6.5000 ----------------------------------------------------------- EA MECH EXHAUST HOOD ----------------- 6.50 Permit PLUMBING Additional desc . Permit Fee . . . . 117.75 Plan Check Fee 29.44 Issue Date . . . Valuation . . . . 0 Expiration Date 11/07/10 Qty Unit Charge Per. Extension BASE FEE 15.00 8.00 6.0000 EA PLB FIXTURE 48.00 1.00 15.0000 EA PLB SEWER 15.00 1.00 7.5000 _BUILDING 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 7.00 .7500 EA PLB GAS PIPE >=5 5.25 1.00 15.0000 ---------------------------------------------------------------------------- EA PLB GAS METER 15.00 Special Notes and Comments 1618 SF LIVING SFD, 476 SF GARAGE, 194 SF COV.PATIO. 2007 / 2008 ENERGY CODES. TYPE V -B CONSTR. R-3 OCC :**PERMIT DOES NOT INCLUDE BLOCK WALLS.,'FENCES, SWIMMING POOLS, SPA, DRIVEWAY APPROACH and BBQ'S** FIRE RECONSTRUCTION INCLUDES 300 sf INCREASE OF PREVIOUS RESIDENCE• AREA OF 1318 SF LIVING AREA.. ------------------------------------ Ot Fees . . . . . ---------------------------------------- . . . . BLDG STDS ADMIN (SB1473) 5.00 ENERGY REVIEW FEE 42.71 STRONG MOTION (SMI) - RES 10.41 Fee summary Charged Paid Credited ------------------------------ Due --------------------------- Permit Fee Total 938.38 .00 .00 938.38 Plan Check Total 493.65 250.00 .00 243.65 Other Fee Total 58.12 .00. .00 58.12 Grand Total .1490.15 250.00 .00 1240.15 �r CITY OF LA QUINTA� SUB -CONTRACTOR LIST JOB A R S ��! O M_" t�i�hY� — PERMIT NUMBER i_ OWNER �a �'"�' I�"" BUILDER rC tis form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to wort on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidanc( of building permit. For each applicable trade, all information request d below must be completed by applicant 'On File" is not an acceptable response. Trade ! Classification .. Contractor :.: ...:.:..:. : :;'.<:::;::::<::::::>::;:::: :..:.:: .. ;:; <.:...:::..::.. S.tatr€:Gontractof s. License ::." prkcra Co ttsa mace: ` ` ::: . City.. Busittes Lkenss':::..:. Company Name Classification (e.g. A, 6, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund. CalComp) Policy Number (Format Varies) Exp. Date (xx/xxlxx) License Number (xxxx) Exp, Date (xx/xx/xx) EARTHWORK (C-12) NIA CONCRETE JC -8) G LI StAi %315-7y /0/Z01117 1Evcresf 1 AI-h'Wat 740000C110/0 t /Z.// 0 /oSyya iaa!/ FRAMING.iC-5) ;`- SP.LC�4 w�l 6 S1o590 1�?.e1Z {��.=_fa-w/ry/(ter/ I/Vf'.12CKy3 81s l/�f� �o%(oa�1i61 STRUCT:""STEEL IC -S - MASONRY (C-29) NIA / PLUMBING(C-36) LTAIV�1"j 'F1Ukt6lY4 - C J(a s��$y g 'IA�� �'!a!'tL' /6 c/o 13 6.� %�0�O 3s�10 ( 7 `� 0©�o 35S' 01 3l -veooy may, 3 �iOtl ,30`% �1��71 � (D�a �✓/��.Il LATH: PLASTER (C•35) Tf cok s t�vCac,fV�f,,,/ /� l �dOt�ilYl�C( l U�%i 4112- /� J`t�� 7 'Cj �,qo � �qG 79053q /� a�! �J� E^'r 4 f<— i� Za 1x � ,piv - sl•klrc Ccw�p. 1%/acl 0 DRYWALL (C-9) H (C -20Y - C 20 t/7O'l�� ' saolt (o 0 3Li9 alb►� ELECTRICAL, "IC=1Qf LCu CIO G3 ?q(b1-7 -7?f) 9y0 of � 61 /loll Pe-1,05-1,05:res. C reef olv><aw•l2po�3og 33000SyS3 Ib �'/aa� %7dll � 6`0 fo 3a SHEET METAL (0-43) N%A FLUgRING (C :TSI." :.::` ° .:'. �� C1� 6 � / ��n AIA4S� W 457,111.5' yD/D � 2®i) GLAZING (C-17):. ` Ir�suLAnoN (c-2! . ...:. �Iv►pi v� a,,,�, wl fi o /� G'2 S�0 0? �'�Zb t ( �vL✓c�T 1�h-'j'bb -14VWob Q 00q 1 SEWAGE pISP: (C-42) �la 110 PAINTING (C=33) �kK � �vctly 'C Ci3?j 3N q 1 °l �-- 10 2d1 b PM' ->I' II&P c-4; 3o wt vL CYSY 3 bb05-67 �3 S3I �1 CERAMIC TILE (C-54) CABINETS 34-6) /���GC% �a/ hint vim- Al a�O $) T— MIX 11 ' - j"k -7 i,4S FENCING (C-13) KI LANDSCAPING IC: -27) `::- p W iA POOL (C-53) N t* Ir P.O. Box 1504. LA QUINTA, CALIFORNIA 92247-1504 �To: EAL Y PAR TMG,- KEN 45116 COMMERCE ST, STE 15 INDIO CA 92201 BUSINESS LICENSE NO. 0005303 Ih' Business License Division (760)777-7000 FAX (760) 777-7105. •r. BUSINESS LICENSE RENEWAL To avoid incurring penalties (Ordinance 3.28.380), please return this invoice along with your check prior to your expiration date of. January 31, 2.007 BUSINESS INFORMATION NOTICE Subject to the provisions of the La Quints, Municipal Code Section 3.28.410, every person engaged in the business of contracting which requires'a state contractor's license shall pay a business license fee either annually or semi-annually. Please mail $25 If renewing for six months or $50 If renewing for one year.' (Circle On Sub -Contras Annual or -'Semi -Annual. Business'License Fee:$ " *Penalty fee is 10% per month of total business license fee *Penalty % $ Name of.Owner(s) or_Officer(s)and Title(s): E .Owned By: Corporation Partnership: Individual:'% 1 - Phone Number: Fax Number: ' If Corporation or Partnership: Tax.I.D. #: Vehicle License Number Permit Number (Finance Department) G*LF.�4Y S I.declare. under penalty of perjury that to my knowledge, all information in this statement is true and correct. Signature(s): Title(s): 1,11j)JI6 X Date: L'd 88£L£9809L JNUNIdd AIV3 N3N ezou OL t0 AeW Building Address 9� TUT 4 4 a" - . P.O. BOX 1504 APPLICATION ONLY 8 495 CALLE TAMPICO Ave10 INTA, CALIFORNIA 92253 1 I r,r r,n,lk 4 BUILDING: TYPE CONST. OCC. GRP. Tel. & Classif. I Lic. # Arch., Engr., Designer mnn qce—Z Address Tel. LA0 P wa>:e Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he 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). ❑ 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 Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or im- provement is sold within one year of completion, the owner -builder will _ ave, the burden of proving that he did not build or improve for the purpose of sale). r✓, O 1, as owner of the property, am exclusively contracting with licensed entractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contra`ctor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation 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 Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation Provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that 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 the above-mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT A.P. Legi Prof ZONE: BY: Minimum Setback Distances: Front Setback from Center RearSet Jf( Side Str �tbc Side Set from FINAL DATE_ Issued by: Validated by:— Validation: YELLOW = APPLICANT Line PINK = FINANCE Sq. Ft. qq "" NO. Size t♦� (y Stories No. Dw. Units y NeW44 Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation/yD r 0 ��vv PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center RearSet Jf( Side Str �tbc Side Set from FINAL DATE_ Issued by: Validated by:— Validation: YELLOW = APPLICANT Line PINK = FINANCE Date 5/12/10 No. 30682 Owner Roger LaCroix Address 53710 Avenida Carranza City La Quinta Zip Tract # Type Single Family Residence CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Jurisdiction Permit # No. of Units 4�_IA4LED kl Q BERMUDA DUNES r rn RANCHO MIRAGE 0 INDIAN WELLS PALM DESERT ,y LA QUINTA �P0 INyo 0 774-121-010 La Quinta 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 53710 Avenida Carranza 1618 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments Fire Reconstruction - Original Sq Ft = 1,318 + 300 new. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: Fire Damage/Demo. Replacement EXEMPT This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 1,618 S.F. or $0.00 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By Exempt - Roper Morris Check No. Name on the check Telephone Funding Exempt By Dr. Sharon P. McGehee Superintendent Fee collected Signature t ~ 1y• Payment Recd ^'x0.00 _ .ever/Under� NOTICE: Pursuant to Government Code Section 66020(d)(1), th will sele to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date dq whit the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public enity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID without embossed seal Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting 71=.780 San Jacinto Dr. Ste. E2, Rancho Mirage; Ca. 92270 ph. (760) 834-8860 fax (760) 834-8861 Letter of Transmittal To: City of La Quinta Today's Date: 5-7-10 78-495 Calle Tampico City Due Date: 5-4-10 La Quinta,' CA 92253. Project Address: 53-710 Avenida Carranza Attn: Phillip Plan Check #: 10-92 Submittal: ❑ 151 ❑ 4th ❑ 2nd ❑ 5th ® 3`d ❑ Other: We are forwarding: ® By Messenger ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup Includes: # Of Copies: Descriptions: Includes: # Of ❑ Your Files Structural Plans Your Review ❑ Checking Struct. Calcs ❑ ® 1 Truss Calculations ❑ ❑ Soils Report ❑ ® 1 Structural Comment List ❑ ® 1 Redlined Structural Plans ❑ ® 1 Redlined Structural Calcs ❑ ❑ Redlined Truss Calcs ❑ ❑ Redlined Soils Reports ❑ Comments: Structural content is approvable. This Material Sent for: ❑ Your Files ❑ Your Review ❑ Checking Other: ❑ By: John W. Thompson Rancho Mirage Office: ® (760) 834-8860 Other: ❑ Copies: 1 1 Descriptions: Revised Structural Plans Revised Struct. Calcs Revised Truss Calcs Revised Soils Report Approved Structural Plans Approved Structural Calcs Approved Truss Calcs Approved Soils Report Other: ® Per Your Request ❑ Approval ❑ At the request of: s Escrow No. 9945 -KL Title Order No. 08 -725116927 -SB EXHIBIT ONE LOT 15, Block 232, OF SANTA CARMELITA AT VALE LA QUINTA UNIT NO. 22, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA, AS PER MAP RECORDED IN BOOK 20, PAGE 24 OF MISCELLANEOUS MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY. P.O. Box 1504 LA Qu1NTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA Qu1NTA, CALIFORNIA 92253 March 29, 2010 Mr. Roger Lacroix 53-710 Avenida Carranza La Quinta, CA 92253 Subject: ' . Minor Adjustment 2010-621 53-710 Avenida Carranza Dear Mr. Lacroix: (760) 777-7000 FAX (760) 777-.71-0.1- This 77-71.01- This letter is to serve as the Planning Department's determination regarding your Minor Adjustment application, pursuant to Section 9.210.040 of the City of La Quinta Zoning Code. Request: Allow up a 10% adjustment to increase the height of the subject residential structure from 17 feet to 17 feet and 7 inches, as shown on the attached plans. Condition: 1. A building permit shall be obtained from the Building & Safety Department prior to construction. 2. The height of the residential structure shall not exceed 17 feet and 7 inches. 3. The proposed remodel and all. other construction shall comply with all other development standards as required under the La Quinta Zoning Code. Decision: Approval is granted for the requested adjustment subject to the above listed three conditions and based on the following findings: • Minor Adjustment 2010-621 is consistent with the La Quinta General Plan, in that the height proposed does not alter the approved land use for the property, or affected land use on surrounding similar properties. • Minor Adjustment 2010-621 is consistent with the intent of the La Quinta Zoning Code, in that the requested adjustment will be conditioned to comply with all other development standards as required under -said Zoning Code. • Processing and approval of Minor Adjustment 2010-621 is in compliance with the California Environmental Quality Act. The adjustment requested falls under CEQA Guidelines Section 15305(a) as a Class 5 Categorical Exemption. • Approval of Minor Adjustment 2010-621 is not detrimental to the public health, safety and general welfare, nor injurious or incompatible with .other properties and land use in the vicinity. The adjustment has no impact on health or safety issues, and will not affect physical land use characteristics in the vicinity. • A records search indicates that there have not been any Minor Adjustments granted for this property.. Please be advised that the City only approves one Minor Adjustment per lot regardless of the percentage of the development standard adjusted. Furthermore, this approval relates only to allowance of the reduction as stated above, and does not imply any entitlement or approval of a building permit for any structures shown on the plans on file. All other development standards of the La Quinta Zoning Code are applicable and shall be adhered to in preparing plans for building plan check. If you have any additional questions, please contact me at 760-777-7125. Sincerely, David Sawyer Planning Manager Attachment C: Building & Safety Department PRODUCED BY AN AUTODEBK EDUCATIONAL PRODUCT rm u 1onODad wwuvDnm H5 omv NV AS 03DnOONd �^ !� iC O NEW EXTERIOR ELEVATIONS NEW RESIDENCE For LA CROIX RE5IDENOE 53-110 AVENIDA GARRANZA LA QUINTA, GA. 92253 (1b0)2-15-410 ©D®®®DO seeWe °tt f I § I� � t $ Iti' g ssppl 66 Y ®8©® ®®®0©00©88© 5 � 4 � =js s� t tm§ 9 Y S O 8 4 S s §11 s a a � � sa$ 0000800 1p§ §t'it § 4 g Z N 0 / Perez Collaborative Drafting Consultants IUAN G. F'EREZ 82-204 HW III Suite G, PMB 151 Indlo, GA. 42201 (-Tb0) bl5. 752 / / 11� / 1onODad wwuvDnm H5 omv NV AS 03DnOONd �^ !� iC O NEW EXTERIOR ELEVATIONS NEW RESIDENCE For LA CROIX RE5IDENOE 53-110 AVENIDA GARRANZA LA QUINTA, GA. 92253 (1b0)2-15-410 ©D®®®DO seeWe °tt f I § I� � t $ Iti' g ssppl 66 Y ®8©® ®®®0©00©88© 5 � 4 � =js s� t tm§ 9 Y S O 8 4 S s §11 s a a � � sa$ 0000800 1p§ §t'it § 4 g Z N o g o' Perez Collaborative Drafting Consultants IUAN G. F'EREZ 82-204 HW III Suite G, PMB 151 Indlo, GA. 42201 (-Tb0) bl5. 752 1onODad wwuvDnm H5 omv NV AS 03DnOONd Kirk, Please visit the site of yesterday's structure fire in the Cove at: r- 53-710 Avenida Carranza. Post it and photograph for the record. Thanks, ' - KY? or low ...y r y )rROAj 7 --I lillta�, f WAII 6AC4yC-- 1 f09/09/09 1 0 ,.l AI r 2009/09/09 _ to -o _1 r yr;' �' th& flyal'* buWre4'k STRUCTURAL AND CIVIL ENGINEERING DENISE R. POELTLER, INC. 77.725 Enfield Lane • Unit # 130 • Palm Desert, California 92211 drpfly@aol.com 29 March 2010 Mr. Tom Hartung, Building Director CITY OF LA QUINTA Department of Building and Safety 78-495 Calle Tampico La Quinta, CA 92253 RE: LA CROIX RESIDENCE Job Site Address: 53-710 Avenida Carranza Subject: Truss Acceptance Letter Dear Mr. Hartung: I have reviewed the total deflection, live, dead, and drag loads used for the design of the gang -nail roof trusses prepared by SELECTBUILD (dated 03-16-2010 and 3-24-2010), and found them in substantial conformance with the structural documents prepared by my firm. Respectfully submitted, Denise R. Poeltler R.C.E. 33446 W.O. 09-169 cc: Roger La Croix a No. 33494'�11 * Exp. 6-30. J, �' CIVIL Juan Perez, Perez Collaborative Design Consultants PHONE (760) 772-4411 0 FAX (760) 772-4409 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 RefrigerantCharge Verification - Standard Measurement Procedure (Pagel of5) Site Address: Enforcement Agency: Permit Number. 53710 Avenida Carranza I La Quinta 110-92 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge ver (cation for compliance, a MECH--24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documentedfor compliance using this form. Attach an additional forms) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag [Zone' 1 Zone 1 System Location or Area Served l Wh6le: House 6 ®Yes ONO 1 E]Yes ao 5/16'inch (8 mm) access, hole upstream of evaporative coil in the return plenum and labeled according tofigure.in.Section",RA3.2.2.2.2. 2 Wes Do 5/16 inch (8 mm) access hole'downstream of evaporative coil in the supply plenum and labeled, according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. Enter Pass or Fail I ✓ E]Pass ✓ ®Fail STMS - Sensor an the Evannratnr Coil System Name or Identification/Tag [Zone' 1 l The sensor is factory installed, or field installed according to manufacturer's 6 ®Yes ONO specifications, or is installed by methods/specifications approved by the Executive The sensor is factory installed, or field installed according to manufacturer's 3 Yes []Yes DO specifications, or, is installed by methods/specifications approved by the Executive The sensor wire is terminated with a standard mini plug suitable for connection to a Director. 4 [3Yes �Io The sensor wire is terminated with a standard, mini plug suitable for connection to a , digital thermometer. The sensor mini -plug is to the installing technician and the HERS rater without changing the airflow through the condenser coil the HERS rateri.without clianging�the� airflow �hrough the condenser coil 5 []Yes The sensor measures the saturation temperature of the coil within 1.3 degrees F The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4, and 5 is a pass. t —Enier�N/A N/A if STMS are not applicable. Otherwise enter Pass or Fail ✓ ❑Pass ✓ Pass ✓ ®Fail STMS - Sensor on the Condenser Cnil System Name or Identification/Tag Zone 1 The sensor is factory installed, or field installed according to manufacturer's 6 ®Yes ONO specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 QYes �o digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 Yes ao The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter ✓ [DN/A ✓ ❑Pass ✓ ®Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail -MECH-25 Registration Date/Time: 8/25/201014:10 HERS Provider: CHEERS By_ CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure e 2 of 5 Site Address: Enforcement Agency: Permit Number: 53710 Avenida Carranza I La Quinta 110-92 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55 °l) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55 OF or below, the installer must use the Alternate Charge Measurement Procedure. Cnaro f nnditinnino Cv0P.mc System Name or Identification/Tag Zone 1 (must be re -calibrated monthly) Date of Thermocouple Calibration 08/20/2010 ` System Location or Area Served Whole House I Outdoor Unit Serial # E100319518 temperature (Tsu 1, db) L Outdoor Unit Make Day & Night !_ I LJJ Outdoor Unit Model A N4A360BAK r Return (evaporator entering)�ai ry; b U I Nominal Cooling Capacity Btu/hr L Date of Verification 08/.24/20101. temperature (Treturn, db) Calibration of Diatl<nnostic Instruments` - Date of Refrigerant Gauge Calibration•, 08/20/2010 �' / �, (must be re -calibrated monthly) Date of Thermocouple Calibration 08/20/2010 ` (must be re -calibrated monthly) Measured Temperatures ° System Name or Identification/Tag Zone 1 Supply (evaporator leaving), air. dry-bulb �11 1 � I I I temperature (Tsu 1, db) L I h !_ I LJJ Return (evaporator entering)�ai ry; b U I L temperature (Treturn, db) Return (evaporator entering) air wet -bulb temperature (Tretum, wb) Evaporator saturation temperature A 4+ (Teva orator, sat) Condensor saturation temperature 127 (Tcondensor, sat) Suction line temperature (Tsuction) 67 Liquid Line Temperature (Tliquid) 119 Condenser (entering) air dry-bulb 116 temperature (Tcondenser, db) Registration Number: 1104B77B844-NC-0001-MECH-25 Registration Date/Time: 8/25/2010 14:10 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of Site Address: Enforcement Agency: Permit Number. 53710 Avenida Carranza La Quinta 110-92 Minimum Airflow Re uirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag Zone 1 Calculate: Actual Temperature Split = Treturn, db - Tsupply, db Target Temperature Split from Table RA3.2-3 using Treturn, wb and Tretum, db Calculate difference: Actual Temperature Split —Target Temperature Split= k Passes if difference is between -4°F and +4°F or upon remeasurement, if betweentr V [/ -4°F and -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified int- Reference Residential;, ppendix RA 3.3. If actual cooling coil airflow is measured the value must be equal to or g erg er ater'than the Calcu°°lated Min mim Airflow Requirement in the table below. Calculated Minimum Airflow Requiremen t(CFM)�yomi al Cooling Capacity (ton) X 300 (cfin/ton) tt System Name or Identification/Tag Zoneir - V 1 Calculated Minimum Airflow Requirement (CFM) 1750Measured (l Airflow using RA' 3.3 �`_ 207 + { i I procedures (CFM) Passes if measured airflow is greater than pass i or equal to the calculated minimum airflow requirement. Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag Zone 1 Calculate: Actual Superheat = Tsuction — Teva orator sat Target Superheat from Table RA3.2-2 using Treturn wb and Tcondenser, db Calculate difference: Actual Superheat — Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail Registration Number: 1104B77B844-NC-0001-MECH-25 Registration Date/Time: 8/25/201014:10 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of Site Address: Enforcement Agency: Permit Number: 53710 Avenida Carranza I La Quinta 110-92 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Zone 1 Calculate: Actual Subcooling = Q 8 I Tcondenser, sat — Tli uid Target Subcooling specified by 8-10 manufacturer 3-26 Calculate difference: O Actual Subcooling — Target Subcooling = System passes if difference is between Pass -4°F and +4°F Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expan_ sion.valve (EXV) systems. System Name or Identification/Ta Y g n Zone "Ir ,1 I Calculate: Actual Superheat Tsuction — Teva orator sat Enter allowable superheat range from 3-26 manufacturer's specifications (or use range . between 3°F and 26°F if manufacturer's' specification is not available) System passes if actual superheat is within the allowable superheat range Enter Pass or Fail Registration Number: 1104B77B844-NC-0001-MECH-25 Registration Date/Time: 8/25/2010 14:10 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of Site Address: Enforcement Agency: Permit Number. 53710 Avenida Carranza La Quinta 110-92 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag Zone 1 1780534 HERS Provider Data Registry Information Sample Group # (if applicable): System meets all refrigerant charge and Pass in a HERS sample group airflow requirements. Enter Pass or Fail HERS Rater Company Name: Energy Driven Solutions Inc. Responsible Rater's Name Responsible Rater's Signature DECLARATION STATEMENT • I certify under penalty of perjury, undt mation provided on this form is true and correct. I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). 7. The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies-Mili=the applicable requirements in Reference Residential Appen=dices RA2 and RA3 and the requirements A P 1 r. x-. - 5o specified on the Certificates) of Compliance (CF-] R) approved by the local enforcement agency. t t. The information reported, on. applicable sections of the,Installation.Certificate(s) (CF -6R), signed and submitted by the person(s) �..� ' LA FJ I tL-.� 1 " J N i 0 , responsible for the installation confCrms to the req+ irements specified on 1 he Certificat' (s) of Compliance (CF -IR) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate CF -6R Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Simmons A/C Responsible Person's Name: CSLB License: Adam Simmons 1780534 HERS Provider Data Registry Information Sample Group # (if applicable): r tested/verified dwelling Unot-tested/verified dwelling in a HERS sample group HERS Rater Information HERS Rater Company Name: Energy Driven Solutions Inc. Responsible Rater's Name Responsible Rater's Signature Dave Bricker Dave Bricker - Signature on File Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: CCN99380828 08/24/2010 r Registration Number: 1104B77B844-NC-0001-MECH-25 Registration Date/Time: 8/25/2010 14:10 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R MECH-23 Verification of High EER Equipment a e I of 1 Site Address: Enforcement Agency: Permit Number: 53710 Avenida Carranza La Quinta 110-92 Verification of High EER Equipment Procedures for verification of High EER Equipment are described in Reference Residential Appendix RA3.4. For dwelling units with multiple systems, the procedures must be applied to each system separately. As many as 4 systems in the dwelling can be documented for comvliance using this form. Attach an additional form(s) for anv additional systems in the dwelling as applicable. 1 System Name or Identification/Tag Zone 1 Responsible Person's Name: CSLB License: Adam Simmons 2 System Location or Area Served Whole House tested/verified dwelling not-tested/verified dwelling 3 Certified EER Rating of the installed 11.5 HERS Rater Company Name: Energy Driven Solutions Inc. Responsible Rater's Name Responsible Rater's Signature equipment (Btu/Watt-hr) Dave Bricker - Signature on File Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: CCN99380828 4 Make and Model Number of the installed Day & Night N4A360A Outdoor Unit 5 Make and Model Number of the installed Aspen ACC60E44 Inside Coil 6 Make and Model Number of the installed Furnace or Air Handler. 7 Minimum Equipment EER required for 11,.4 compliance as reported on the CF -1R y ❑ When a high EER system specification includes'a time delay relay, the installation of the time delay relay must be verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Time Delay Relay Verification Procedure. ❑ When installation of specific matched equipment is necessary to achieve a high -EER, installation of the specific equipment must be verified for compliance credit. Refer to Reference Resid'eritial Appendix RA3.4.3.for the Matched Equipment Verification Procedure. If the Certified EER Rating in row,3,isl equal or greater than the requiredr 8 minimum EER in row 7, the unit Pass complies. r If the unit complies enter Pass t I 1A, 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 the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). I n n I r-- ? I r-- . I I • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate R� J0 r. 14- a ' p' b kk, (the installation) compliestwith the applicable requirements in Rete' ence Res'de 4tial Appendiice{s RA2 and RA3 and the requirements specified on the Certificate(s) of Com p6nce(CF-11 R) approveVd by'thc local ennforLJ c melnt ageny. • The information reported on applicable sections of the Installation Certificates) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate(CF-6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Simmons A/C Responsible Person's Name: CSLB License: Adam Simmons 1780534 HERS Provider Data Registry Information Sample Group # (if applicable): tested/verified dwelling not-tested/verified dwelling in a HERS sample group HERS Rater Information HERS Rater Company Name: Energy Driven Solutions Inc. Responsible Rater's Name Responsible Rater's Signature Dave Bricker Dave Bricker - Signature on File Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: CCN99380828 08/24/2010 Registration Number: 1104B77B844-NC-0001-MECH-23 Registration Date/Time: 8/25/201014:10 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF4R-MECH-22 HSPP/PSPP Installation; Cooling Coil Airflow & Fan Watt Draw Test (Page 1 of 2 Site Address: Enforcement Agency: Permit Number: 53710 Avenida Carranza La Quinta 10-92 As many as 4 systems in the dwelling can be documentedfor compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP) in the supply plenum When the Certificate of Compliance (CFI R )indicates Cooling Coil Airflow or Fan Watt Draw verification are required, HSPP or PSPP are required to be installed in each air handler in the dwelling. Procedures for installing HSPP and PSPP are described in Reference Residential Appendix RA3.3. This measure requires verification by a HERS rater. Select one method from the two choices below for compliance with the HSPP/PSPP requirement for this dwelling. ® Dia ostic Fan Flow Using Plenum Pressure Matching according to the procedures in RA3.3.3.1.1 HSPP 1/4 inch (6 mm) hole labeled and located downstream of the evaporator coil in the supply System Name or Identificattiion/Tag �' plenum as shown in the figure in Section RA3.3.1.1. I �' 1/4 inch (6 mm) hole equipped with a permanently installed pressure probe, labeled and PSPP located downstream of the evaporator coil in the supply plenum as shown in the figure in a� Section RA3.3.1.1._ System Name or Identification/Tag 5 Zone" outdoor unit. System Location or Area Served Whole'House Enter the minimum airflow requirement 350 from the CF -1R (CFM/ton). Confirm that a HSPP or PSPP has been)/,/ installed on the air handler per the z`5 Pass - Calculate the target minimum airflow for 1750 requirements of RA3.3. 1. l the test by multiplying the CFM/ton criteria Enter Pass or Fail' Cooling Coil Airflow Verification When the Certificate of Compliance indicates, Cooling Coil Airflow,ver f cation is required, the procedures for measuring the cooling coil airflow must be performed as -spec filed in Reference Residential Appendix RA3.3. Results of the cooling coil airflow diagnostic test must be entered in the, table belrnv.'This'measure requires verification by a HERS rater. Select one method from the three choices below for compliance with the Cooling Coil Airflow test requirement for this dwelling. ® Dia ostic Fan Flow Using Plenum Pressure Matching according to the procedures in RA3.3.3.1.1 Q Diagnostic Fan Flow Using Flow Grid Measurement according to the procedures in RA3.3.3.1.2 El I Diagnostic Fan FIow�Usirig Flow Ca tire ljod&a6cordi rig tthe rocedures, intPA3.3.3.1.3 System Name or Identificattiion/Tag �' ZOne 1 I .— I �' System Location or Area Served ~ i Whole House a� Nominal Cooling Capacity (ton) of the 5 outdoor unit. Enter the minimum airflow requirement 350 from the CF -1R (CFM/ton). Calculate the target minimum airflow for 1750 the test by multiplying the CFM/ton criteria specified on the CF -1R by the nominal cooling capacity of the outdoor unit (ton). Target CF Enter the diagnostically tested airflow 2070 (CFM). Tested (CFNt) The system complies if Tested (CFM) is equal or greater than Target (CFM). Pass Enter Pass or Fail Registration Number: 110-4137713844-NC-0001-MECH-22 Registration Date/Time: 8/25/2010 14:10 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-22 HSPP/PSPP Installation; Cooling Coil Airflow & Fan Watt Draw Test e 2 of 2 Site Address: Enforcement Agency: Permit Number. 53710 Avenida Carranza I La Quinta 110-92 Fan Watt Draw Verification When the Certificate of Compliance indicates Fan Watt Draw verification is required the procedures for measuring the Fan Watt Draw must be performed as specified in Reference Residential Appendix RA3.3. Results of the Fan Watt Draw diagnostic test must be entered in the table below. This measure requires verification by a HERS rater. Note: Fan watt draw must be measured simultaneously with cooling coil airflow. The fan watt draw measurement and cooling coil airflow measurement must simultaneously meet or exceed their target criteria specified by the CF- I R for the dwelling. Select one method from the two choices below for compliance with the Fan Watt Draw test requirement for this dwelling. E. I Portable Watt Meter Measurement according to the procedures in RA3.3.3.3.1 Responsible Person's Name: Utility Revenue Meter Measurement ding to the procedures in RA3.3.3.3.2 System Name or Identification/Tag Zone 1 HERS Provider Data Registry Information Sample Group # (if applicable): Utested/verified dwelling System Location or Area Served Whole House in a HERS sample group HERS Rater Information Enter the air handler Target (CFM) from the 1750_ Responsible Rater's Name Responsible Rater's Signature Dave Bricker cooling coil airflow test table above. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: CCN99380828 08/24/2010 Enter the fan watt draw requirement from the CF -1R (Watt/CFM).• 58�~' Calculate the target maximum Watt draw for 1200.6. the test by multiplying the Watt/CFM criteria andler specified on the CF -IR by the air handler- Target Tet (CFM). Target (Watt) Enter the diagnostically tested Watt draw 945 (Watt). Tested (Watt The system complies if Tested (Watt) is less than or equal to Target (Watt) - Pass - Enter pass or Fail 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 the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material; component, or manufactured device- er quinngBERS verificatian that is identified on this certificate e�. � , •, p Ki. (the installation) complies with the applicable requirements in Reference Resident'ial Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -IR) approved by the local enforcemdnt agency. N� U I 1 t t `�. I • The information reported on applicable sections of the Tnstalla ion Certifi ate(s� (CF -61R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on 6 Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate CF -6R Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Simmons A/C Responsible Person's Name: CSLB License: Adam Simmons 1780534 HERS Provider Data Registry Information Sample Group # (if applicable): Utested/verified dwelling not-tested/verified dwelling in a HERS sample group HERS Rater Information HERS Rater Company Name: Energy Driven Solutions Inc. Responsible Rater's Name Responsible Rater's Signature Dave Bricker Dave Bricker - Signature on File Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: CCN99380828 08/24/2010 Registration Number: 1104B77B844-NC-0001-MECH-22 Registration Date/Time: 8/25/201014:10 HERS Provider: CHEERS Cerfifcto of Occupancya Y: o OF9 Building & Safety Department This Certificate is issued pursuant to the requirements of Appendix Chapter 1 Section 110 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Budding Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 53-710 AVENIDA CARRANZA Use classification: SINGLE FAMILY DWELLING Building Permit No.: 10-92 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC Code Edition: 2007 CBC Sprinkler Installed: NO M Owner of Building: ROGER LACROIX Address: 53-710 AVENIDA CARRANZA City, ST, ZIP: LA QUINTA, CA 92253 s �b'1—L By: KIRK KIRKLAND Building Official Date: AUGUST 24, 2010 i! POST IN A CONSPICUOUS PLACE