0402-345 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04
W Prr:;j� ssionals Code, and my License is in full force and effect.
QM,• --License # Lic. Class Exp. Date
rLU 728102 6.� B MC �f� �,/�,r� / 9/30/04
Z r- Date 5�' L/ Q (/ Signature of Contractor /*�'+ e'l Zu'
(� 0. � ` _ /
It- ~ �' OWNER -BUILDER DECLARATION
J
Ha I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z_ ( ) 1, 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
LO
O N Date Signature of Owner
_.
Q WORKER'S COMPENSATION DECLARATION
CD Cc I hereby affirm under penalty of perjury one :of the following declarations:
r H O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W L= compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q (� () I have and will maintain workers' compensation insurance, as required by
O Q Section 3700 of the Labor Code, for the performance of the work for which this
LO
Il rn H permit is issued. My,workers' compensation insurance carrier & policy no. are:
cb Z Carrier OLD RIEPUBLIC INSU Policy No. $1f eI0M600
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Of
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(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 forr 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
111.2 Code, I shallfort with comply with those”Vjog§.,.g�,�s /
Date:.- , Applicant
,• Warning: Failure to secure Workers' Compensation coverage is unlawful and
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
Y 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 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 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,fdr inspection purposes.
. Signature (Owner/Agent)DateE�f
i
q
BUILDING PERMIT PERMIT#
0402 -.345
DATE VALUATION f yq 2() ?CC''�eLOT TRACT 9
323
JOB SITE
ADDRESS 79"]3=,fWafaZJ� Dplyn
APN
W9-3W_(f
OWNER
CONTRACTOR / DESIGNER / EN (NEER
%,FWAR WACO Cyi+ W WC)22MA
1r>-NNAk HOWS OF CAU UMIRMA
7 8,40 1 C11143..FMAX 111
78.401 CIRGz3jA}WA1111 _
I Qum int, C`.A. 92253
LA QUWA (:A 92253
kl&GY177=0131 C73I,19 34.34
? .
USE OF PERMIT
SWULP,
SPD - LOT 16, PldtN IYA� PERWRT fr= NCI 114CLUOZ BLOCK IVP Ll-%
POOL, SAA OR DiBli+ EW'AY APPROACH 11t; REDUCTION TO PLAN C RECIC
FKE ]DULr TO MULTIPLE ISSLf".Ct OF SJn.ME PL.n.N TYPE
TRACT CONSTRUCTION M .
G3A22AOUC:ARPORT 447.00 3F
ZRIMM110 cosy OF CONRIMUC110N
COMM TRUC TSION FEE 10) -000.418-060 $713,00
PL" CHECK .F'RIE, 101-000-439-318 $14793
Vi.EC;I-l"1GUU. F1719 101.000=421.000 SS3.50
ELECTRICAL ME 101-000-64.20-10"
PJAIM11R}G FEE 101-000-419.000 $153.73
STRO"6 O MOTION FEE - RES10 101-000-241-000 $12.03
ORA.L1 NG3 1.171E $} 1405
I3SNPL0PER IMPACT P1'!Lp
DC17014 AND PLAN ME=
$3,618,99
.- 1X33 PM -PAID I1WAS
50.00
MAR IYETKIS DTJX NOW
&3'"S.99
C! u Y OF LA ti® II'il �a4 /
FtF�AHCE DEF -i. ✓/
RECEIPT
DAT (��
BY C`
DATE ED
INSPE TO
OPERATION
DATE
NSPECTOR
L
OPERATION
DATE
INSPECTOR
BUILDING
APPRO /' `'
MECHANICAL APPROVALS
Set Backs
Forms & Footings
Slab Grade
_
_ _
nderground Ducts_
Ducts
Return Air
{ ��
Steel
_ _
Combustion Air
Roof Deck
_ _ _ _
i
Exhaust Fans
O.K. to Wrap
_
,.d
F.A.U.
Framing
_ _ _
Compressor
Insulation
_ _ _
Vents
Fireplace P.L.
_
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath 12
L
Final
Final
BLOCKWALL APPROVALS
steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVA S
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
_ _
`'
Plumbing Final
Plumbing Top Out
_
Equipment Enclosure
Shower Pans •
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
. p
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)
COMMENTS:
1
��
AUG -19-2004 VU 06-:48 AM TEAM HEATING & A/C FAX N0, 9096943803
P. 32
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 1 oft CF -6R
Site Address: 79-854 Barcelona Drive Permit Number
Tract Number. 29323
Plan #; 1Y Phase:
Lot Number 16 Project: Esplanade Builder. Cornerstone Dev.
An Installation certificate is required to be posted at the building site or made avalible for all appropriate inspections.
Atter completion of final inspection, a copy must be provided to the Building Department (upon request) and the building
owner at occupancy, per Section 10-105(b).
HVAC SYSTEMS:
Heatinq Equipment
o ciency Duct Heating Heating
Equip. CEC-CZriffied MFr Name Identicle (AFUE, etc.) Location Duct Load Capacity
Type and Model Name Systems (ate CFA R) (attic etc.) R -value (BTU / Hr) (BTU / Hr)
US Air arc
Cooling Equipment
of Efficiency Duct Cooling Cooling
quip. ULU Certifiedama IdenWe (SEER, eta) Location Duct Load Capacity
T ' e and Model Number Systems (—CF -1 R) (attic, etc.) R -value (BTU / Hr) (BTU / Hr)
US Air a c
r, tnv u11aers10neu, "0 ..y 7" ipmcni nsreu aoove 1b.1 / IS me ao[uai agwprnam nrsrarlcu, c) cgwvaren[ ro or more
efficient than that specified in the a mate plian (Form CF -1 R) submitted for compliance with the Energy
Efficiency Standards for resld ntia ildi gs an 3) a Ip ent that meets or exceeds the appropriate requirements for
manufactured devices (fro e A Ir Ici cy Wia s or Part 6), where applicable.
•Team Mechanical
igna ure, Date Subcontractor(Co, Name
OR General Contractor (Co. Name) OR Owner
MINIMUM REQUIREMENTS FOR DUCT LEAKAGE COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
CFA:
Systemof
Indicate the maxlmunl a owa le Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Gimate Zone 8 through 15
0.5 x Floor Area x (0.08) for Climate zones 1 through 7 & 16
x 400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow X.06
D`5Pressurization Test Results
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
WT -24 Compliance Credit was Taken for TXV
ys em �mof
Indicate the awmum a owa le Duct Leakage and the calculation used:
0.7x Floor Area x(0,06) for Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0,05)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow 1 1X.06
DUE Pressurization Test Resu
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
OT -24 Compliance Credit was Taken for TXV
TXV wa:
TXV wa:
PAGE 1
F2001-01 (4-02) Action Now T-24CF6-RTD&TXV macro
AUG -19-2004 THU 06`,48 AM TEAM HEATING & A/C FAX N0. 9096943803
P. 33
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 2 oft C,F-611^
Site Address: 79-854 Barcelona Drive Permit Number. 0
Tract Number. 29323
Lot Number: 16
Plan #: 1Y Phase:
Project: Esplanade Builder. Cornerstone Dev.
System =mof j
Indicate the aximum al owa le Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone 6 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
Mu Pressurisation Test Results
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
�T-24 Compliance Credit was Taken for TXV
ys em = of
m
Indicate the aximum s owa le Dud Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone 8 through 15
0.5 x FloorArea x (0.06) for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
uct Pressurization Test Results
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
tWeT-24 Compliance Credit was Taken for TXV
m= of
Indicate the maximum alible Duct Leakage and the calculation used,
0.7 x Floor Area x (0.06) for Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity In Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
Ma Pressurization Test ReAults (CFM IM 25 pm
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
T-24 Compliance Credit was Taken for TXV
ys rhof
Indicate the maximum a owa le Duct Leakage and the calculation used,
0.7 x Floor Area x (0.06) for Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity In Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
Muff Pressurization Test Results
100 x Test Leakage / ran Flow = % Leakage
Check Sox for Pass or Fail (Pass o 6% or Less)
=T-24 Compliance Credit was Taken for TXV
X.06
x .06
x .06
TXV m
TXV wai
TXV wai
TXV was
I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is
in conformance with the requireme r compliance credit. (The builder shall provide the HERS provider a Copy of the
CF -6R signed by the builder emplo a rs tr%cerfifyinghatdiagnostic testing and installation meet the
requirements for compliance credit
Team Mechanical'
0-05 igne ura eInstallingSubcontractor(Co. Name
Performed OR General Contractor (Co. Name) OR Owner
COPY TO; Building Dep nt
HERS Provider (if applicable)
Building Owner at Occupancy
PAGE 2
F2001.01 (4-02) Action Now T-24CF6-RTD&TXV macro
Certificate of .Insulation o
9
Your Home has been insulated with CertainTeed Fiberglass Insulation products, which are designed
for today's safety standards and tomorrow's energy requirements. 27
C3
Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated o
with fine -retardant chemicals that will likely lose their effectiveness over time. It has not been treated H
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
a
settle over time as may other insulation materials.
0
z
This also certifies that CertainTeed Fiber Glass Insulation has been professionally installed in this home o
to provide the following thermal performance:
Job Name: Tapestry at Esplanade Tract: 29323-2 Phase: 4 y
Lot N.: lb Plan: lY Address: 79-854 Barcelona Ar., La Quinta, CA
Ceiling Area: R-38 Blown Garage Ceiling: Interior Walls:
Overhangs: Exterior Walls: R-13 Unfaced Batts
With Living Above +
Ceiling: Garage Wall: Cantilevered :
Inaccessible to Blow Floors NVILiving Above
S�iittracor. 4J Insui�Inc.tion Co., �c.
00 nceaL 11 Ca 91701 (16261 12-6070 Liceose#465709
Signed
`/ A w
Conchita Ortiz, Secretary/Treasurd --os• R. Scott Jenkins, President--or--
Lou Merola, Director of Operations Officer
R- means resistance to heat flow. The higher the R- value, the greater the insulating power,
0
Asir your builder for the fact sheet on R- values. Keep this certificate with your other
valued papers. If you ever sell this home, this certificate should be passed on to the buyer. T