0402-343 (SFD)LICENSED CONTRACTOR DECLARATION
I'hereby affirm under penalty of perjury that I am licensed under provisions of
0;kpter 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
728102 13 Inc 9P30/04
Date `t-� Signature of Contractor/ 61
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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
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 01,D RE IXP�I�IC 2a4i! Policy No.
(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,sh all forth with complywith those proves ns
..Date: d lh� 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
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 for inspection purposes.
5.1;,.
.Signature (Owner/Agent) � •� Date •
BUILDING PERMIT PERMIT#
41(1''-3i3 -
DATE VALUATION 14 S120aW.�rft LOT TRACT
r
JOB SITE
ADDRESS 7".22 �GAJZ M,ORA MUM-
APN
-3WO24
OWNER
CONTRACTOR/DESIGNER/EN (NEER
IS WAR HOMM OP CAUFORti U%
LENNAF: HOMM OF C'AIIF'ORNIA
78.401 C MG1IL AY, 111
78.401 C 1.005Ht+ AY 111
LA4 t.T.Ci A. Cts,, 92253
NA'
?i.,kOUI14'T.E•+. GA 92253
(760YI77-0131 c 3L41: 3434
USE OF PERMIT
LS
.SFD o IZNT PLAN I Y.B. P&MIT DOES NOT [NCLU DE BLt7CK WALLS
y�,
1100 A, b�ill I?'E3.mewAY.&I'PRO.ACH, 75 % FUMUC 1 [ON TO P1..RN CtWCK
.�, SP
ItI Z DUE TO MI7L'I'IPL'LT ISSUANCE OF SA.MF, PLAN TYPE
TRACT C.ONSTI UC.'TION %041,DD SF
PC3I'c NIP.A.TIO 51-7. IV SF
Q I Acir.,lG.ARPORT 447,00 OF
Ei�'�!`S.ltMk:' 'A (110s3°C 011 WS51RUC.",i`.I(MN
1.211=.40
L ll%w 31':fih SUMMARY
C ONOT1' UC:TION I:LL 101-000-418-000 M3,UD
PLAN CIiXCK FEr. 101-000-439-1318 $147.193
Aadl ANICAL FEF 101.000-421.000 333.50
FL ECT,RICAL KC '101-000-420-000
PLummlio wo 101--000-419-000 f134175
STRt)NO IviOT1014 i - M91D 101-O0-241-000 $13.03
(HA%INO FEE 101-000-429-000€w'.aE1
E)EV9'1,O.P,L�'II 11414t CT$1yA0S.f30
. t
j
n St3I TfT�".tOK LAND lai'.W MM'.
�3,E,3 S.99
110145 Mr. 4_1AW 11*911M 1M
$0.00
MAR 24 200
CITY OF LA QW-N-fA
Flid/aP9CE DEF%
RECEIPT
DATE f
BY J
DAT I LED
INS OR
_�,
OPERATION
DATE
INSPECTOR
OPERATION
DATE
I INSPECTOR
BUILDING APPROVA .
'MECHANICAL APPROVALS
Set Backs
Un ._ ground Ducts
Forms & Footings
Ducts
_
_ _
Slab Grade /
Return Air
'
Steel
Combustion Air
Roof Deck _
O.K. to Wrap
aust Fans
A.U.
_
Framing
Compressor
_
Insulation i
Vents
_ _
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
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
Heater Final
_
Water Piping
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
COMMENTS:
t
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
_
Rough Wiring
_
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final_
Utility Notice (Perm)
J '
06:48 AM TEAM HEATING & A/C FAX N0, 9096943803 P. 28
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 1 of 2 CF -6R
Site Address: 79-822 Barcelona.Drive Permit Number-
Tract
umber
Tract Number 29323
Plan #: 1Y Phase:
Lot Number: 14 Project: Esplanade ' Builder. Cornerstone Dev,
An installation certificate is required to be pasted at the building site or made avaive for all appropriate Inspections.
Atter completion at final inspection, a copy must be provided to the Building Department (upon request) and the building
owner at occupancy, per Section 10-103(b).
HVAC SYSTEMS:
Wantinn Pn„irnmant
Of iciency Duet Cooling Goolling
Equip. CEC coWe Mtr Name ldenticle (SEER, etc.) Location Duct Load Capacity
T e and Model Number Systems (>=CF -1R) (attic, etc.) R -value (BTU / Hr) (BTU / Hr)
US ,r 963CNX060a Ic
I, the undersigned, veiny mat equipment itmed apove Is: 1) m me aumin egUIPFF1CHL 11MU110Y, 41 equlva MIR ,U UJI MUM
efficient than that specified in certificat f cam 'ance (Form CF -IR) submitted for compliance with the Energy
Efficiency Standards for resid nti Iq
in s, nd quipment that meets or exceeds the appropriate requirements for
manufactured devices (from e p E Cie Cy ations or Part 6), where applicable.
Team Mechanical
Igna f ure, a e ng SubEontractor(Co. Name
OR General Contractor (Co. Name) OR Owner
MINIMUM REQUIREMENTS DUCT LEAKAGE COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6%p Duct Leakage)
CFA
System ® of
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
x 400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x(6)
Measured Fan Flow
ME Pressurization Test Results (CFIOI-@_2
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass' 6% or Less)
�T-24 Com Bance Credit was Taken for TXV
Ys m of
Indicate the maximum e o ble 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 Flout
u Pressurization Test Results ((;FM g 25
100 x Test Leakage I Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
[7]T-24 Compliance Credit was Taken for TXV
x.06
X.06
TXV was
TXV was
PAGE 1
F2001-01 (4-02) Action Now T-24CF6-RTDBTXV macro
AUG 4i, „ 06:48 AM TEAM HEATING & A/C FAX N0. 9096943803
P. 29
HVAC INSTALLATION CERTIFICATE for Tested Duct Leaka e & TXV Page 2 of CF -6R
Site Address: 79-822 Barcelona Drive Permit Number. 0
Tract Number. 29323
Lot Number: 14
Plan #: 1Y Phase:
Project:. Esplanade Builder: Cornerstone Dev.
System � of
Indicate the maximum allowable 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
Mu Pressurization Test Results
100 x Test Leakage / Fan Flow - % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
Y�;24 Compliance Credit was Taken for TXV
ys em = of
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
ME Pressurization 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
PT-24
stem = of
Indicate the maximum a owa le Duct Leakage and the calculation used:
0.7 x Floor Area x (0.08) 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 (Heafing'Capacity In Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
urx Pressurization Test Results
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
PT -24 Compliance Credit was Taken for TXV
ys em "� of
Indicate the max mum 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 (0.08)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow
u Pressurization Test Results
100 x Test Leakage / Fan Flow :=: °rb Leakage
Check Box for Pass or Fall (Pass = 6% or Less)
pT-24 Compliance Credit was Taken for TXV
X'06
x ,06
X.06
TXV wa
TXV was
TXV wa
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 requireqre-n'N for compliance credit. (The builder shall provide the HERS provider a copy of the
CF -6R signed by the builder em toys su ntract certifying that diagnostic tesdng and installation meet the
requirements for compliance c It.)
Team Mechanical
E&— Signatu Dam installing Subcontractor(Co. Name
Performed OR General Contractor (Co. Name) OR Owner
COPY TO: Building Department
HERS Provider Qf applicable)
Building Owner at Occupancy
PAGE 2
F2001-01 (4-02) Action Now T-24CF6-RTD&TXV macro
Certificate of Insulation
Your Home has been insulated with CertainTeed Fiberglass Insulation products, which are designed
for today's safety standards and tomorrow's energy requirements.
Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated
with fire -retardant chemicals that will likely lose their effectiveness over time. It has not been treated
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
settle over time as may other insulation materials.
This also certifies that CertainTerA Fiber Glass Insulation has been professionally installed in this home
to provide the following thermal performance:
Job Warne: Tapestry at Esplanade Tract: 29323-2 Phase: 4
Lot #.: 14 Plan: IY Address: 79-822 Barcelona Dr., La Quinta, CA
Ceiling Area: R-38 Blown Garage Ceiling:
Overhangs:
With Living Above
Interior Walls:
Exterior Walls: R-13 Unfaced Batts
Ceiling: Garage Wall:
Inaccessible to Blow
. OJ Insu
Ca 917112 {626
Cantilevered :
Floors WlLiving Above
CO., Inc.
License 4465709
Conchita Ortiz, Secretaryllreasui er --oiV- R. Scott Jenkins, President--or---
Lou Merolla, Director of Operations Officer
R- means resistance to heat flow, The higher the R- value, the greater the insulating power,
Ask your builder for the fact sheet on R- values. Keep this certificate with your other
valued papers, Ifyou ever sell this home, this certificate should be passed on to the buyer.
T