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0402-339 (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 `-1°rofessionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 728102 B WC n9130/04 Date ' Z 30 Signature of Contractor 1e.,'dA 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. (�) 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,n ItipUy31,1C j1d 3L7 Policy. No. ?tGTx C10�7`Y1S00 (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 thoselpr•v ions../ 'VApplicant 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 ofcompensation, 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. Signature (Owner/Agent) r Date BUILDING PERMIT PERMIT# NO2-3'1► DATE VALUATION LOT TRACT S,145;482.20 1€1 2 903.2 3 �`� C'•' ( JOB SITE ADDRESS 79..W1 BA.RCELOVA SiMa APN OWNER CONTRACTOR / DESIGNER / EN INEER 1"9AR. 1101R.9 OF CAY. IFORMA UNWAR HOMES OF >`' UFO1RNLN 78.431 C HIGHWI\Y 111 78.401 C IjsC3•H AYA I I LA QUNfA t`' -A 92"1'53 LA.QUINTA CA 92253 Q60)777.0131 C:Ii-0 3434 USE OF PERMIT SIM �, Li'.YT 1; PLAN 4YRA. PE"I:1: IT I. Es NOT INCLUDE BLC C'K WALI.ig P004 SPA OR. f9RljPL'sWAt'.rfi.PPROA.CH. •i-911611EDUCTION TO PLA14 CHECK 1171x' DUE TO Mt.1.LT?:.PILE ISSUA.14CE OF SAME PLAN 1' -I P TRACT CONSTRUCTION %$11.00 SF PZr RCHIPIL i 10 5160 S? 0.A.I2ACI,MARPO12T 425,00 3F ^wr', CONSTRUCTION FEE, 101.000.418-000 $900.50 Plata N CHECK r� L 101-©G0-4 49-3 18 � 164.83 MECHANICAL FEE 101.000-421-000 $5'.:39 ALECTRICAL Mt 101-000-420-000 $1:9.8t1 PLUMBING ME 101-000-419-000 516V79 STROrNO MOTION FL+'L? - MID 101-000-241-000 $14.34 G.RA'L INO HE. 101-000--423-000 $11.00 DEVELOPERIMPACT FF -S �2,4JS.00 Yt1i3 ' 1Yl'TI C�1'l w 1� '1!©1�1 MM 6'L.."f.iV Ci".kx".0.;K .:1 $3,148.03 M130 PKK -F AW , � 93 G $0.00 n U 1P1y.IZAW MEN DU' NO'114f S3 748.03 MAR 2 4 2004 t;li/ Fij�NCE aEtrI. .../// RECEIPT DATE - BY I DAT I LED INSPECTOR OPERATION T DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs A Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air _ _ _ _ Roof Deck Exhaust Fans O.K. to Wrap _ F.A.U. Framing Compressor _ Insulation Vents _ Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall 1 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 PPROVALS Gas Test Electric Final Waste Lines40 rt _ Heater Final Water Piping _ Plumbing Top Out Plumbing Final Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection v _ Pool Cover Encapsulation Gas Piping _ Gas Test _ Appliances Final COMMENTS: i 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)' U AUG-19-2004A`THU 06:46 AM TEAM HEATING & A/C FAX N0, 9096943803 P. 20 HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 1 oft CF -6R Site Address: 79-801 Barcelona Drive Permit Number: Tract Number 29323 Plan #: 4Y Phase: Lot Number. 10 Project: Esplanade Builder Comerstone Dev, An installation certiticate 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 10-109(b). ' HVAC SYSTEMS: Heatina Enuinment of Efficiency Duct Heating Heating Equip. CtiC Certifled-MfrNOMO Identicle (AFUE, etc.) Location • Duct Load Capacity Type and Model Name Systems (>= CF -1 R) (attic, etc.) R -value (BTU / Hr) (STU / Hr) TIT-- 13S Air a c 4.2 U9777—a c C.nnlinn FnuinmAnt ciency Duct.Cooling Cooling Equip. CEC-Cartifled Mir Name Identicle (SEER, etc.) Location Dud Load Capacity Type and Model Number Systems (>=CF -1 R) (attic, etc.) R -value (BTU / Hr) (BTU I Hr) PIP US Air a Ic US Air a c 1, me unaerslgneo, vemy mai equipment nsiea aoove 13. "I) IS ma 691U41 egUIP111Cn11115L 111. 41 6G 6114d!V l{ ia u, nwmc efficient than that speclfled in the ficate of plian rrtl CF -1 R) submitted for compliance with the Energy Efficiency Standards for residenp I b ing , d eq pm t that meets or exceeds the appropriate requirements for manufactured devices (fro A p(i ce ff1 an u or Part 6), where applicable. Team Mechanical Igna ure, Date installing Subcontractor(Co. Name I OR General Contractor (Co. Nome) OR Owner MINIMUM REQUIREMENTS FO CT LEAKAGE COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) CFA: System © of Indicate the mawmum a owa Ie 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 PTU per hour) x 0.06) Measured Fan Flow DUE Pressurization Test Results 100 x Test Leakage I Fan Flow = % Leakage Check Pox for Pass or Fail (Pass � 6% or Less) T-24 Compliance Credit was Taken for TXV y m Q of �� j 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 16 0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 8,16 x 400 x (Cooling Capacity in Nominal Tons) x (0.06) 21.7 x (Heating Capacity In Thousands of Output PTU per hour) x (0.06) Measured Fan Flow Uu-a Pressurization Test Results 100 x Test Leakage I Fan Flow = % Leakage Check Box for Pass or Fail (Pass = 6% or Less) OT -24 Compliance Credit was Taken for TXV X.06 TXV wiv TXV wai PAGE 1 F2001.01 (4-02) Action Now T-24CF6-RTD&TXV macro AUG-19-2004--'TH[l 0647 AM TEAM HEATING & A/C FAX N0, 9096943803 P. 21 ,, HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 2 of 2 CF -6R Site Address: 79-801 Barcelona Drive Permit Number. 0 Tract Number. 29323 Plan M 4Y Phase: 4 Lot Number 10 Project Esplanade Builder: Cornerstone Dev. System Q of Indicate the maxlmum 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 D-0 Pressurization Test Results 100 x Test Leakage I Fan Flow = % Leakage Check Box for Pass or Fail (Pass = 6% or Less) T ompliance Credit was Taken for TXV Ys24 C m rI of m Indicate the awmum 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 TruF Pressurization Test Resu 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 y 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 RTU per hour) x (0.06) Measured Fan Flow ITO Pressurization Test Results 100 x Test Leakage I Fan Flow = % Leakage Check Box for Pass or Fall (Pass = 6% or Less) T-24 Compliance Credit was Taken for TXV ZY—sFern =,f� 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 u Pressurization Test Resu s 100 x Test Leakage / Fan Flow = % I-eakage Check Box for Pass or Fail (Pass = 6% or Less) OT -24 Compliance Credit was Taken for TXV X.06 X.013 X.06 TXV wai TXV wiz TXV wiz TXV wa 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 complia credit. (The bullder shall provide the HERS provider a copy of the CF -6R signed by the builder emplo ee nt dors ing that diagnostic testing and Installation meet the requirements for compliance credit Team Mechanical es Iona ure, a Installing Subcontractor ame Performed OR General Contractor (Co. Name) OR Owner COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy PAGE 2 F2001-01 (402) Action Now T-24CF6-RTD&TXV macro Certificate of Insulation Your Borne has been insulated with CertainTeed Fiberglass Insulation products, which an designed for today's safety standards and tomorrovrs energy requirements. Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated with fine -retardant chemicals that will likely lose their effectiveness over time. It has not been treated with chemicals that can corrode wiring or metal. Fiberglass wild not absorb moisture nor will it settle over time as may other insulation materials. This also oertifies that CertainTeed Fiber Glass Insulation has been professionally installed in this home to provide the following thermal performance: Job Name: Tapestry at Esplanade Lot #f.: 10 Plan: 4YR Ceiling Area: R-38 Blown Garage Ceiling: Overhangs: With Living Above Tract: 29323-2 Phase: 4 Address: 79-801 Barcelona Dr., La Quinta, CA Interior Walls: Exterior WalIs: R-13 Unfaced Batts Ceiling: Garage WaU: Cantilevered : Inaccessible to Blow Floors WlLiving Above Sub tractor OJlnsuiatio Co., Inc. 60 5. n 1702 ( 6) 812.6 0 9cense 14465709 Signed Conclzita Ortiz, Secretat3areasurer --or--. Scott Jenkins, President--or— Lou Meroia, 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. If you ever sell this home, this certificate should be passed on to the buyer. N A 0 v m 7