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0210-233 (SFD)C/) F— N U) 04 W O =) CM W 6Zr` 0 0. 0 C) J LLI LU a. U) Z co LO . N ON Ua) CL Q Z LO a CC 0 XLB� m< O a0� 4. Z aro O R LICENSED CONTRACTOR DECLARATION I:hereby affirm under penalty of perjury that I am licensed under provisions of Chzpter 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 690"1 B.'91x' A 6130/01 Date Signature Signature of Contractor; ��^ j6 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). t ( ) 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 STATE ]MAIDPolicy No �'` { t ��•1y� i (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 those provisions. Date: ! / „1-� Applicant 4 A, tr Imo-- v.. 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 propertyy forinspectionpurposes. Signature (Owner/Agent)4 gf Date BUILDING PERMIT PERMIT# v.% DATE VALUATION LOT TRACT 90 2�858_1 JOB ' ADDRESS -� �:� �.} t� % 1�DC% APN 772- 4OUfQ.3 OWNER CONTRACTOR/DESIGNER/EN 1NEER Xrr Hf3ML,£." 7:2N INt/IMM?lM, M. PO BOA $10 1425 EA:TFal�.i.11TY.DRTVT' 1,A QMNU CA. 92253 Pr1OMIL ' AZ 95034 (602) 57.1636 MU4 4990 USE OF PERMIT :SFA. W LOT ", PL.A14 P3A 119MT DOES NOT INCLUDE, 31DCK WAJA,•'3, P0014 OP.A 0R DRJV9WAY'APPR0ACH 114.4 :b' d ONSTRUC,fION 90 soF Pt;R4`;HIP&T-1.0 (73.60 SP G RA.Cf CARPORT Stt£i,UP OF � ��§r.(Y '�¢f�ryry ��,�vyj / (�(��+yy'y'� �,( •gyp g�q' (wry .1E±�rl d,(Q).l.riis- dial' 1.-7,�:LunitS.+4i�F-.i:on (� �.ly 191734.90 19 1734.90 C01 VTR,UCTI(a) .RZ 101.000.418.000 $989.50 Pl,&q 4 t;`HWK FEE 1-01-000-439-319 W.31V tom' C'!$AWIc:AL FRE 101.000.421.000 ii3OA 11ZC'TX1r,A1.,FEE 101-000,.420..000 $201.30 1'14Um 8 rNci sm. 101-000-419-000 3100.00 ,STRO'NO YOTTOM FRE • PM11) 101-000-241-•000 $19.0 0t;(AD! If0 FBE 101.000,14P. 3.000 Si!. 00 DEV'rA CIPBR,11u1PAM FLIX $ I,U9t.f1U f t - X671.i it'Fl J, M1.! .iWF'7Q d.d�.i 'M I,hC,�A`� 6'A4V.i.d . �J,Aa )1:4i,-..ICiA-i Am 94,11334 DMI I J40W ��'��M E�'OTALPERMITITEN NOV 2 0 2002 ' CITY OF LA QUINTA ,. FINANCE DEPT. :RECEIPT DATE BY DATE FINALED INSPECTOR t f 'T,� - ✓ : - .w c t �� iZ �_..; INSPECTION RECORD ' OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR ' BUILDING APPROVALS MECHANICAL APPROVALS 'Set BacksUnderground Ducts Forms 8 Footings 5 —/d—�— Ducts Slab Grade — b — Return Air Steel — O Z Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framinn Comoressof . 7 Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Utility Notice (Gas) / /'— P ELECTRICAL APPROVALS Temp. Power Pole Underaround Conduit Low Voltage Wiring Fixtures_ Main Service Sub Panels Exterior Receptacles G. F.I. 5mo a Detectors Temp. Use of Power 'Utility Notice (Perm) 14 1g Final Steel Electric Bond Main Drain Approval to Cover Test Gas Test Electric Final Heater Final Plumbing Final Equipment Enclosure O.K. for Finish Plaster Pool Cover POOLS - SPAS COMMENTS -Xlz4zz, BLOCKWALL APPROVALS Set Backs Footings Bond Beam Final ' PLUMBING APPROVALS Waste LinesF24—?�vT�� os Water,Piping Plumbing Top Out Shower Pans Sewer Lateral `— Sewer Connection 17—�Z Gas Pipina Final Utility Notice (Gas) / /'— P ELECTRICAL APPROVALS Temp. Power Pole Underaround Conduit Low Voltage Wiring Fixtures_ Main Service Sub Panels Exterior Receptacles G. F.I. 5mo a Detectors Temp. Use of Power 'Utility Notice (Perm) 14 1g Final Steel Electric Bond Main Drain Approval to Cover Test Gas Test Electric Final Heater Final Plumbing Final Equipment Enclosure O.K. for Finish Plaster Pool Cover POOLS - SPAS COMMENTS -Xlz4zz, INSULATION CERTIFICATE This is to certify that insulation has been installed in conformance with the current energy regulation, California Administrative Code, Title 24, State of California, in the building located at: 50-195 CAMINO PRIVADO, LOT 90,LA QUINTA ,CALIFORNIA CEILINGS: TYPE:BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-38 WALLS: TYPE : BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-21 FONC 'CINT C : RJT LICENSE # 61 TITLESU b�/l� 7 S HMID DBUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 TITLE: ADMINISTRATIVE ASSISTANT DATE: 11/13/2003 INSTALLATION CERTIFICATE O----i As'a Site Address DUCT LEAKAGE AND DESIGN DIAGNOSTICS LEAKAGE REDUCTION (CFM @ 25 PA) 3 of Permit Number Test Leakage (CFM) 1 i I Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity in Thousands of Btu/hr, enter calculated value here If fan flow is measured, enter measured value here Leakage Fraction. = Test Leakaget(Measured or Calculated Fan Flow) a Pass if leakage fraction 5 0.06 13 For AEROSOL TYPE SEALANTS ONLY - The following diagnostic testing was completed: Duct Fan Pressurization at rough -in measured leakage (CFM) CHECK AFTER FINISHING WALL: ❑. Yes ❑ No Q Pressure pan test or House pressurization test ❑ Yes ❑ No ❑ Visual inspection of Duct Connections 12 THERMOSTATIC EXPANSION VALVE STXV) ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection Yes is a pass ❑ DUCT DESIGN CF -6R A13 Pass Fail ❑ ❑ Pass Fail ❑ ❑ Pass Fail I- ❑ Yes ❑ No ACCA Manual D Design calculations have been completed, Duct Design is on the plans and duct installation matches plans. 2,. ❑ Yes ❑ No T is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -IR - Measured Fan Flow = ❑ ❑ Yes for both I and 2. is a Pass Pass Fail [3 1, the undersigned, verify that the move diagnostic test results and the work 1 performed associated with the test(s) is.in conformance with the requirements for compliance credit. (The builder shall provide the HERS provider a copy of the CF -6R. signed by the builder employees or sub -contractors certifying that diagnostic testing and. installation meet the requirements for compliance credit.] Tests Date nstall' g Subcontractor (Co. Name) OR General Contractor (Co. Name) Performed COPY T6. Building Department HERS Provider (if applicable) Building Owner at Occupancy INSTALLATION CERTIFICATE (Page 3 of 13) CF -6't Site Address Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM Qa 25 PA) Test Leakage (CFM) 68 Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity in Thousands of Btu/hr, enter calculated value here If fan flow is measured, enter measured value here Leakage Fraction_ = Test Leakage/(Measured or Calculated Fan Flow) Pass if leakage fraction 5 0.06 (] . o Pass Fail ❑ For AEROSOL TYPE SEALANTS ONLY - The following diagnostic testing was completed: Duct.Fan Pressurization at rough -in measured leakage (CFM) CHECK AFTER FINISHING WALL: ❑. Yes ❑ No ❑ Pressure pan test or House pressurization test ❑ Yes . ❑ No ❑ Visual Inspection of Duct Connections ❑ ❑ Pass Fail Cl- THERMOSTATIC EXPANSION VALVE (TXV) ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection Yes is a pass ❑ DUCT DESIGN l ❑ Yes ❑ No ACCA Manual D Design calculadons have been completed, Duct Design is on the plans and duct installation matches plans. 2' ❑ Yes ❑ No . TXV is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -IR Measured Fan Flow Yes for both I and 2. is a Pass ❑ ❑ Pass Fail ❑ ❑ Pass Fail ❑ 1, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is in conformance with the requirements for compliancecredit. ['The builder shall provide'the HERS provider a copy of the CF -6R. signed by the builder employees sub -contractors certifying that diagnostic testing and. installation meet the requirements for compliance credit.] Tests Signa Install' g S bcontractor (Co. Name) OR General Contractor (Co. Name) Perform COPY TO: Building Department HERS Provider (if applicable) Building Owner at .O.ccupancy D ENERGY -= CADEC S - P.O. Box 621 Rancho Mirage. CA 92270 Email: Rxrvwn62370ao1.com Ph/Fax (760) 564 X44 Cell: t760) OWsPOW 2-5G-1667. 5-D pluljo-e!20 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF -4R P14.Title Da pj T. c% 17&0 ilder Contact Firm: P"E;ff y k2V1 SES Street Address: PO • E6X (*21 Copies to: Builder, HERS Provider wilder Na e - 3 Telephone Plan Number z50-1052 GA COUP # Telephone Sample Group Number 1-7 0 -J 0 v2. to Sample House Number HERS Provider: C.fi•E-E.Q.S. City/State/Zip: 490-11011 IChycT .g2270 HERS RATER COMPLIANCE STATEMENT The house was: 13/Tested ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification. I certify that the houses identified on this form comply with the diagnostic tested compliance requirements as checked on this form. ET'The installer has provided a copy of CF -6R (installation Certificate. Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts) Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. 13 --'MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Duct Pressurization Test Results (CFM Qn 25 Pa) Test Leakage Flow in CFM If fan flow is calculated as 400cfm/ton x number of tons enter calculated value here If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) = Check Box for Pass or Fail (Pass=6% or less) ❑ THERMOSTATIC EXPANSION VALVE QXV) ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection Yes is a pass Measured values uo 14- 11 Pass Fail ❑ ❑ Pass Fail D e - PO. - ENERGYC A 11 E C S�"`� Bar 621 Ph/Fax (760) 564 21744 Rancho Mirage, CA 92270 Cell: (760) @WPM= 250 -Ir; SZ Email: RKrown62370aol.com CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -411 1DA11h1U 4 T-1-;s:-eD: _ v3 Projec Title TJ-.7-- �-70 A wAla� 5-L/q QuIAP�Al-�.ritP I Isij"'—1 SR'A' j ' NARA&, k (7&0) a?!3--,'327' Contact HE Telephone Te Cenifying Signature Date Firm: PESEi��E&ay 6E2Vl SES Street Address: P-0 G2 Copies to: Builder, HERS Provider 015 uilderNa a P L,A. Plan Number Sample Group Number Sample House Number HERS Provider: C-ti•EE.Q.S• City/State/Zip: 640 -Holl ItAyc A 270 HERS RATER C STATEMENT The house was: ITTested ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, 1 certify that the houses identified on this form compIN. with t e diagnostic tested compliance requirements as checked on this form. LThe installer has provided a copy of CF -6R (Installation Certificate. ETDistribution system is fully ducted (i.e, does not use building cavities as plenums or platform returns in lieu of ducts) ff'Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with clock backed, tubber adhesive duct tape to seal leaks at duct connections. LTJ MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM If fan flow is calculated as 400cfm/ton x number of tons enter calculated value here 0 If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) _ ��•� Check Box for Pass or Fail (Pass=60/a or less) ❑ THERMOSTATIC EXPANSION VALVE (TXV) ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection Yes is a pass Pass Fail ❑ ❑ Pass Fail Page I of I' 14712 SW SCHOLLS FERRY .+ ,. # 328 BEAVERTON,OR 97007 PHONE: 503-524-8268 FAX: 503-213-6222 E- IL: minelson(Wattbi.com John Hardwick 2-26-03 RJT Homes, LLC 79700 50" Ave Lp LaQuinta; CA 92253 ` RE: Structural Observation of: Lot 90 and Lot 91. .l John, Sample observations were made of the above house to ascertain whether the intent of the construction documents is being followed. Of the structural items that remain uncovered and easily observable, it appears that, in general, there is reasonable compliance with the intent of the construction documents with no unresolved deficiencies. Please call with any questions. pFESS/ • Q�o�� J• pf sq `'.s Sincerely, 62Cr 7 z A Sf/y( sl9 WG CNII OF CA��E� Mike Nelson, PE I Certificate of OccupanCY ,- 45 r_19M ' C OF'T9ti Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 50-195 CAMINO PRIVADO Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0210-233 Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: R -L Owner of Building: R.J.T. HOMES LLC. Address: TO BOX 810 City, ST, ZIP: LA QUINTA CA 92253 By: GARY SHOWALTER -�" Date: 11/12/2003 Bui ding Official POST IN A CONSPICUOUS PLACE 0