04-3930 (SFD),%`
P.O. BOX 1504
78-495 CALLS TAMPICO
,LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 7.77-7153
BUILDING PERMIT
Application Number . . . 04-00003930_ Date 5/06/04
Property Address . . . . . 52621 CAHUILLA CT
APN: 770-300-005-23 -28470 -
Tenant nbr, name . . . . . . 5440 SQ. FT. SFD
Application description . . . DWELLING - "SINGLE FAMILY DETACHED
Property Zoning LOW DENSITY RESIDENTIAL
Application valuation . . . . 34.7700
Ow ex' Contractor
-------------------------
HOPKINS JOHN W KELLY PACIFIC CONSTRUCTION CO
GREENBRAE CA 94904
(415) 464-0900
WCC: STATE FUND
WC: 3150001375 10/01/04
` CSLB: 346196 08/31/05
CCC: B
------ Structure Information 5440 -SQ. FT. SFD -----
Construction Type . . . . . TYPE V - NON RATED
Occupancy Type . ... . . . DWELLG/LODGING/LONG <=10
Flood Zone .- . . . . . NON -AO FLOOD ZONE
Oth est uctinfo . . . . . CODE EDITION 2001 CBC
n # BEDROOMS 3.00
�j FIRE SPRINKLERS NO
@�N p 2 2004 GARAGE SQ FTG 1055.00
PATIO SQ FTG 1192.00
CITY 07- NUMBER OF UNITS 1.0 0
rr101 CED NUMBER
FIRST FLOOR SQ FTG 5440.00
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 1507.50 Plan Check Fee 10.00
Issue Date . . . . Valuation . . . . 347700
Qty Unit Charge Per Extension
BASE FEE 639.50
248.00 3.5000 THOU BLDG 100,001-500,000 868.00
--------- ------------------------------------------------------------------
Permit . . . . . . ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee . . 241.50 Plan Check Fee 29.26
Issue Date Valuation 0
Qty Unit Charge Per Extension
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: �- 3130 Date:
Applicant: Architect or Engineer-
'X6921—
n neer:
Applicant's Mailing Address:—Architect—or En jneer's Address-.
/`� P►��'�,�-ems P erl�-
No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S 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 Professionals
Code, and my License gin full force and effect.
LicenL se Class 6 License No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or through his or her own employees, provided that the improvements are not intended or offered for sale. It, 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner.
WORKERS' 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
_1-- e-�i�sue My woAers' compensation insurance_carrie andpotic number ar
�Carrier >"� 1� f�f I Policy Number / S 5 / -%7-S
- 1 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 �) •� Replicant��/� !/ ��• ,pr4-Pi
-- -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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.
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
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 at 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 Ouinta, 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
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. 1 agree to comply with all city and county ordinances and state laws relafing to building
construction, and hereby authorize representatives of this county to enter upon'the above-menfioned property for inspection purposes.
Date +C' `7 Signature (Applicant or Agent):
Application Number ..
. 04-00003930
Page 2
Date 5/06/04
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
5440.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
190.40
1055.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
21.10
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
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
----------------------------------------------------------------------------
Permit .
. . . . .
MECHANICAL -
Additional
desc
Permit Fee
. . . .
222.00
Plan Check Fee
55.50
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
5.00'
9.0000
EA
MECH
FURNACE <=100K
45.00
5.00
9.0000
EA
MECH
B/C <=3HP/100K BTU
45.00
8.00
6.5000
EA
MECH
VENT FAN
52.00
10.00
6.5000
EA
MECH
EXHAUST HOOD.
65.00
----------------------------------------------------------------------------
Permit .
. . . . .
PLUMBING
Additional
desc
Permit Fee
. . . .
269.25
Plan Check Fee
67.31
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
24.00
6.0000
EA
PLB
FIXTURE
144.00
1.00
15.0000
EA
PLB
BUILDING SEWER
15.00
7.00
6.0000
EA
PLB
ROOF DRAIN
42.00
2.00
7.5000
EA
PLB
WATER HEATER/VENT
15.00
1.00
3.0000
EA
PLB
WATER INST/ALT/REP
3.00
1.00
9.0000
EA
PLB
LAWN SPRINKLER SYSTEM
9.00
15.00
.7500
EA
PLB
GAS PIPE >=5
11.25
1.00
15.0000
EA
PLB
GAS METER
15.00
.";f-
Page
X
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
2255.25
Page
3
Application Number . . . .
. 04-00003930 Date
5/06/04
-----------------------------------------------------------------------------
Special Notes and Comments
.00
5440 SQ. FT. SFD THIS PERMIT
DOES NOT
INCLUDE BLOCK WALLS,POOL SPA
OR DRIVEWAY
APPROACH. $10.00 DEPOSET FOR
PLAN CHECK
----------------------=-----------------------------------------------------
Other Fees . . .. . . . . .
. ART IN PUBLIC PLACES -RES
369.25
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
97.99
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
34.77
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
2255.25
.00
162.07
.00
2907.01
.00
5324.33
.00
Credited Due
.00
2255.25
.00
162.07-
62.07.00
.00
2907.01
.00
5324.33
Comments
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:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 5,440 S.F. or $12,185.60 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 Cc/PDNB-Mark Powell Check No. 089310
Name on the check Telephone
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by
Payment Recd 1$0.00
$12,185.60 Over/Under
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve toZ►orlfy 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 on which 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 entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
INSTALLATION CERTIFICATE (Page 1 of 13) CF -6R
Site Address
Permit Number
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
Information -provided on this form is required; however, use of this form to provide the information is optional.) After
completion of 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:
Heating Equipment
Equip. # of Efficiency Duct Duct or Heating Heating
Type (pkg. CSC Certified Mfr Name Identical (AFUE, etc.)' Location Piping Load Capacity
99.e L'r-��1�
,
Cooling Equipment
Equip. CEC Certified Compressor # of Efficiency Duct Cooling Cooling
Type (pkg. Unit Mfr Name and Identical (SEER, etc.)' Location Duct Load Capacity
eat t Njjmbej Systems f>_Cg-IRvalueletc. R -value (Btu/hr)u/hr
141I —,Z.— L Gam' 2 cam
1. > reads greater than or equal to.
L tluj iiml reignetl,-vihlfy that quipftiettt listed awe is: 1) is the actual equipment installed, 2) equivalent to or more
vift,.iem 0miI 3llat; spz..ift�att in tete •xedificate of compliance (Form CF -1R) submitted for compliance with the Energy
1gle.Wuy Slundur.& fue =ie_nba1 buildings, -:aid 3) equipment-thatTrteets or xceeds the appropriate requirements for
m ufactur (from the Appliance Ff ciency Regulations or Part 6), where -applicable..
Signature, Date Installing Subcontractor (Co. Name)
O_R1 Gmcral Contractor (Co. Name) OR Owner
WATER inTIiNGMUMS:,
Distribution If Recir- # of Rated'' Tank Effi- External
-Heater CEC CertifiedNifr Type (Std, culation, Identical input (kW Volume ciency' Standby= Insulation
Type tName& Modcl Number Point -of -Use) Control -type _ SysOems orSudhr) (gallons) (EF, RE) Loss (%) R -value'
2 a t;= thsm ur+Aival. to 15,0001"jr), ebetric resistance and heat primp water heaters, list Energy Factor.
£crvlppc rigt �, ; t traitc�i irgxR ut"muter ftn 75,00013tu/br), list Recovery Efficiency, Standby Loss and Rated Input.
Fo.alao:��g��:raieny al.^r�,di:;tRCu>ver)TlTici�ruyand Rated;lnput.
3. R-12 external insulation is mandatory for storage water heaters with an energy factor of less than 0.58:
Faucets & Shower Jl a&
All faucets and showerheads installed are certified to the Commission, pursuant to Title 24, Part 6, Section I 11.
I, the undersigned; verify that equipment, Gstcd°. above any signature is: ) j-thc actual l e uipment ins k -.1t; 2) Cquivalmitto
or more efficient than that specified in the. ceaiiiv*7, of- cmpiix-_�e �r (Form--CF-:riur ratpB'rknc.-, %z -Wk tom°
iz
o C_
ff arils for rfsiderdW fa 1diiigs; and' 3) nquir mat 4h1d meels or exceeds 4he appropriate
raas ~v tired c9evif�a (farts .Rtrpiivrlct? �%drieracy l egarlalioscs or aro 6), where applicable.
Signature, Date Installing SubconUicior (Cm Name) OR,
GeneralContractor(fo Tlww).€13; comet ,
COPY`O: tBuilding Department
;NIERS Provider (if applicable)
Building Owner at Occupancy
,VP
Compliance Forms
August 2001
A-23
AIR
TIGHT
ENERGY
SERVICES
Duct Testing/H.E.R.S. Ratings
ALAN WEAVER
C.H.E.E.R.S. & CalCert Certified Rater
74478 Highway 111 #292 Phone (760) 880-5504
Palm Desert, CA 92260 Fax: (760) 202-3197
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of7) CF -4R
Project Title L/ _
5-2-(02-4 � �A-�-c �t t.�+
CJ—
Project Address'
Sr",
K X� D
Builder Contact Telephone
- z.1- 2,0 o5--
Date
"K E 9L -e -y /� C • ICI C•
Builder Name
Plan Number
HE S t Cc ZOO meq% Telephone Sample Group Number
enifying Signature Date Sample House Number
Firm: A:A 54L4+/Ce3 HERS Provider:
Street Address:-? `-irCity/State/Zip: 0� C.ft
Copies to: Builder, HERS Provider g "0
HERS RATER COMPLIANCE STATEMENT
The house was: 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.
9� 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.
MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
Duct Pressurization Test Results (CFM a 25 Pa)
Measured
values
Test Leakage Flow in CFM 7__00C)
if fan now is calculated as 400cfm/ton x number of tons enter calculated
value here
If fan now is measured enter measured value here q ,�
Leakage Percentage (100 x Test Leakage/Fan Flow)
Check Box for Pass or Fail (Pass=6% or less) ❑
Pass Fail
THERMOSTATIC EXPANSION VALVE (TXV)
1 Yes ❑ No Thermostatic Expansion Valve is installed and Access is ❑
provided for inspection
AIR
TIGHT
ENERGY
SERVICES
Duct Testing/H.E.R.S. Ratings 1%
ALAN WEAVER
C.H.E.E.R.S. & CalCert Certified Rater
74478 Highway 1.11 #292 Phone (760) 880-5504
Palm Desert, CA 92260 Fax: (760) 202-3197
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF -4R
Project Title
_62-4 z/ d_44,, C -4 -
Project Addres
M Ani �o &'�
Builder ContactTelephone
ur.✓44+� 6Cr F30o- �So
rEIJS Rater Telephone Sample Group Number
e -C 2-06-4
7 -
Date
Builder Name
Plan Number
t enifying Signature Date
F i rm : A_, 2 r� �! Ln —'5k, aJ
Street Address: -2444%6 %4r'J�
Copies to: Builder, HERS Provider
Sample House Num er
HERS Provider:
City/State/Zip:
9 1- 7
HERS RATER COMPLIANCE STATEMENT
The house was: 1z 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.
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 duc(s)
0 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.
XJ MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
Duct Pressurization Test Results (CFM rt 25 Pa)
Measured
values
Test Leakage Flow in CFM 00
If fan now is calculated as 400cfm/ton x number of,tons enter calculated
value here
If fan now is measured enter measured value here L—)
Leakage Percentage (100 x Test Leakage%Fan Flow) = 57z
Check Box for Pass or Fail (Pass=6% or less) ❑
Pass Fail
L THERMOSTATIC EXPANSION VALVE (TXV)
Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection ❑
AIR
TIGHT
ENERGY
SERVICES
Duct Testing/H.E.R.S. Ratings
ALAN WEAVER
C.H.E.E.R.S. & CalCert Certified Rater
74478 Highway 1.11 #292 Phone (760) 880-5504
Palm Desert, CA 92260 Fax: (760) 202-3197
t`
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R
Project Title /I II ,^�
�(P 24 :.,c— kLA H aj—,q
Project Addre ' A
Date
1)
Builder Contac
ter
Builder Name
O
Telephone Plan Number
g$6
Telephone Sample Group Number
7-,-,'V- Zoof" . 3-!?' T_.
Certifying Signature -Date Sample House Num er
Firm: ' 2 CZS HERS Provider: CA -L C4t
Street Address: ��-]�� 1 City/State/Zip: / M
Copies to: Builder, HERS Provider g Z�
HERS RATER COMPLIANCE STATEMENT
The house was: $ 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.
q9 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.
TMINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
ct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
Duct Pressurization Test Results (CFM ct 25 Pa)
Measured
values
Test Leakage Flow in CFM -7-00 t)
If fan now is calculated as 400cfm/ton x number of Cons 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) ❑
Pass Fail
*THERMOSTATIC EXPANSION VALVE (TXV)
Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection ❑
AIR
TIGHT
ENERGY
SERVICES
Duct Testing/H.E.R.S. Ratings
ALAN WEAVER
C.H.E.E.R.S. & CalCert Certified Rater
74478 Highway 111 #292 Phone (760) 880-5504
Palm Desert, CA 92260 Fax: (760) 202-3197
CERTIFICATE OF FIELD VERIFICATION' AND DIAGNOSTIC TESTING (Page I of 7)
Ak-,ws k
Project -rine
Pro ct�Adddres s
Builder Contac Telephone ,
:7 zoos-
Date
oos-
Date p
Builder NameA` ,4."
Plan Number
CF -4R
H Rater Telephone Sample Group Number
Certifying Signature -Date Sample House Numb
Firm: Q I •-N�-�i�/TS'�/L-�e�' HERS Provider:
Street Address: :7(/40 �y_ /J/ City/State/Zip:
Copies to: Builder, HERS Provider �%z.?.bc7
HERS RATER COMPLIANCE STATEMENT
The house was: 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.
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 retums in lieu of duc(s)
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.
Q. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
values
Test Leakage Flow in CFM ZDD-O
If fan now is calculated as 400cfm/ton x number of tons enter calculated
value here
If fan now is measured enter measured value here
Leakage Percentage (100 x Test Leakage%Fan Flow) 35
Check Box for Pass or Fail (Pass=6% or less) ❑
Pass Fail
H ERMOSTATIC EXPANSION VALVE (TXV)
1--1I Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection �! ❑
AIR
TIGHT
ENERGY
SERVICES
Duct Testing/H.E.R.S. Ratings
ALAN WEAVER
C.H.E.E.R.S. & CalCert Certified Rater
74478 Highway 1.11 #292
Palm Desert, CA 92260
Phone (760) 880-5504
Fax: (760) 202-3197
..-
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF -4R
.. .. / I t-) C f` . N A 1 �1 a v — ---(" .
Project Title �a �
4 Z—% t 4p,"i LLA— .
7- z/ - Z� �-
Date
Project Address Builder Name
-� A�-�
Budder ContactTelephone Plan Number
�� C7 b.0 a to-
H er GC 2-4--:io46c45 Telephone Sample Group Number
�lJ`tisv-P�1 -I — 7d'- Zoo 1— 5
Certifying Sign-attuure / Date
F i rm: 14'i !t / te✓ Ci!
Street Address: '7Yq..7f6 r4✓y/
Copies to: Builder, HERS Provider
Sample House NQnber
HERS Provider: L O—xo-�
City/State/Zip:
HERS RATER COMPLIANCE STATEMENT
The house was: Lp- 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.
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 retums 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.
TMINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
Duct Pressurization Test Results (CFM t7a 25 Pa)
Measured
values
Test Leakage Flow in CFM
If fan now is calculated as 400cfm/ton x number of tons enter calculated
value here
If fan now is measured enter measured value here
l�
Leakage Percentage (100 x Test Leakage�/Fan Flow)
Check Box for Pass or Fail (Pass=6% or less) 91 ❑
Pass Fail
THERMOSTATIC EXPANSION VALVE (TXV)
Ef Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection ❑
SPECIAL INSPECTION DAILY REPORT
TANDrS
INSPECTION INC.
PO BOX 13766
PALM DESERT, CA 92255
OFFICE/FAX 90 9.769.9717
PAGER 760.776.3339
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PALM DESERT, CA 92255
SPECIAL INSPECTION DAILY REPORT
OFFICE/FAX 909.769.9717 ;
PAGER 760.776.3339
TYPE OF INSPECTION PERFORMED
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TANDY'S
INSPECTION INC.
PO BOX 13766
PALM DESERT, CA 92255
OFFICE/FAX 909.769.9717
PAGER 760.776.3339
TYPE OF INSPECTION PERFORMED
SAMPLE INFORMATION
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TICKET NUMBER MIX NUMBER TIME SAMPLED AIR TEMP STEPPE SLUMP TIME IN MIXER
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PO BOX 13766
PALM DESERT, CA 92255
OFFICE/FAX 909.769.9717
PAGER 760.776.3339
TYPE OF INSPECTION PERFORMED
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UNLESS OTHERWISE NOTED, AND TO THE BEST OF MY ABILITY I HAVE FOUND THIS
WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS & APPLICABLE
BUILDING LAWS.
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UNLESS OTHERWISE NOTED, AND TO THE BEST OF MY ABILITY I HAVE FOUND THIS
WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS & APPLICABLE
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Certificate ®f Occupancy
V W:
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C� OF'T19� 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: 52-621 Cahuilla Court
Use classification: Single Family Dwelling Building Permit No.: 04-3930
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Occupancy Group: R -3/U-1 Type of Construction: VN Land Use Zone: RL
Owner of Building: Kelly Desert Development Address: 100 Drake's Landing Road #105
City, ST, ZIP: Greenbrae, CA 94904
By: Daniel P. Crawford Jr.
Date: 7/22/05
Building Official
POST IN A CONSPICUOUS PLACE