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0209-055 (SFD)LICENSED CONTRACTOR DECLARATION ' I hereby affirm under penalty of perjury that I am licensed under provisions of Chaoter 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 701039 .Pi 1~110 ,� ? %W07 Date ✓ Signature of Contractor 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 STAU FU11D Policy No. WD -164013-91 (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 rose visions. y Applicant / ��ed' Warning: Failure to secure Workers' Compensption 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 personat whose request and for whose benefit work is performed under or pursuantto any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmlessthe 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. Sig -nature (Owner/Agent) Date '° 7 ' 6.! BUILDING PERMIT PERMIT# , ' DATE VALUATION LOT TRACT65 JOB SITE ADDRESS 4"52 ,tZ4,14CHO 4►1�L5J,i lr?�lMb,d�F� F!J B\! APN 64940"_,X�i OWNER CONTRACTOR / DESIGNER / EN (NEER 9968 ?rfi-nEpff 191r,, u UJ.'I'H 102 78-401 • , Ii7i3I IW:fali 111 SAX PJFM CA 92131 1.,A QLT.(kl'rA CA:. 92253 (766)771.3363 (MVi +lM USE OF PERMIT SYD , LDT 05 P1,AW XR. PEVAIT DOWS WOT l)d% L fl'!li:1<i1'OCK VAJAA POOL, SPA. OR DIRMWA Y A-I� °I O.ACf'I . K TRACT CONSTRUCTION _ 3,wiw Sly` PORCH/PATIO MOO 5t? CARAOFWARPORT 062,00 SF 'FS/ :IM) c osw Or conarR =m10,,N'' 2,1. i.6724 A"UMMARY '' CONST.RUC TIt» M_, 3 01 -000-4 l V-000 s1pon.50 iPLA1d��CH7!!%..yy K .�',�y' 101t -1000-�%•�20-�3y�18 $956.24 dY[1Ca�v�iYM4iGA , F &'ur 10 D� 00©9421 "000 5,015 a 101-000-421-000 91,. :TR1CAL 0`Lf, 101-000-420000 3171•A7 PLUMBNO lei+; 101-000-41.9.000 $101.25 STIP.r raO MOTION VE—Z - tPM10 101-0.00..241-000 NIX X CRADWO RX. 161.000,42'3-0 0 $19.00 •. X)E'L•� UPP..6t: I'i! PACT PZZ $7,405%00 ,AXP IN PUBUC PLACES = RX.31E 2/0-000fi445e000 $34.18 €a SUR,,-T:(YFAL CONI.AIRIAX [oil :€N'IYY�tt,�P[��y.�yd7�+<'7',1TWI�•JK, 311 790 P - unr :s. DUE. now�� C,, T RECEIPT DATE BY ` i Aa DATE FINALED INSPECTOR ' er. INSPECTION RECORD OPERATION a DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs 1 I Underground Ducts Forms & Footings I ! / - - 07- Ducts Slab Grade I ; / Return Air Steel 8 0- Combustion Air Roof Deck 1 ] - p Exhaust Fans O.K. to Wrap 1? F.A.U. Framing 1. Compressor Insulation I; -- -3 Vents Fireplace P.L.' l i Grills Fireplace T.O. I' Fans & Controls Party Wall Insulation i : Condensate Unes Party Wall Firewall Exterior Lath �/3 - Drywall - Int. Lath- ]' Final 17"3 1 7— Final II POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs 1 } Electric Bond Footings '' Main Drain Bond Beam I Approval to Cover Equipment Location i Underground Electric I Underground Plbg. Test Final I' Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water PipingI Plumbing Top Out _ _ ` Plumbing Final Equipment Enclosure Shower Pans "O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection ! ; _ Encapsulation Gas Piping Gas Test Appliances { Final COMMENTS: Final Utility Notice (Gas) 7' ELECTRICAL APPROVALS li Temp. Power Pole ' I Underground Conduit Rough Wiring Low Voltage Wiring } Fixtures I( Main Service Sub Panels }; Exterior Receptacles 11 G. F.I. I ! Smoke Detectors i i Temp. Use of Power i } ii ri Final ; } Utility Notice (Perm) Ii APR -01-2003 15:29 WESTERN INSJLATiON 909. 686 8786 P.04i19 EST IT I, ': ULAARON., L.P. 4911 Tatham Skeet, Riverside, California 99501 Tel, (909) 6136-8760 F= (909) 686.8786 INSULATION CERTIFICATE THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULA711ON, CALIFORNIA ADM INISTRATIVE CODE, TITLE 24, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:- TRACT/PHASE: T:TRACT/PHASE: TALANTE / PHASE 4 LOT #: 65 SITE ADDRESS: 49.852 RANCHO -SAN FRANCISQUITO - LA QUINTA, CA, WERIOR WALLI: BAITS MANUFACTURER: JOHNS MAffOLLE THICKNESS: 3 1/2" R- VALUE: R-15 CEILINGS: BAITS MANUFACTURER: JOHNS MANVILLE THICKNESS: 13" R- VALUE: R-38 11 SWEST HOUSING (TERN INSLILAT',ON, L,P. 04/28/03 .08:03 PAX 7149211631 Alliance r PGA 3 HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 1 oft CF -6R Site Address: 4q - %52- AAµGNO �Ah. F9AiVcIsq✓rr,8 Tract Number. a%q Lr4- Lot Number. An mstsnatron cftfible ,s required to De posted At the bulICLUI site or made aveiibie for atl appropriate imsoea,ons. Atter completion of fimi rasp Dun, a copy must to proftco io the eurldtng Department (upon request) end the oudd:re- owner at occupancy, per section 1C -103(D). HVAC SYSTEMS: Heating Equipment a of EAiciency Duct Heating Heating Equip, CEC Certified Mfr Name ' IdeftWo (AIDE, etc.) Location Duct load Capaety Type and Model Name Systems (ae CF -JR) (a*. etc.) R -value TU /Hr) NTLI /Ho I I 17 - I I Cooling Equipment 0 of F fie>an y Duct Cooling Canting Equip. CEC Certified Mfr Name IdeflWe (8)°2R. etc) Location Our- Load Caoacty Ty0a Ono Model NurnDer Systems (a=CF-1R) (attic, etc.) R•value (M / Fri (5 TU i Hrj i, the unaersrgnea, venry tnat equipment Astec active & t) r5 :re actual equipment rnstaneo, e; equivalent to or mcre of eent than tflat Spicifrod in trip cenificale of =mplianrg (Form CF -1111) Submitted for c_mpliance wwlth the =ne --y EFiciencl Standards fpr residential buildings. and 3) equicment that meets or exceeds the appropriate requirements `cr manufs s (from the Appliance Effie.enc/ Re;uiati:as or part 6), where applicable. 4S ALUANCE MECHANICAL HVAC at ate tns:arlingu.confractor ( a. ane OR General Contractor (Co. Name) OR Owner MINIMUM REQUIREMENTS FOR DUCT LEAKAGE COMPLIANCE CREDIT Duct Dieonosk Leakage Testing Results (MGximllm 6°% Duct Leakage) CFA: Svstern r-Tjof Indicate the maximum a to—waole Duct Leaka6e and me t<lculauon used: E0.7 x Floor Arm x (o,m) for Gimaw Zone 8 tfrougn 1: 0.: x Floor Area x (0.06) for Comate Zones 1 lhrov;- 7 i; 16 14C0'x (Cooling Caps M. in Nominal Tons) x (0-05) 21.7 r (Heating Capacity in Thousands of ouzut i-. a per hour) x (c.oe) Omer uc: Pressuritatlon Test Results (CFM (11 25 FA) 100 x Test Leakage / Fan Flow = % Leakage Check Bey rot Pass or Fail (Pass = 6% or Less) Paas rau -24 Compf;ance C dit was Taken for 7XV FXV was instaueo L MT -24 ® cf � . il Indicate the maximum a owaofe Duct Leakage -rd (`e tar -,Aa uon use^: 0.7 x Floor Area x (0.06) for Climate Zone B Through 1E 0,5 x Floor Area x (0.06) for Climate Zones 1 t;•rou;n 7 (; 16 400 x (Codiing Capacity in Nominal Tons) x (C.Ce) 21.7 x (Heathng Caparry. in Thousands of 3 per hour) x (0.06) Qthar uc: Pressurization Test Results (CFM @ 25 FA) 100 x Tev Leakage / Fan Now = % Leakage Check Ecr :or Fags or Fail (Pass = 6% or Lass Pass ran [:.-:]T-Ze Compiiance Credit was Taken for 1XV ?XV was ina:a„ey I I PAG= , 'zr�(:' •01 (4-02) Aeion Now 7-:dCZi RT08TXV -..a Q05