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002846 (AR)P.O. BOX 1504 No. Building 78-105 CALLE ESTADO Address 80--319 palm J=VX2?A CirC1.f-LA QUINTA, CALIFORNIA 92253 Owner j U7=1 _ . w Mailing Address rv-,nM City ZipTel. M . 11_a,l[`ta_ .. 9.2253 342-1692 Contractor . ?�Q1r Address BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description P.O. Box 2&23 ''City� Desext Zip . 92261 Tela 340-3525 State Lic. City & Classif. , 483454 Lic. # app2iad Sq. Ft: No. No. Dw. � Size . 12 -stories --Units . Arch., Engr., .. .. Designer New ❑ Add ❑X Alter ❑ Repair ❑ .' Demolition ❑ Address Tel. City Zip State - Lic. # t`t LICENSED CONTRACTOR'S DECLARATION hereby affirrti,that I am licensed under provisions of Chapter 9 -(commencing with Section 7000) of Dwvisio 3 of=the Busi ess and Professions 'Cb►dpe,--annd my license is infull force " and effect. . • . i* 3 SIGNATURE? °. 11 DATE ' d(' OWNER BUILDER DECLARATION Estimated Valuation hereby affirm that I am exempt from the Contractor's License Law for.the followingq • ' reason: (Sec. 703 1..5, Business and Professions Code. Any city or;county which .requires a permit to construct, alter, improve, demolish, or repair -any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to -. .. -PERMIT . - • ' ' AMOUNT - . the provisions of the Contractor's License Law, Chapter 9 (commencing with. Section 7000) of Division 3 of the'86siness and Professions Code, or that. he is exempt therefrom, and .the basis.. for the Any Section 7031.5 by 'any''applicant.'for Dep. . ' . alleged exemption. violation of a permit 'subjects the applicant to a civil penalty of not more than five hundred dollars ($500).'. • ,Plan.Chk: Plan Bal. - 36.7? 0 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, Buisness and .Chk.. COrist. Professions- Code: The Contractor's License Law does not apply to an owner of property who - ;�� builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered' for sale. If, however, -the building Mech.: - or improvement is sold within one year of completion,- the owner -builder will have the burden Electrical_ - of proving that he did,not build or. improve for the purpose of sale.) - -• O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing e struct the project. (Sec. 7044, Business and Professions Code.,. The Contractor's License Law • does not to builds improves thereon, for S.M.I. - - in apply an owner of property who or. and who contracts such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) .. r ..;,i Grading 0 1 am exempt under Seca B. & P.C. for this reason Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION •I'hereby affirm that I have'a certificate of consent to self -insure; ora certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800,.Labor.Code.) Policy No. Company !-.-.1 Vii'• ex rlei4_'" . Qcopy is filed with the city. . 0 Certified copy is hereby furnished. .. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE. (This section need not be completed if the permit is for one - hundred dollars ($100) valuation 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. Date " Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption 'you should become ' subject to the ' Workers' Compensation provisions of the' Labor Code, you must forthwith comply with such provisions or this permit shall be deemed' revoked. ' CONSTRUCTION LENDING AGENCY . I hereby affirm that there is a construction lending agency for the performance of the . work for which this permit is issued. (Sec. 3097,.Civil Code.)., Lender's Name Lender's Address This is`s building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. ' I certify that I have read this application and state that the above information is correct. I agree to comply with all,city and county ordinances and state laws' relating to building construction, and hereby'yauthorize representatives -of this city to enter the above-. mentioned property for, inspection purposes. ► t Signature of applicant J_ - S i.ut_ A .' l - Date 1_9V7 Mailing Address Y City, State, Zip HARD COPY TOTAL 1idJ a 447 REMARKS ZONE: BY: Minimum Setback Distances: Front. Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from.Property Line FINAL DATE INSPECTOR Issued by: Date 1-20-87 Permit Validated by: Validation: A7141 1 2u 1;.5,2'6 CK CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. ® POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SO. FT. ® WALL SQ. FT. ® SQ. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR Q 3/ac HOUSE SEWER FRAMING Z 'l l FINAL INSP. GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK' GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ( ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL ` GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING Z 'l l FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH 2tj/eNSULATIONISOUND ' /O FINISH GRADING L INSPECTION f7 T. OCC. FENCE FINAL. INSPECTOR'S SIGNATURESIINITIALS, GARDEN WALL FINAL Desert Sands Unified School District t CERTIFICATION OF PAYMENT OF , SCHOOL FACILITY FEES T0: City of La Quinta DATE: / Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 This is to certif that developer of �. which is located atJ jl�L� �'! ''Within this District, has paid school facility fees imposed pursuant to the auth�p°rit/y generated by Gov rnment Cod Sectio 53080. in the amount of covering a total of square fe-e4 of ) residential or ( ) industrial/commercial development tha uilding permits for this footage in this development -may w d by your urisdiction. for DESER SANDS•UNIFIED SCHOOL DISTRICT White Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 C®p���qp p��y�g � X67 qg�p 65 cpcp �gg'�'� � �p�p' _ pyy� _ � �..//1 . _�ypy �ypO�y� - __ _. ... ...i._... -.. .. U1)uHE uroi -De �7 'eF {i �i+ 0�0�7Y1W �SA� L'a6��t0 ' r� COINDIVOWALLV A EPTE � FORis-GH �,� Tri P /'�p�_fyP ill AND, ALL ILI. P.CICI4jik 1@iiY�_... _ __ _ _ _ ._ i .. A-•.� � a�{'`�'67ul i 1 • L -CITY _ Lia. . commup_it ®0elop�"ent/Bidg Dip o CONDMONALLY ACCEPTED FOR C3U�J®T R CT0®� ; .BDECT T® INSTALLATION -AND ALL APPLICABLE. C®® i 1r �• i \ �.. N Z 1-4 A a o sa s s A I.RiCXERTS OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of Palm Desert A/C - Heating / 374937 Contractor Name / License No. rage i oz 1.3 Project Address OS -1092 Contractor Contact Telephone Permit Number Paul Van VI men 760-777-1724 101360 H Rater ` Telephone Sample Group Number 3uly 22, 2008 CC14-1798441939 Date Certificate Number C&Vrying Signature Air Experts Air Conditioning HERS Provider.Ca10ERTS Inc. Firm: City/State/Zip:L.a Quinta / CA / 92247 Street Address: PO Box 94 Copies to: Homeowner HERS Provider and Building Department This CF -4R has been registered with the CaICERTS® registry in accordance with the Title 24 &Title 20 of the CCR. CaICERTSO is an aDDroved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was ❑Tested 9 Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check testedbuilding.nvri y that the new The HERS rater issusb ntion system Is fully ducted and correct tape Is used before a CF -4R may be released on every_ release the CF -411 until a properly completed and signed CF -6R has been received for the sample and tested buildings. The installer has provided a copy of the CF -611 (Installadon Certificate). New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). New systems where cloth backed, rubber adhesive duct tape Is Installed, mastic and drawbands are used In combination with cloth .�..'..e w...+ tnw M cPal leaks at duct connections NEW CONSTRUCTION Measured Duct Pressurization Test Results (CFM @ 25 Pa) Values N/A 1 6FM' Fan Flow: Calculated (Nominal _� Cooling '' _l' Heating) or-:::-' Measured Not Tested 2 Enter Total Fan Flow in CFM: N/A N/A 3 Pass It be8le8ge P ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Not Tested 4 Dud System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow In CFM: Final Test of New Dud System or Altered Dud System Not Tested 5 for Dud System Alteration and/or Equipment Change -Out. Enter Reduction In Leakage for Altered Dud System Not Tested 6 [Une 4 - Line 5] - (Only if Applicable) 7 Enter Tested Leakage Flow In CFM to Outside (Only if Applicable) Not Tested 8 Entire New Duct System - Pass If Leakage Percentage < 6% [ 100 x ( Line 5 / Line 2 )]: Not Tested ❑Pass El Fall STANDARDS: For Altered Duct System and/or HVAC TEST OR VERIFICATION Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: El ❑ Fail Not Tested if Leakage Percentage <= 15% [ 100 x (Line 5 /Une 2 )]: Pass Pass If Leakage to outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: Not Tested ❑Pass El Fall L102Pass Pass If Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] Not Tested El Pass El Fail and Verification by Smoke Test and Visual Inspection El 1:1 Fail Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection Pass Pass if One of Lines #9 through *12 pass ❑ Pass 0 Fall �� CaT( ERTS Page 2 of 13 •r CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 81 CF-4R Palm Desert A/C - Heating / 374937 80-241 Palm Circle Dr. - La Ouinta, CA 92253 Contractor Name / License No. Project Address 08-1092 Contractor Contact Telephone Permit Number Paul Van VI men 760-777-1724 101360 r �1ERS Rater 1 Telephone Sample Group Number July 22, 2008 CC14-1798441939 n ` CertlfyJng Signature e L Date Certificate Number Firm: Air Experts Air Conditioning--i-HERS Provider:/ipCaI uinta Inc. Street Address: PO Box 94 City/State/Zip:La Quints / CA / 92247 r, Copies to: Homeowner HERS Provider and'Building Department This CF-4R has been registered with the CaICERTSO registry in accordance with the Title 24. & Title 20 of the CCR. CaICERTSO Is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was ❑Tested R Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form compiles with the diagnostic tested compliance requirements as checked on this form. The Installer has provided a copy of the CF-611 Installation Certificate). HERMOSTATIC EXPANSION VALVE TXV : Access is provided for inspection. The procedure shall consist of visual verification that the TXV.is installed on the system and installation of the specific equipment shall be verified. HVAC System TXv ❑ Pass ❑ Fail