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04-6472 (SFD)P:. O,\Box 1504. QF 9 78-4955 CALLE TAMPIC.O -ilk QUINTA CALIFORNIA 92253 'QUWC4(j BUILDING &SAFETY DEPARTMENT (760)',777-.7012 FAX (760) 777-7011 INSPECTION REQUESTS. (.760).777-71.53° BUILDING PERMIT �Abplicat.ion Number . . 04-0000647 . Date. 10116/04 Property .Address 52-680 AVENIDA VELASCO APN: 773-295-010-15•-00000.0- Apglication description .....DWELLING.- SINGLE FAMILY DETACHED Property. Zoning COVE RESIDENTIAL Application valuation 104910 .. Owner Contractor BUILDING HORIZONS BUILDING HORIZONS `-'42600 .COOK .ST .#12.0, 42600 COOK STREET; .#120 PALM DESERT CA'. 92'2113 PALM .DESERT.`. -CA :92211 :.. .. .34.=4748 (760). 0 r . WCC : CV . INS .' WC:. 1705454:03 12/.01/04 CSLB :. 812160 - 09/30/.06 ...:: ' CCC: B ------. 'Structure*Information SINGLE FAMILY DWELLING -.---- Construction Type TYPE V.- NON :RATED. Occupancy Type . . . ... . DWELLG/LODGING/"CONE <=10. Flood Zone NON -AO FLOOD.ZONE Other struct info CODE EDITION 2001 CBC # BEDROOMS 3...00 FIRE. SPRINKLERS. ISO , .. ;. GARAGE 'SQ . FTG 4 6 9,'. 0:0 . . . PATIO SQ FTG 36..00 . NUMBER. -OF UNITS .. 1 .'00 FIRST FLOOR SQ. FTG ` i665.,00,,:- 665. 00:- 7 Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee.657.00 Plan Check Fee. .. 4.27.'05. Issue Date Valuation 104910. Qty Unit Charge. Per. Extension BASE FEE .6,39.50 5.00 3..5000 THOU BLDG 100,001-.500,000. 17.50 Permit MECHANICAL Additional desc `...:.. ..Permit.*Fee 59.00 Plan ;Check .Fee 14.75 •Issue Date. Valuation 0 :. Qty. Unit .Charge Per Extension BASE -FEE 15.00 . 1.00 9.0000 EA MECH.FURNACE <=100K 9.00 1.00 9A0.00 EA MECH B/C <=3HP/100K BTU. 9.00 3.00' 6.5000'EA MECH VENT FAN 19.50 P.O. Box 1504 VOICE°(760) 777-71)1"2 .78-495-CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 922.53 INSPECTIONS (760)-777-71.53 BUILDING & SAFETY DEPARTMENT Application Number: 04 Date: Applica , : Architect or Engineer:_ Applicant'4e2 ! n � dress:) Architect or Engineer's Address: RZZC( Lic. No:: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (oomrrnericing with Section 7000) of Division 3 of the Business and Professionals Code, and my License -y in full force and effect j License Class I \ Ucense No. Dale 2 Contralto, OWNER -BUILDER DECLARATION I hereby aff rm' under penalty of perjury that I am exempt from fibs ContradW.. State License Law for the following reason (Sea 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.ft alleged exemption.' Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally 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 Lav, 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 oftered for sale. H, however: the budding or Improvement Is sold within one year of completion, the owner -binder wnl have the burden of proving -that he or she did not build or imorove.for the purpose of sale.). - 1. as owner of the property, am exclusively contracting with licensed contractors to constrict the project (Sea 7044, Business and Professions Code. The Contractors' State. Ljoense:Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractors) licensed pursuant to the Contractors' State License Law4peqt%ry�one ) U I am exempt under Seahis reason Data�m ` WORKERS' COMPENSATION DECLARATION hereby affirm under penalty.lowing dedarations:.1 have and will monsent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the wok for which this permit is issued . i,I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work forwhich this permit is Issued. workers' compensation insurance prier a nyr�m�r are: ' Carrier LU XP _ Policy Number I S r ld3 _ 1 certify:that. in the performance of the work for which this: pernit Is issued, I shah not employ any person In any manner so as to become subject to Bhe workers'.. - compensation laws of California; nd agree that, if I shomdd become subjed lothe workerstcornpensatkm provisions of Section 3700 of the Labor Code. I shall forthwith comply with those proyipns. . WARNING: FAILURE TO SECURE WORK S' OMPENSATION COVERAGE IS UNLAWFUL", AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEhiALTIES AND CIVIL FINES UP TO ONE HUNDRED THOS1801D DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 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.periormance of the work for which this permit Is issued (Sea 3097. Civ. C.). Lenders Name Lenders Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a pemnit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose.behaN 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 Wnta, its officers, agents and employees for any act or omission related to the work being performed under or following Issuance of thio permit. 2. Any permit issued as a result of this application becomes nun and void lf 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 informatiqqo correct 1 agree to comply with an city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter the toned property for inspection purposes. Date Signature (Applicant or Agent): ;f Page 2 Application Number 04-00006472 Date. 10/16/04 Qty Unit Charge Per Extension 1.00, 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------- Permit . . . --------------------------------------------=--------- . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee 97.66 Plan Check Fee 24.42 Issue. Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1665.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 58.28 469.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.38 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc.. Permit Fee . . . 117.00 Plan Check Fee 29.25 Issue Date .Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 8.00 6.0000 -EA PLB FIXTURE 48.00 1.00 15'.0000 EA PLB BUILDING SEWER' 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT '7.50 1.00 3.0000 EA PLB WATER'INST/ALT/REP 3.00 1.00' 9:0000 EA PLB LAWN SPRINKLER"SYSTEM 9.00 6.00. .7500 EA PLB GAS PIPE >=5. 4.50 1.00 15.0000 EA PLB GAS METER 15.00 Permit . . GRADING'PERMIT Additional des'c Permit Fee 15.00 Plan Check Fee .00 Issue Date Valuation 0 Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Special Notes and Comments 1665.S.F. SFD PERMIT DOES NOT INCLUDE BLOCK WALL,' POOL/S.PA OR DRIVEWAY APPROACH ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 1 t I r T , Page Application Number -3 04�1-00006472 ," Date 10/16/04 --- -----------------,-------------------------�--- ---------------------------- Other Fees J ENERGY REVIEW FEE )42,:71 DIF FIRE.PROTECTION=RES ,' 97.00 a DIF,. LIBRARIES .- RES 22.5.00 " DIF PARK MAINT FAC -RES ' . 5 . 00 DIF PARKS/REC'- RES 502.'00' STRONG MOTION (.SMI)•- RES 10.49 DIF STREET MAINT FAC -RES .15.00 '. DIF TRANSPORTATION - RES 1098.00 yPaid Fee summary, Charged Credited Due Permit Fee Total 945.66 .00., _00, 945.66 Plan Check Total '495.47 250.00. .00 245.47 Other - Fee Total' 2,458 .20 �_.00 X00 2458.20 Grand Total : 3899.33 250.00 .00' 3649.33 } SZ - c.acD Building Address Owners Mailing Address TWT P.O. BOX 1504 78-495 CALLE TAMPICO J 910's C-40 LA QUINTA, CALIFORNIA 92253 tt Zip `l2Zl l -Agbl ^0 ter. r�uuicaa / I i,^1L cu A. 6ve— City lZip ITO. & Classif. ` 1 J ZL(oD Arch., Designer Address Tel. S Z`[ Mw . City ZipState tv ! C1- Lic. # .LiCE14SED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, 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 the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he 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). 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, Business and Profes- sions 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 or im- provement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for th' eason Date 611-1101 Owner WORKER'SFCOMPIENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ 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 the work for w h this permit is issued, I shall not employ an person in any manner so o become s ect to Workers' Compensation Laws of Californ' Date �� 21 owner NOTICE TO A PLICANT. If, afigr mak' is Certificate of Exemption you should become subject to the Workers' Compensatio 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 a 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 authorize representatives of this city to enter the above-mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT 6,0 If — 16� ;7a APPLICATION ONLY BUILDING: TYPE CONST. = 0 OCC. GRP. R 3 - (J— I A.P. Number '773 Legal Description Lok * LC Project Description 5 r n Sq. Ft. 0 p / _5 No. No. Dw. Size 6�71� Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT Plan Chk. Dep. Minimum Setback Distances: Plan Chk. Bal. Front Setback from Center Line Const. Rear Setback from Rear Prop. Line Mech. Side Street Setback from Center Line Electrical Side Setback from Property Line Plumbing S.M.I. INSPECTOR Grading Date Permit Driveway Enc. Infrastructure Validation: YELLOW = APPLICANT PINK = FINANCE TOTAL REMARKS AMOUNT 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 Permit Validated by: Validation: YELLOW = APPLICANT PINK = FINANCE 6ERMUDAouNEsr" Desert Sands .Unified School District RANCHO MIRAGE O 6 INDIAN WELLS os 47-950 Durie Palms Road • La Quinti,- California 92253 (760) 77774200 - PALM DESERT Y • LA OUINTA r1p INDIO 1� July 26,2004 1. Mr. Todd Berg Acting Executive Director Boys & Girls Club ' Building Horizons 42-600 Cook St., #120 Palm Desert, CA 92211 . Dear Mr. Berg: Thank you for your recent letter requesting a waiver of Developer Fees for the 2004/2005 projects located at: 52-680 Ave Velasco, La Quints APN 773-295-010 52-700 Ave Velasco; La Quinta APN 773-295-011 Desert. Sands Unified School District is proud to supportyour organization and therefore will grant exemption of developer fees for these two locations. We look forward to collaborating with you again`in-the future for the benefit of the children that we jointly serve:' ' Please call me at (760) 771-8515 with any further questions or -concerns. Best regards, Peggy Reyes Director, Facilities Services PR/bs Southland Title" orpo ation RECORDING REQUESTED BY: Southland Title - Inland Empire AND WHEN RECORDED MAIL TO: Building Horizons Inc. 42600 Cook Street Suite #120 Palm Desert, CA 92211 A.P.N.: 773-295-010 -011 Order No.: 62600608 Escrow No.: IN2593-RS THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX IS $88.00 DOC tib 2002—a2mas8 06/11/2002 08:00A Fee:27.00 Page i of i Doc T Tax Paid Recorded in Official Records County of Riverside Gary L. Orso Assessor, County Clerk b Recorder m7,$ U PAGE SIZE DA PCOR MMOR SMF MISC. A tR. COPY LONG- REFUND NCHG EXAM GRANT DEED (X) Computed on full value of property conveyed, or () Computed on full value less value of liens or encumbrances remaining at time of sale () Unincorporated area: (X) City of La Quinta FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged Charles H. Hofgaarden, Successor Co -Trustee and Karen Mandeville, Successor Co -Trustee of The Hofgaarden Familv Trust hereby GRANT(S) to Building Horizonslnc.a California Nonprofit public Benefit Corporation following described property, in the County of Riverside, State of California. Lot 14 & 15 of Block 150 of Santa Carmelita at Vale La Quinta Unit No. 16, in the City Or La Giuinta, County or Riverside, State of California, as per map recorded in Book 18, Page(s) 99 of. Miscellaneous Maps, in the office of the County Recorder of said County. Dated: May 9, 2002 STATE OF CALIFORNIA COUNTY OF 4-4-5 A316A1C: On. % b %yl -y 2_001 before me `-Z-© /fi +! Co c,0- L) a Notary Public in and for said County and State, personally appeared CA4a/r`.s H{ , leo G'G AP_ 0 &'-V 'kvi) YC A-RE,D /n Awpr-y i Ile personally known to me (or proved to me on the basis of satisfactory evidence) to be the persorG ss whose namys , Ware subscribed to the within instrument and acknowledg-94 to me that be4he/the executed the same in hisi4er/their authorized capaci ies and tildi by bum/their signatur (s on the ins rument the erso�s)�' or the entity upon be alf of which the perso s)' acted, executed the instrument. WITNESS my hand and official seal. Signature +i /L.. 9 Siqnature of ISS. The Hofgaarden Family Trust Co - Charles H. r Co- ' COMM. #1347054 .NOTARY PUBLIC -CALIFORNIA ' LOS ANGELES COUNTY .. My Comm, Exp. March 18, 2006 JOHN R. COCHRAN (This Area for Notary Seal Only) MAIL TAX STATEMENTS AS DIRECTED i C) n rn MAIL TAX STATEMENTS AS DIRECTED RC DISTRICT - PLANNING REVIEW FORM This form is to be used by CDD, staff for review of'single family dwellings in the RC (Cove Residential) District per Section 9.50.090 'of the Zoning Code. Its purpose is to determine: 1 j that the proposed housing design does not duplicate the same architectural style of any house within 200 feet of the applicant, .and/or 2) if there is a need for the applicant to file for Master Design Guidelines: If the applicant does need to file .a Master Design Guideline, please transmit this information to -the Building and Safety Department as,part of your correction list. Please attach additional explanations as necessary. APPLICANT: llt �1, tYl bYl. S .SITE ADDRESS: ^a — p O V P)a S CG ACASE NO,: X03-�AW -773'-o�� - ��Q ' LEGAL: LOT l BLOCK /S -O- UNIT C S.C.@V.L.Q. CHECK AND APPROVED.BY:• W. N sCIii" DATE: Inform the assigned Building plan checker,upon your assignment to this case. The CDD Executive Secretary maintains a log book to track applications and assign .case. numbers. REQUIRED ITEMY N [COMM ENT/CORREC'TION Verify legal and APN information Consistent with MDG on file. (as applicable) .MDG filing required (5 filings since 9/3/98) Architectural variety within 200 feet of the surrounding area: Architectural design, features , Other Requirements: I i t , INSTALLATION CERTIFICATE (Page 1 of 13) CF -6R Site Address �� „ �� ���/La 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. CEC Certified Mfr Name Identical (AFUE, etc.)',. Location Piping Load Capacity 'heat pump) and Model Number I Systemc f>CF- I R valuPt S (attic t R value (g ,/t+r) (Btu/hr) . v f -iii Cooling Equipment C Equip. CEC Certified Compressor # of Efficiency Duct Cooling Cooling �` / Type (pkg. Unit Mfr Name and Identical (SEER, etc.)' Location Duct Load Capacity Dhr at nUmp) Model Number systems I?_CF- I R valuel (attic. etc.) R-yalue (11tu/br) (Riulbr) ICT >le1T N 07t 1. > reads greater than or equal to. I, the undersigned, verify that equipment listed above is: 1) is the actual equipment installed, 2) equivalent to or more efficient than that specified in the certificate of compliance (Form CF -1R) submitted for compliance with the Energy Efficiency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for manufacture evices (from the Appliance Efficiency Regulations or Part 6), where applicable. /_1 /z/r /7r'L �42(Jr'T':�N/V�' •—�/t-t=om tgna e, Date Installing Subcontractor (Co. Name) } r, OR General Contractor (Co. Name) OR Owner W ER HEATING SYSTEMS: Distribution If Recit-. # ofRated' Tank Effi- Extemal . Heater CEC Certified Mfr Type (Std, culation, Identical Input (kW Volume ciency' Standby' Insulation Type Name & Model Number Point -of -Use) Control Type Systems or Btuthr) (gallons) (EF RE) Loss (%j R value' 2 For small gas storage (rated input of less than or equal to 75,000 Btu/hr), electric resistance and beat pump water heaters, fist Energy Factor. For large gas storage water beaters (rated input of greater than 75,000 Bnybr), list Recovery Efficiency, Standby Loss and Rated Input. For Instantaneous' gas water beaters, list Recovery Efficiency and Rated Input. 3. R -l2 external insulation is mandatory for storage water heaters with an energy factor of less than 0.58. Faucets &.Shower Heads: All faucets and showerhe ads installed are certified to the Commission, pursuant to Title 24, Part 6, Section 11'1. I, the undersigned, verify that equipment listed above my signature is: 1) the actual equipment installed; 2) equivalent to or more efficient than that specified in the certificate Oi7 compliance (Form CF -1 R) submitted for compliance with the Energy Efficiency Standards for residential bt.tiidings-, and 3) equipment that meets or exceeds the appropriate retpiirements for manwact>mred devices (froth tce.Appiiance Efcien'cy. Regulations or Part 6), where applicable. COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy _...:a:..:g ouixo;itractor (Co. Name) OR General Contractor (Co. Name) OR Owner L;ompoance Forms August 2001 A-23 - CERTIFICATE OF /FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF4R �_/����lGi•�na bY6rrz�m< �/��� Project Title Date ,0/y7 Builder Name .. Firm: Street Address: Copies to: Builder, HERS Provider Plan Number Sample Group Number Sample House Number f% HERS Provider: City/State/Zip: HERS RATER QOMPLIANCE STATEMENT The house was: Tested ❑ 'Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verifications i certify that the houses identified on this form comply wi� diagnostic tested.compliance requirements as checked on this form. td );he installer has provided a copy of CF -6R (Installation Certificate. D' ib ion 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 �., bac rubber adhesive duct tape to seal leaks at duct connections. with cloth dd'MIN NM RE QUIREMENTS 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 If fan flow is calculated as 400cfin/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) e C THERMOSTATIC EXPANSION VALVE (TXV) , 1�`Yes ❑ No . Thermostatic Expansion Valve is installed and Access is provided for inspection Yes is a pass ❑ MINIMUM REQUIREMENTS.FOR.D.UCT-.D-ESIGNCOMPLIANCE CREDIT - - MINIMUM 1' ❑ Yes ❑ No ACCA Manual D Design requirements have been met (rater has verified that actual installation matches values in CF -1R and design on plan. 13 P Fail 13 Yes$ Fail 2• ❑ Yes ❑ No. TXV is installed or Fan flow has been verified, If no TXV, verified fan flow matches design from CF -1R { Measured Fan Flow = ❑ 13Yes for both 1 and 2 is a Pass Pass Fall Compliance Forms August 2001 A-16 . ,...,: ..:.'�.•: � :.:•.:.<:-..v.r: �....�..v r ..y.:<.• ,..: •.r.:c cr. /•;•: vis. /<nr. /'i .rfir.•..v.�r.:-: r i.:-ir: <: . ....v.a>..<.�.�.::vena�n..,.�:ri::.✓:•..rr:::..::a_i.•l.vnr.:.:::.':. r. _. .. ...-... :_-..r .,,,.. _ .._ 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 at 52-700 AVENIDA VELASC0, LA QUINTA, CA. CEILINGS: TYPE: BATTS MANUFACTURER: Certainteed THICKNESS: R-38 WALLS: TYPE: BATTS MANUFACTURER: Certainteed THICKNESS: R-19 GENERAL CONTRACTOR: BUILDINGS HORIZONS. LICENSE # BY: TITLE: PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517: Ap SY: TLE: ACCOUNT REPRESENTIVE .DATE: -03"--VZ�5 .. .:.. ,::... ..�..,.:::. '.....:.�'.:i.._..,...la. : ,.., i.l J: .. rt .rv....... rte.. i.... J/.J:. N.< .✓. i.. iJ.�... ..ln....rl._/sYr:Jl.:..S..J//✓../_.VJl.., .•-.�...��. �.. f.._.-... .. ... .. .... .._ .. 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 t, 52-680 AVENIDA VE:LASCO, LA QUINTA, CA. CEILINGS: TYPE: BLOW MAUNFACTURER: Certainteed THICKNESS: R-38 WALLS: TYPE: BLOW MAUNFACTURER: Certainteed THICKNESS: R-19 GENERAL CONTRACTOR: LICENSE # BY: TITLE: PARAGO SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517 BY:.. L� `itTLE.- ACCOUNT REPRESENTIVE DATE: 60 39tid t7OCZ9t'c.09L VE :6- ; d.: '�'t1t3Zi"c'0E 30' Code Program STRUCTURAL' OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance to the approved plans and specifications, at significant construction stages and at completion of the structural system. Structural observation does not include or waive the responsibility for the inspections required by Section 108, 1701 or other sections of the code. Report No. This renort includes all construction work throunh a day of V 1h-4 1- 2005 Pane Nn of Project Address: Structural Observer of Record (SOR): Phone No. of SOR: 521,8C NVO,,Y%ci& Vit P,- - , L,p-QiIt AAy1 CA, PORTION OBSERVED, IF NOT WHOLE (.os -G&, 'Building Permit No.: Structural Observation performed by: Professinel Lic./Reg. No. of Observer: Phone No. of Observer: IC P,(S Co t k -,Os l.'�-�2e7 (�di)(oos-loSlo� FOUNDATION - WALL FRAMES FLOOR . PORTION OBSERVED, IF NOT WHOLE ® Footing, Stem'Walls, ❑ Concrete ❑ Steel Moment Frame It Concrete - ❑ Mat Foundation ❑ Masonry ❑ Steel Braced Frame , ❑ Steel ❑ Caisson, Piles, Grade Beams ®Wood ❑ Concrete Moment Frame ❑ Wood ❑ Retaining Foundation Hillside Special Anchors El Other: ❑ Masonry Wall Frame ❑ Others: ❑ Others: ❑ Others: OBSERVED DEFICIENCIES: A", SKS-yc2� l�)S MAR 2005 1 DECLARE THAT THE FOLLOWING STATEMENTS ARETRUE TO THE BEST OF MY KNOWLEDGE: Q,�oFESs/�� 1. 1 AM THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS CID OF THE CITYO Z 2. I, OR ANOTHER ENGINEER OR ARCHITECT WHO 1 HAVE DESIGNATED ABOVE AND IS UNDER W #C3 0 Z m MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH P. t 6 =D SIGNIFICANT CONSTRUCTION STAGE TO VERIFY. IF THE STRUCTURE IS IN GENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; 3. ALL DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED ABOVE; �gTCIVIL FpF CAUFO��\Q `. STAMP OF STRUCTURAL OBSERVER OF RECORD SIGNATURE DATE w0s Certificate of OccupanCY •Safety. GoF9�� Building & 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 in 9 provisions of the Building Code and the various ordinances of the City regulating - building construction and/or use. BUILDING ADDRESS: 52-680 AVENIDA VELASCO Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05=6472. k Occupancy Group: R-3 Type of Construction: VV-N Land Use Zone: RC Owner of Building: BUILDING HORIZONS Address: 42-600 COOK ST. #120 City, ST, ZIP: PALM DESERT, CA 92211 By: STEVE TRAXEL Date: 06-09-2005 _ -Building Official ' POST IN A CONSPICUOUS PLACE