06-2655 (SFD)4
4
P.O. BOX 1504 Qum&
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00002655 Owner:
Property Address: 61238 TOPAZ DR SHEA LA QUINTA
APN: 764-280-999-158 -300237- C/O JEFF MCQUEEN
Application description: DWELLING - SINGLE FAMILY DETACHED. 8800 N GAINEY CENTER 350
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 186889
Contractor:
Applicant: rchjtect or Engineer: SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA, CA 92253
(760) 777-6005
`lam LiC. NO.: 672285
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
-
Section 7 00) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Licen C s B License No.: 672285
,B3te 1 �ractor:
/ OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's 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 Contractor's 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).:
(_ 1 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 through his or her own employees, provided that the
improvements are not intended or offered for sale. If, 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.). _
(_ 1 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.).
I—) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
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:
LQPERMIT
i
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date
AUG 0 2 2006
7/12/06
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.
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 and policy number are:
Carrier AMERICAN HOME Policy Number 1247619
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 he workers' compensation laws of California,
and agree that, if I s oul ,come subject to the kers' compensation provisions of Section
700 of the L r I hall rth ' h comp) those provisions.
atb a msL pylic t:
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 1$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.
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 Quinta, 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 corr t. 1 agree to comply with all
city and co ty ordinances and laws relating to bur di constr ti and her thorize representatives
of thi u y t e
A�potnure above-mentioned a inspe 'on pu seate: Applicant or Age
n
Application Number . . . . . 06-00002655
Structure Information SFD PLAN 5505 W/CASITA MBR GAR & PAT EXT -----
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . .
. . . DWELLG/LODGING/CONG <=10
Other struct info . .
. . . CODE EDITION 2001
# BEDROOMS
4.00
FIRE SPRINKLERS NO
GARAGE SQ FTG
539.00
`
PATIO SQ FTG
536.00
NUMBER OF UNITS
• 1.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
2094.00
Permit
BUILDING PERMIT
Additional desc .
Permit Fee . .
944.00 Plan Check Fee
613.60
Issue Dat: . . . .
Valuation
186889
Expiration Date
1/08%07
Qty Unit Charge
Per
Extension
BASE FEE
639.50
87.00 3.5000
----------------------------------------------------------------------------
THOU. BLDG 100,001-500,000
304.50
Permit . .
MECHANICAL
Additional desc'.
Permit Fee . . .
83.50 Plan Check Fee
20.88
Issue Date
Valuation . . . .
0
Expiration Date
1/08/07
Qty. Unit Charge
Per
Extension
BASE FEE
.15.00
2.00 9.0000•EA
MECH FURNACE <=100K
18.00
2.00 9.0000
EA MECH B/C <=3HP/100K BTU
18.00
4.00 6.5000
EA MECH VENT FAN
26.00
1.00 6.5000
----------------------------------------------------------------------------
EA MECH.EXHAUST HOOD
6.50
Permit . .
ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee
99.07 Plan Check Fee
24.77
Issue Date
Valuation
0
Expiration Date..
1/08/07
Qty Unit Charge
Per
Extension
BASE ' FEE
15.00
2094.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
73.29
539.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
10:78 -
LQPERMIT
Application Number . . . . 06-00002655
----------------------------------------------------------------------------
Permit PLUMBING
Additional desc .
Permit,Fee . . . 133.50 Plan Check Fee
33.38
Issue Date Valuation . . .
. 0
Expiration Date 1/08/07
'Qty Unit Charge Per
Extension
BASE FEE
15.00
14.00 6.0000 EA PLB FIXTURE
.84.00
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
Permit . . . GRADING PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 1/08/07
Qty. Unit Charge Per
Extension
BASE FEE
15.00
------ ---------------------------------------------------------------------
Special Notes and Comments
SFD - Plan 5505C, 2094 SF, Lot 158
w/casita. (247
sgft), MBR box•bay (26 sgft)., ext garage
(83 sgft), ext patio (315 sgft), 2094
SF. Permit does not include block wall,
pool or driveway approach
2.001 CBC, CMC, CPC, 2004 CEC, 2005
ENERGY CODES
---------------------------------------'-------------------------------------
.Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
74.00.
DIF CIVIC CENTER - RES
480.00
ENERGY REVIEW FEE
61.36
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI) - RES
18.68
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1666.00
LQPERMIT
LQPERMIT _ -
l
Application Number
. . .
06-00002655
'
Fee summary.
Charged.,Paid•
Credited
Due__
--
Permit Fee Total
---- - - - - --
1275.07
---- . -- - - --
.00
---- - - - - --
.00
---- - - - - - -
1275.07
Plan Check Total
= 692.63
.00
.00
692.63
Other Fee Total
3776.04
.00
".00
3776.04
Grand.Total
5743.74
.00
.00
5743.74
LQPERMIT _ -
Nov 07 2006.3:48PM HP LASERJET FAX
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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:
_ f
61 38 Topaz Drive, Lof 715:8, Phase 16A, Trilogy Project, La Quinta, California '.
CEILINGS:
TYPE: BLOW MANUFACTURER: CERTAINTEED Thickness: R-38
WALLS:
TYPE: BLOW MANUFACTURER: CERTAINTEED Thickness. R-13
i
GENERAL CONTRACTOR: SHEA HOMES LICENSE #
r,
BY:
E.
r
TITLE:
PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY
LICENSE # 632072
BY: TITLE: OFFICE MANAGER DATE: 11/7/2006
0
JCM Inspections
' 39725 Garand Lane Suite F
Palm Desert, CA 92211 I
INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS
COMPRESSION STRENGTH TEST RESULTS
Client: Shea La Quinta,.LLC Date: 11/15106
Project: Trilogy @ La Quinta - Shea Homes Project No: 02-1109
60-800 Triolgy Parkway.
La Quinta, CA 92253
Set ID Structure Age of Test Compression Strength
JCM ID Location. Date Cast Cylinder ID (days) .(psi)
Set A Phase 16A - Lot # 7158 Slab on Grade 8-23-06. r Concrete
273-762 Bedroom 2 Required psi: 4000
4505 7 3000
4506' . 28 4160
4507 28 4200
CERTIFIED:
rJC Inspections supplies the service
TOof compression strength test results only.
Per ASTMC39
Page 1 of 1
9
I
• 'JCM Inspections
39725 Garand Lane Suite F
Palm Desert, CA 92211 MM
INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS
REINFORCED CONCRETE INSPECTION REPORT Dates: Noted Below
Project Name: Project No:
Trilogy @ La Quinta - Shea Homes 02-1109
Project Address: City:
60-800 Triolgy Parkway La Quinta, CA
IBC
Title 24
Other:
Client: Sub -Contractor:
Shea La Quinta, LLC DCCCC
General Contractor: Architect: Structural Engineer:
Shea Homes for Active Adults Bassenian Lagoni Borm & Associates, Inc./ Suncoast Post Tensi
Slump (inches): Supplier:Superior
Time Sampled: �"� ,) �r, Mix Design: D83625P
Time in Mixer (min.): SS' Specified Strength (PSI): 4000
Water Added @ Jobsite (gals.): >� On ti Addmixture: POZZ 322N
f
Concrete Temperature (F): Truck #: h 4 � Ticket #: J 33 $�
Ambient Air Temperature (F): C,� Field ID Marking: Set A - 4 cylinders
Weather:
Unresolved Items:
None
❑ See Below
Location of Sample:
❑ No Samples Taken
D ription of Work Inspected: Phase �L'� ;K Lot#`` 1'7-0 Product a Plan
C�1 3R �T�Q,z. Qc,•��,
S�- - o(a
1) Received mill certifications for rebar and tendons placed.
2) Typical exterior Footings including Garage Footings/Door (11,12,13/SD-1), Tie Beams (20/SD-1), Typical Interior Footings/Rib including step (15,18/SD-1),
Seven Strand Tendons (4,10,12,13,16/SD-1), Simpson Strong Walls (24/SD-1), Anchor Bolts and H(olldowns (6,7,8/SD-1), Pad Footings and additional
rebar placed as per these details and as noted on _ r 't n �� CJI' - r, LA�t�. , Gt(` t 0 � n " ; .,n ( 1
t T'n '1 Yte (oar%o_
% , �iow C'_� -X'? r Rei fnnn 1, V
Also, typical details 2, 3/SD-1 and Notes on SNA apply. Checked rebar for grade, size, placement, coverage and splices. Rebar and tendons were
securely tied and supported off the earth. Accepted for concrete placement.
1) The placement of concrete for areas noted above except Garage Interior Footing and Slab on Grade. Total cubic yards placed: approx (� ,
A mechanical vibrator was used to consolidate the concrete. Approved #4 rebar slab dowels were placed @ 18" o.c.
2) Molded 4 cylinders for compression tests with breaks at 7 days (1), 28 days (2) and one for holding purposes.
q, -tea_ hco
1) The placement of concrete for Garage Interior Footings and Slab on Grade Total cubic yards placed: approx 1 Verified correct mix design.
y certify that I have inspected all of the above work, unless otherwise noted, and to the best of my ability I have found this work to comply with the approved
pecifications _applicable building laws. Final report issued at project completion.
Inspector: Jack C. Millin ICC Certification, No: 0842216-80
Contractor's Representative:
Copy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency Page of I
i
`JCM Inspections
M'd ^� 39725 Garand Lane Suite F
Palm Desert, CA 92211
INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895
ah
INSPECTIONS
PRESTRESSED CONCRETE INSPECTION REPORT Date: �_ 7�n-OLD
Project Name: Project No:
Trilogy @ La Quinta - Shea Homes 02-1109
Project Address: City:
81-260 Avenue 62 La Quinta, CA
Q IBC
Title 24
Other:
Client: Sub -Contractor:
Shea La Quinta, LLC Sun Coast Tensioning
General Contractor: Architect: Structural Engineer:
Shea Homes for Active Adults Bassenian Lagoni Borm & Associates, Inc./ Suncoast Post Tensi
Size and Type of Tendons: 1/2" Diameter Seven Strand Stress -Related Tendons
Jack Machine Calibration: Received Sheet from Sun Coast -Gage Pressure in psi to Machine Load in kips
SL10r, psi to 33.04 kips/33,000 lbs
Calibration Date: Machine #
Phase 6 Lot# "+, s$ Product,,I,. Plan
Weather:
unresolved Items:
[]`None
See Below
Description of Work Inspected: Specified CCo Q l' -M 'A ti -1 % " r•ke�
Lot # Location Tendons Elongation (in) Actual Elongation (in) I�
N- 1, ~I
S O
r� r, P Lt,
W r e( ,
/
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ncl�� c�Wtt<rV C �rP�
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✓
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✓
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I certify that I have inspected all of the above work, unless otherwise noted, and to the best of my ability I have found this work to comply with the approved
PlWpecifications applicable building laws. Final report issued at project completion.
Inspector: Jack C. Millin ICC Certification No: 0842216-89
r
Contractor's Represen `"tive:
��`1✓,,
Copy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency Page of
NOV 29,2006 16:21 BCI*TESTING,ri1 000-000-00000 Page 10
CERRFICASE OF FIELD
1238
TESTING (Page 1 of 8) CF -4R
�t Builder Name
- La Ouinta. CA 92253 Shea Homes Inc,
HERS Rater
William Henson
Compliance Metho4 (Prescrl we)
Certifying Signature y r': •"�
- Telephone Plan Number
loft
5505 Casita
Telephone Sample Group Number/ Lot # (if applicable)
760-772-7.954 45913/ 7158
I Climate Zone 15
I Date Ceriftrcate Number
November 28, 2006 CC3-1798386495
Firm: BCI Testing - HERS Provider;CaICERTS, Inc.
Street Address; 77-760 Country Club Drive ste I City/State/7-ip:Palm Desert/ CA/ 92211
Co ins to. BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT
The house was 0 Tested n 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
dlagflOrtic tested compliance requirements as checked on this form, the HERS rater must check and verify that the new distribution
system Is fully ducted and correct tape is used before a CF -4R may be released on every tested building. The HERS rater must not
releasr the. CF -4R until a properly completed and signed CF -6R has hero received for the sample and tested buildings,
The installer has provided a copy of the CF -69 (Installation Certificate).
_ New D,str'ibution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts).
I I New systems where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in romhination with cloth
backed, rubber adhesive duct tape to seal leaks at duct connections.
!JMINIMUM REQUIREMENTS FOR_ DUCT. LEAKAGE REDUCTION COMPLIANCE CREDIT: Main System
NEW CONSTRUCTION
0
R Pass n Fail
I . I Pass ❑ Fall
LJ Pass U Fail
I I Pass [..]Fail
[:)Pa. ❑Fail
❑ Pas❑fail
[:]Pa. I�1, , I Fail
Duct Pressurization Test Results (CFM (Z 25 Pa)
Measured
Values
1
Enter Tested leakage Row in CFM: ,
77
2000
2
Fan Row: Calculated (Nominal'••:' Cooling '•...: Heating) or `• . 'Measured
Enter Total Fan Flow in CFM:
•
3
Dass if Leakage Percentage : 5% (100 x (Line I /Line 2 fl:
ALTERATIONS: Dud _System and/or HVAC Equipment Change -Out _
4 Enter Tested Leakage Row In CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct
System Alteration and/or Equipment Change -Out.
5
Enter Tested Leakage Row in CFM: Final Test of New Duct System or Altered Duct System for
Duct Sy :tem Alteration and/or Equipment Change -Out. t
^
6
Enter Reductinn in I rakege for Altered Duct System
[Line 4 - Line 51 - (Only if Applicable)
7
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)
8
Entire New Duct System - Pass If Leakage Percentage < 6% [ 100 x ( Line 5 / Line Z
TEST OR VERIFICATION STANDARDS: For Altered Dud System and/or HVAC
Equipment Change -Out, use one of the following four Test or Verification
Standards for compliance:
9
Pass if Leakage Percentage 15% [ 100 x ( Line 5 / Line 2)]:
`
10
Pass if Leakage to Outside Percentage r= 10% [ 100 x ( Line 7 / Line 2 )1:
11
Pass If Leakage Reduction Percentage r- 60% [ 100 x ( Line 6 / Line 4 )]
and Verification by Smoke Test and Visual Inspection
17.
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
Pass if One of Lines #9 through # 12 pass
'
0
R Pass n Fail
I . I Pass ❑ Fall
LJ Pass U Fail
I I Pass [..]Fail
[:)Pa. ❑Fail
❑ Pas❑fail
[:]Pa. I�1, , I Fail
E
NOV 29,2006 16:22 BCI*TESTING,ri1 000-000-00000 Page 11
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of B) CF -4111
iw� �rrw
• Project Address Builder Name
61238 Topaz Drive - La wnta, CA 92253 Shea Homes, Inc.
Q. ---........
Builder Contact Telephone Plan Number
_ 5505 Casita
HERS Rater Telephone Sample Group Number/ Lot (if applicable)
William Henson _ 760-772-2954 45913 / 7158
Compliance Method (Prescriptive) _ Climate Zone i5
Certifying Signature Dato Certificate Number
' November 28, 2006 CC3-1798386495
Firm; BCI Testing HERS Provider;CaICERTS, Inc.
Street Address; 77.766 Country Club Drive ste I City/State/Zip:Palm Desert / CA / 92211
Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEM15NT
The house was P 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 house identified on this form complies with the
diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verily that the new distribution
system is fully ducted and correct tape is used before a CF -4R may be released on every tested building. The HERS rater must hot
release the CF4R until a properly completed and signed Cr -6R has been received for the sample and tested buildings.
The installer has provided a copy of the CF-tsR (Installation Certificate).
New Distribution system is fully ducted (i.e., does not u -,e 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
backed, rubber adhesive duct tape to seal leaks at duct connections.
FVNINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT: New System
NEW CONSTRUCTION
Duct Pressuncdlion 'rc;t Results (CFM 4 25 Pa) Measured
Values
1 Enter Tested Leakage Row in CFM; -
25
2 Fan How' calculated (Nominal; ' Cooling `• Heating) or `..-' Measured
800
Enter Total Fan Flow in CFM:
3 Pass if Leakage Percentage < 6% 1 100 x ( Line 1 / Line 2 )l: -
3.13%
FRI Pass n Fail
ALTERATIONS: Duct System and/or HVAC Equipment Change -Out
4 Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct
System Alteration and/or Equipment Change -Out,
5
Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for
Duct System Alteration and/or Equiprnent Change -Out.
Enter Reduction in Leakage for Altered Dura Systerli
6
11 ine 4 - I ine S1 - (Only if Applicable)
7
Enter Tested Leakage Row in CFM to Outside. (Only if Applit;ihlr.)
8
Entire New Duct System - Pass if Leakage Percentage < ti% 1 100 x ( Line 5/'Line 2 )l:
❑ Pass ❑ Fail
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC
Equipment Change -Out, use one of the following four Test or Verification
Standards for compliance:
9
Pass if Leakage Percentage <:= 15% ( 100 x ( Line 5 / Line 2)]:
Pass if Leakage to Outside Percentage •: • 101/4 ( 100 x ( Line 7 /Linc 2 )l:
-1 Pass El Fail
I .I Pass I. I Fail
10
it
Paos if Leakaqe Reduction percentage >= 60% 1 100 x ( Line 6 / Line 4 ))
❑Pass []Fail
and Verlflcatlon by smeke'lest and Visual Inspection
12
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
❑ pass ❑ Fail
n Pass n Fail
Pass it One of Lines #9 through # 12 pass
•
NOV 29,2006 16:22 BCI*TESTING,ri1 000-000-00000 Page 12
CERTIFICATE OF FIELD VERIFICATION A DIAGNOSTIC TESTING (Page 3-4 of 8) CF -4R
Project Address Builder Name
61238 Topaz Drive - La Quinta,.CA 92253 _ Shea Homes, Inc.
Builder Contact Telephone Plan Number
5505 Casita_
HERS Rafer TcicAhone Sample Group Number/ Lo! b (if applicable)
William Henson 760-772-2954 45923/ 7158
Compliance Method (Prescriptive) Climate Zone 15
Cerfifying 5rgrlafure Date Certificate Number
November_28r 2006 CC3-1798386495
Firm: BCI Testing HERS Provider:CaICERTS, Inc.
Street Address: 77-760 Country Club Drive ste I _ City/State/Zip:Palm Desert/ CA/ 92211
Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT
The house was Q Tested D Approved as part of sample testing, but was not tested.
A, the HERS rater providing diagnostic testing and hold verification, l certify that the house identified on this form complies with the
diagnostic tested compliance requiremonts ds checked on this form.
The installer has provided d copy of the CF -6R (Installation Certificate).
IvIrNERMOSTATIC EXPANSION VALVE (TXV): Main System
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 shalt be verified.
Main System HVAC System TXV (�!'� pass n Fail
•
•
NOV 29,2006 16:22 BCI*TESTING,ri1 000-000-00000 Page 13
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8) CF -4R
Project Address SuilderName
61238 Topaz Drive - La Quinta, CA 92253 Shea Homes, Inc.
guilder Contact Telephone Plan Number
_ 5505 Casita
:lrRS Rater Telephone Sample Group Number/ l.ot t (if applicable)
William Henson 760-772-2954 45913/7158
Compliance Method Prescri tive) ./ -� Climate Zone 15
Certifying Signature Date Certificate Number
November 28, 2006 CC3-1798386495
Firm; RI Testing HERS Provider:CaICERTS, Inc.
Street Address: 77-760 Country Club Drive ste T- City/SLate/2ip:Palm Desert / CA 1.92211
Cvoies to: BUILDER: HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT
The house was R Tested ❑ Approved as part of sample testing, but was not tested.
,4s the HERS rater providing diagnostic testing and field verlfication, I certify that the house identified on this form complies with the
diagnostic tested compliance requirements as checked on this form.
The installer has provided a copy of the CF -61z (installation Certificate).
[VITHERMOSTATIC EXPANSION VALVE (TXV): New Svstem
Access Is provided for inspection. The procedure shall consist of visual verification that the'IXV is installed
on the system and installation of the specific equipment shall be verified.
New System HVAC System TXVJ 0 pass D Fai!
•
0
NOV 29,2006 16:22 BCI*TESTING,ri1 000-000-00000
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 5 of 8) CF -4R
• Pro)eet Address Builder Name
61238 Topaz Drive - La Q4inta, CA 92253 Shea Homes, Inc.
Builder Contact Telephone Plan Number
_ 5505 Casita
HERS Rater Telephone Sample Group Number/ Lot # (if applicable)
William Henson 760-772-2954 45913/7158
Compliance Method (Prescriptive) Climate Zone 15
Certifying Signaturei f ^ Date Certificate Number
/,"/; it F'a,. fr.'Xn•-..�
_..,_., ..-_ :'-'/�' `• November 28, 2006 CC3-1798386496
Firm: BCI Testing HERS Provider:CaiCERTS, Inc.
Street Address: 77-760 Country Chub Drive ste I City/State/Zip:Palm Desert/ CA /92 211
Copies to; BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT
The house was 0 Tested ❑ Approved as part of sample testing, but was not tested,
As the HERS tater 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 installer has provided a coy of the CF -611 (Installation Certificate).
HIGH EER AIR CONDITIONER: Main System
Procedures for verification are available in RACM, Appendix RI.
1 �RYes C No EER values of installed systems match the CF -1R
2 LT.I YesI❑-I No For split systems, indoor coil is matched to outdoor coil
3 ❑ yes ❑ No Time Delay Relay Verged (If Required)
—u� Yes to 1 and 2; and 3 (It Required) is a pa Pass Fail
IV IHIGH EER AIR CONDITIONER' New System
Procedures for verification are available in RACM, Appendix RI.
1 R Ycs I ic1 No EER values of installed systems match the CF -1R
z L=J Yes ❑ No For split systems, indoor coil is matched to outdoor coil '
3 E] Yes ❑ No time Oefay Relay Verified (If Required)
Yes to 1 and 2; and 3 (It Required) is a pass Pass
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