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0306-451 (SFD)LICENSED CONTRACTOR 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 is in full force and effect. License # Lic. Class Exp. Date Date ?("!� <�� Signature of Contractor _-'�"�"`•�\�I'�9' 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 I Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty o� 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. (p�,) 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 13TAR- FLf140 Policy No. (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 CodeI shall forthwith comply-with.tbose provisions. Date N -=- LL-� licant LAPP Warning: Failure to secure Workers' Compensation 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 person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the 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 inspectionnppureyoses., S,ignaiure (Owner/Agent)e` -. �.e -�'= -' 1� �� 1j Date '1. BUILDING -PERMIT PERMIT0306 4M DATE / VALUATION SJ 89il %i' .-I i LOT �yj TRACT JOBSITE&S—MU 1e, wi°�..�'.T,Veif��aLEY ADDRESS �' _ APN OWNER CONTRACTOR / DESIGNER / EN INEER IFIR gE�T4I'A l.iVELOR Vii' CORP. 14 20 Z`gALaYKVTA 55, F, MMIQUAVE. bryE 205 cA, s goi 'urol.fys CA.921173 (" �j'79s3n 8 CHIN A9i I USE OF PERMIT ,,`.IC F FMtLY DW I TING w`f6r � .I.A. ! CS�Y!.er'is� .:.f4, k'k+K.!'i+ ,. 1J� l..r ti4tJ sFd4..i,1:.1sJ X}/. Ji•� I/f »� i,..t•�.i� . P00.L., 'UP,& 01k DRUV E ,N APFCBOAM-1; . itis, AJ.DUC T I0% To RAX •1i1 IC PF1LY 1)TJiI TO MUi„`f irri—XfliSUANCAfi OY SAMY. PVL?L14 '. YP 0.ilr,3UQ11;1X11AJDT10R:r 49iX0 SP 9:iTINIATYD COS 4:lk!' C•(J.l'��1't'�iT� iC� u9J!� 3;i�Fr,% c a: �� C01 4!Ty`U CT1011 .`,`rKB 1 01 -91010.4 / {li 1,000 0XYi'V'. . .. fi f _ . yy1��1.��rheeTTT�;�}H tFICIC 7A�li.f7.9Zr'4.CS+uCI:Zs F".t*ri •'�\P t °iV'lilr�� r'V�✓'�/ !V,{ i; P�i`V 7t��:x7'11ty1�^.A:�1't.�+3�'�j FS Jay sn(mf r rttaT N - :.i: ki:+ �i.� r`t t�-'° 4 °•43f)Ct . �r. a rt33.�:4�F�1�i�:t. 1u=,`1aUef�a.��'��(;1?0 �5:a� -:. • ??i�'d`;G►:C.f."IP;6'.ti D.id4:i"r�F1C:'a" t?'��. Z �4�;9.i!�3 . ._. ��`�•'`�-'Qrlit�.`w'�ytti�t�.�.��.�:+ii'��ii��j.al�h�� l'�'�rY'.�.... �"yyf{SL9.�•✓Z' LESS .PRX. f11AM—O. r -cs ` to.011 r RECEIPT DATE y' BY D E F NALED INSP T R INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs & Underground Ducts Forms & Footings Ducts Slab Grade ZIj I K Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap O ( F.A.U. Framing Compressor Insulation /p Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Q Drywall - Int. Lath Final Final a BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVAL Gas rest Electric Final Waste Lines V Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection Z' Pool Cover Encapsulation Gas Piping Gas Test Appliances Final Final S Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service - Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part 1) CF -4R THE LAURELS a1 - 7— -05 Project Title Date 55088 Laurel Valley, La Quinta, CA. First Pacifica Dev. Corp. Project Address Builder Name Dave (909) 841-1942 2-S Builder Contact Telephone Plan Number Tim Topham (951) 780-7265 1 HERS Rater Telephone Sample Group Number o? / /2005 9 Sys. 1 Track 29122 Certifying Signature Date Sample House Number Firm: Enemy Calc Services, Inc HERS Provider: CHEERS Street Address: 16551 Mockingbird Cyn. Rd. City/StatefZip: Riverside, CA 92504-9638 Conies to: Builder. HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: ❑ Tested 5d 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. 0 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 draw bands are used in combination with cloth backed,, rubber adhesive duct tape to seal leaks at duct connections. ❑X MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM If fan flow is calculated as 400cf n/ton x number of tons enter calculated value here 1200 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) or Commission approved equivalent ❑ 1 Yes ❑ No Thermostatic Expansion Valve (or Commission approved equivalent) is installed and Access is provided for inspection ❑ ❑ Yes is a pass Pass Fail January 5, 2001 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part 1) CF -4R THE LAURELS Project Title 55088 Laurel Valley, La Ouinta, CA. Project Address Dave (909) 841-1942 Builder Contact Telephone Z– -Z-05 Date First Pacifica Dev. Corp. Builder Name 2-S Plan Number Tim Topham (951) 780-7265 1 HERS Rater Telephone Sample Group Number 7� �2–/ `L--/2005 9 Sys. 2 Track 29122 Certifying Signature Date Sample House Number Firm: Energy Calc Services, Inc HERS Provider: CHEERS Street Address: 16551 Mockingbird Cyn. Rd. City/StatefZip: Riverside, CA 92504-9638 Conies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: ❑ Tested &OR 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. ❑x 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 draw bands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. O MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM If fan flow is calculated as 400cf Vton x number of tons enter calculated value here 1200 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) or Commission approved equivalent ❑' Yes ❑ No Thermostatic Expansion Valve (or Commission approved equivalent) is installed and Access is provided for inspection ❑ ❑ Yes is a pass Pass Fail January 5, 2001 iesteri RESIDENTIAL tion Ll CONTRAC4'1lIG 4211 LAtham Str®et • Riverside, Califomia 92501 • Phone: (909) 686.8780 • Few. (909) 886-8786 Llcense # 794484 CIr6R INSULATION CERTIF GATE THIS IS TO CERTIFY THAT INSULATION HAS SEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: TRACTIPHASE: THE LAURELS/ PHASE 1 LOT 9 SITE ADDRESS: 55-088 LAUREL VALLEY - LA QUINTA, CA ._------------------........................................ CEIUNGSR BATTS MANUFACTURER: JOHNS MANVILLE THICKNESS: 13" R- VALUE: R -B ICE LINQS, BLOWN INSULATION MANUFACTURER: GREENFIBER THICKNESS: 8.10 R- VALUE: R-30 CEILINGS: BAITS MANUFACTURER: KNAUF THICKNESS: 1iY R VALUE: R•30 ILINGS: BATTS MANUFACTURER: KNAUF THICKNESS: 6'/," R- VALUE: R-1 9 EXTERIOR WALLS: BATTS MANUFACTURER: KNAUF THICKNESS: 3 W R- VALUE: R-13 INTERIOR WALLS: BATTS MANUFACTURER: KNAUF THICKNESS: 3'/m R—VALUE: R-11 GENERAL CONTRACTOR: THE BREHM COMPANIES BY: TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE NU BER: 794484 BY: TITLE: PR UCTIO ANAGER DATE: JANUARY 11, 2005 01/11 39Vd NOIltiin%l N831S3M 9BL89B9196 L9:80 900ZIL1112 Deo 16 04 l 1's 46a Energy Calo Services Inc. 740'-0558 INSTALLATIOV.CERTJLFICATE U't►Sc 3 u[ 1J) Caf GR. �T•�Silt Addrex+ �<fi1 1'rrmit Numhcr DUCT LEAKAGE AND DESIGN DIAGNOSTICS ;>f!!L:\ 1: M1("l' I,P;AKACF: 14I{I)I1('FI0N Pfasxurtcallon Text Rtmulbs (CPU 0 25 PA) I'usl l.uak,r�a; (CI;tA ) V.111 Flow I I Fan Flow tf; Calcul,110d os 400 chVton x numbor of tons, or u6 21-7.x Hoat1rg Capacity 2S in. Thousands of Btufir, actor calcuintod valvo hero If fnn flow Is measured, enter measured Value here leakage Fractioin = Test LeakagW(Measured or Caleulat@d Fan Flow) b Pass 1f aaxogl: fraction -/- 0.064 vs ❑ Py;;v f;;il Pntxt:vrruttlon Tust Results (CFM (P 7.y VA) Fun Flow 11 For, Flow it; Calculatod ac 400 cfm/tcn x numbor of tons, or as 21.7 x Hoatng Capncity -zn 1n' Thoasanox of $tu/hr, ontor rtdoulat(td vulur. hero C �J if fan flow is measured, enter measured value hero Leakage Fraction a Test leak.age'Waasvred or Calculated Fan Flow) r Paas if loakago fraction •/• 0.M IL -J, ❑ • Pala Fad t4LJ For AEROSOL TYPE SKAII.ANTS ONt,1' -. rho following alaQnostie costing was comptoted: \ Duct Fan Pressuiizatlon of rough•in measured leakage (CFM) ' 1 CHECK AFTER FINISHING WAIL: Yes ❑ No ❑ Prossuro pan tort or Houno proocuraatan tela lJ Yes 13\ ❑ No ❑ Visual Inspection of Duct ContlocUuns Pa� Fan YDS ❑ No. Thomlostatic Expansion Valva is 1nstaliM and Arxrtss is provlaod for tnnovelon Y09. ❑ No ACCA Menw110 Design calcuNtlons have been COntplutOd Duct Oualgn 1s on the plana and duct 1irtallabon matches pWns. 7. Yer. ❑ NO TXV 1s 1nrtaillid OF Fan flow I1, -L,, boon vortfiO4. It no TXV, vardlatd fart flow match@s dewgr. from CF- IR' Measured Fan Flow = YOs for doth 1 and 2 1!;.1 Pass' N� Ot I. the uncterstgned, vtrrrfy that Ih& above dtAgnostic text rttsuiG+ and 11111@ worn I pertprm@d 3Ssoci3t@d with lhg test(s) is .n lcont CO With the MQWO(nonto for cornpltanaj efodd (Tho builder 1hall provido IM) MbRS provtdor a copy of thr C:F•r)R ,-gnoa by Ina, builder omploy000 Or Dub-cotivactoru cxmitytng that dt9gnoLfso testing and 1nxt:rltittor. mtwi th(! ntputromrint:; for complianco credit.) 'lMto Signature. Dago ' Instaihhg Subcontractor (cc. Nauru) OR Porformed General Contractor (Co. Name) COPY TO: Buildinq 0opartmont HERS Nrovtdur id applscablo) Building Owner at Occupancy ComphnAco Form; ;�npUtmt;< r JApa_.... lavre-1 Laurels pl. 2 INSTALLATION CERTIFICATE (PAGE I OF 8) CF -6R SITE ADDRESS p . PERMIT NUMBER AN INSTALLATION CERTIFICATE IS REQ(JIRI�` BE POSTED AT THE BUILDING SITE OR MADE`'AAIIr ABLE 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 CEC CERTIFIED MFG. #OF ;EFFICIENCY DUCT DUCT OR HEATING HEATING EQUIP NAME IDENTICAL (AFAU ETC.) . LOCATION PIPING LOAD CAPACITY TYPE AND SYSTEMS CF -1R VALUES .(ATTIC ETC.) (R -VALUE) (BTU/HR) (BTU/HR) HEAT PUMP MODEL # FAU CARRIER 58STX070112 2 ' 80% ATTIC 4.2 87K 70K FAN COIL FIRST CO. SPF19HX3-E 1 ' 80% ATTIC 4.2 COOLING EQUIPMENT EQUIP CEC CERTIFIED COMPRESSOR # OF EFFICIENCY DUCT DUCT COOLING COOLING TYPE PKG UNIT MFG NAME AND IDENTICAL (SEER ETC.) LOCATION R VALUE LOAD CAPACITY HEAT PUMP MODEL NUMBER SYSTEMS (CF -1R VALUE) (ATTIC) (BTU/HR) (BTU/HR) A/C CARRIER 38HDC0363 2 12SEER ATTIC 4.2 36K 36K HP YORK HP018X1221 1 12 SEER ATTIC 4..2 18K 17AK 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 -IR) SUBMITTED FOR COMPLIANCE WITH THE ENERGY EFFICIENCY STANDARDS FOR RESIDENTIAL BUILDINGS, AND (3) EQUIPMENT THAT MEETS OR EXCEEDS THE APPROPRIATE REQUIREMENTS FOR MANUFACTURED DEVICES (FROM THE APPLIANCES EFFICIENCY REGULATIONS ON PART 6), WHERE APPLICABLE. WILLIAMS HEATING CO. SIGNATURE, ATE INSTALLING SUBCONTRACTOR (CO NAME) OR GENERAL CONTRACTOR (CO NAME) OR OWNER THERMOSTATIC EXPANSION VALVE (TX's) YES THERMOSTATIC EXPANSION VALVE (OR COMMISSION APPROVED EQUIVALENT) IS INSTALLED AND ACCESS IS PROVIDED FOR INSPECTION. O NO YES IS A PASS PAS& FAIL COPY TO: BUILDING DEPARTMENT HERS PROVIDER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY L Certificate of Occupancy � ui�cv _ Lwnaosnhn�4 G� OF. T 9► Y p 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: 55-088 LAUREL VALLEY Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0306-451 Occupancy Group: R3 Type of Construction: V -N Land Use Zone: RL Owner of Building: GENERAL BANK Address: 1420 E. VALLEY BLVD. City, ST, ZIP: ALHAMBRA, CA 91801 By: GARY HARTMAN �^ Date: March 9, 2005 Building Official POST IN A CONSPICUOUS PLACE