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0202-085 (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 B ,0111/0! Date y to f) %� Signature of Contractor f" 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 (Seca 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: Cartier Policy No. C9OLLSH ZPA01A TN1. NWC -.'W406V-03 (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 those provisions.. 9 Date: ^"�3 f % rlf'f iApplicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition.to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety,. for 'a permit subject to the conditions and restrictions set forth• on hiS` 0 application. t 1. Each person upon whose behalf this application is made & each person ate whose: request and for whose benefit work is performed under or pursuant to° ' any permit issued as a result of this applicaton agrees to, & shall, indemnify'; & hold harmless the City of La Quinta, its officers, agents and employees. " 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. , } Signature (Owner/Agent)?-! �' -f Date•�� s, r BUILDING PERMIT PERMIT# DATE VALUATION LOT 020.7.051,rj, TRACT 48 JOB SITE ADDRESS APN 1 LMLeNlY AVE= 604-072-006 OWNER CONTRACTOR / DESIGNER / EN (NEER CENTURY C ROvimIX CCA&AUWNZ8 CMA.i'URY i ROWE L CO .W. r.1:r. . 15311 5 BO. T, v" Et -011 125nm 4200 15135 10 fir TY U'1' ILI— r, 'I3PIEI 011200 SK14 RMWARD• O CA .92408 SAMBEFWARDAYNO CA 924tr- USE OF PERMIT SPIP - WT 4$. M` NTIC ELLO nZRA'.f'.AOSY P"N 3ARKV. P,LIaMIT DOES 'HbT. INCLUDE BLOCK WA t4 POOTVA OR DR.tVEWAY'AP.PROACH, MAN CHECK FSE UDUCFPD FOR Mt "A.'!`tA' LE ILTAMC,°E OF aA.M2PW4 TYPE. TRACIFCONUTRUCTION .2.21 s. 00 sn? `f"f)R.CHIPATTO 29.00 sy CA.RAORMAlRFt03i,`I' 625.0 SV F,7M% T= COST OF C:0AWRIUC TON 1311419,10110 CW"!°RUCTION FIX 101-000,418-€30- $7310€ PTAN CHECK AZE 101-000A.39-318 $160.12 Rtt'aadlIC��y.� UCA�1, FRE101.16100-A}:v��1� S60100 p00 00 S139-52 y,U Pr UMBINO rME 101.000.4.19.000 W4,00 $1..3.39 STRONG MOTION FZE . REMD 101-0004AHI.y-0 jp0}'0 O®LA1140 T'fiF, 00- VZVEw. IPPIR IMPACT IpPIP -4Q, f CON&TRUM1/NT AND PIANT.HW: P• �w/ ��+� • LH3.7 PU—PAID PFX3 j- ' $01.00 `� rxmg im iv Niit ' FEB 14 2002 614 X117 13 �9d �`E�4��•��• . RECEIPT DATE 'BYA' �6111 TOR DATE F NALED INSP INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs — Z Underground Ducts Forms & Footings Ducts Slab Grade 3- — Z S Return Air Steel — 7_ Combustion Air Roof Deck Exhaust Fans O.K. to Wrap j - F.A.U. Framingwr - Compressor Insulation _ Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wail Insulation Condensate Lines Party Wail Firewall Exterior Lath Drywall - Int. Lath _ Final - ®� Final - O POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Top Oute 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 �Z Utility Notice (Gas) 2 - 0 t ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring �2 Z Low Voltage Wiring Fbdures Main Service Sub Panels �-- J Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) Z Certificate of Occupancy o City of La Quinta Building. and Safety Department OF,�f°t � This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: Use Classification: SINGLE FAMILY DWELLING Occupancy Group: R-3 Type of Construc Owner of Building: TD.DESERT DEVELOPMENT of Building Official 44-601 LIBERTY AVENUE Bldg. Permit No.: 0202-085 tion: V -N Land Use Zone: R/L Address: PO BOX 1716 City: LA QUINTA CA. 92253 By: GARY SHOWALTER Date: 08/20/02 POST IN A CONSPICUOUS PLACE Builder Name: Project Name: Builder Field Contact: HVAC Company Name: HVAC Installer: Duct Leal(age Measured @ 25 PA Duct Testing Certification Form Hers I _hC Self'Certifier Results qY-(al I-lee2Ty A✓E. Tract # 2q /q% Lot #� System Z Of (One form per system) Telephone No. Telephone No. CFM Indicate the maximum allowable Duct Leakage and the calculation method used: 0.7 x An.., x (0.06) for Climate Zone 8 through 15 CFM ❑ 0.5 x Anoor x (0.06) for Climate Zone 1 through 7 & 16 CFM 400 x (Cooling Capacity in Tons) x (0.06) (eO CFM ❑ 21.7 x (Heating Capacity:in Thousands of output BTU per hour)'x (0.06) CFM Print Name Signature -2- Date Jan 29 OP 11:37a Richard Simpson 661 947-6869 p.4 INSTALLATION CERTIFICATE (Page 3 of 8) CF -611 Site AUdt Hy Y- (00/ •/,//3ek7T Aielvvis Pet�m6t umber DUCT LEAKAGE AND DESIGN DIAGNOSTICS DUCT LEAKAGE REDUCMOH Pres.surualion Tett Results (CTM ra) 21 PA) 't'csl l.caltage (CFM) J I'an I'low If Ilan Flow is CaloulatW a.,z 400 cWton x number of'tons. or as 21.7 x I Ict►timg Capacity in Thou►ianda of lhwl/ . orator oaloulatod valuo holo If tan flow is mcasun d, anter measured valuo hero Leakage, Traction —'foil Loakagolft. rurod of Culculatod Ilan flow) Pam ifloakogo Itaoliou:90.06 �� ❑ Pass. Fail ❑ For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed: Duct Fan Prcasurie.alion al rough -in uwasurud leakage (CFM) CHECK AFTER FINISHING WALL: ❑ Yea ❑ No ❑ PreSsuto pan f" or I luuw pivMuruatitYfi foal ❑ Yes ❑ No ❑ Visual luspcotion of Duct Conncotions ❑ ❑ Pass Tail �Tt•f�� ERMOSTATIC EXPANSION VALVE (TXV) r 1�dY"q ❑ No ThsMMO iatie Exp"406 Valve (or Commission approved equivalent) is installad and Awe.-rs iv FruvidW for int,"tion ❑ Yes 6 a pass Fail ❑ DUCT DESIGN l ❑ Yet ❑ No RCCA Manual D lk-Agn calculations hove been complutud, Dual Dasign it on the plans and dual installation malohas plans. 2. ❑ Yae El No TXV is installed or I'm flow hm c beau voriliud. If no TXV, varillud fan flow ntatehas design from CF- lIL Mcmurad Fan Flow = Ycs for both 1 and 2 it; a Paras Press Fall ❑ 1, tho undtasignod, verily that lha.abovo diagnostio Wet Ivsulbi sad tl►p work I performod associated with thu tcst(s) is in ounibnumco with the mquirem:nls lire compliance urudit. I'17tu builder shall pravido Wu I IHRN provider a copy of Iho CF -6R siguW by the builder• ctuployces or sub -con aotors vadil'ying that diagnus6o fuming and ius:tallWion utaut Iho regairomonl, 14complianou crudi't.i APR 2 5 �tltl gnty� Posts ign tun; I)ato Iaatailiug Subcotitraoior (Cd. Naroo) OR Pcrformcd (kncra) Contractor (Co. Name) COPY TU: Building Deparhucut HERS Provider (if applicable) Building Owner tit Occupancy 32nusry 4, 2001 Builder Name: Project Name: Builder Field Contact: HVAC, Company, Name: HVAC Installer: Duct Leakage Measured @ 25 PA Duct Testing Certification Fora 4 G SelfResults '4/aern r1 Avc=Nvc Tract # Lot #� System of 2 - (One form per system) Telephone No. Telephone No. CFM Indicate the maximum allowable Duct Leakage and the calculation method used: ❑ 0.7 x Alloor x (0.06) for Climate Zone 8 through 15 CFM ❑ 0.5 x Afloor x (0.06) for Climate Zone 1 through 7-& 16 CFM 400 x (Cooling Capacity in Tons) x (0.06) Z . CFM ❑ 21.7 x (Heating Capacity in Thousands of output BTU per hour) x (0.06) CFM Print Name Signature Date i Jan 29 02 11:37a Richard Simpson INSTALLATION CERTIFICATE 661 947-6869 p.4 CF -6R -77—(PO/ 1_t. a'2%- 4VrN&e DUCT LEAKAA AND DESIGN DIAGNOSTICS DUCT LEAKAGE REDUCTION Test Rcsulir (CFM (a) 25 PA) G 'fest Leakage (CFM) 7 Fan I'low If fan blow is Calculatod aq 400 ofm1ton x number of tons, or as 21.7 x I looUmg C:apaoity in 'ihouNandrt of litu/br, opwr calculatod valuo burn If tan flow i. nu:asun:d, c:ntar muasuzcd valuu hcru I.uakage fraction -'YcA Loabagel(Momurod or C."Iatcd fan I'low) - Pa,be if loakago fraotiou S 0.1* Q 0 ,� ❑ PeS4 Dail ❑ For AEROSOL TYPE SEALANTS ONLY -The following dingnoade testing was completed: [)no[ Fan I'rcmud/ation at rough -in measured leakage (CFM) CHECK AFTER FINISHING WALL: ❑ Ye.. ❑ No ❑ i'w&%u u pant" or Iluusa pro nori'talion um ❑ Yes ❑ No ❑ Visual Inspeution of Duct Connections ❑ . ❑ Pass fail THERMOSTATIC EXPANSION VALVE (TXV) Y�y ❑ No Thl=oslalw Expaa,;,ou Valve (or Commission approved equivalent) is mstallaf and Aa:u,4s is provide d for mipaction ❑ YW 6 a peas i'as:. fail ❑ DUCT OESIGN 1 ❑ YQS ❑ Nu RCCA Manual D DcAgn onlaulationshavu bt:cn oomplolud, Duel Doxign is on lbc plans and duct installation matohos plans. 2. ❑ Yes ❑ No TXV iv installed or I'm flow has bona vuritiod, If no TXV, verified fan flow matchai d►t ign from Cir -1R. Mcasurod Fan Flow = Yes for both 1 and 2 is a Pars Pass Fall ® 1, the underaigucd, Yorify Owl tho Abovo diaguo+tic tu.1 ratults aad the work 1 performed associated with the last(s) is in eunfurmtmw with tho mquimmanN 1br complianoL credit. (Thu builder shall provide Iho I IER5 providur a eopy of Ihu CF -OR s;iguod by tho builder cu►playoca or sub -contractors cartil'ying that dinguo-4io losting and iu..tallation stew oho roquiromoni, tirr compliance cax:dil. J _ APR 2 5 2002 ex, 7 1'Ct;ts 8ignalmu, Datc la.talling Subcontractor Wo. Name) OR Performed Goners) Contractor (Co. Name) COPY '1'O: Building Departrnont 1113RS l'rovldor (ll'appllcablc) Building Owner ut OCcvVal..lCy January 4, 2001 - ------ - 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: 44-601 Liberty Avenue, Lot 48, Monticello -Heritage, La Quinta, California CEILINGS: , TYPE: BLOW MANUFACTURER: CERTAINTEED THICKNESS: R-38 WALLS: TYPE: BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-13 GENERAL CONTRACTOR: CENTURY CROWELL COMMUNITIES LICENSE # BY: TITLE: PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 BY. TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/12/2002 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: 44-601 Liberty Avenue, Lot 48, Monticello -Heritage, La Quinta, California CEILINGS: TYPE: BLOW MANUFACTURER: CERTAINTEED THICKNESS: R-38 WALLS: TYPE: BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-13 GENERAL CONTRACTOR: CENTURY CROWELL COMMUNITIES LICENSE # BY: TITLE: PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 BY: TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/12/2002 Installation Certificate: Residential CF -6R Site Address 44-601 Liberty Avenue 1. BUILDER INFORMATION Century Homes 1535 South D St. #200 San Bernardino, CA 92408 INSTALLING CONTRACTOR: 2. PROJECT INFORMATION DISTRIBUTION TYPE Flexible Ductwork in Attic and Between Floors DUCT OR PIPING R - VALUE Flexible Ductwork Will have a R -Value of 4.2 or Better PERMIT # SUBDIVISION: Heritage CITY: La Quinta COUNTY: Riverside WEST PAC AIR CONDITIONING I, the undersigned, verify that the equipment listed in the category above my signature is the actual equipment installed and that the equipment meets or exceeds the requirements of the Appliance Efficiency Standards. In addition, Ihave verified that the equipment is equivalent to or more efficient than the equipment specified on the Certificate of Compliance submitted to demonstrate compliance with the Energy Efficiency Standards for residential buildings. 3. HEATING INFORMATION HEATING MANUFACT HEATING UNIT ACTUAL EFF. HEATING EQUIP HEATING EQUIP. MAKE MODEL # AFUE CAPACITY LOAD Furnace Lennox G40UH-48B-090X 80% 88000 G40UH-36A-070X 80% 66000 4. COOLING INFORMATION COOLING EQUIP. A/C MANUFACT COMPRESSOR ACTUAL EFF. COOLING EQUIP COOLING MAKE ' MODEL # SEER CAPACITY LOAD Lennox 12ACB36 12 12ACB30 10 The building design heat loss and design heat gain rate have been determined using a method specified in Section 150(h) of the Energy Efficiency Standards, and are two of the criteria used for equipment sizing and selection. 5. SUBMITTED BY �� , Signature Installing HVAC Contractor DATE: .4 j:Y%JlIRNv:I.•'sii+��I/1t%IiY./:HiY:'!/.�►q!F•N.lfiYV/%!!✓.•L./l"OM,/HJT/A:/7X.%�!(lR�j"�N'!"l:K.'%R'D'd.'w'P.."/I:YN%!',it!/T%i1Ys�•A�iI,Mn%lpY.ryJ.v.ir�v,wrl�OfiY'rl'itilw:a•:aN/�✓�MM:v�:i:Af.'vp%✓.'/YN'%`.d/i I�: l,. I SSUL6TIO CERTIFICATE This is to certify that insulation has been Installed in conformance with the current energy t regulation, California Administrative Code, Title 24, State of California, in the building located at: 44-601 Liberty Avenue, Lot 48, Monticello -Heritage, La Qulnta, California CEILINGS: TYPE: BLOW MANUFACTURER: CERTAINTEED THICKNESS: R-38 WALLS: TYPE: BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-13 GENE CONT CTOR: CENTURY CROWELL COMMUNITIES LICENSE # 7/y18 BY: TITLE: ��2 PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 BY, TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/12/2002