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0202-090 (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 r� Signature of Contractor 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). r ( ) 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. SecI have and will maintain workers' compensation insurance, as required by tion 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 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 Code, I shall forthwith comply with those provisions.--,- rovisions.` -) Date:, i : r'.,�L y Applicant '` 1 * i ; `5 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 isperformed under or pursuant to any permit issued as a result of this applicatbn 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) � }t 9 / •. ` , Date__- 7///-J „ . :-BUILDING PERMIT PERMIT# DATE / •I VALUATION LOT dlLQlw� TRACT 1/��•y.�'3 �- $1132.01 120 53 JOB SITE APN ADDRESS 44 -CM IJL=) RW AVI!I4,}ls il' 2DOfd OWNER CONTRACTOR/DESIGNER/EN INEER CT44I CfAY aigOWL. L,L CC)1v9Ml,7M.I C}".MORSI'' CIROWRI, C OIC&AC3MUES 1535 301 1 ov 9=1!r, nE. #200 153530, T" MRzl:M pix?', 0200, am B"a.. ' w(DINO CA Ver 08 SAM BERN IN'I"`i CA 92408 (909)381.6{3ti`7 C BIJIJ 2170 USE OF PERMIT Vr,.Y-1_0T 53. Wt N'PdC.`iw, W KRITAIN:PiKAN W.IIWI. PERMIT DOES NOT I CLUI 9 B WC K WALLS,. POOIA- PA OR DWEIVA.Y tS P'.PROACH. PLAN CHECK P'EF; R,H-DUCNi3 FOR, Vf-D121PIX, IoSCIANCE OV,Lfb.M9 PLAN TyrotA. TRACT CONSTRUCTAY114 11,215.00 OF , P'ORtCIF1/PATIO 39.00 SO 0ARAONCAP3AO T 622.00 u.P' ?XRhffr PRY SUAQ "Ry CONST.RUCTIU14FEE 101-000-413-1000 SM100 PLAN CH .41K;+`9F i{Ta-bD0�43SI-3a$ �Ibt3,fI Pr ICHAVICAL= 101.000.471.000 $00,00 SLFf TPUC,A L IfS? 101-000-420-00-- 4336.511 PLUMBING RX 10l oOOO-419.000 $1 4;00 S71'MNO A40TION ISE,$ d I2 "ID 1.01--000-241 -000 ORADING MP, 101-OM423.000 X20.40 D11',VEi,.c3Ptr IMPACT IP, E gl,fPCY;.U£f 4 C4:� � i� °€ fii 1 AND PLAN CHEMC / $3, 0193 ' ta � M. -PAID V U1, $0100 FEB 14 2002 Iy�-,eE W ��Yd,eL. h1 tY•�1 ��i�i �w wtl) $.- `.TJ�17 i�^.. "RECEIPT DATE / % r BY �.' D INA ED INSPEC R INSPECTION RECORD OPERATION DATE INSPECTOR- OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings /D -L Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Z -Z Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Al Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wail Firewall --2- Exterior Lath -- - Drywall - Int. Lath Final Al - - Final C— z BLOCKWALL APPROVALS Steel POOLS - SPAS Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping _ PLUMBING APPROVALS Gas Test Electric Final Waste Lines —/ - Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sever Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Q(7 -cgs Utility Notice (Gas) d ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring 8� Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power, Final' m Utility Notice (Perm) +� ' COMMENTS: Avelvve L41-1-420 I-ti3e-It7v Tract ## 2 L'/ Duct Testing Lot # Certification Form System of 2— (One form per system) Builder Name:; Project Name: ( ki�z'. Builder Field Contact: Telephone No. HVAC Company Name: tAkf 4 L HVAC Installer: `' _ Telephone No. Self=Certifier Results Duct Leakage Measured @ 25 PA W CFM Indicate the maximum allowable Duct Leakage and the calculation method used: ❑ 0.7 x Afloor 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 X 400 x (Cooling Capacity in Tons) x (0.06) CFM ❑ 21.7 x (Heating Capacity in Thousands of output BTU per hour) x (0.06) CFM � t � Print Name Signature If- ZS -0 Z Date Duct -Testing Certification Form AQ e AU V Tract # 2 Lot # System 2 ofz (One form per system) Builder Name: Project Name:(/ Builder Field Contact:. Tefephone No. HVAC Company Name: .G HVAC Installer: Telephone No. Self -Certifier Results, Duct Leakage Measured @ 25 PA_ CFM Indicate the maximum allowable Duct Leakage and the calculation method used: ❑ 0.7 x Afloor x (0.06) for Climate Zone 8 through 15 CFM ❑ 0.5 x Ano,), x (0.06) for Climate Zone 1 through'7 & 16 CFM 400 x (Cooling Capacity in Tons) x (0.06) CFM ❑ 21.7 x (Heating Capacity in Thousands of output BTU per hour) x (0.06) CFM 4ffk-� Print Name Signature Date r Jan 29 OR 11:37a Richard Simpson INSTALLATION CERTIFICATE 661 947-6869 p.4 gc 3 of 8) CF -6R I/ - - -- -- ---- [.Piw�UY�/ DUCT LEAKAGE AND DESIGN DIAGNOSTICS DUCT LEAKAGE REDUCTION Tcst Rc%UIIs (CFM (u)25 PA) 'feel Lcakagc (CFM) �© Fan flow If Fac Flow iy Calculate m 400 ofkattoa x number of tour, or m 21.7 x I loaling Capacity in Thoumnda of "tuft. enter calculate value harp If tan Row a mcam.umd, carter mewured value here 12(JU Leakage Fraction ='I" I-cakagolftasured or C tdoulatW Faa flow) Pam ifleakago fraction 50.06 v t') � ❑ Pesti Fail ❑ For AEROSOL TYPE SEALANTS ONLY -The followlnA diagnostic testing was completed.- ompleted:Duct DuctFan Pressurization at rough -in mcamfed leakage (CFM) CHECK AFTER FINISHING WALL: ❑ Yeas ❑ No ❑ Prc"ru pan IX or I louso promariyation to l ❑ Yes ❑ No ❑ Visual Inspeution of Duct Connactiows ❑ ❑ Pass ]'ad THERMOswm EXPANSION VALVE (TXV)--_.—.. _._.. .__-- • -•—•_-... YEN . ❑ Nu Thorwor. 46,; Expaa,ioa Valve (or Commission approved equivalont) is installctl and ix provided for mhpeo ion [a YW 6 a pan:: ,18! fail ❑ DuCT DESIGN 1' ❑ Yes ❑ No ACOA Manual D M-4ipa oalaulations have been oomplutud, lhrat 11mign is on tho plane and duct installation malchoy PIM. 2. ❑ Yaq 0 No TXV is imtailcd or Flet flow hex btwtl varil'ivtl, If no TXV, vini lud liar flow ntatchah do..ign frost CF -11L Moasurad Fan Flow = Yes lbr both 1 and 2 ire a Pars Pass Fall ❑ I, Iho undersigned, vudly that tho abovo diagaomio tort reNita aad dic worts 1 performed aea ociatud with the tcat(s) iv in uonlbrntanoe with the mquimmunts lire compliant uradit. ITho buildur shall provido Uat I IBRN ptvvidur a copy of Iho CF -611 xiguuJ by the buildve cu►ployoca or mb-oon moors cartilying that diaguu-slio tu.%tiug onJ iumallalion nwet Iho rvgoirvmea6: Air compliance credit.] �jill � , , " �� APR 2 5 2002 LJRY 19 c I'e:,ls Silotia un;, Uatu lustalliag Subcontractor Co. Namo) OR Pcdormcd (;Cass) Contractor (Co. Name) COPY TO: Building Dcpnrtrneat HERS Provider (il'applicahlc) Building Owner rat Occupa»cy January 4, 2001 , T .1 Installation Certificate: Residential CF -6R Site Address PERMIT # 44-620 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 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 �/ G ( DATE: �t Z--� b HOZ Signature Installing HVAC Contractor i ,7'1/17/2013 01:33 FAX Z 014/014 INSULATION CERTIFICAr This is to certify that insulation has been installed in conformance with the current energy regulation, California Administrative Code, -Tide 24, State of California, in the building located at: 44-920 Liberty Avenue, Lot 53 Monticello -Heritage, La Quanta, California TYPE: BL�O, W _ r MANUFACTURER: Certainteed Thickness; R-38 WALLS: A TYPE: BATTS MANUFACTURER: Certainteed Thickness: R-13 r GENE CON CTOR: CENTURY CROWELL COMMUNmTES LICENSE BY: TITLE: Sv PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/12/2002 Certificate of Occupancy City of La Quinta Building and Safety Department 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: 44-620 LIBERTY AVE.. Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0202-190 Occupancy Group: R/3 Type of Construction: V/N Land Use Zone: R/L Owner of Building: CENTURY CROWELL COMM. Address: 1535 SO. "D" STREET, STE #200 Building Official City: SAN BERNARDINO CA. 92408 By: GARY SHOWALTER Date: 09/10/02 POST IN A CONSPICUOUS PLACE