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0202-088 (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�� rf �;t '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). () 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:. 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, Ishall 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. Date:.`` ILL -6 Applicant— C, pplicant 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 SafetyK' 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 186 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. F Signature (Owner/Agent) �' /% ;� Date. • .. BUILDING PERMIT PERMIT# DATE . 'VALUATION LOT- TRACT 1460-- cd %`.% $13291.0,20 1 JOB SITE ADDRESS APN 1 44-61776 UT3MaY AMM 604-072-006 OWNER CONTRACTOR / DESIGNER / ENGINEER m�`�C'(gpYry�plyygcrRom't}�1}:1LCC�(�^,Jl+lsyi'IdUK-MM t'.:V'�+7'�`119.1/�2:1!'y�C�.�:1i�lC.�t.t,7��;�l2ryvt}1.:��'k�73`. L,13 1.535 00. S'DM UMM, g ay X .020 ' 15245 Alit, "1Y' VY7M*XS s �9•. M 02,00 SAN REWkRDWO CA 92,408 SP14BUMARVINO CA 92408 USE OF PERMIT SYD -LOT 51, MONTIC&W HETL'MAX P14W 3CPUM. M&MIT 00. NOT INCLUDE rNWICK VALU% PC+:1WPA (A DRP UWA'i" APPROACH, PITIM ClffMK FLOE R2EDUCZ..0 I%`OR .M4JLMPLZ ISSU"Cg Oil SAME; P1,A)1 '1' r Pe TR&C:i 0020TRUCTION �1215109.Sp Poluni/p rlo 39.00 sy 0Ag3AWCAAR.PORT 6'eS' .00 sy 1;:'u n C OSIr or CO?Vlx' 'UMCM 1Y2,910,20 f9:�I►ri171 � �S�i!'.�i3Akrlf�.i,1a'!%' 0(!r1qSTRUC1,10�N yRge 101 -000-41 et -000, PUN CHOCK ME 101.000.439-311,.9 $140.11 M=1ICAL PES: 101 «> 003 421.000 $0180 >; L F.CTAIt"...iiL PEE 1:01 $1313.53 PILM 1UYNC Pep, 101--000.419.0100 $124,011 ST R0140 MM 10W, FLEE - WSM 101.00-1-242-000 f3RLA3 INO FEE 101.000 123-bC* I?E'Ed'1 P1!R IMPACT me $),007m • tea. '1 � .. _ _ _. " �• .tl9$r s.r�. A a'� p� ,�V"WRpp MUMND ry' j��y' �/�f-TW 'a. I�, ui./ fv.. A� irL7d,V ,{�,LV �L,!dwC`i.lV `l•1 ! . 5 K 8: 3 PRF, -,PAID FM9 .: FEB 14 2002 • ` "' ' r ram � i cS oU NOW WYOFuQuon- RECEIPT DATEI B t1f," DATE FINALED INSPEC�TO�p INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs — - Z/ Underground Ducts Forms & Footings - Z_ Ducts Slab Grade - Z Return Air f Steel .. Z. -Z Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing .,3' — Compressor Insulation Vents Fireplace P.L. _ Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS steel 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 3 - a s Heater Final Water Piping Plumbing Top Out Shower Pans / Plumbing Final Equipment Enclosure O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) —24 2 ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring 4 r Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) 72r� �� Installation Certificate: Residential CF -611 Site Address 44-676 Liberty Avenue 1. BUILDER INFORMATION Century Homes 1535 South D St. #200 San Bernardino, CA 92408 INSTALLING CONTRACTOR: 2. PROJECT INFORMATION PERMIT # SUBDIVISION: Heritage CITY: La Quinta COUNTY: Riverside WEST PAC AIR CONDITIONING DISTRIBUTION DUCT OR PIPING R - TYPE VALUE Flexible Ductwork Flexible Ductwork in Attic and Will have a R -Value Between Floors of 4.2 or Better 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 MANUFACT COMPRESSOR ACTUAL EFF. COOLING EQUIP COOLING EQUIP. MAKE MODEL # SEER CAPACITY LOAD A/C 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 (��" i Signature Installing HVAC Contractor DATE: 2 1 �•O 10/17/2013 01:32 FAX INSULATION CERTIFICATE A This is to certify that Insulation has been installed in conformance with the current energy z regulation, California Administrative Code, Title 24, State of Californie, in the building located at: 44676 Liberty Avenue, Lot 51 Monticello -Heritage, La Qulnta, California CEILINGS: TYPE: BLOW MANUFACTURER; Certainteed Thickness: R-38 �i WALLS; TYPE: SATTS MANUFACTURER: Certainteed Thickness: R-13 GENE L CO RACTOR: CENTURY CROWELL COMMUNITITES LICENSE # Y P f PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 J 10013/014 TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/12/2002 Liar:nvv..:.�i.>is�e�,v.�i.w..riiis,vis+si:r,ririr.nwi vv v_if vii:•i its r�,o-....,r. ,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 located at: 44-676 Liberty Avenue, Lot 51 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 COMMUNITITES LICENSE # BY: TITLE: PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 BY TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/12/2002 i 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: 44-676 Liberty Avenue, Lot 51 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 COMMUNITITES LICENSE # BY: TITLE: PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072 BY TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/12/2002 E Builder Name: Project Name: Builder Field Contact: HVAC Company Name: HVAC Installer: Duct Testing Certification Form Self-�Certifier Results Duct Leakage Measured @ 25 PA yW-(,-)(I kldep. y 4.,ENv6: `Tract # 2�1`?? Lot # �f System oft (One form per system) Telephone No. Telephone No. 7 y. ,Kv/ q -� CFM Indicate the maximum allowable Duct Leakage and the calculation method used: ❑ 0.7 x Aftoor x (0.06) for Climate Zone 8 through 15 CFM ❑ 0.5 x At,00r x (0.06) for Climate Zone 1 through 7 & 16 CFM 400 x (Cooling Capacity in Tons) x (0.06) f Q ii CFM ❑ 21.7 x (Heating Capacity in Tfi'pusands of output BTU per hour) x (0.06) CFM 'C.fC. r Z�-O z Print Name Signature Date Jan 29 02 11:37a Richard Simpson 661 947-6889 p.4 INSTALLATION CERTIFICATE (P#gc 3 of S) CF -6R ite Addresas _ Permit umber DUCT LEAKAGE AND DESIGN DIAGNOSTICS ❑ DUCT OESIGN 1 ❑ Yos ❑ No ACCA Manual 1)1)csibm caloulations havo been complotod, Duci Design is on the plans and duct installation malehes plana. 2. ® Yora ❑ No TXV is installed or Fan flow Mix bvun vurifivd. If no TXV, verified Ilan flow mntchay &.ign from Clay l IL Mcmurod Iran Flow= ❑ ❑ Yes Ibr both 1 and Z ia: a Pare PASS Fail ❑ 1, tho undarsignud, waxily that tho abovo diagn0+1iV tvst re;w(tN aAd tiir, work I pctformed associated with tho tcst(s) is in eonikinnanee with ilio mquimnwnta Ibr eompliance,crudit. ('!'ho builder shall provido the I IEMN providor a copy ol• Iho CF -6R acipW by the buildow cuiploya:a or sub -contractors oortil'ying.that diagnumio Io:atiug and in:%tallation mW the requirement, lkn• complianc;a; credit.) dA4 ti P0 2 5 2002 Tcsis Signalum, Dato lastalling Subcontraotor (Co. Name) nR Pcrlormcd Gonera) Contractor (Co. Name) COPY '1'U: lluilding Depailinortl I113RS Provider (irapplicable) Building Owner ut OccuPa»C.y January 4, 2001 DUCT LEAKAGE REDUC71O N Prassurualion'I'cst RCsulls ((.'I'M fa) 25 PA) , 1� `7 Torr l.cakage (CFM) Fan flow If Ilan Flow is Caloulatcd ds 411(1 ofwlton x numbor of tons, or ma 21.7 x lloafing (,apaoity in Thoucaandy of iltuft. vtalcr oaloulatod valuo horo If fan [low is maasumd, e:nla.x moasurod value hero 17,60 IAnkago Fraotion -'rpt l.cakagc/(M,;arutud or ("- Iatcd Fan flow) n Pans if loakagu fraotiou 50.(16 �,� � �j� ❑ Pass Fail ❑ For AEROSOL TYPE SEALANTS ONLY -The following diagnoaNc teNting was completed: Dual Fan Prumuriiatiou al rough -in [masural lcakagc (CFM) CHECK AFTER FINISHING WALL: ❑ Yes ❑ No ❑ 1'rex, M pan tail or liouw prossurvation lam ❑ Yes ❑ No ❑ Visual Insp don of Duel Connuotiow; ❑ ❑ Pass I'ad POT—HERMOSTATICEXPANSION VALVE (TXV) Jnl Yw� ❑ No 'l'L moblaiie Tsxpaugion Valvo (or Commission appi+bved equivalent) is installad and Au:c w is providcxl for ini pection ❑ Yes i.. a pass 'a.. Fail ❑ DUCT OESIGN 1 ❑ Yos ❑ No ACCA Manual 1)1)csibm caloulations havo been complotod, Duci Design is on the plans and duct installation malehes plana. 2. ® Yora ❑ No TXV is installed or Fan flow Mix bvun vurifivd. If no TXV, verified Ilan flow mntchay &.ign from Clay l IL Mcmurod Iran Flow= ❑ ❑ Yes Ibr both 1 and Z ia: a Pare PASS Fail ❑ 1, tho undarsignud, waxily that tho abovo diagn0+1iV tvst re;w(tN aAd tiir, work I pctformed associated with tho tcst(s) is in eonikinnanee with ilio mquimnwnta Ibr eompliance,crudit. ('!'ho builder shall provido the I IEMN providor a copy ol• Iho CF -6R acipW by the buildow cuiploya:a or sub -contractors oortil'ying.that diagnumio Io:atiug and in:%tallation mW the requirement, lkn• complianc;a; credit.) dA4 ti P0 2 5 2002 Tcsis Signalum, Dato lastalling Subcontraotor (Co. Name) nR Pcrlormcd Gonera) Contractor (Co. Name) COPY '1'U: lluilding Depailinortl I113RS Provider (irapplicable) Building Owner ut OccuPa»C.y January 4, 2001 Builder Name: Project Name: Builder Field Contact,- HVAC ontact:HVAC Company Name: HVAC Installer: Duct Testing Certification Farm yy- G71 Llac27y At.cFN&*'( Tract # Lot # S System of Z (One form per system) Duct Leal(age Measured @ 25 PA L Self'Certifier Results Telephone No. Telephone No. 0 CFM Indicate the maximum allowable Duct Leakage and the calculation method used.- 0 sed:❑ 0.7 x Atioor. x (0.06) for Climate Zone 8 through 15 CFM ❑ 0.5 x All= x (0.06) for Climate Zone 1 through 7 & 16 CFM ❑ 400 x (Cooling Capacity in Tons) x (0.06) 7 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 661 947-6889 p.4 INSTALLATION CERTIFICATE (Page 3 of 8) CF -6R SiteAddraff I Ny _ (p i �/� �rt7y ✓C N c PerlmitNnmhir DUCT LEAKAGE AND DESIGN DIAGNOSTICS _❑ DUCT LEAKAGE REDUCTION Pressurization ,rest Rcsulls (CTM (1(125 PA)' 'fon(Lcakagc (CTM) 7• Ilan Flow If I1nA Flow is Caloulatod as 400 ol'm/toa x numbor of lona, or as 21.7 x I loalimg Capaoity in Thouran& of OfAr. enter caloulatod value hero Zt If fan flow in mcarsunsl, enter measured value hen: l.cakago I'molion ='ry t l.cakagc!(N1,sarut or C:aloulatcd lean Flow) Pae if loakage fraotion s 0.06 o q ❑ Pass rail ❑ For AEROSOL TYPE SEALANTS ONLY -The fidlowing diagnonde testing was completed: Incl Fan Prussuricalion at rough -in mcasunxl Lcakagc (CTM) CHECK AFTER FINISHING WALL: ❑ Yes ❑ No ❑ Pre&4uru pan t" or I louse prossuraation loch ❑ Yes ❑ No ❑ Vinuai In pcetion of Duet Conneelionv ❑ ❑ Pass Fail THERMOSTATIC EXPANSION VALVE (TXV) Y.y ❑ No 'l'huyntoriatru I.Npan':;on Valve (orCommission approved oquivalont) is installod and Atxttm is providod for mrVxtion r ❑ Yus 6 a pans Pa" Fait ❑ DUCT OEslem 1. ❑ Y,.s ❑ Nu ACOA Manual 1) design calculations have been oumplolud, Duet Dadgwis on lbo plans and dud installation malchos Plans. 2. ❑ Icy ❑ No TXV is insiallod or Fan flow has bean vordiod, If no TXV, verified tan flow matchw; dwzign from C11aI IL Mcasumd Tan Flow = i Yes for both i and 2 ir. a Pans Pass Fail ❑ 1, tho undmigacd, vwify that Aho above diaguostiV Asst rasvlts a4d the work I perforrned associated with the tcnt(n) is in confumtanco with the mqui nwrits fitr comp4anur: omdit_ (Tho buihlor shall provido tho 1 MKS pruvidor u copy of Iho CF -6R xiguod by tho builder cutploya:a or sub-0onfraclors certifying that dingum-lio IQ%ting and iaylallation uww lhu ryquiromoiuk lirr compliance credit.] APS 2 5 200�( Tows Signature, Date Installing Subcon(raofor (Co. Na o) OR Performed Genera) Contractor (Co. Name) COPY TU: Building, Department 111IRS Provider (if applicable) Building Owner ut Occuva»cy January 4, 2001 non 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- Use Classification: SINGLE FAMILY DWELLING Occupancy Group: R-3 Type of Construction: CVO e --U Owner of Building: EVEtOPMENT 676 LIBERTY AVENUE I w1 Bldg. Permit No.: 0202-088 Land Use Zone: R/L Address: 1535 �S{.5 Q., L252 C` n o -v` d i -o City: LAeUfNTA CA. 9225-3' yayb8 By: GARY SHOWALTER Date: 08/20/02 Building Official POST IN A CONSPICUOUS PLACE