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0202-174 (SFD)' H N W O �Cn re W r r- dZ� OLU LU � ca r` U) Z cr) LO N N 0 °) 0- Q Q It Z U-) H 0 X LLI LL M. U 0 O aL.0,g mt Z ab 5 r` C3 R 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 7;4158 B 1013142 Date f " 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 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 piovided four 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 GOLDEN BA,(:)LE DIS. . 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. _ Date: t Applicant -_-✓ 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, a§ 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, indemnity & 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. J/ Signature (Owner/Agent) �' %` r' Date BUILDING PERMIT PERMIT# DATE VALUATION LOT 0.2,M'. r 4 TRACT 23 JOB S1TE APN ADDRESS 79-V30 0FCfLAR.A'17 0,N C0TfRT CAA -07:k-606 OWNER CONTRACTOR/DESIGNER/ENGINEER CkN. °1`t R,Y CRC WELL C*0M ii.3NIs1&- CvRJTC'i.RY ('k0';A16J i:UB<,C.i+WlV171±' 1.535 SO `D' MMF, ME f*00 15sz Iwo, Ato o SAN BIMN.tY1{i3THO c'A. 92,408 S.iU4 DIEM NSF L)WO CI 92110K USE OF PERMIT 2NGLY-FAlyn i MM•L1NO 3FD -1^01' Z, PL..AIN 4FA. PERMIT DOZ3 .NOT INC".Ll fJE H*LOCK WAIA..% POOL , VPA OR DRIVEWAY APPROACiL "°'b UPI WO PION' TO F'l,.t1N CHECK' FFE FDR MULTIPL>r MMI,A14CE OF SAME PLAN +TPF TRACE 01K3* 'RUC71ON 4650,00 3F FORCWP,ATIO ffv 56r 1Acth:IC.AItPOPIT 604.00 *21 M IMA9.'t D C09.17 010 (':0141rMT7s: 10.112 011 CONST-:CiC IaP FEE 19) _000--118--000 $�:s4.4tt► PLAN CI•iiECi: RX 101-00":39-318 i7,t:5 MEC HANK AI, FE9 1.01-000-421-000 $66_0 1PL,FCTRJCAi. FEE 101-000-420-M) Pl„1 4i31Nzy 'r"" 101=f3()0.419.4} 3TRD1,40 NOTIOM ,t•:EE - R MID 101.1,300-241-066 '” $13.66 01W)INO WX 101.000.42"-0.06 $1El,tit} DE?V LLTER IMPACT F -FEV, '�'I if I I•.�I Illi �. �' l'� -. Z%f3-J'C CAI .:C71+i TR .?��i kl. �Lf to .�.F1F�K $3,316,08 ' 'i((y'Tl4.la-1,M.N�':l.° �'.&S 1!TC.'13„ C}1�9 y',,�ti? RECEIPT DATE BY FOATX FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & FootingsDucts �- Slab Grade /S Z Return Air Steel _ L Combustion Air Roof Deck Exhaust.Fans O.K. to Wrap F.A.U. Framing - 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 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 I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines 3 - Heater Final Water Piping Plumbing Top Out �i` Plumbing Final Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test O 2 - Appliances Final Filbal Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole - Underground Conduit Rough Wiring t - Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power . Final Utility Notice (Perm) COMMENTS: Installation Certificate: Residential CF -6R Site Address 79-830 Declaration. Court 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 of4.2 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 MANUFACT COMPRESSOR ACTUAL EFF. COOLING EQUIP COOLING EQUIP. MAKE MODEL # SEER CAPACITY LOAD A/C Lennox 12ACB42 12 12ACB36 12 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/BAY 111G.u.Q / J �c.Q.bd1�` Signature Installing HVAC Contractor DATE: 12--1 V' o'L INSULATION CERTIFICATE This is to aertlfy that Insulation has been Inatedled In conformance with the current energy regulation, California Administrative Code, Tltie 24, Stste of Califomia, in the building located at: 78430 Declaration Court, Lot 23, Montiasll",, aritage, La Quinta, CaUtornia C91LING TYPE: BLOW MANUFACTURER: CERTAINTEED THICKNESS: R-38 TYPE; YY► PPE ATTS MANUFACTURER; CERTAINTEED THICKNESS: R-13 ©ENE CONT CT CENTURY CROWELL COMMUNRIIES LICENSE #71111 BY: TITLE: S •.— PARAGON 3CNMiD BUILDING PRODUCTS, A MASCO COMPANY LICENSE #.832072 BY: TrrLE: ADMINISTRATIVE ASSISTANT DATE' 12112/2002 Jan 28 OE 11:87a ALI.A Richard Simpson TE —130 Dec1,0"Tt" Coves - 661 847-6868 p.4 DUCT LEAKAGE AND DESIGN DIACNMIC:S A4. V= L EM"E REDUCTION Pmaaarcbatiea Ted Rwatlta (CFM fd 13 pA) 'Coat f.cakege (t;.7�M) �3' 8 1'aa Flow V FDA FkM M Galaadatad ar 400 dhdlan I MMbor of MM Oran 21.7 x l be ft C"Ity Is Tbww each or lftt t. aaw oaloalwW vahw bom 1f tan flow is ==mnvd. eater moaau , valm bou LaeOP VOW" - TOd,LadWphdR4Q"MW or Cala ddW Non Mow) 1100 it lotUP fiaatiam s 01116 ❑ PM Fan13 For AEROSOL TYPE SEALAM ONLY- The lblmwla8 dhpaaatte laeinR was pkbede:" duet Fan Pmmwirative d iia aum nod, untag (CFM) CURCK AM1R PUGN U#G WALL: ❑ Yes ❑ Ne ❑ Picamw pen wwt er 1km* pwnw*mjw.ww ❑ Yto ❑ e ❑ viMW k*Mdoa ntf)mCtCoaaroodM ❑ ❑ P+" pad 7MMOSTAM UPAMMM VALVE MM Yvx ❑ No 11MOMOwk if-VM404 vats (or Conuaimim approved ---- .—_ _,� • . MUMIMO in ladallW Md Amm is pswMW tar r,+poeti,E3Yos ix a Pte' 1.WX Fog ❑ um of vv 1.13 Ya a ®No nc+:A lMaiwal n nmalpn eeloaiatio w leavn 6wm uunW ok* DW MWP J9 on ilio glad eed dant im ellofte masaho Plow. 2. ❑ Yoa ❑ No Txv b bwA Wd vrlras now Lax W n wiat A irso Txv, .=,d f" lbw WWhW 61imp Aom (7-M Memwmd Fan Mew - O 13 Ya► roc both 1 =.d 2 bi a Pews pas pan x1. tho MWApod, YwWy that U chow &Wwo*l A M Wm ad tho wak 1 Poftood amooWd wo a. taet(a) is 1. Mbfin"M with t6o ""b' -1 Coc COMPU M oaodit 'rhe befft•"pMW& th0,111MprawodW a carplr Ortho 01-0 ApW by to baildor ar nabsonbrawory ooetlly* tba j&lovaa4ie SUN* aw im ou"inn =".Thu avgen MW* 1br oompGmoe o>rodtt.J •vwwst• (WOO CmRaaeler (Co. Name) ill= PM idYr (F4Wptio+abk) Building Oamer at Ocauaa"-%, Jades 4.201 ; Jan Z8 o2. u s 8Ta Richard Simpson 861 847-6888 p. INSTA1LI ATION CERTIFICATEf Pagc 3 of 8) CF -6R 1740 26e 036 DO-C-14k4TfoA C4,KA-t DUCT LEAKAGE AND DESIGN DIAGNOSTICS mmuum w 1 Cm MOM (CFM 64 U PA) roil t.oakag¢ (cwM} van view If has FkW to Cabsblod m Opp oikallaa -. ans jw of boo. ar av 21.7 x l bMiNg (4mby In TltoUM& of "fo e . ow odpWdW vable bolo Irrm, now nanmwod. GNAW mow mood Valeo iow, % pQ 1.aalaW i e6alloa s Taal or Cdaa MW Von 1 bW) Psaa1 abdcpEn rna soub .❑ AIPRM01.Yr TUAtAM or v - Tie 1l�llew6pl diq�pe le�la� Gas eomphe rim lima13For fled[ Kass PmmmakjLw al Mvgb•m nand lcek4p (LTM) CUCKAIFFRR PIMMIl` :1'AA U ❑ yo ❑ Nu ❑ homm psa wrl ae jk""FfflmWhWimWm E7 yom ❑ No O vimd l QfUmdC"—l-nom1 Cl O 1M YAK MMOSTATIC iEWAlrllWN VAi: a (DA -10 UY*, ❑ go 'Q::: U.—owe ;ow i'iun"* 'M mmmvod N1..1Vr1-mMl b habA d.ad ASI io pr vMW toe h-pmlid u Yap is apm DUCT fiE211SN I' ❑ yoo ❑ WRCCA MMjWd D?lo dp oaicaiotiear iuvo 000� oco�pa;w,o' IJWI � M Va, ��v' • ' 'r",'1 err-l:wd�lldiA� �d nLer 2. Q yon (3 No Txv b'bmillod or'l+m lbw bN boas vaeitiop. 1f ao —A -v. Wnfim .. ta..s CF 10 1aa scow ma61 � iLV� �.1'-atA. �ln.aeert Irre Mo�v a _._. ❑ tr �:.�'ro�bulh.l.aa1120p's Pleas Wall Ik0 t8]'k� 9d. Wpiy �:Z:O C�i1S iL�1«1Gii11i0,:1�: sad e110 wok lOd mean l VjW IYD coalb»emm0o t; i(� 1�0 : ,f L�Ci�i[ii itiEl FT1bf:. ''i`iUlt iT.lilpit;aQan 'o�'Iv a�iiir i ci_-mss' : =p *robe Ul- ilt �aEgeeW byes e�.t v: a1i +`w�'r-..,.�.:. �Ls •�. iw red i litdmr q �-tJ OO�Ila000,Lwrp�-i —. - the :%: TO& MAMMA 8��1. laato ` (Co. Nakao} CQPY 1'tl: ttoil9avts UepintsnpuR - lii�iiS, t�s'rridor, (irapplioablo} lhiiMOU Owner at OrCunoncy .lgmmmLry 4, 3M1 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 folio wing: BUILDING ADDRESS: 79-830 DECLARATION COURT Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0202-178 . . Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: CENTURY CROWELL COMM. Address: 1535 SO. "D" STREET #200 Building Official City: SAN BERNARDINO By: STEVE TRAXEL Date: 9-30-2002 POST IN A CONSPICUOUS PLACE