The URL can be used to link to this page

0306-446 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of F— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and WProfessionals Code, and my License is in full force and effect. =) C License # Lic. Class Exp. Date d 760044 13 3;.13 M5 �' o OZ r --Date �•-''1-��'`.1 �ignature of Contractor.�� 1\Ti+ � t CSD—O` ?. J CID6 OWNER -BUILDER DECLARATION W WW I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: Z_ ( ) 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). cr)() I am exempt under Section B&P.C. for this reason U-) N Date Signature of Owner ON Q Q WORKER'S COMPENSATION DECLARATION C) 2 Ir Z I hereby affirm under penalty of perjury one 161 the following declarations: LO r � O () 1 have and will maintain a certificate of consent to self -insure for workers' X W LL compensation, as provided for by Section 3700 of the Labor Code, for the mJ Q performance of the work for which this permit is issued. Q L) I have and will maintain workers' compensation insurance, as required by O U Q Section 3700 of the Labor Code, for the performance of the work for which this rn F— permit is issued. My workers' compensation insurance carrier & policy no. are: � Z Carrier MM F911i) Policy No. '46-93-'1,1353 w C) V J (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 provision' . Dater \ .)Q , *)Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is • correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. i Signature (Owner/Agent )t �� rDate)t BUILDING PERMIT, PERM' (am-oo DATE VALUATION 01 i9,>i 15. 0 LOT TRACTJOB SITE �� 1t 1Yf`1f�3,�Cj�.� 5 APN % ;�.i-P�—s✓ ADDRESS OWNER CONTRACTOR / DESIGNER / EN (NEER 1420 E, VALLEY DIX.J..). 5 E, "ITERM., M Vi`li t',0 . AN':T',�SAaiMA Ci',. 91861 :Rig :1.4 AKTJr S E fa rairvt�„ 36i3zt t -1.11h 11911 USE OF PERMIT _ i.v1 A. " e7,.,1 !'1.n[9.::.A .LT. ICL:rtLM7 l 4.}K.,A `i \:..Y -{\W 4J.✓ Wf:�a.l :...OVA✓ia. Wd"..6.:� . 4�� i�i S 6»a! \�4.�e�6ii��'�t•4o`d @ll:`,i ��'3J�}d$ t::si PIJRu:i'1 PAy�`IwwKO S rf"f:3i1 a?�` pp 1�,,Al2`130 {;OST OF C70IM T1�t07+�°YTON �.O,I Z'4..20 s �y+t y�r ryyy«�p��i• 1 �FIRD 1?��u`a�IW .Pr�wi'f ►3 �.lyYJ.7�:4,;` klY r,V41MUCTION FEE. T0 -()00_418_000 x:34.9 Pf..A11 CF3k l.",k TZ? $ 17.761 i0ITCHA1'N7.=.,FEE M-000-423-000 $114100 , I?1=, TRJZ7AL FEE 101—S'i�l(1-420-000 PLUfid1311~K VER 101-, -412-001 i'YA.25 TX 01,1401hoTiON Fe -Z JUSM I W - 000-249. -0001 $18.9 OFCMMMO FES' 105,-000 423-(.' ) $1510 SUZ-TOTAL iwCJMEMCAMCi:N A14JO PLAN C"HWX'K $4,0 6.f)S I&M S ZE-F.^yM.ITE.) .00 170TALEUMMFUSIPIEt NOW Is 9,4 RECEIPT DATES j BY DATE FINALEO INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air 01.01 Roof Deck Exhaust Fans O.K. to Wrap 3 6 F.A.U. Framing ( Compressor Insulation /p 6 Vents Fireplace P.L. r Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath z/ 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 APPROVAL Gas rest Electric Final Waste Lines — Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: - Final 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) RFnl-QTFRFD INSPECTOR'S WEEKLY REPORT JON TANDY 78-194 Elenbrook Ct. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY g�Pp9�� O POST TENSIONED CONCRETE O ASPHALT O OTHER ❑ REINFORCED MASONRY ❑ FIRE PROOFING JOB LOCATION �� ^� Los Qs- REPORT SEQUENCE NO. TY P $F UCTURE ®-r(,� Q S' PERMIT 0. DATE Li 1 DAY OF WEEK MA IAL DESCRIPTION i; ARCHITECT INS CT MRS. CHARGED r1r to4b J ENGINEER ASSISTANTS HRS. CHARGED INSPECTION DATE GENERALr� �� ,& :CONTRACTOR lcz S ' SUB e u CONTRACTOR c '7l En o.N' Soo 4, c o .. ,AAjQ V'v C, -a V o t JC 0 CL • T % av- - -Ft \a�Q - Ch�� q-4\ I ,,,` kj,)e\('- �` - `To •lam t•� o� ro S wl COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE.ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. SIGNAT OF REGISTERED SPECTOR DA E OF REPORT REGISTER NUMBER CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part 1) CF -4R THE LAURELS 1-27-05 Project Title Date 55067 Winged Foot, La Ouinta, CA. First Pacifica Dev. Ccrp. 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 Numbar /2005 9 Sys. 1 Track 29121 Certifying Signature ' Date Sample House Number Firm: Energy Calc Services, Inc HERS Provider: CHEERS Street.Address: 16551 Mockingbird Cyn. Rd. City/State/Zip: Riverside, CA 92504-9638 Copies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT " The house was: 0 Tested ❑ 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 -rdentified on this form comply with the diagnostic tested compliance requirements as checked on this form. El The installer has provided a copy of CF -6R ( Installation Certificate) 0 Distribution system is fully ducted (i.e., does not use building cavities as plenums o•- platform returns in lieu of ducts) Where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands we used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections.- onnections._MINIMUM 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 35 If fan flow is calculated as 400cfin/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 = 2.92% Check Box for Pass or Fail (Pass=6% or less) 0. ❑ „ Pass Fail ❑X THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved eouivaleni 0 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 1-27-05 Project Title Date , . 55067 Winged Foot, ` La Ouinta, CA. First Pacifica Dev. Caro. - Project Address Builder Name Dave (909) 841-1942 2-S - r. Builder Contact Telephone Plan Number - Tim Topham (951) 780-7265 1 r HERS Rater Telephone Sample Group Numbar • ..� /2005 9 Sys. 2 Tract 29121 . Certifying Signature Date Sample House Number Firm: Energy Calc Services, Inc HERS Provider: CHEERS Street Address: 16551 Mockingbird Cyn. Rd. City/State/Zip: Riverside, CA 92504-9638 Copies to: Builder, HERS Provider - HERS RATER COMPLIANCE STATEMENT The house was:' ❑X Tested ❑ 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` F comply with the diagnostic tested compliance requirements as checked'on this form. - 0 The installer has provided a copy of CF -6R ( Installation Certificate) s ❑ 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. ® MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values . ' - A Test Leakage Flow in CFM 23 ' If fan flow is calculated as 400cfm_ /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 = 1.92% Check Box for Pass or Fail (Pass=6% or less) Pass Fail ❑X THERMOSTATIC EXPANSION VALVE &XV) or Commission approved equivalent El Yes ❑ No Thermostatic Expansion Valve (or Commission approv-1d equivalent) is installed and Access is provided for inspection �S ❑ Yes is a pass Pass Fail !, f ` ` { . January 5, 2001 ; r Dec 16' 04 11 t 46a Energy Calc Services Inc. 740'-0558ab�7 wL� e� p. d Poo iNSTALLATIOV.CERTIF'1CATE p'ugc J. of. 13) Site Addrerd Verruit Numbrr DUCT LEAKAGE AND DESIGN DIAGNOSTICS lvs I: 0Il(T I4;AKAC1: 1(1•;1>t�('l'IpN Ptassunzatron Test Rusultx (CFW 0 2b PA) rust l Awk.ay-v (C' F lot ) i'.m Flnw•. it Fan FIpW I); CJIWI IIOd 15 dQQ CfitUlt)n X nU►nbOr Of tons, Or 051f.% % Hooting Cop icity in Thousands; of Btymr, WAO(CalWatod Valeo horp If ton flow Is measured, eider meosumd Value here Leakage Fraction = Test L@Aage/(Meissured or CJlculeied Fan Flow) b Pa's if lookogc fraction -/- 0.06 Posy -Fad MN'.: ply("1' I,FAKA(:F MCMI(TION ,xvVrrvttion Tust Rosulls (CFM tO 25 VA) 1';m Flow ^ 11 FDP FIOW i0 CGIcU{alod aG 400 Cfm/ten X nUr)ibof of tons. Of as 21.7 X Hoaklig Capncily � - in' Tho)isnos of Stu/hr, anter c:dculatod wales hero If fan flow is measured, enter measured value horo Leakage Fraction Test Leak.agtil(Measureti or ColciAtted Fon Flow) r. Paas if loakagu fraction • /. 0.06 ❑ Patti 1 -:ell . lJ, For' '.1EROSOI, TYPE SKAI,ANTX 0Nk -• Tho following diagnostic tosting.was comploted: Duct Fan Preesu6codon of rough -in mensurod leakago (CFM) ` CHECK AFTER FINISHING WALL: L`SJ Yos ❑ No ❑ Prossuro pan tort or Houco proosureatan tact _ Yes ❑ No ❑ Visual Inspection of DuctConnoctiuns r7 ploqs Vail '1'I11iNM<1,\'1'�#'I't(' is\1'A111UN Y'Af Yf' !'1'C�1 Yees ❑ No. Thormostatic-Expansion Valva is mstaliM and ACCOAA is provtdod for Inapperon D i0% rs a Pam Pass Fid ' YOB: ❑ No RCCA Nianwrl 0 beslgn calculations have been Comptutod Duct Ouaign w e1 tho plant and d-irt vert tlhrbon rnatches plans, 7. YOs ❑ No ' TXV ig inmallod or Fan flow Ni, boon voraripA• If no TXV, vdrdn•td fan (low matches design. from CF -IR Measured Fan Flow = Yos for Doth 1 and 2 is a Piss' I, tho unoefBrQn4d, VW4 Mat th6e'2bove dragnost4 tfOMt resviW and the work I pertormed associ3ted'W'9h the test(-.) i5 in CO4kforrnonGO with tho MQvuornontb for complionc/i Crodd (Tho buddor Rhall provide tnn MLRS prowdor at cop of tho C.FX)R s -by MO builder omptoy000 or Dub-cotitroctoru anitymg that diaorl"te tosti and installation mtxri tho r n9 0 imm m : au t for complianco crodit.) 7(nto S�gnaturc. Oato )nstLjIbnp Suboontraetor (co. Name) OR Porformetl General Contractor (Co. Nine) COPY TO: Bulldinq Department HERS Nrovidsr (d app!ieable) Building Ownor at Oeabpancy A 2!, Comobanco Forms 'ioptunix!r '1.00? .�� INSTALLATION CERTIFICATE (PAGE.1 OF 8) CF-6R SITE ADDRESS PERMIT NUMBER AN INSTALLATION CERTIFICATE IS REQt4&'ffi BE POSTED AT THE BUILDING SITE OR MADE ASAI 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 :EATING HEATING EQUIP NAME IDENTICAL . (AFAU ETC.) LOCATION PIPING .AAD CAPACITY TYPE AND SYSTEMS CF-IR VALUES (ATTIC ETC.) (R-VALUE) iBTU/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 -IR VALUE) (ATTIC) (BTU/HR) (BTUIHR) A/C CARRIER 38HDC0363 2 12SEER ATTIC 4.2 36K 36K HP YORK HP018X122.1 1 12 SEER ATTIC 4_2 18K 17.4K 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 -1R) 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. t WILLIAMS HEATING CO. INSTALLING SUBCONTRACTOR (CO NAME; OR GENERAL CONTRACTOR (CO NAME) OR OWNER THERMOSTATIC EXPANSION VALVE (TXT) THERMOSTATIC EXPANSION VALVE (OR COMMISSION APPROVED EQUIVALENT) IS INSTALLED AND ACCESS IS PROVIDED FOR INSPECTION. ❑ NO YES IS A PASS PAS$% FAIL COPY TO: BUILDING DEPARTMENT HERS PROVIDER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY tion. L.P., RESIDENTIAL. CONTRACTING 4211 Latham Street • Riveralde, Calitornla 92501 Prone: (909) 686-8760 • Fax: (909) 686.8786 License # 794484 - CF6R INS I ATION CERTIFICATE THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24, STATE OF CAI-IFORNIA, IN THE. BUILDING LOCATED AT: TRACTIPHASE: THE LAURELS/ PHASE 1 LOT 9 SITE ADDRESS: 55-067 WINGED FOOT - LA QUINTA, CA ----------- i-....-....................... r Q BATTS MANUFACTURER: JOHNS MANVILLE THICKNESS: 13" R- VALUE: R-38 CEILINGS: BLOWN INSULATION MANUFACTURER:. GREENFIBER THICKNESS' 8.1" R- VALUE: R-30 CEILINi�s: BATTS , MANUFACTURER: KNAUF THICKNESS' 10° R- VALUE: R-30 CEILINGS: BATTS MANUFACTURER: KNAUF' ' THICKNESS: 6'/: R- VALUE: R-19 ' EXTERIOR WALLS: BATTS MANUFACTURER: KNAUF THICKNESS: 3 %7 R- VALUE: R-13 ' INTERIOR WALLS: BATTS , MANUFACTURER: KNAUF THICKNESS: 3 W' R - VALUE: R-11 GENERAL CONTRACT, OR: THE BREMM COMPANIES BY: TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE N R:794484 BY. TITLE: PR UCTION MANAGER DATE: JANUARY 11, 2006 01/90 39Vd NOIiv-lnSNI N831S3M 98LB989196 L9:80 9002/LT/10 r I ,, 4