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0306-445 (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 t � . Date"-� (" { _� signature of Contractor . n - 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 tof construct the project (Sec. 7044, Business & Professionals Code). O I am exempt under Section B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affi m,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 Sl'A' RMID Policy No. 44.03411-3 . (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 37,00 of the Labor Code- i shall forthwith comply with those provisions. ,--Date: -'.< 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 •Rr. -S 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 enterVupon the above-mentioned property forinspectionpurposes. Si nature Owner/A en; 1 �� �,,� =1ti R\ Date 9 ( 9 ) BUILDING PERMIT PERM'Taatr� DATE VVALUATION LOT' �y TRACT,`^ �I JOB SITE ADDRESS �fAY,?tYG,,n.�. APN i�•�a'fi4i� OWNER CONTRACTOR / DESIGNER / EN &NEER t kIRZI R 14 20 .5IE, CtFR1111S 41UM VITTRI, 1W ••��Yyy3,,,ft[idi � ue6:SCfIN�.iy�': Appl CK -�A�. :)ANDoYpp W73 (W9_ P981U3S C'lRA .4911 • r , USE OFffnpPERMIT Y7 .O�.c•'1.�47'�1'r 1.�.1QiLW.�Js,1. s.✓vi1�,i�nLrd.6Hk�' _ Slot; , A.A.r A ri-n-VI .stns:. --i i s i. ui .0 a ter .Aiyi. ,eii r eii Via.. t, - ye ,...i j�001, SRO, C .I DR,A"�';F'`VAY Ai'3�1�C�.<�CH. 75% �l�'.CIC ION T �'i:.�� Cf5 ! I7UR `i O tAIJI Pi.X) I.33taAMCKOF °.,.+`1MIR PLAfu TYPE 6U*S7'OM C.',Iz,�4',,',TPu. Jt'1'IC'2t Z423,01t 9F 21110 SF �ad4R.LOFT ^t^rsPC_''ft'f 466.9!v 3F J�, ,A.b'iJll4..G i.i%:G� 'k;V-'r O �4!��'S�69%.C1.0.J-Ro/.Li:Oa.'t sr�l�!��t -101 :4•) v, PU,N C':HFCK N'i:F 101.000-4x11.000 41? .iU , 1 f G :i'IiFfiPa:,l ')�. 307: t?.Q-•�:Z�f•D(itf 4147 1'LUMBINO F1 j:t3�1 L��"►t7 ��1 QL�ta i"s 7 - 000 itt,tlt G��t,AF7iTfO ial�;;�:"� S Sa`'l a�31�.:e,�•�;;a0(jf'!.. '`�,f a:,�fi - . EIP, f�Ui1{'�V11'' FR �7t <<+ .gft .• _ gO.�Lt��7'jyI��.OPy rr� �}} yy Iy y ��ry AR M Pf.)k��.. C P!,4: RV! - i..t3o�/.5E- M f 01-•CM-14.5—wo YL33 1�ul�taJ�~i701H° f\N'lD Tx;may t"]11. CK S>af.4i�'p�Ct.s1� • 30 t- �L+......-+,., - r` .• Tx r dC NOV , TOTA 3W �J,�, �0�►;� �. 1, Crry OF .LA�QUINTA. EIW€1MCE DEPT. RECEIPT DAddTE BY `v f DATE FI ALED INSPECT R l 71 � kJ INSPECTION RECORD OPERATION I DATE I INSPECTOR BUILDING APPROVALS Set Backs Footings Forms & Footings Bond Beam Slab Grade Steel Roof Deck _ 6 OX to Wrap Final Framing S o 6 Insulation A /g Fireplace P.L. Water Piping Fireplace T.O. Plumbing Top Out Party Wall Insulation Shower Pans Party Wall Firewall Sewer Lateral Exterior Lath Sewer Connection z Drywall - Int. Lath 3Z7 OPERATION I DATE I INSPECTOR MECHANICAL APPROVALS Underground Ducts Ducts Return Air Combustion Air Exhaust Fans F.A.U. Compressor Vents Grills Fans & Controls Final COMMENTS: Final Utility Notice (Gas) I _f / / . ELECTRICAL APPROVALS Tema. Power Pole Low Voltage Wiring Fixtures Main Service v Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Tema. Use of Power Final Utility Notice Final Final 3 D.r 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 Gas Piping PLUMBING APPROVAL Gas Test 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 z Encapsulation Gas Piping Gas Test Final COMMENTS: Final Utility Notice (Gas) I _f / / . ELECTRICAL APPROVALS Tema. Power Pole Low Voltage Wiring Fixtures Main Service v Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Tema. Use of Power Final Utility Notice REGISTERED 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 0 REINFORCED CONCRETE 0 POST TENSIONED CONCRETE 0 REINFORCED MASONRY 0 STRUCT. STEEL ASSEMBLY (pp' &PZl04 0 ASPHALT 0 OTHER 0 FIRE PROOFING JOB LOCA 1 N ISS - 9S w � REPORT SEQUENCE N0. Tr OF STRUCTURE l z � PERMIT NO. L � s DATT_ Ll i W DAY OF WEEK -r6-,v---� - MATERIAL DESCRIPTION RCHITECT . r^ S o Sed c. INSP T R HRS. CHARGED Exr,ll ?-ME ENGINEER (:�. ASSSTANTS MRS. CHARGED INSPECTION DATE GENECORAL �� r NTRACTOR d PosC SUB CONTRACTOR r S i S a d 2- C Lai morkV, V, %(Nock C3.7wpl rq - C C'arty. T M i i COPY SENT TO CLIENT 0 CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT t HAVE INSPECTED TO THE BEST OF MN 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. (SIG NEAT OF IIEG13TERE I(N'SSPECTOR nC �G V DATt OF REPORT REGISTER NUMBER CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part 1) CF-4R -THE LAURELS - Z-- -05 Project Title Date 55095 Winged Foot, La Quinta, CA. First Pacifica Dev. Carp. Project Address Builder Name Dave (909) 841-1942 3-R 'Builder Contact Telephone Plan Number ` Tim Topham (951) 780-7265 1 , HERS Rater Telephone Sample Group Number �`--" ' =—/2005. 8 Svs.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: ❑ 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. comply with the diagnostic tested compliance requirements as checked on this form. 0 The installer has provided a copy of CF-6R ( Installation Certificate) ❑ Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform R, returns in lieu of ducts) - ❑ Where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands ar used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. ,. / MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLL,NCE CREDIT , Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) 'Measured w Duct Pressurization Test Results (CFM @ 25 Pa) values - Test Leakage Flow in CFM i If fan flow is calculated as 400cfin/ton'x number of tons enter calculated value here1000 If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow = Check Box for Pass or Fail (Pass=6% or less) ❑ ❑ Pass Fail ❑X THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent ❑ Yes ❑. No Thermostatic Expansion Valve (or Commission approved equivalent) is installed and Access is provided for inspection ❑ ❑ Yes is a pass Pass Fail Y_ . January 5, 2001 ; - r CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part 1) CF -4R THE LAURELS 2 ' X05 Project Title Date 55095 Winged Foot, La Ouinta, CA. First Pacifica Dev. Carp. Project Address Builder Name Dave (909) 841-1942 3-R Builder Contact Telephone Plan Number Tim Topham (951) 780-7265 1 HERS Rater Telephone Sample Group Number /2005 8 Sys. 2 Trac( 29121 Certifying Signatur Date Sample House Numter ` Firm: Energy Calc Services, Inc HERS Provider: CHEERS Street Address: 16551 Mockingbird Cyn. Rd. City/State/Zip: Riverside, CA 93504-9638 Copies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: ❑ Tested ® Approved as part of sample testing, but was rot tested - As the HERS rater providing diagnostic testing and field verification, I certify that the houses Identified on this form comply with the diagnostic tested compliance requirements as checked on this form. ❑X The installer has provided a copy of CF -6R ( Installation Certificate) ❑ Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts) Where clothbacked, 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. : D -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 ' -If fan flow is calculated as 400cfm/ton x number of tons enter t calculated value here 1600 F If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow= Check Box for Pass or Fail (Pass=6% or less) ❑ Pass Fail ❑X THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent ❑ Yes ❑ No Thermostatic Expansion Valve (or Commission approved equivalent) is!installed and Access is provided for inspection ❑ ❑ Yes is a pass Pass Fail F. January 5, 2001 f , Dep 16 04 11t46a Energy Calo Servioes Inc. 780°-0558 — P.3 o5 S W L^'`5 INSTALLATIOV.CERT,IFICATE Site AdOCK11 Vertuit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS Wil:` 1: 1)1�("t' 0,l;AKAG1; 1<I{I)ti(-1'I(1N ProsruMAIIOn Test Resufts (CIM 0 2b PA) l "I l Awk.a1w (C l: 1A), I',m 1'111u .. . I t Fan Flow IE Caloul,ilod as do0 choon x n'Umbor of tons, at or. 21.7.x Hoatirg Cv"pocily in Thousands of Stun(, actor calculatod vacuo hornIf fan flow is measured, eater measured Value.here leakage Frat;tlon Test Leakaoe/(Measured or Calculated Fan Flow) b Pass if loakage fraction -/- 0-06 �� ❑ P; g Feil X1:1:: 11111("1't,KAKA( F,JACM1('1'ION mx- !tion Test ROsulls (CFU raQ 25 PA) •tux! i'xa6a;tc ((_'I�.'vl) - Fan Fknv n Fan Flow is Calculatod ac 400 cfm/tcn x numbn-r of tons, or as 21.7 x Hootmq Capncity, 1�1 m' ThOasandx Of Btu/hr, entor raloulatrd valur. hero 1 If fan flow is measured, enter measured value hero Leakage Fraction n Test Leak.agei Measured or Calculated Fon Flow) r ❑ Paas if loakngo friction • /• 0.06" _ Parti Fail For AEROSOL TYPE SEA1ANTS ONI -•'rho following diagnostic tosting was eomplofod: Duct Fan Pressurization of rougn-in moacurod Ieaxago (CFM) CHECK AFTER FINISHING WALL: Yos ❑ No 0 Pfossuro Pon Lost or Houco pmocun¢ation tort Yes ❑ No ❑ Visual Inspection of Duct Connoctiuns ❑ , _.. Vail 1\..XWEXPANSION VALVE Yqs ❑ No. Thomtostatic Expansion Valve is mstallnd and Accagy is providod for Innpm ton YQ+ is rr paws iI Ini<'f 11F;NIt:N \ Y&S. ❑ No ACCA Manumf b Design calcu%ttlons have been cornplutod Duct Dowon w on tho plana and duct car fallabon matches plans. 7 YOF. 0 No TXV is inrtUllod or Fan flow h;iy boon vonfioA. It no TXV, 'Ord -d fill flow matches dewgr. from CF -1R Measured Fan Flow = J Yos for Doth 1 and 2 is a Pass I -al' °t tpt 11 tho unoerstgnaa, var�fy that the abavo dragnost4 cast n+auiw and the work l performed associated ,with the tests) iso con mons, with tho reotutoenonts for comphanai crodd. (fho buildor nhau proV40 Ino HERS providor tj copy, of tho (;F -6R ;.OrWo by Me builder employ000 Of, bub-C011iVoctoru C(:ndy;ng that tasting and installation mrxii tht wQuu(emnnt:: for compliance crodit.); frhto Signature. Data Installing Subcontractor (co. Name) OR Porfofmod General Contractor (Co. Name) COPY T0: Buddlnq 0opartmant HERS Nrovldur.d apptu'ablu) . building Owner at Occupgncy Comphanco Forms ' :�npa mbc!r 2W2, q "!j F JSTALL'ATION CERTIFICATE. (PAGE 1 OF 8) Laurels pl..3 SITE ADDRESS PERMIT NUMBER AN INSTALLATION CERTIFICATE IS REQUIRED TO BE POSTED AT THE BUILDING SITE OR MADE AVAILABLE 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 HEATING HEATING EQUIP NAME IDENTICAL (AFAU ETC.) LOCATION PIPING OAD CAPACITY TYPE AND SYSTEMS CF -1R VALUES (ATTIC ETC.) (R-VALUE)-,BTU/HR) (BTU/HR) HEAT PUMP ' . MODEL # . FAU CARRIER 58STX070112 1 80% ATTIC 4.2 87K 70K FAU CARRIER 58STX090116 ' 1 80% ATTIC 4.2, 112K 90K ` COOLING EQUIPMENT EQUIP CEC CERTIFIED COMPRESSOR # OF EFFICIENCY DUCT, DUCT COOLING ' COOLING TYPE PKG • 'UNIT MFG NAME AND ` IDENTICAL (SEER ETC.) LOCATION R VALUE LOAF• CAPACITY 1-117, AT PUMP MODEL NUMBER SYSTEMS (CF -IR VALUE) (ATTIC) (BTU/HR) (BTU/HR) ' + A/C CARRIER 38HDC0303 1 12 SEER ATTIC 4.2 30K 29.2K A/C CARRIER 38HDC1483 1 12 SEER ATTIC 4.2 48K 47.7 K 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. WILLIAMS HEATING CO. SIGNATURE, DATE INSTALLING SUBCONTRACTOR (CO NAME OR GENERAL CONTRACTOR (CO NAME) OR OWNER THERMOSTATIC EXPANSION VALVE (TXT) YES THERMOSTATIC EXPANSION VALVE (OR COMMISSION APPROVED EQUIVALENT) IS INSTALLED AND ACCESS IS PROVIDED FOR INSPECTION. CJ YES ISA PASS / PASS" -FAIL COPY TO: BUILDING DEPARTMENT HERS PROVIDER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Western tion L.p, RESIDENTIAL CONTRACTING 4211 Latham Street • Riverside, California 92501 • Phone: (909) 686.8760 • Fax: (909):686.8786 License # 794484 CF611 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:' ' TRACT/PHASE: THE LAURELS/ PHASE 1 LOT . 8 ' SITE ADDRESS: 55.095 WINGED FOOT — LA QUINTA, CA y C LEI INGS: BATTS , MANUFACTURER: JOHNS MANVILLE THICKNESS: 13" - R- VALUE: R-38 " CEILINGS. BLOWN INSULATION MANUFACTURER: GREENFIBER THICKNESS: 8.1° R- VALUE: R-30 CEILINGS: BATTS MANUFACTURER: KNAUF THICKNESS: 11r R- VALUE: R-30 CEILINGS: BATTS MANUFACTURER: KNAUF THICKNESS: 6'/z R VALUE: R-19 ExTERIOR WALLS: BATTS MANUFACTURER: KNAUF THICKNESS: 3W' R- VALUE: R-13 INTERIOR WALLS: 13ATTS MANUFACTURER. KNAUF THICKNESS: 3 W R - VALUE. R-11 GENERAL CONT THE BREHM COMPANIES BY: TITLE: DATE: INSUL&TION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE N BER: 794464 BY: TITLE: PRTPLICTION MANAGER DATE: JANUARY 11, 2005. bi/b0 3Jdd NOIviiISNI Nd31S3M 9BL89B9196 L9:80 900Z/L1/10 r u� I�� QAC �°.� —... {• � - _ rr (j'�- - tt Cert�f cate o,f Occppany� 4 Iva ' } �' c,� x. ; �; ".t . •':� ;s �`' t . '" �: (i ^ .. CCC�V� oF. ��F BOW E &-S O "t`• Department 9► Y Y:. r. -.. `. � � - - 'p � X - - n � - , r � Ste• � -1 , This ;Certificate. is issued pursuant t&lhe requirements of Section,109 of the .California Building ` :certifying that, atk, the time '. of issuance,,, this structure was in. 'compliance. with, the k5'provisions �,of the, Buildir►g Code and the wear ous ordinances of City�`regulatincr building .the construction use. -and/or c �•�' '� - `BUILDING ADDRESS: °55=095 55'095 -WINGED, V 41 yf Use `cla`ssification: SINGLE_ FAMILY_ DWELLING- =;. ' �' � Bu ldiAg permit No., 0,306-445,,' Occupancy Group..R-3 i' Type.of Construction: V -N �� ' - :" Land Use Zone; RL �4� yGENERALBANK=��<�� 4�. �OwnerofBuildin Address: 1420 E.:VALLEY BLVDT. . City, ST, ZIP: ALHAMBRA, CA�91801 �� By: GARY HARTMAN r Date: March: 9, 2005.1 _ 77 7- . �-Building Official J -._ ' `�. n -,�- , �� �•' ..'}• �' . ,� [ - aft... ' ; � v 5 � { �, POST IN .A CONSPICUOUS PLACE � ..oma ... ...