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0305-443 (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 +#/ !y�}}� y/J L�ic. Class Exp. Date r 7 Dated�' ) ` ti Signature of ContractorZ' 10, r 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 's l .$ .ixy Policy No. 46-03•$,03 (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 complywith those provisions. Date: t ';'_ f.. > '' Applicant.' A`iVarning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. y IMPORTANT Application,is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to/en.,ter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent-) Date BUILDING PERMIT PERM'ih; DATE VALUATION r{.IiJ� l .?J LOT 6 TRACT 2912 i JOB SITE4y�1fr, i� ADDRESS APN .}7W,.$`tC1 fSiyfi OWNER CONTRACTOR/DESIGNER/EN &NEER Cf..91i 2 Psi. 43A,b3 1C� �� i� � ��.� t� � �t3• !';:6+T�( a �>i Z.U) +. 1420 F. VALLE Y f-MRITS AVPMR C.A 9161C) t wU%,k?RDS CA 9231i3 (9o) -19"a -36n CEL,O 491J, 7 USE OF PERMIT WrJ NteC.yA j3 ..61.Y'd.M1. i'i:,iClN*'t3 ld7l.:F 'i 1A :i 1iV6:i., 3.1v L'�D�4�1.YaYiL.Lizi P00,14 40A OR T)F11' t 'V4AY 6APP) ,'%CK SP POFCK,T'aoiIBJ it10 ? 0A AV IF" '; P$,) RT NY 2SSt,t !WED COST 0F C:C;iWSM13C°E=X 20C,6,1,3. 70 C{<'0,61RUCT1014 '`s r' , i3}. •�1i�U• l £t•C)C)() G3.Ur� 111LAH CHVCK P r," 1(} i _001.x-0139-318 HKIIAWKUAL FFV, 101-(M.42' I -MY) s t W00 L3,9 ;TRICAI.. FFM 1.01-(100 412;0.000 $147,JD . 1a �>C� t�913ti�0 F+�.T: ? t14 � UO(1R4I �• �O© �) :"�- 3 "lFt.i*'QP,O'TiO)4'.11;F, RIxMID :t1g•.C)0f1-a�?1-C)Q�J ar.or> (AI).t 40 .ART 10 PUBLIC; Na�,.P,' ';t, } 37K 17(;-00G-445 -000 FEW 131Q$f_XNI e 101 E! 4.,.,7X01) " ', ICd LJ" f�': w tRf.a . .9JV �7. LS}JL L 41a11P ti'.M i"d.rAN OTIECUR T01 Ar" P1472,W111 AAv�pE..a' IU .0 M. RUW $4,164,39 2y RECEIPT DATE BY DATE F /SAL INSPECT�q. %f Ab/ 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 Roof Deck 3 —/ 6 •aC/ Exhaust Fans O.K to Wrap F.A.U. Framing p Compressor Insulation o Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Z 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 Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Water Piping Heater Final 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 ZZ -Z—lAfl Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels 1' Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: _ aPrI-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 ` ❑ REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE O ASPHALT "❑ OTHER ❑ REINFORCED MASONRY. ❑ FIRE PROOFING JOB LOCA ION �� rr ` ` REPORT SEQUENCE NO. T PE OF STRUCTURE PERMIT N0. DATE DAY OF WEEK M RIAL DESCRIPTION 1 ARCHITECT INSF . ICTOP HRS. CHARGED r ENGINEER A556TANT5 r`HRSrCHARGEO INSPECTION DATE GENERAL SUB 'CONTRACTOR L c f � CONTRACTOR al - - - 8 `` A t if tve.��, E -N -- \ f�QcS�f r f'�a• �lsLI:� t'A.r nc&AWt CSL — r'® r` m L COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE -BEST OF MY 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. Cn� �- SIGNAT E OF AEGISTERib IINSSPECTOOR�"] V SCJ L ` l ATE OF REPORT REGISTER NUMBER I • u CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part 1) CF41t ; THE LAURELS r _ Z • -05 - Project Title Date ' 55151 Winged Foot, La Quinta, CA. First Pacifica Dev. Ccrp. Project Address Builder Name Wally Alps (760)578-4083 3-S Builder Contact Telephone Plan Number Tim Topham (951) 780-7265 1 HERS Rater Telephone Sample Group Number - / Z /2005 • 6 Sys.�< 1 Trac: 29121 CertifyKg Signature Date Sample House Number ` Firm: Energy Calc Services, Inc - HERS Provider: CHEERS -Street Address: 16551 Mockingbird Cyn. Rd. City/StatefZip: Riverside, CA 92504-9638 Copies to:. Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: ❑' Tested J0 Approved as part of sample testing, but was n -3t tested a -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) 4 ❑ 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 arr used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. D MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION, COMPLLkNCE 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' ' calculated value here,. `1000 ". 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'eouivalent ❑, 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 o? 7-• -05 Project Title Date 55151 Winged Foot, La Ouinta, CA. First Pacifica Dev. Ccrp. Project Address Builder Name a ' Dave (909) 841-1942 3=S Builder Contact Telephone' Plan Number Tim Topham (951) 780-7265 1 HERS Rater / Telephone Sample Group Number - /2005 6 Sys..ZTrack 29121 Certifying Signature Date Sample House Number - Firm: Enemy Calc Services, Inc HERS Provider: CHEERS Street Address: 16551 Mockingbird Cyn. Rd.- City/StatefZip: 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 n.')t 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) H ❑ Distribution system is fully ducted (i.e., does not use building cavities as plenums or"platform returns in lieu of ducts) ❑ R 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. - ' 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 r' Y - Test Leakage Flow in CFM - If fan flow is calculated as 400cfin/ton x number of tons enter calculated value here 400 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 0 THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent :- ❑ Yes ❑ No Thermostatic Expansion Valve (or Commission approves ` equivalent) is installed and Access is provided for inspec-ion ❑ ❑ Yes is a pass Pass Fail January 5, 2001 Deo 16.04 11t46a ' EnerCy Calo Servioes .Ino. 780-0558 p p,3 5� I S � - W �-'nS•2G , 'C'Ot�'� a• Lc\oaIC. L��p INSTALLATIOV.CERTJFICATE . ... �.' U•u&c3ur1)) C:a-GR." Site Addrena e r - . 1',•rmit Nurinc�i. � •. DUCT LEAKAGE AND DESIGN DIAGNOSTICS . 4 M--S 1: Dtl("1` I,►;ADAC&: Itl%Dll('l•IpN surrzalion Test Results (CFM list 27 PA} ' • _ Fan FptH• , I Fan Flow IL- C ACVl;ttod os 400 OWton x numbor of tons, or or. 2 1. 7 x HooOrxj Capacity = in Thousands of Btu/hr, or+tor calculntod vacuo horo If fon flow Is measured, enter measured Value: here t leakage Fraction - Test leakaoti/(Measured or Calculated Fan Flow) b r Pass If Ioakage fraction -/• 0_lki ` ❑ ,} � • .. 'Pais Furl - t ,1:S«: 1111("1'I RAKACV 1R1•;DU<'1'1ON >zsyrrrjttion Tost,Rosults (CFU rtQ 25 VA) 1 l A i.�:akagc (C'F..M) ' Fan How 11 For, Flow is Calculalod of; 400 cfm/ten x numbor of tons, or as 21.7 x Hontmp Capneity + In' Th"saeos of Stu/hr, entor o:rlculatod valur. ht rca If fan flow is measured, enter measured value horo •I. ' Leakage Fraction a Test leak.a9e/(Measured or Calculated Fan Flow) r o _ Ionkago 1faLh0A �•/-. O.AIi Pati Frill r For .,111-:1401%ol, '11.1'1•: SKAI,ANTS (rYt,Y •• Tho followingdlaQnoetie tasting was complotytl: Duct Fan Pressueizatlon of rough-in me�cunoa leaxago (017M) ' CHECK AFTER FINISHING WAIL: Yos ❑ No ❑ Prossuro pan toot or Hou5c proosuniahon tort Yes ❑ No ❑ Vistiol Inspection of Duct Connections ❑ :., Pas Vail IIt'RMOSTATIC ENPANSION VAI-Vt.: f1'\v1 Yqs ❑ No. Thormostatic Expansion Valve is mstAlIM and Acu,rxis f ; provrdod for rnapoclion r ' . YON is ra p:,ata - , Fall - IJ tr(_:i gF:11l:N Yos. ❑ No ACCA hlanuaal O Design calcuNtlons have been _ ccrnplutod Duct Dualgn w on tho plana and duct InnWIlauon t matches pWns, . Yor. ❑ No TXV'Is lnrt;dlod or Fan flow No* boon vorifigd, If no TXV, ` vordKad far" flow matches desigr. from CF-IR < ` Measured Fan Flow Yes for both 1 and 2 it; Pass I; the unoero�Qn4d. vartfy that Ih& above dtagnOatrG fast results and lfiaa work 112ertOtmed assoclated with thy tests) is .n e AnOrmonco with tho.rogvaroenonto for a mpllanoj crodd. (Tho buildw •shall MOW trio KERS prOvidor o cop- of fhn C F-riF s-flnoo by Ina, oulaer omploy000 M Dub-eouvactort; mnrtymg that dlagnostie costing and Inwtan:stior. nitx)i the vauimmolnl : for compliance crodil.) + a x Tonto . Signotueo. Data Installing Subcontractor (co. Namc) OR , Porformod Ceneral Contractor (Co. Name) COPY T0: Building Dopadmont - HERS Nrov(dut in app:iwblu) Suilding Owner at Occupancy � Co?nphanc0 Forms, :xapu mgt 1200? .« w' A?i. r _ _ o a — �� `� Lo Laurels pl..3 INSTALLATION CERTIFICATE (PAGE 1 OF 8) CF -6R 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 INI FORMATION IS OPTIONAL.) AFTER COMPLETION OF FINAL INSPECTION, A COPY MUST BE PROVIDED TO THE BUILDING DI;PARTMENT.(UPON REQUEST) AND THE BUILDING OWNER AT OCCUPANCY, PER SECTION 10-103(b). HVAC SYSTEMS: HF..ATING EQUIPMENT CEC CERTIFIED MFG. #OF _ EFFICIENCY DUCT DUCT OR HEATING HEATING EQUIP NAME IDENTICAL ` (AFAU ETC.) LOCATION PIPING, LOAD CAPACITY TYPE , _ AND SYSTEMS CF -IR VALUES (ATTIC ETC.) (R -VALUE) IBTU/HR) (BTU/HR) HEAT PUMP MODEL # FAU CARRIER 58STX070112 1 80% ATTIC 4.2, 87K 70K FAU CARRIER 58STX090116 1 80% ATTIC 4.2 12K 90K COOLING EQUIPMENT EQUIP CEC CERTIFIED COMPRESSOR # OF EFFICIENCY DUCT DUCT COOLING COOLING TYPE PKG UNIT MFG NAME AND IDENTICAL- (SEER ETC.) LOCATION RVALUE LOAD CAPACITY HEAT PUMP MODELNUMBER 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 38HDC 1483 1 12 SEER' "ATTIC 4.2 48K . 47.7 K I, THE UNDERSIGNED, VERIFY THAT EQUIPMENT LISTED ABOVE IS (1) IS THE ACTUAL EQUIP M- ENT INSTALLED (2) EQUIVALENT TO OR MORE EFFICIENT THAN THAT SPECIFIED IN THE CERTIFICATE OF COMPLIANCE FORM (CF -I R) 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. I':.\RT 6), WHERE APPLICABLE. I WILLIAMS HEATING CO.' S 1 GNATURE,'Dkff 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. ❑ NO / YES IS A PASS PAS) FAIL COPY TO: BUILDING DEPARTMENT H ERS PROVIDER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY . Wester tion 16. P. RESIDENTIAL. QNTRAQTING 421 t Latham Street • Riverside,. California 92501 • Phone: (909) 696-8760 •fax: (909) 686.8786 License 11794.484 ` CF6R 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:. TRACTIPHASE: THE LAURELSI PHASE 1 LOT. 6 SITE ADDRESS: 666-151 WINGED FOOT — LA QUINTA, CA CE LI INGI! BATTS MANUFACTURER: JOHNS MANVILLE THICKNESS: ` 13" R- VALUE: R-38 CEILINGS, BLOWN INSULATION MANUFACTURER: GREENFISER THICKNESS: 8.1" R- VALUE: R•30 CEILINGS: BATTS MANUFACTURER: KNAUF THICKNESS: 10" R- VALUE: R-30 EC ILING-% BATTS MANUFACTURER: KNAUF _ THICKNESS: 6'/." R- VALUE: R-19 • EXTERIOR WALLS: BATTS ' MANUFACTURER: KNAUF' ' THICKNESS: 3 Y? R- VALUE: R-13 , INTERIOR WALLS: BATTS { MANUFACTURER: KNAUF THICKNESS: 3 W' R —VALUE: R-11 GENERAL CONTRACTOR: THE BREHM COMPANIES BY: TITLE: DATE - INSULATION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE NUMBER: 794484 BY.00� .TITLE: F PR DUCTION MANAGER DATE: JANUARY 11, 2005 UT/Z0 39dd N0I v-lnSNI N831S311 ' 9BL8989196 L5:89 5092/LZlLO °r 4