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0403-223 (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 #f 41 pLiicW.91103 y c. Class Exp. Datte9 / rry '176 Date`' Z4/" --PV Signature of Contractor,��" �✓ `f 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. (!Ix> I have and will maintain workers' compensation insurance, as required by Soction 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 AA6.3GA?I �:A,aJiL Policy No. F'E'.1a3115d (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 tl oselprovvJsion's. Date: ��' �p ��'� 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 i80-'„0ays 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. ,,Signature (Owner/Agent) i�� f;` �'� Date BUILDING PERMIT :.:EMIT# (M03-223 DATE VALUATION LOT TRACT 52 JOB SITE APN ADDRESS 7,+g ; Ps1�iFCvr}��T l /�09•�c* 604—`�i 37-0 OWNER CONTRACTOR / DESIGNER / ENGINEER LIa�C�.t R (_10MMM'1` ES UNNAR IJW 24800 CIMMADKI E, 91200 24 809, CFI.hIURTA IMVY, H200 M�b�.+•AOJty ♦. EJO CA. 92691 h: -412210N VTEJO Cfi, 92691 . (949)5,3- 5CO C':��:i`P 3434 USE OF PERMIT SIrO, IDT 3d P.I„&N ,3YA. �ZRMIT DOM INVII INCGUM'u' 6;_nCXr_'WA.1 L, P001,, SPA. OR, f_” �,RFtMbTliY APPRO.&tIR TILAC>`T ir4i' STRUC: IP -14- %394AKf BIS , 0ARA ?W,ARPORT 4X09 SF EvrWAIRD COST OF CONSYRIS(MON 16016a160 PIERMIT11.2 SUMMARY CO),40TRUCTIO?b �Eg 1131.«0: 0-x# 18«0{30 SVOLOD 4'J14 CREC Ii)1-C)uu-d _ ?Ili !'722,56 ME04)EiANICALRv 301-000«421.000 560.00 ELECTRICAL MER 101-£200-420-000 $1411 �I,T7It�I�fAi� 1�'EZ+ T�'J1P00!f�4•I4�0t36 34b%.�� ;TRd3'90 MOTIOM ISE _ RESID 101-000 -241-000 `a.ts.I?ft ORAD ING IRS >E.7EL6.�;PEIt ;rg!�.t0 f+'1?E -SY�-y TOTAL CC3MYRi. OTIC?R A14D PLAY K $4,41 0.9S ^_ ` I tt 1a *'S4? :I<tia3 _ gip, t347 _ OR 0 CITY OF LA (?uvj iTA FINANCE DEP- RECEIPT DATE BY / DATE FINALED Ae - 7—� INSPECTOR OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs _ Forms &Footings '' Underground Ducts Ducts � _ Slab Grade Return Air SteelCombustion 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 Wali Insulation Condensate Lines Party Wall Firewall Exterior Lath 177 evzl Drywall - Int. Lath Final Final m BLOCKWALL APPROVALS steel POOLS - SPAS 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 Heater Final Water Piping—� Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection .p Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fbdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: Y ENERGY P0. Box 621 Ph/Fax (760)564-2044 Rancho Mirage, CA 92270 Cell: (760) 250-1852 Email: DESNRG (&AOL.COM ' ,n CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSeTIC TESTING (Page I of 7) CF -4R LA QUINTA DEL ORO 09 30 44 Date Project Title � ; iNnin CA 1 ENNAR HOMES fRED WARIN�= �'� INION ST, 'Project Address Builder Name NACHO CASTENADA 760-078-6968 PLAN 3-Y 2 UNITS Builder Contact Telephone Plan Number � ALAN WEAVER 760-880-5504 GROUP 1 HERS ter Telephone Sample Group Number, #CCNAW183226 09-29-04 52-2 1 OF 2 Certifying Signature. Date Sample Lot Number Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS Cit /State/Zi RANCHO MIRAGE, CA. 92270 Street Address: P.O. BOX 621 y P - - ?8`HGo JA PA dtoiJ _ Copies to: Builder, HERS. Provider -- -- . HERS RATER COMPLIANCE STATEMENT ; The house was: ®Tested ❑ Approved as part of sample testing but was not tested g and field verification, I certify that the houses identified on this form comply As the HERS rater providingdiagnostictestiO with the diagnostic tested compliance requirements as checked on this form. 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 cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. ® MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured values Duct Pressurization Test Results (CFM @ 25 Pa) Test Leakage Flow in CFM, 83 a If fan flow is calculated as 400cfmlton x,number of tons enter caluel here 1400 If fan flow is measured enter measured value here r , Leakage Percentage (100 x Test Leakage/Fan Flow) = 5.928_ Check Box for Pass or Fail (Pass=6% or less) pass Fail ® THERMOSTATIC EXPANSION VALVE (TXV) Thermostatic Expansion Valve is installed and Access is Yes El No a j provided for inspection ® _ IBSOft ENE Y , RG ��' -- CADEC . , SC" P0. Box 621 Ph/Fax (760) 564-2044 Rancho Mirage, CA 92270 Cell: (7601250-1852 Email: DESNRG OAOL.COM CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R 11119-30 D4 LA QUI NTA DEL ORO Date Project Title . o unMCc FRE- -= - -= — CA Builder Name Project Address 760-578-6968 PLAN 3-Y 2 UNITS NACHO CASTENADA Telephone Plan, Number Builder Contact 760-880-5504 ALAN WEAVER GROUP. 1 Telephone Sample Group Number HERS ter 2 OF 2 DI— JA�. � #CCNAW183226 09-29-04 52-2 Certifying Signature Firm: DESERT ENERGY SERVICES LLC Street Address:. P.O. BOX 621 P 'der Date Sample Lot Number HERS Provider: CHEERS City/State/Zip: RANCHO MIRAGE, CA. 92270 Copies to: Builder, HERS - rove 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. ® 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) ct tape is installed, mastic and drawbands are used in combination with cloth ® Where cloth backed, rubber adhesive du backed, rubber adhesive duct tape to seal leaks at duct connections. ® 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) Test Leakage Flow in CFM If fan flow is calculated as 400cfm/ton x number of tons enter calcuated value l here 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) ® THERMOSTATIC EXPANSION VALVE (TXV) values 94- 1600 5.875 Pass Fail , ® Yes [],No Thermostatic Expansion Valve is installed and Access is iEl provided for inspection INSULATION LoPs, 4•)1 1 Latham Strcat, Riverside, California 92501 Tcl. (951) 686-8760 Fax (951) 686-8786 CF6R I1ySULATION CERTIFICATE THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORNIANCE WITH E ' THE CURRENT ENERGY REGULATION, CAUFORNIAADMINISTRATIVE CODE, TITLE 24, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: TRACT/PHASE: LA QUINTA DEL ORO I PHASE 2 - LOT 52 , SITE ADDRESS: 78-400 VIA PAVION - LA QUINTA, CA CEILINGS 0. PLANS 2 & 4: BLOWN INSULATION MANUFACTURER: GREENFIBER THICKNESS: 10.3" '•R- VALUE: R-38 CrtILIN23N PLANg 2 $► 4: BATTS MANUFACTURER: JOHNS MANVILLE THICKNESS: 131, R- VALUE: R-38 CEILINGS: BLOWN INSULATION . MANUFACTURER: GREENFIBER THICKNESS: R- VALUE: R-30 SUM& BATTS MANUFACTURER: JOHNS MANVILLE THICKNESS' 11" R- VALUE: R-:10 EXTERIOR WALLS: BATTS MANUFACTURER: KNAUF THICKNESS: 3 1112 R- VALUE: R.-13_ r GENERAL CONTRACTOR: LENNAR HOMES BY: r TITLE: DATE: . lNSULT' ®N CQ TRACTOR. WESTERN INSULATION, L.P. LICENSE NUcw BY: TITLE: PRODUqOtl MINAGER DATE. SEPTE R 30, 004