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0403-224 (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. r License # ! P�p Liic.. Class Exp. Date t 103 Date L Signature of Contractor /`; j�!! /7 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 pfoperty, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). I ' O 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 wbrkers''compensation insurance carrier & policy no. are: Carrier AM I{4II>:a#3.1 C� kSL"a:�.'j, Policy No. 1C.i3 20l1,3a 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,' e 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 thgse provisions. Date: Ll. /i• .!/ri Applicant -A-'// I✓� /( /I �� Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT ,Application is hereby. made to the Director of Building and Safety for a permit subject to the conitions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as ;a result of this applicator agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building �. construction, and hereby authorize representatives of this City to enter upon. the above-mentioned property for inspection purposes. Signature (Owner/Agent)eff1Z- -Z Date BUILDING PERMIT PERMIT# DATE VALUATION y LOT TRACT53 305 JOB SITE APN ADDRESS OWNER CONTRACTOR/DESIGNER/EN (NEER :UNNAR COAMA`tIN`EV E8 !4&00 CI3WM.NTA DR1VE— #_Z0Q 24800 CWJ WAKrA'DPX 1 #$tai? "`'.10,13 VIVO CA 926 i ?I+a`t�BXCiAi V.WJQ fi' A "a x,69 ) .(949)598-6500 C21411 2 .34, USE OF PERMIT SM, LOT 53 PLAN I y aa, PEPU%ll r noon tour fIdLlyiflrix trl ,o -.X— <'hLL, P001, SPA OR DRIVEWAY APPROACH. TRACT COMIN:€ RUCTION '4640-00 PMCHPATIO 499.00 3F 0ARACK!MPORT 462.00 SP 39 J139740 OCYN3TRUC TRYIN FEER FLAIR CHECK F61? 1. t11 ••Gs'3C��3`3- � � �° b'!'�3.°� '. t>t FICIIl LAICAL FGA 'I Oil -00 0-421 ate ID ELF,CTRI=, "a,17, 101-000-420-000 �I'PON0 fV OT 1014 FE RM3D GRADINO RE 101-O�0-423-000 $13.00 l3Lt'VZ1,0PZRIMPACT FEE �7.�IOS.QO ' �31,F�= PC3TA�t.,'2't'3�1�'i:` �1'C'A'�iO�I lti'� I+°°1�,t�►Afi C��t..C�' �3;�;��?.?�i APR 0 6 25d� ��,l Cb 7! OF LA L-iWNTA FINA^`CE DEPT. RECEIPT DATE// BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE TINSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts _ Forms & Footings '� _ _ Ducts Slab Grade _ Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap oo F.A.U. Framing �_ Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 6 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath _ chi Final Final 66 — - 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 APPROVALS Gas Test Electric Final Waste Lines Water Piping � � Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans OX for Finish Plaster Sewer Lateral Pool Cover Sewer Connection , a _ p f7 Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit,_ Rough Wiring S Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) INSULATION, 4211 Ladiwn Strcct, Mverside, California 92501 Tel. (951) 686-8760 Fax (95 1) 686-8786 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: TRACT/PHASE-. LA QUINTA DEL ORO / PHASE 2 LOT '53 SITE ADDRESS. 78-390 VIS. PAVION LA QUINTA, CA ----------------------- ---- ---•---------- 1 GEIUN2§ J2 !PL NS 2 & 4: BLOWN INSULATION MANUFACTURER: GREENFIBER THICKNESS: 10.3° R- VALUE: R=38 CEILINGS PLANS 2 & 4:. 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: JO' -!NS MANVILLE THICKNESS: 11" R- VALUE: R-30, EXTERIOR WALLS: BATTS MANUFACTURER: KNALIF THICKNESS. 3 1/2 R- VALUE: R-":3 GNERAL CONTRACTOR: LEiVNAR HbMES BY: TITLE: -- DATE: t INSULAMN Cg RACTR: WESTERN INSULATION, L,P. LICENSE quAAB BY - TITLE: PRODU N MANAj GER DATE: SEPTEMSER 30, 2004 D = = ENERGY w S"C" P0. Box 621 Ph/Fax (760) 564-2044 Rancho Mirage, CA 92270 Cel(: (760] 250-1852 Email: DESNRG na AOL.COM CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I,of 7) - • CF -4R LA QUINTA DEL ORO 09-130 D4 Date Project Title LIE 4NAR HOJAES FRED WAR INC 8 rl INTON $T, INDIA CA Builder Name Project Address 2 UNITS NACHO CASTENADA 760-578-6968 PLAN I=Y Builder Contact Telephone Plan Number ALAN WEAVER 760-880-5504 ' GROUP 1 HERS Rater - Telephone Sample Group Number #CCNAW183226 09-29-04 53-2 1 OF 2 Certifying Signature Date Sample Lot Number Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS Street Address: P.O. BOX 621 City/State/Zip: RANCHO MIRAGE, CA. 92270 ?8-;39o��a° PtiJcoa� Copies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT il ` The house was: ® Tested ❑ Approved as part of sample testing but was not tested 1 s 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) ® 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 DiagnosticLeakage Testing Results (Maximum 6% Duct Leakage) Measured - Duct Pressurization Test Results (CFM 25 Pa) values Test Leakage Flow in CFM 79, If fan flow is calculated as 4006fm/ton x number of tons enter calculated `value here 1400 ' If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) = 5.642 ® ❑ Check Box for Pass or Fail (Pass 6% or less) { pass Fail ® THERMOSTATIC EXPANSION VALVE (TXV) ® Yes ❑ No Thermostatic Expansion Valve is installed "and Access is ® El provided for inspection ` D= ENERGY S,, - o E em — 4 PO: Box 621 Ph/Fax (760) 564-2044 Rancho Mirage, CA 92270 Cell: (760] 250-1852 . Email: DESNRG OIAOL.COM CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I iof 7) CF -4R LA QUINTA DEL ORO Date Project Title LE 4NA HnMES• . FRED WARIN `'� 'urnt►r c r wnIID CA Builder Name ' Project Address 760-578-6968 PLAN 1-Y 2.UNITS NACHO CASTENADA Telephone Plan Number Builder Contact 760-880-5504GROUP 1 — ALAN WEAVER Telephone Sample Group.Number HERS #CCNAW183226 09-29-04 53-2 ~ 2 OF 2 > Date Sample Lot Number. certifying Signature CHEERS Firm: DESERT ENERGY SERVICES LLC HERS Provider: City'/State/Zip: RANCHO MIR AGE, CA. 92270 Street Address: P.O. BOX 621 ; 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 testin a field vera is checked on this form that the houses identified on this form comply` with the diagnostic, tested compliance req ® 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) ®installed, mastic and drawbands are used in combination with cloth Where cloth backed, rubber adhesive duct tape is backed, rubber adhesive duct tape to seal leaks at duct connections. ® MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCECREDIT Duct Diagnostic -Leakage Testing Results (Maximum 6% Duct Leakage) Measured values Duct Pressurization Test Results (CFM.@ 25 Pa) Test Leakage Flow in CFM 461 If fan flow is calculated as 400cfm/ton x number of tons enter calculated 1000 value here If fan flow is measured enter measured value here • • Leakage Percentage (100 x Test Leakage/Fan Flow) CoEl + ❑ .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 provided for inspection