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0101-320 (SFD)U) H N W p � M r- LU oZ� O O F- LLIa� I) Z M LO N ON (.5 d Q Z Lo Q 0 0 J J mQU rnH It Z_ ao5 I- C) 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 787785-6 B I I130/V D te"` f Signature of Contractor 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&RC. 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 Policy No. MARION U'AA INC x'1001244102 (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 provisions. „©ate: -" Applicant— War ing: pplicant Warning: Failure to secure Workers' CompensatiorV 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 Bove -mentioned property for inspection purposes. t8ignature (Owner%Agent) Date" BUILDING PERMIT PERMIT# DATE VALUATION LOT TRACT "24.7216M 3:4 28838.2 JOB SITE APN ADDRESS , Y-2 OI. ' V� iA18LflC� ^ 7Iss2-990.02-2 OWNER CONTRACTOR / DESIGNER / EN INEER M R ap"LY110RM tc 23 G` 0 RI'S?F.�`�StxSPUP 9MIS 2 4, 523 CkMAYRATF,.P1JZA UUME, 245 WNTCRT BRACE1 CA 92,660 USE OF PERMIT ftti.,tr FMMA' DINE -ING ffiUl OF CAE., MRITIAr9C 1 3 WORT B1aA09 CA 92660 (M)`119.4915 CB I 63654 SMPLA20C VCASITA T•W:33 PFPJ'%41T DO a NOT =1=9 - 9WCMkIISA'0OUl�i�M'IWAY APPROACH, 'M.) PIAN CHPOK "I -Z R'f DL1C,'1!&'. N .VOR 1S,Qi#1,'.riP1& ISSUANCE 0? SAME PLhN TYV:?. CUSTOM +C'wNe"FRUCTION V16.00 OF POP,a: I-TVATIO 813.00 a"1r GAR.AWYC:A.RPM WIN OF "1E-1WI�.,. 006—ST4.10'COI4I►°.9:1'tti67MY V14,726m) ►E;, CONSTRUCTION' e, ' 101 -000-43 8-05M $1,427,00 FWII,N C H CYC PEE 101.000.439-w 18 02"I90 mi, C:1g ,lccAL fra 101.000.421-000 $1:24100 L,=TR IC.APw FPZ 10 1 - -420-000 $203,06 :?lrUMn1140 VER 101.000.419.000 S180,r STRONG MOT1C'1d PEP, a R&SID 101-000-241-000 $32,47 0RAD1114.43FEE 101-000-423-0 00 $10,00 DE 1PLIO'M, IMPACT KIM $1,907.00 1011T 114PUBLIC* PLAMO - RE -817:'i031 000.255.000 6311,82 - --- — - '( �4 ri AS' fit i� 1 G" IZCr%d . 17 3:�.IM C7 `X $4,513. q 0 \ M MG -sari !r'i', 1 J. iuc - , ��� e "We y�� qy 9�y�7� q Qp `'r, � Iy�CY�.hrd ,l"aG..e's D�).3� NOW �6=u��e7el�l ! I JUL a 2 2001 CITY OF LA OUINTA � 't 3ECEIPT 1 I BY i I OVE FIIKLE,9 IN PECTOR .. INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE. INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings Qjl/f� Slab Grade /% �/ �f 3 Underground Ducts [� Ducts Return Air V '� Steel Roof Deck g/� Combustion Air Exhaust Fans O.K. to Wrap _ d F.A.U. /! Framing _ _ _ _ �(�� 6 Compressor / Insulation 6� 6�( Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation _ Condensate Lines Party Wall Firewall Exterior Lath Drywall -Int. lath Final 7*7 Final � - — - � _ POOLS - SPAS BLOCKYVALL 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 Waste Lines ���%d, // Electric Final _ Heater Final Water Piping 66 � �t/y a Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection _ Pool Cover 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 �—7_ G.F.I. Smoke Detectors _ �/ 1 Temp. Use of Power Final `/� Utility Notice (Perm) „JIJL.1_.2002 13:34 17602334081 MAYER ROOFING #2917 P.006i007 u Corporate Officc: Box 462990 ® 1 Phone; (760)7:37-8.888 L scondi(lu, CA 92046 i PORATE FAX: (760) 737-0350 Lirsost N 663581 WESTERN PACIFIC HOUSING LA QUINTA 760-564-7022 (FAX) Attn: JOHN,, ►o f mg on "LEGENDS Cad P.t,.A. WEST” Ph 1 LOT #33 07-11-02 Mayer Roofing, has supplied. and installed "15 11O'hagin cloaked roof vents, on lot #33 of S1-200 GOLF VIEW DRIVE, 'file vcttls have been installed pc7 manufacturers specifications. Now, Exact vent locations are detennined by.huiider. RESPECTFULLY SITBMITTED SC:O"I"I' BEECHAM OPERATIONS MANAGER Mayer Roofing, Inc. Page 1 of 1 .S.SR .(-ihrary Street ♦ Smi ['ernando, CA 91341) 193 Oruncgc. Street . Riwr ide, C_A 92502 (8 18) 839-6004 . IAX (8 19) 839-4493 (909) 732-0601 . FAX (909) 782-.0904 f•v , d �- 1 WESTERN INSULATION, L.P. 4211 Latham Street, Riverside, California 92501 Tel. (909) 686-8760 Fax (909) 686-8786 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 LEGENDS @ PGA WEST #28838-1/-2, PHASE 1 LOT #: 2033 SITE ADDRESS: 81-200 GOLF VIEW DR. LA QUINTA, CA ----------------------------------------- w WALLS: MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13 CEILINGS: BAITS BLOW MANUFACTURER: JOHNS MANVILLE THICKNESS: 11 R -VALUE: R-30 GENERAL CONTRACTOR: WESTERN PACIFIC HOUSING BY: TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE NUMBER: 794484 BY: TITLE: P DUC ON MANAGER DATE: A ARY 28, 2002 INSTALLATION CERTIFICATE (Page 3 of 13) CF -6R Site Address 1� 1too 610L;F N1 I f:—V-1 Ty— • LOT 4t-- 3S Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA)r) j Test Leakage (CFM) / Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity el 10 in Thousands of Btu/hr, enter calculated value here If fan stow is measured, enter measured value here Leakage Fraction = Test Leakage/(Meastued or Calculated Fan Flow) _ Pass if leakage fraction S 0.06 ❑ Pass Fail ❑ For AEROSOL TYPE SEALANTS ONLY - The following diagnostic testi3g was completed: Duct Fan Pressurization at rough -in measured leakage (CFM) CHECK AFTER FINISHING WALL: ❑ Yes ❑ No ❑ Pressure pan test or House pressurization test ❑ Yes ❑ No ❑ Visual Inspection of Duct Connections ❑ ❑ Pass Fail ❑ THERMOSTATIC EXPANSION VALVE (TXV) ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection ❑ ❑ Yes is a pass► Pass Fail ❑ DUCT DESIGN I • ❑ Yes ❑ No ACCA Manual D Design calculations have been completed; Duct Design is on the plans and duct installation matches plans. . 2. ❑ Yes ❑ No 'TXV is installed or Fan flow has been verified. If no TXV, verified fan flow thatches design from CF -IR. Measured Fan Flow = Yes for both 1 and 2 is a Pass Pass Fail LJ I, the undersigned, verify that the above diagnostic test results and the work 1 performed associated with the test(s) is in � _ conformance with the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF -6R signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit.] Tests gna re, DaltInstalling Subcontractor (Co. Name) OR Performed General Contractor (Co. Name) COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy Compliance Forms August 2001 A-25 INSTALLATION CERTIFICATE (Page 3 of 13) CF -6R Site Address $j 260 C_r0Z.h- V' Z>,D-' *' -: ermit Number DUC LEAKAGE AND DESIGN DIAGNOSTICS 2 7-0•1�1 10Y DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) ' Teri: Leakage (CFM)�-'g Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 z Heating Capacity in Thousands of Btu/hr, enter calculated value here I 1 g If fan flow is measuied, enter measured value here Leakage Fraction = Test Leakage/(Measured or'Calculated Fan Flow) Pass if leakage fraction <_ 0.06 ill ❑ Pass Fail ❑ For AEROSOL TYPE SEALANTS ONLY - The following diagnostic testing was completed: Duct Fan Pressurization at rough -in measured leakage (CFM) ' CHECK AFTER FINISHING WALL: ❑ Yes '❑ No ❑ Pressure pan tat or Nouse pressurization test ❑ Yes ❑ No ❑ Visual Inspection of Duct Connections ❑ ❑ Pass Fail ❑ THERN10STATIC EXPANSION VALVE (MV) ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection 1❑ J Yes is a pasv Pass Fail ❑ DUCT DESIGN 1 • ❑ Yes ❑ No ACCA Manual D Design calculations have been completed, Duct Design is on the plans and duct installation matches plans. 2• ❑ Yes ❑ No TXV is installed or Fan flow has been verified.. If no TXV, . verified fan flow matches design from CF -1R. Measured Fan Flow = ❑ ❑ Yes for both I and 2 is a Pass Pass 'Fail I, the.undersigned, verify that the above diagnostic test results and the. work I performed associated with the lest(s) is in conformance with the requirements for compliance credit. (The builder shall provide the HERS provider a copy of the CMR signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit.) Tests sure, Date Installing Subcontractor (Co. Name) OR Performed General Contractor (Co. Name) COPY TO: Building Department i HERS Provider (if applicable) Building Owner at Occupancy Compliance Forms August 2001 —A -2s . INSTALLATION CERTIFICATE (Page 3 of 13) CF -6R Site Address S \Zzo 6DL,p vIi 17Q - w7 '3 '''7."ermit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS TDN VDilCT LEAKAGE REDUCTION ` Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM) V57 Fan Flow If Fan Flow is Calculated as 400 cf Vton x number of tons, or as 21.7 x Heating Capacity in Thousands of Btu/hr, enter calculated vaiue here 1 If fan flow is measured, enter measured"value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) = Pass if leakage fraction S 0.06 - ❑ Pass Fail ❑ For AEROSOL TYPE SEALANTS ONLY - The following diagnostic testing was completed: Duct Fan Pressurization at rough -in measured leakage (CFM) ' CHECK AFTER FINISHING WALL: 1JYes ❑ No ❑ Pressure pan test or House pressurization test ❑ Yes 0 -No ❑ Visual Inspection of Duct Connections ❑ ❑ Pass Fail ;', ❑ THERMOSTATIC EXPANSION VALVE (MV) ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection ❑ .� Yes is a pass► Pass Fail ❑ DUCT DESIGN 1 • ❑ Yes ❑ No ACCA Manual D Design calculations have been completed, Duct Design is on the plans and duct installation matches plans. 2.❑Yes ❑ No TXV is installed or Fan flow has been: verified. If no rx'v, . verified fan flow matches design from CF -1R. Measured Fan Flow= Yes for both I and 2 is a Pass ❑ ❑ Pass Fail 1, the undersigned, verify that the above diaenostic test results and the work I performed associated with the lest(s) is in conformance with the requirements for compliance credit. (The builder shall provide the HERS provider a copy of the CF -9R signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit.] 1g Tests "a• ire, Dat InstallingSubcontractor(Co. Name) OR Performed General Contractor (Co. Name) COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy Compliance Forms August 2001 • • . —A-25 .