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0109-059 (SFD)V N _ W = ch r` O U-) rW P_ Z c000 wCID LL1 I- a W Z M LO O� U Q It Il — Z T Q O O_JQ mUU O CL: rn H Z cb n J 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 787856 s Datee2 �Signature of Contractor d� I,I df OWNER -BUILDER DECO(RATION 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 �((Yypp�>> 77gy�77,�W ��(r'� .rr}},pp pp�� •��,�t��}} Policy No. 1``�yyppii F'd',1biEFIC Gigi'alYd.E ANS, 4SO102" (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 subj ctt the workers' compensation laws of Californiar�d ag a that if I shgome subject to the workers' compensation pr• I Ions f Section 37 of a Labor Code, I shall forthwith comply with tho rove ions. Dater Applicant— Warning: pplicant Warning: Failure to secureVorker aCompensation 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 suc 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 i correct. I agree to comply with all Ci d S to laws,r�1'at' g to the buildin .. construction, and hereby authorizes e ese atives o�rRhi City to enter up the above-mentioned property foh ect' pu • b �s. Signature (Owner/Agennt, ��'•� ' ,C;�'� Date BUILDING PERMIT PERMIT# DATE VALUATION LOT [)(} l 1 TRACT JOB SITE ADDRESS-- APN OWNER CONTRACTOR / DESIGNER / EN (NEER 'SH!..R OF CAIM)RN)A INC 6940YON XARN `T AVE, STK 200 23 CORDO ,?, FeME'P A SUTn� 145 T�#•T CA 92606 NLWaRf BEACH C'A. 9266 (949119.4975 (79L A) 6364 USE OF PERMIT ISM7111Z FAWLY D•'(7 IN0 S.FD - LL4:)T A VL.AN 93)., PERMIT 00P i 1.40 IMC1,1' D9 H1XC i.: Wt' US POOLAPA Oi3Dk1.1VFNAY APPROACH. %% PLAN C:RWX SRR REDUCTIOW, INF:9, IS, kV.flNCE OF SAME P1" "P'ItP& C;URi`OPA 00143TRU0110H �OjcDo SP 170Rk.`HIPATIO 912.00 s 0A IWCAR—PORT 8? V A•Y•` 4W coff.' or, CrO,fi��II€"�IrJS'� 32�,+.6.00 ggp��( )) /,;;yy��;;4�� ,,��77qq••��+•��ppyy��pp11U1U1"1�1 VJ�4p4JL�•�..gM1,.Jy.�"7R+,:&L1]�iY �✓0.7,7�S"��lefi+lVAddAlirld 9 P 4 fA�yy 'f is P•�R�e 'COAIa�IRUd' Y ON F 101.000 41 o°'bd00 $1,427.DU ;P,3,,AN f;'f3ECK IMM 101 •�00-4;39-318 $233.110+ ME M.NICAL MOM 101-000-421«000 $124.00 'X1: X rRICA.L I'MM 101 -OW-420-000 00 $203.06 PLUME RIO PER 101.000.419Rt'3iitb ts°7'RONU MOTION F U- AUSIL) 01-000-241 •{2 t9 �3a.4� OiRA1;FWO14M. i.0ln0jtn+•,�25n � $li4,Ri4 M 9V'UX)PP)l IMPACT FBI? v,r1iaaq ART Yid' IJUBUC: PLACES - REUIE •2'ii0-000.445. 00 $311192 SUB-TI,(Y ALC'! -1e1 TM(1Cq'10W,i AND 11_AN'ICVTi?.t".X $4,513.10 ;FIs PRS --AID VERU S0.00 a IUM, -PERMTEMS VUE NOW SEP 11 2001 CITY OF LA QUINTq FINANCE DEPT. RECEIPT } BY ^ DA F D INSPECTQPF INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR " BUILDING APPROVALS MECHANICAL APPROVALS Set Backs _ Underground Ducts Forms &Footings ZO L 11a/ Ducts Slab Grade �b�b�� Retum Air Steel Roof Deck _ �2/if - -/ _ Combustion Air Exhaust Fans O.K. to Wrap �a �� F.A.U. Framing Compressor Insulation /C p fj Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath L. Final (plj�� Final 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 �d/� �� Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection _ �6/'� ` / 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 G. F.1. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) K.n.Y.06.2002 09:53 17602334081 MAYER ROOFING . e b Corporate Office: P.O.1Sox 462690 F,,candido, ("A 92046 1NCORPORATED License is 663561 WESTERN' PACIFIC HOUSING LA QUINTA 760-564-7022 (FAX) Attn: JOHN #2543 P.006l009 Rftafing on "LEGENDS <a>, P.G.A. WEST" Ph 2 LOT #38 Phone: (760) 737-3339 FAX: ('760)'737-0350 05-6-02 Mayer Roofing has supplied and installed 715 " O'h win cloiked roof vents, on lot *38 at 81-255 GOLF VIEW DRIVE Tile vents have been installed per manufkturers specifications. Note: Exact vent locations are determined by builder RESPECTFULLY SUBMITTED re! SCOTT BEECHAM OPERATIONS MANAGER Mayer Roofing, Inc. Page 1 of i 58 LK,_ijy srreet . San F'cmando, CA 91340 113 Orange Street . Riverside, CA 925112 (K 18) :438•-6064 . FAX ('818) 838-4493 (909) 782-0601. FAX (909) 7112-0804 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Tight Ducts & TXV) CF -4R PROJECT INFORMATION Project Title: LaCala Project Address: 255 Golf View Drive Builder Name: Western Pacific Voice #: Builder Contact: Michelle Lopez Voice #: 442-6199 ext462 Project ID # : 21$r359-2— ,$r359-2- Lot # Lot 38 Plan # 9 Sample Group #: HERS INFORMATION HERS Rater: Scott Johnson Certification # : 30027 HERS Firm: Action Now Voice #: 949-631-2274 Address: 2575 Westminster Avenue, Costa Mesa, CA 92627 HERS Provider: CHEERS Voice #: 800-424-3377 HERS Address: 9400 Oakdale Avenue, Chatsworth, CA 91311 HERS RATER COMPLIANCE STATEMENT ®T-24 Compliance Credit was Taken for Tight Ducts T-24 Compliance Credit was Taken for TXV TXV Verified YesO The house was: Tested / Verfied Approved as a part of sample, but was not tested / verified The installer has prove ed a copy of CF -6R Air Distribution System is Fully Ducted (sheetmetal, ductboard or flex duct) 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 the connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) CFA: System [T] of Indicate the maximum a owa le Duct Leakage and the calculation used: 0.7 x Floor Area x (0.06) for Climate Zone 8 through 15 0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16 400 x (Cooling Capacity in Nominal Tons) x (0.06) 21.7 x (Heating Capacity in Thousands of'Output BTU per hour) x 100 x Test Leakage / Fan Flow Other uct Pressurization Test Results (CFM @ 25 PA) Check Box for Pass or Fail (Pass = 6% or Less) Pass System LZL� of Indicate the maximum a owa le Duct Leakage and the calculation used: 0.7 x Floor Area x (0.06) for Climate Zone 8 through 15 0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16 400 x (Cooling Capacity in Nominal Tons) x (0.06) 21.7 x (Heating Capacity in Thousands of Output BTU per hour) x 100 x Test Leakage / Fan Flow Other uct Pressurization Test Results (CFM @ 25 PA) Check Box for Pass or Fail (Pass = 6% or Less) Pass System L--]�' I of Indicate the maximum al off 0.7 x Floor Area x (0. 0.5 x Floor Area x (0. 400 x (Cooling Capac 21.7 x (Heating Capa 100 x Test Leakage / Other uct Pressurization Test RE Check Box for Pass or Fail Raters Certifying Signature 3-2—)-02 s INSTALLATION CERTIFICATE (Page 3 of 13) CF -6R Site Address � 2515GOLF- L01 -Z3 Z Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS e-4 S I Ztik DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) 2FanTest Leakage (CFM) S72 - Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity in Thousands of Btu/hr, enter calculated value here If fan flow is measured, enter treasured value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) _ Pass if leakage fraction 5 0.06 [] Pass Fail ❑ For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testitng 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 (T -XV') ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection 13 El 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 ins.allation 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 1 and 2 is a Pass Pass Fail EY/I, the undersigned, verify that the above diagnostic test results and the work I 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 -611 signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit.] 1X31 tsz Tests kiature, Date Installing 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 19111C -S— (_1DLF VI EI tiv Permit N er 5.� DUCT LEAKAGE AND DESIGN DIAGNOSTICS Ta : 5 l.f�:-Qt,N 61 S DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) 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 in Thousands of Btu/hr, enter calculated value here ^� If fan flow is rneasuied, enter measured value :sere Leakage Fraction = Test Leakagel(Measured or Calculated Fan Flow) _ Pass if leakage fraction 5 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: ❑ Yes '❑ No ❑ Pressure pan test or House pressurization test ❑ Yes ❑ No ❑ Visual Inspection of Duct Connections ❑ ❑ Pass Fail ❑ THERMOSTATIC EXPANSION VALVE (TXV) Q Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection t� ❑ 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• ❑ No TXV is installed or Fan flow has been verified. If no 'r)&,, ❑.Yes verified fan flow matches design from CF -1R. Measured Fan Flow = Yes for both 1 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 test(s) is in conformance with the requirements for compliance credit. (The builder shall provide the HERS provider a copy of the CF4R signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit.) s t3 / d z Tests nature, Date Installing Subcontractor (Co. Name) OR Performed 0General ;;ontractor (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 VW --W A02 'LD`r 9C 39 Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS TON DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM) (to Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating. Capacity in Thousands of Btu/hr, enter calculated value here l0 If fan flow is measured, enter measured value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) _ / Pass if leakage fraction <_ 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: ❑ 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 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 -IR. Measured Fan Flow = Yes for both I and 2 is a Pass Pass Fail S 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.) s is1�� Tests Pgnature, Date V Installing 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 . 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 2 LOT #: 2038 SITE ADDRESS: 81-255 GOLF VIEW DR. LA QUINTA, CA ----------------------------'-------------------------------------- EXTERIOR WALLS: MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13 CEILINGS: BATTS 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: 94484 BY: TITLE: P DU TION MANAGER DATE: //AROARY 28, 2002 Certificate of Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following; BUILDING ADDRESS: Use Classification: SINGLE FAMILY DWELLING Occupancy Group: R-3 Type of Construction: VN 81-255 GOLF VIEW DRIVE Owner of Building: SRHI, LLC Building Official Bldg. Permit No.: 0109-059 Land Use Zone: RL Address: 16940 VON KARMAN AVE STE 200 City: IRVINE, CA., 92606 By: DANIEL P, CRAWFORD JR. Date: 6/18/02 POST IN A CONSPICUOUS PLACE