Loading...
0109-060 (SFD)'A H - N W W Ouch � d � W o Z CIO0' HCD W W t1_ I- a Z co LO Oq UQ lt0_Z lr ��O LL Q J J mUU O CL: in la Z_ 00 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. 6 License # Lic. Class Ccp. Date nt �, Date y Signature of Contracto OWNER -BUILDER DECL 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 7 B&P.C. for this reason natp — .. 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. PACIFIC RAWFIE IN& 430109= (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 manne s�p.as to become sypjegf to the workers' compensation laws of California agree that if I SOi t(become subject to the workers' compensation pip I ons f Sect. 700Af the Labor she" � Code, I sha f, rthwith comply with thho r�g ns. � Dater Applicant ..- '%n Warning: Failure to secure Workers'Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. t 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application a d state that the abonformation is correct. I agree to comply with all C' d S to laws re ti 6to the building construction, and hereby authoriz r res e atives of is ity to enter upon the above-mentioned property f I pect'• n pur Signature (Owner/Age ) 1 "� ' Date Z . -...._..�........ ..-..u,• ..• �..� ._�-u�a-.._s f..�.�.uc�,.�.v_......-- ..za.v .ic._ ...-a ��I.,.c�L ,�.�r<a BUILDING PERMIT PERMIT# DATE VALUATION LOT 0109-o )% TRACT ;1;24'3.f3" T Qb 2.RRRr JOB SITE ADDRESS I_►��•$@ //_y� �����pt' �✓�tyy��y�y}� �� al ©2.•.2m : Yaur v v PY . fia 911:+ `a APN 762,3904)28 OWNER CONTRACTOR / DESIGNER / EN INFER 16949 VON KM2AIN-N0_ WrE. 200 23 C0"0_RJ't3,PY"__A. rA"245, rI vrtwl CA 92606 OMMORrBEACH CA 92,660 (0,49.};i2���'i� USE OF PERMIT T / p y� �y 19.}Stl 1Y �b1S7�l4111J: SJ NV.t.rF..(L•L7C9'�d aPE3 • L,: D l` 3q, i ✓3 .4';AX. MWIT DOES NOT IWCA:4.i.W !3)dtYC;f: WM.?X,K}Csl;,d£%'PA OR OWYLYWAY APPROACH.ft PLAN l'°'.Fir�� X D' E AI:T~'lWCT1011 FOY, ICSU"CZ f' F SAMa PI Aad T YK CUSTOM COAT2.UCTION 2,S1600 SP Pd6''lPlTO 5100.610 dC t: DARAGEM&RPOR`!' ?89.00 SF �p.Sl1is" SUM!144Lw .Y: tONSTRUCTflON PRE 101 -OM -418-000 51,140,00 Pi. A]q CHECK ME 101-000-4: 51. 1i8 $234.03 :fTE $165. PTIO a3FDINO PR 101��30tt�41 �D�fDOtD �D42. l3 S' RCYNO MOTION FE -F, a i'ESID 101-000--241 -,000 $24,21 O'k AD INC IWIR 101-000.423-000 $20.0 W9k:T.,K).PER IMPAC: T . fr $E,Jtt"l Ofd ARX iia PUBLIC PL ACM -0 - Rall 270.000.44:5d000 10 Imp", P ' . Apt U,ION, 40YPT (1WICK $3,914,83 e I YM :L?R& PAID FM $0.00 'AL X1'ERhMJi'kXS DUE N OW SEP 112001 CITY OF LA QUINTA 4 FINANCE DEPT., RECEIPT DATE ;BY. DALE IN•AALEDO Z 5 INSPECTOR ..JJ INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings ��QQI/�� /d�0� Underground Ducts Ducts Slab Grade 7/ �7 Return Air Steel Roof Deck _� _ 0/ Combustion Air Exhaust Fans /2f �C/ O.K. to Wrap /,l- fi 6� F.A.U. Framing // Dy Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. ' Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath 7/Q� Drywall - Int. Lath _ Final ��ISaz— Final POOLS - SPAS BLOCKWALL APPROVAL:3, 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 Al 1�� Electric Final Heater Final Water Piping _ Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer. Lateral Pool Cover Sewer Connection �ljl 7�� 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.I. Smoke Detectors Temp. Use of Power Final _ Utility Notice (Perm) zr 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 #: 2039 SITE ADDRESS: X81-265 GOLF VIEW DR. -LA QUINTA; CP: - EXTERIOR WALLS: MANUFACTURER: JOHNS MANVILLE THICKNESS: CEILINGS: BATTS BLOW MANUFACTURER: JOHNS MANVILLE THICKNESS: 3 5/8 " R -VALUE: R-13 11 " R -VALUE: R-30 GENERAL CONTRACTOR: WESTERN PACIFIC HOUSING BY: TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE NUMBER: 794484 � BY: TITLE:PRO CTION MANAGER DATE: JANUARY 28, 2002 �l MIM.06.2002 09:54 17602334C81 MR:ER ROOFTN5 #2543 P.009/009 � n Corporate Office: r.o. Box 462890 ®. ® Phone: (760) 737.8888 Escondido, CA 9'2046 tNCORPORATED FAY: (760) 137-0_,50 License 9 663581 WESTERN PACIFIC HOUSING LA QITMTA 760=564-7022 (FAX) Attn: JOAN Rgot3ng on "L. &.�GENDS Cal P.G.A. WEST" Ph 2 LOT W 05-6-02 Mayer .Roofing has supplied and installed 1110 " O'h$ein cloaked roof vgnts , on lot. #39 at 81-265 GOLF VIEW DRIVE 'tile vents have been installed per wanufacturers specifications, Note: Exact vent locations'are determined by builder RESPECTFULLY SUBMITTED SCO'T'T BEECIUM (. OPERATIONS MANAGER Mayer Roofing, Inc. Page 1 of I 55K Libriuy Street . San l crna.udo, ('n 91340193 Orange Street . Riverside, CA 92502 (8)$j -OiOa 93R_60(A . FAX (R! R) 839-449-1 (909) 782-0601 . FAX (!>09) 782 INSTALLATION CERTIFICATE (Page 3 of 13) CF -6R Site Address S 12 05' (T- o -LF- V 1 F— W p�- Va—r 3tr a9 Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS 2 �P►S t,.c tpr DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM) Fan Flow If fan Flow is Calculated as 400 cWton x number of tons, or as 21.7 x Heating Capzcity y in Thousands of Btu/hr, enter calculated value here If fan flow is measuied-, enter measured value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) = Pass if leakage fraction 50.06 ❑ 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 ❑ THERMOSTATIC EXPANSION VALVE (XV) ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection Yes is a pass ❑ 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 rXV, verified fan flow matches design from CF -1R. Measured Fan Flow = Pass Fail ❑ ❑ Pass Fail ❑ ❑ Pass Fail Yes for both I and 2 is a Pass Pass Fail /I.,e 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 r , 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 (2 �� (,� V Gtr ��- Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS ?� �N L�j),N6 DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM) (p (X Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity n in Thousands of Btu/hr, enter calculated value here - I If fan flow is measured, enter measured value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) _ Pass if leakage fraction <_ 0.06 ❑ For AEROSOL TYPE SEALANTS 0,N1Y - 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 fSd" ❑ Pass Fail ❑ ❑ Pass Fail THERMOSTATIC EXPANS IOiy VALVE Cf'XV) U Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection L7 ❑ 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 D 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 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 61azurc, 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 61V05 (�jOLF \I ► a, -LJ Dp- - i.c7t # 31' Permit Number DUCT -LEAKAGE AND DESIGN DIAGNOSTICS its s zio DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM) r% O Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity n in Thousands of Btu/hr, enter calculated value here If fanflow is rrieasuked,- enter measured value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) _ Pass if leakage fraction:5 0.06 ❑ 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 ❑ TFJZJRMOSTATIC EXPANSIO\ VALVE (TXV) o ❑ Pass Fail ❑ ❑ Pass Fail Yes ❑ No Thermostatic Expansion Valve is installed and Access is —/ provided for inspection LLLjjj ❑ 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. -I Eno TXV, , verified fan flow matches design from CF4R. Measured Fan Flow = Yes for both 1 and 2 is a Pass Pass `Fail Z1,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 -9R signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit.] Tests rg ature, Dae 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 . 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: 81-265 GOLF VIEW DRIVE Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0109-060 Occupancy Group: R-3 Type of Construction. VN Land Use Zone: RL Owner of Building: SRHI, LLC Building Official Address; 16940 VON KARMAN AVE.. STE. 200 City: IRVINE, CA., 92606 By: DANIEL P. CRAWFORD JR. Date: 5/15/02 POST IN A CONSPICUOUS PLACE