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0109-053 (SFD)H N_ LU W O M W o Z (D O ( O '^ W W f— 0- U) N Z M LO CV ON 0 °) �a Z 0 CE LO Q 0 0J J Go Q U Il M H It Z_ ob 5 �0 J LICENSED CONTRACTOR DECLARATION 1 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 a ect. License # Lic. Class p. Date Date/ 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&P.C. for this reason Dato 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. At;ii�lt` �4fI � tiYS. MUM) (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 mann r as to become ubject to the workers' compensation laws of California ala �e that if _ (d become subject*to the workers' compensation v slo of S ction 0 of the Labor Code, I shall forthwith comply wit 0* ions Date: C=at' r' Applican - y r Rr . Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. ' IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at ; whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this applicatio,n e�nd state that the abgve information is correct. I agree to comply with all City,�antate laws r/Eying to the building construction, and hereby authoriz pre� ntatives Of h' City -to enter upon the above-mentioned property�f i �pe tfon pur o� r. a Date Signature (Owner/Agent) BUILDING PERMIT PERMIT# DATE VALUATION - LOTryr "C)}5jt)_Sj+T,�y TRACT s�e{pp.yy nn..�� yy JOB SITE ADDRESS _$j'=�'C' 701 Vieu):DRR�� APN OWNER CONTRACTOR /DESIGNER / EN (NEER ala'rIy X.TZ WA OF C M.4WORNIM 19C. 169140 VON KAMY--AN AAM 917. 200 23 COR.P4?kt,A:"1EPLAZA. RIME 245. MWITE Cdr 92606 NEWPORT BEACH. H. C:`A RU60 (949Y/ 19-4917.1 CBTX 6364 USE OF PERMIT 11M.1 1Y FAI&LY IMM-1111MG SrD - f.P T% 1°I. kW &M.PFRMIT DOF—S 140T ,INC3..UDIX SLOC.K WALLS, 110OL&PA OR, DRIVFWA,'1' APPR ),A.0 H. '81% PJAAN C11WK 1 W7, 1tI"Di3tn'.10N FOR WSUKOCZ VF SAMEPLAN TYPE P CUSTOM E'ORSTk1.O f 0,14 3000.011 SF PO, CHIPA t'10 760160 SD GARA.(MCAKPORT 696M sr C4.+'d8X OF �se'i..�+8.STRU�.4. ON /f81,442.8,D ��q��ggqq^^��,,�� {ry Ya t�' -r�ppp- �.C$.y9��.i,F;,o�,D P�CJifn6YIT dL� A7Cr t��T+1i:1.'VA. A& 71i . C01491`RUCTIONfER 101.000,418.000 Sts .54 PLIA.N' 042IICK. YU 101E 00-439-316 $260.17 Ali:Z:'°&i,AN1CPJ. FEZ 101-000-4214 00 $124.40 F, U11rTs:1CAIa VIZV 1131-00"20-01W. $132.at1 P1;UMB-510 PRE 1531••0051-19"000 320;9.75 STWMO MOTION N PE ^ RESSID 101-000-241-000 $21L14 t: RA.MAO FOR 101.000-423.000 9?t?M DMI, KILOPF-R. IMPACT P. rZ $I,'�f77 fl0 ART 0.1 P¢,Ik11a C Ka"1c'.F..J - K.F.S.IE 270-0W-4454,100 $203.61 ✓ 4 yV- . � 1+f'2I"�'C3'C: MIT A3>1!U C;IMC':5�. PR `�Q 917 p a o_ 11M M-p�MIES r202. $010) : )I_AL I ;��a�: f EN ME NOW SEP $4,073 d 11 2001 CITY OF LA QUINTA FINANCE DEPT. RECEIPT DATE '� ;BY r DATE FI SP INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING Set Backs Forms.& Footings Slab Grade Steel Roof Deck O.K. to Wrap Framing Insulation Fireplace P.L. APPROVALS _ �" !j( ��/�� 6 6W /2�0�/ MECHANICAL APPROVALS Underground Ducts - - Ducts _ Return Air Combustion Air Exhaust Fans _ kZ F.A.U. - Compressor Vents J - Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines / Party Wall Firewall Exterior Lath Drywall - Int. Lath Final BLOCKWALL APROVAL Final 94d _ - POOLS - SPAS 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 Waste Lines g/�� Water Piping Gas Test Electric Final Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection _ 9�28� ( Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) 9� ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service c Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) / �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 2 LOT #: 2025 _ SITE ADDRESS: X81=280 -GOLF VIEW DR. LA QUINTA, CA EXTERIOR WALLS: MANUFACTURER: CEILINGS: MANUFACTURER: JOHNS MANVILLE =BATTS JOHNS MANVILLE THICKNESS: 3 5/8 " BLOW THICKNESS: 11 11 GENERAL CONTRACTOR: WESTERN PACIFIC HOUSING BY: TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE NUMBER: 794484 BY: TITLE: Ph DU ION MANAGER DATE: ARY 28, 2002 R -VALUE: R-13 R -VALUE: R-30 INSTALLATION CERTIFICATE (Page 3 of 13) CF -6R Site Address N ZR - �,G'Ti # TS- Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS 2 L M /DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM) 4 Pd__ 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 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 past 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 matches design from CF -1R. Measured Fan Flow = • 0 0 Yes for both 1 and 2 is a Pass Pass 'Fail /1,e 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.] TestsS' n re, 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� �oZic It ) P—�� LIP L- OT* 2S; Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS H T-D+A L'y DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM) 8 Fan Flow If Fan Flow is Calculated as 400 cfnVton x number of tons, or as 21.7 x Heating Capacity q in Thousands of Btu/hr, enter calculated value here I riD 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) 19 Yes ❑ No Thermostatic Expansion Valve is installed and Access is _/ ❑ provided for inspection B 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=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 -8R signed by the builder emplor suctors certifying that diagnostic testing and installation meet the requirements for compliance credit.] GN /61, TestsS' ature, Date t 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 V--� ila Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS 0 DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM) g Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity e7 in Thousands of Btu/hr, enter calculated value :sere If Earl flow is measured, enter measured valuc 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 testing was completed: Duct Fan Pressurization arrough-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) Lel Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection ❑ Yes is a pasr 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..lf no TXV, . verified fan flow matches design from CF -1R. Measured Far. Flow = Yes for both I and 2 is a Pass Pass Fail I, the undersigned, verify that the above diaenostic test results and the work I performed associated with the test(s) is in conformance with the requirements for compliance credit. (The builder shall provice the HERS provider a copy of the CF-bR signed by the builder employees or sub-conuactors certifying that diagnostic testing and installation meet the requirements for compliance credit.] I esis Performed COPY TO: nature, Date Installing Subcontractor (Co. Name) OR Building Department HERS Provider (if applicable) Building Owner at Occupancy General Contractor (Co. Name) Compliance Forms August 2001 —A-25 . MAY.06.2CO2 09:53 1_7602334091 Corporate Office: P.O. Bux 462890 Escondido, CA 92046 MAYER ROOFING #2543 P.006/009 A6® ® Phone! (760) 7_37 -SSSS INCORPOR�4TE FAX: (760) 7'37-0350 Liue3c! 6033Nl WFSTERN PACIRC HOUSING LA QUTNTA 760-564-7022 (FAX) 05-6-02 Attn: JOHN rA Rooting on "LEGENDS Q-) P G'A WEST" Pb 2 LOT #25 - Mayer Roofing has supplied and installed "12 " O'bagin eloalcA roof vents ,cin lot 425 at 81-280 GOLF VIEW DRIVE Tile vents have been installed per manufacturers specifications. Note: Exact vent locations are determined by.builder RESPECTFULLY SUBMITTED SCOTT BEECHANT OPERA'110NS MANAGER Mayer Roofing, Inc. Page] of 1 SSR Library Street. - San Femando, (.:A 91340 193 Uringe Street . Rivmidc, CA 5)702 (818) 838-6064 . FAX (818) 838-4493 (909) 782-0601 . !'AX (909) 782-0804