0303-195 (SFD)LICENSED CONTRACTOR DECLARATION ,r
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
606486 T3 11 AN
,."Date , A Signature of Contractor's //
OWNER -BUILDERS' CLARATION
( hereby affirm under penalty of perjury Va't I am -exempt from the Contracto'r'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). ,
( )f" I, as owner of the 1property, 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'peAalty of perjury one of the following declarations:
() I have anis 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' hich'this permit is issued.
SecI have'and will maintain workers' compensation insurance,'as required bji
tion 3700 of the Labor Code,46r the performance of the. work for which this
permit is issued. My workers', compensation insurance' carrier &' policy no are:
Carrier STATE FUND Policy No. 171-50q.-03
(This section need not be completed if the permit valuation is for $100:00 or less).
O I certify that in the performance of the work for which this,permit.is issued,
I shall -hot employ any person in any manner so as to become subject. to ttie
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 these provisions_,
Warning: Failure to secure Workers' Compensation coverage is, unlawful and
shall subject an employer to criminal penalties and civil fines up to $1001000,.in .
addition to the cost of compgAsation, 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. 3
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.r '
"Signature (Owner/Agent) � `�Y Date Y' a
OD L
PERMIT #
BUILDING- PERMIT OOH-:a�
DATE VALUATION S.150,049.10 LOT TRACT 34521
JOB SITE
ADDRESS,,, .44.8 IO'VYA CATtMA
OWNER
CONTRACTOR! r ER
L6,QLWrmym ORO 141, LP
COTS C+?.`3r01STH,D'RM- a- ...Cr-TKRZ,WC<
005 CAMSAN RNA
5005 CALLE BA14 -'RARRM, :1.4 3M., DI"
FAM SPM'C68 CA. 92264.
1).{ ZPMXGr5 CA 922M
(760)1254M CBLO 6867
USE OF PERMIT
=Mr. r.ANw_Y D. wm wa
rJ! ? , .['S Y .,f Y `ntVl.A1 J4. Ga>f l t [A�Fl.4LAJIde, Lb Lr Pn
WA" P0049PA OR DRIVL-WAY.APPROACH..
BkiG'Tis3ti8'd'Ia:1SCfItAN GG S+'
f)O1tCWPA7.*_T1D
YCARPOAT
f; " 'I1!/ 4Y i? CS7 OF C(7MMUC..1701:5
v:�Y5049.1.0
i^C3NOOTRUCTION FRE ,..^`;. -101.000-418.000 S819,V0
..�
PI,,A'td 101-400439-318 miss i'�•I , $671,45,
I tG'It.43� AL I l4'$-000.42l.et➢40:
FJXCTRIC A L. FAE 101-000-420-000 $131.32
P1,iJit4i31NC1 :E .. 141 000419.00
,
'!'l7.OkI tdiOT10� PPE R S16 Y (83. 0* 00-' 4 2 X000
GRADING FES . t�tuL10�3.423a400 S1'�I.�l�':
DEVUDPER,I.MPACT FEE " $2,405.00
KE DEPOSIT 101-000.430-318 4400.00
e
StIR;-TOTAL TAL CO3X�'JiRUC7�1;C�7tk' AND PJ:—kN CH =3
94;:�C'f9,
• , T�C�a E=P� 1�
�w340,f}�O
800.77
APR1.6:. P3.. :
CITYOF LAA( SETA.
6 ?i;AA WCF_D_EPT.
RECEIPT
DATE'
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
p
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
- r,�
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Insulation
--0
s / -
Compressor
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
`/ ,2� D S
Final zc oS
BLOCKWALL APPROVALS
steel
POOLS - SPAS
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
g�d
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
lo
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
— —
Encapsulation
Gas Piping
Gas. Test
Appliances g =17
.i
Final
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)' C/—
COMMENTS:
Certificate of Insulati®n :. .
Your home has been insulated with John Mansville Fiberglas insulation products, which are designed
• for today's safety standards and tomorrow's energy requirements. - -
Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated
with fire-retardant chemicals that will likely lose their effectiveness-over time. It has not been treated 14*
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
r t settle over time as may other insulation materials.
This also certifies that insulation have been professionally installed in this home to provide the",
following thermal performance.'
Job Name:LA QU f NTS . Tract: 3o52� . Plan# Phase. Mo U+EL. .
` Lot No 36 " Job Address: 441 910 VIA CATAUtJA
µ *"- Ceiling Area: Rap 8l.owN ,�, `Garage Ceiling: Non -Access:
` T With Living Above > & Sloping Areas
' Exterior Walls: 9L urjrAcw is .Overhangs: `Access Attic:
• With Living Above
- Between Floors: Interior Walls: "
` Subcontractor...
-.�• Signed:
' R-means resistance to heat flow. The higher the R-value, the greater the insulating power.
Ask your builder for the fact sheet on R-values. Keep this certificate with your other _ -
• valued papers. If you ever sell this home, this certificate should be passed on to the buyer.',
SEP -07-2005 WED 02:39 PM TEAM HEATING & A/C
FAX N0. 9516943BU3 r. uj
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage &TXV Permit
Site A dress: 448 f 0 VHS Catalina Plan fit.
Tract Number. 30521 proed. La Quinta Del Oro
Lot Number. 30
System M of
Indicate the malnmum a owable Dud leakage and the calculation used;
0.7 x Floor Area x (0.06) for Climate Zane 8 through 15
0.5 x Floor Area x (0.08) for Climate Zones 1 through 7 818
400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of OuW BTU per hour) x z05
Measured Fan Flow
Pressurizatlon Test eau s
100 x Test leakage / Fan Flow = % Leakage
Check Box for Pass or Fad (Pass = 6% or Less)
�T-24 Com l-ance Credit was Taken for TXV
yarn P9 of
Indicate the maldmum allowable Duct leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone 8 through 1
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 Capaa in Thousands of output BTU per hour) x (0-06)
Measured Fan Flow
u Pressurization Test esu is►�
100 x Test leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 8% or Less)
1ya7-24 ComPkance Credit was Taken for TXV
m Q of
a
Indicate the maximum e 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 (0.08) for Climate Zones 1 through 7 816
400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU r hour) x (0.06)
Measured Fan Flow -25 X'06
u Pressurisation Test IkesultS
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 610/6 or Less)
T-24 Compliance Credit was Taken for TXV
ysED.of
Indicate the mawmumowable Duct leakage and the calccdatton 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 7 816
400 x (Cooling Capacity in Nominal Tons) x (0.08)
21.7 x (Heating Capa i in Thousands of OuW BTU.per houC x (0.06)
Measured Fan Flow(x.08
Tu -c- Pressurization Test Results
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
0T-24 Compliance Credit was Taken for TXV
TXV wa
? of 2 CF -6R
1X Phase: Models
Budder: Lennar Homes
W,TAM
TXV wa
TXV wa
I, the undersigned, verify that the above diagnostic test results and the work I perfomred associated with the test(s) is
in corftrmance whh the requireme for compliance credit (The builder shall provide the HERS provider a copy of the
CF -GR signed by the builder a
M,7Mc:er0f0ng that diagnostic testing and instaftatlon meet the
requirements for compliance cred Team Heatft 8 Air Conditioning
'Tests
gnature am lnstaAing subanm
trador (Co. Nae) UK
PerformedGeneral Cwdmctor (Cv. Name)
COPY TO: Building Department
HERS Provider (W applicable)
Building Owner at Occupancy
PAGE 2
F2001-01(4.02) Action Now T-24CFt3•RTDSTXV macro
SEP -07=2005 WED 02.39 PM TEAM HEATING & A/C FAX NO. 9516943603 F. UL
HVAt INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 1 d2 CF -13R
Oa—mid Wuelhar
Tract Number: 30521 Plan #: 1X Phase . Models
Lot Number 30 Project: La Quinta Dal Oro Builder: Lennar Homes
An installation certificate Is required to be posted at ft building site or made avalible for all appropriate inspections.
After completion of final inspection, a copy must be provided to the Building Department (upon request) and the building
owner at occupancy, per Section 10-103(b).
HVAC SYSTEMS: `.
rl9a➢n8 MMUN IIIIVI1% vwn,v,u.nirv, .
ot ftff ide—ncy Eluct Heating Reaung
Equip. Name Identide AFUE, etc. Location Duct Load Capacity
Type and Model Name Systems >= CF -1R attic. etc. R -value BTU / Hr BTU / Hr
c
c
V001111V MgUIt11/IVII%
o Emclancy-Cooling mg
ulp. me Idantx:le SEER, etc. Location Duct Load Capacity
Type and Model Number Systems >=CF -1R atti-etc R -value BTU / Hr BTU / H
e R4.2 36.13M
c
:_...:_ Ir. ~ Mnrn
i, the undersigned, venrytnat egwpinent ilowu ilDo1IC is: I110 Via a\.wa; 04U410111015%ufemvl r, -1 vya,.wv,,...... •,•...-
efficlem then that specified in the certificate of compliance (Form CF -1 R) submitted for compliance with the Energy
Efficiency Standards for ntial ild d 3) equipment that meets or exceeds the appropriate requirements for
manufactured devices th pt) n Effi 'enry RagoAations or Part 6), where applicable.
8fZ6R005 Team Heating & Air, Inc.
re, aWilalling SLOCOMOCIor eme
OR General Contractor (Co. Name) OR Owner
MINIMUM REQUIREMENTS FOR DUCT LEAKAGE COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
CFA:
System M of M
Indicate the maximum owable 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 (Coding Capacity in Nominal Tons) x (0.06) 72 fen flow 1200
21.7 x (Heating Capacity in Thousands of Output BTU er hour) x (0.06)
Measured Fan Flow
Vu—c. Pressurization Test Results WPA
100 x Test Leakage / Fan Flow = % Leakage 3.67%
Check Box for Pass or Fail (Pass = 696 or Less) Paso x Fal
[MT -24 Com (lance Credit was Taken for TXV TXV was:utEdled
yecat � o(n '
Indicate the maximum'—ajE�vable Ord Leakage and the calculation used, '
0.7 x Floor Area x (0.06) for Climate Zone a 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) - 72 ten now. tzoa
21.7 x (Heating Capacity in Thousands of OMut BTU er hour) x (0.06)
Measured Fan Flow :.06
Pressurization Test Results 4e
100 x Test Leakage / Fan Flow = % Leakage 4.00%
Check Box for Pass or Fail (Pass = 0% or less) Passx Fail
Q T-24 Compliance Credit was Taken for TXV Txv was InstaUed
4
' PAGE 1
F2001-01 (4-02) Ad1on Now T-24CF642TD&TxV macro