0303-196 (SFD)U)
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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.
'L•icense # Lic. Class rExp. Date
C36' 1l�30IG
Date Signature of Contractor'-/.'
d•
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I amexemptfrom 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).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to construct, the project (Sec. 7044, Business & Professionals
Code).
O 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 forwhich,this permit is issued.
Se(,) I have and will maintain workers' compensation insurance; as required by
ction 3700 of the Labor Code, for the performance of the work for which this
permis issued. �F workers' compensation surance ca�y no. are:
�STA�DPolicy
170�0ef
.»-(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.
Date• %� ^ t Applicant' ✓ `,-
Warning: Failure to secure Work rs' Compensation coverage is unlawful and
shall subject an employer to cri�inal 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 of
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 above-mentioned property for inspection purposes.
`
Signature (Owner/Agent)f��i�:1"��1-�.�Date
BUILDING PERMIT PERMIT M--96 "
DATE I VALUATION e�a�Qi7���,0 LOT'." TRACT
�y,tJ�1
JOB SITE ADDRESS 4 90'VT � Cts fAL) 1A _
APN 604-W2-009
OWNER
CONTRACTOR / DESIGNER / EN (NEER
LA, QUTbiTADEL ORO 149, L.P.
C't:3XWERMN a iD VELOPSkS,'INC.
5005 CAUX SAN•RAx'RAEL;
"5005 CAU, A RA,1U.,,, BI
PALM S'1tT IGS CA, 92264 "
PALMSPRING8 CA 92261
(760)325-4289 CITL41 6867
USE OF PERMIT
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TRACT CONS7111310TION %4 00 Sl:
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QARA0Pt A00RT,. -
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:ESSTMAM., COST OF C'ONYMUCI'y'�Pt'�
1i5�,�'�3.¢;{➢
COwl RUCTION ri E 101'000-418,000-,".
PLAN CHWX t "tiA9.70
;
h1690HANICA . FRE 111-000421-000
R'LICTRICALL IPF11. 101-000-4204060
Pi,�.13asFfl'�iCt:1?1?l $i�1-�iUL�b1��0(Y43 �1�.��'
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ST.RONO MOT) FEE -'.P.9 1 t'e9 i1Q0-4�d1-000
tSR,AlDraa OLE 101.000-423=1100.. $E 4Ct
ji3EVM.OPE;4 1MPA(ZT lf`22 '. $ atLAQ.t7it
F w •E� 1'a a;;l'r 101.000.439-3.18.. _$so oo
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APR 16 11
CITY OF LA QUIMITA
FNANCE DEPT :.
RECEIPT
DATE/
BY
DATE FINALED
'INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
J
Set Backs
Underground Ducts ,
Forms & Footings
Ducts 6
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
F.A.U.
OX to Wrap,
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
_
Drywall - Int. Lath
_
Final
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.
p
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
OX for Finish Plaster
Sewer Lateral
Pool Cover
S€wer Connection
=
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final _...
Utility Notice (Gas) OS
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage.Wiring ::
FoQures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
Certificate:, ®f Insolation
1 Your home has been insulated with John Mansville Fiberglas insulation products, which are designed r
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 firbjetardant chemicals that will likely lose their effectiveness over time. "It has not been treated
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
" + settle over time as may other insulation materials. • -
k A This also certifies that insulation have been professionally installed in this home to provide the
following thermal performance.
Job Name: :(A 'Qur&rM JeLC; o Tract: '30SZ l °Plan# y2 Phase i MOACL
' Lot No: Z9 Job Address:�tb— V /A
- Ceiling Area: 'R�,�p $ Li4jL•, Garage Ceiling: Non -Access:'
With Living Above Sloping Areas. ,
Exterior Walls: 7✓I� 13 CA404 gds: ^ -overhangs: Access Attic:
With Living Above
Between Floors:,Interior Walls. .
- ^ Subcontractor— ..
` Signed: .�.
• _ w��iGaSd�r�_ LNSctLNn 4G r• - _ ` -•
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. 9516943803 P, 05
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 2 of 2.CF-6R
Tract Number. 30521
Lot Number. 29 Protest:
System Q of
Indicate the maximum—e-SAmble Dud Leakage and the calculation used:
0.7 x Floor Area x (0.08) 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 Capaft in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flowl X.06
VU—c Pressurization Test Results (CFM QS 25 -PA -T-
1100
5 A100 x Test leakage if Fan Flow = % Leakage
Check Box for Pass or Fail (Pass - 6% or Less)
rj T-24 Com liaime Credit was Taken for TXV
Ys m Of
Indicate the maximum a 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 7 816
400 x (Cooling Capacity in Nominal Tons) x (0.08)
21.7 x (Heating Ca pac ► in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow X.06
ru-c Pressurization Test Results"(C 25 PA)
100 x Test Leakage / Fan Flown % Leakage
Check Box for Pass or Fail (Pass = 6% lir Less)
�T-24 Com Ifance Credit was Taken for TXV
5y9DBm of �]
Indicate the maximum allowable 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 per hourl x (0.06)
Measured Fan Flow[.—X.05
Pressurization Test Results jrFM (19 25 PA)
"
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
r--IT-24 m Com liarim Credit was Taken for TXV
yataI o1
Indicate the maxlmum elrowable 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 7 816
400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flaw X,06
b -ug Pressurization Test Results (CFM @ 25 A
100 x Test Leakage I Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 69A or Less)
QT -24 Compliance Credit was Taken fbr TXV
Plan #:
La Quinta Del Oro
TXV wa'
TXV wa
2Y Phase: ' Models
Builder. Lenner Homes
TXV wai
TXV ww
I, the undersigned verity that the above diagnostic test results and the work I performed associated with the testi(s) is
in conformance with the rektui rots for comp ' ce credit. (The builder shall provide the HERS provider a copy of the
CF -8R signed by the builder pi su trakxors certifying that diagnostic testing and installation meet the
regirrirerments for compliiance�
4-,' J 912tiJ2on5 Team Heating & Air Conditioning
`e6E gn c installing Subc:untractor(Co. Nanre) OR
Performed General Contractor (Co. Name)
COPY TO. Building Department
HERS Provider (d applicable)
Building Owner at Occupancy PAGE 2
F2001-01 (4412) Action Now T-24CF6-RTD&TXV macro
SEP -07-2005 WED 02:39 PM TEAM HEATING & A/C . FAX N0. 95169438U3 F. U4
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage &TXV page 1 oft CF -6R
Site Address: "Ovu VW vowm,a Plan #. 2Y Phase Models
Tract Number 30521
Project: La Quinta Del Oro Builder. l.ennar Homes
Lot Number: 29 all
An installation certifirAte is required to be posted at thetlm9the Buildisite or ng
a artmentkble r(upon request) anti (ding
After completion of final inspection, a copy must be prow g Dep
owner at occupancy, per Section 10-103(b).
HVAC SYSTEMS:
Heating Equipment Comfortmaker
efficient than that spec
Efflclency Standards h
manufactured devices
MINIMUM REQUIREMENTS
Identicle (AFUE, etc. Location Dud
Quetama I row CFAR1 (attic. etC.1 I R -value
Identide kSEER, etc.J Location I _Dud
nt listed above s:1) is the actual equipment installed, 2) equivalent to or more
certiflcate ofcompliance
FAR) submitted
Energy
X�" 3)eq equipment tthat meets oredappropriate requiemfor
fBct
Regulations or Parte), where applicable.
Load
8I26/P005 Team Heating & Air, Inc.
Installing eo o. Name
OR General Contractor (Co. Name) OR Owner
DUCT LEAKAGE COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
CFA: �
System 03 of 2
Indicate the maximumnowable Dud Leakage and the calculation used:
0.7 x Floor Area x (0.08) 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 Capacity in Thousands of Output STU per hour) x (0.05)
Measured Fan Flow I X.M.
Pressurization Test Assults A
100 x Test Leakage I Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
MT -24 f�llance Credit was Taken for TXV
" y�°"-m steor
Indicate the maximum erawatils 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 7 816
400 x (Cooling Capacity in Nominal Tons) x (0.08)
21.7 x (Heating Capacity in Thousands of Output STU er hour) x (0.06)
Measured Fan Flowl x AS
Vu—c Pressurtzation Test esu s
100 x Test Leakage/ Fan Flow = % Leakage
Check Sox for Pass or Fail (Pass = 6% or Less)
r—IT-24 Compliance Credit was Taken for TXV
TXV wai
TXV ww
FAUt 1
F2001-01 (402) Action Now T-24CF6-RTD&TXV macm
2000
loon