0403-235 (SFD)LICENSED CONTRACTOR DECLARATION
I kereby affirm under penalty of perjury that I am licensed under provisions of
l'- ' Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 W Professionals Code, and my License is in full force and effect.
O =) M License # Lic. Class Exp. Date
LU 7C*241 AD ?1 113
o Z r` ,Date / Signature of Contractor
(D 0 ri
JI. -
C) OWNER -BUILDER DECLARATION
W a rl- I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z_ ( ) 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).
c`') () I am exempt under Section , B&P.C. for this reason
LID
N Date Signature of Owner
ON
CA
d Q WORKER'S COMPENSATION DECLARATION
o Cc I ,hereby affirm under penalty of perjury one of the following declarations:
r O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W compensation, as provided for by Section 3700 of the Labor Code, for the
mJ Q performance of the work for which this permit is issued.
Q (� (gip) I have and will maintain workers' compensation insurance, as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
Il rn H permit is iS�ued..M.y worje compensation insurance carrier & po4cy, no. are:
It Z Carver FsrslF.F f(Mi (:tO'�J1'G Policy No. V1[;A 'L1252 M
o7 Z)y
C/
r J (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;p.ovisfons`.
Date. �/ 1t -r> Applicant
/ 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 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) �' �; Date'
BUILDING PERMIT PERMITk
DATE VALUATION ✓���•{ LOT 64 TRACT ._i I
JOB ADDRESS a:V� �� �a.v L-I�
APN 0104 : i iFl
OWNER
CONTRACTOR/DESIGNER/EN (NEER
111
I: K10T'AR l`:010MtIQIAWO
2400
2.418t31) CIUM, iT p'"Wi_V�.71
(549)5418-8580 C LA s: 3434
USE OF PERMIT
wt4l/, �..7 C .a4'S.6Y l t1, k'lt-e!h64'lA l P.i4.3l:rtf A<\lA IL14%1A.L LIAL
P0014 SRA Of', DWRWA`Y' APPROACH,
`3'S3&VT &17
PokcI3/pNCIo 359.00 Sr
04TINGOCARPORT 465.00 fir
:r.I.MNICTED C11TM, Orr CCC.r"!CVirr?U, rt0N
C 10,NZ;TRV `1 JVk1 WE 101 •-000-418,000
I`I�ANC�t,ECKTt?!� 20t-(i€�C�•s13cJ lls IIli3�.4�
HFr.HAll ICIALITE 101=•000. 21.000
I 101-000-420.000 $143.99?ICCI
i�1.TJIvII3TK0 vrllrl 101-000-419.000 $1W:25
UT110140 MOTIOW P'E8 - R SID 101-X500-241-000 $16.99
ORAMNO'Fier- 101.0130•423.000 S#15,00
I9I?VR10PFP 1PAPACT PEE $7,405M
BOB-TMW,. CfJWNi.i'r `�` CW 90 PLAN i JFfiK
Ca:�,� i�.�tE•
�•�� 0 6
RECEIPT
DATE
BY
DATEF NALED
INSP OR
4 y o L
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
t A 3
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
V9_
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
_
Compressor
Insulation
_ _ y
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
— 17— dy 5 -
Drywall - Int. Lath
Drywall
o _S
Final
Final a
BLOCKWALL AP ROVALS
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 APP OVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Q . -o'
Encapsulation
Gas Piping
Gas Test
A&ZOWiL
Appliances
Final
Final j, p ,4
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduft
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final Id b '�
Utility Notice (Perm)
COMMENTS:
c
CITY OF LA QUINTA
oBUILDING & SAFETY DEPARTMENT
y of rNE 777-7012
INSPECTION REQUEST LINE
777-7153
Owner.
Contractor
Permit Number
POST ON'JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS_ 44_830 -VIA MTRARFT
SFD LOT 64 PLAN 2Y A. PERMIT DOES NOT
INCLUDE BLOCK WALL, POOL, CPA OR
DATE INSP. `
TEMPORARY POWER
SETBACKS
U/G PLUMBING / WASTE
t U/G ELECTRICAL / GROUNDING
FOOTINGS / STEEL j
i CONCRETE SLAB i
i
DO NOT POUR CONCRETE U T ABO SI ED
ROOF NAIL / PRE-ROOF
OKAY TO WRAP
I FRAMING COMBINATION _
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL
INSULATION _ y
COVER NO WORK UNTIL ABOVE SIGNED f
INTERIOR GYP. BD. DRYWALL -15- 4/
EXTERIOR LATH
GAS TEST ,6
SEPTIC ABANDONMENT
SEWER CONNECTION----^-- hp -Z- o l
SEPTIC / GREASE INTERCEPTOR I
MASONRY INSPECTIONS
FOOTINGS / STEEL
BOND BEAM
POOL/ SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE / SETBACKS
U/G PLUMBING ;
U/G GAS
U/G ELECTRICAL
PRE-PLASTER (ALARMS/ BARRIERS
FINAL INSPECTIO S
TEMP. USE OF PERMANENT POWER
ELECTRICAL
PLUMBING
MECHANICAL �
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT. o
FINAL / JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT 1'O
TURN SON UTILITIES OR OCCUPY BUILDINr
10/27/2004 08:28 5516868786 d, WESTERN INSULATIjIl RAGE 07/07
s
E "I"E N .IN ULATIO , LoP*
4211 Latham Street, Riverside, Califa moria 92501
Tci. (954686-8760 Fax (951.) 686-8786. .
CF6R INSULATION CERTIFICATE
THIS IS TO CER
TI Y 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:
r
TRACT/PHASE: LA QUANTA DEL ORO 1 PHASE 2
LOT 64
SITE ADDRESS' 44-830 VIA MARABEL - LA QUINTA, CA
CEILINGS P, PLANS 2 &- , -.- - - - -BLOWN INSULATION
MANUFACTURER: GREENFIBER THICKNESS: 10.3" R- VALUE: R-38
CEILINGS l@ PLANS 2 & 4: BATTS
MANUFACTURER: JOHNS MANVILLE THICKNESS: 13" R-VALUE: R-38
CEILINGS: f BLOWN INSULATION
MANUFACTURER; GREENFiBER ! THICKNESS: 8.1" R- VALUE: R-30
CEILINGS: BATTS
MANUFACTURER: ,JOHNS MANVILLE THICKNESS: 11" R— VALUE: R-30
Ei(- TRRIOR WALLS, BATTS
MANUFACTURER, KNAUF ' THICKNESS: 3 112" R- VALUE: R-13
GENERAL. CONTRACTOR: LENNAR HOMES
BY: I T
TITLE;
DATE: s
INSULATION ONTRACTOR: 'WESTERN INSULATION, L.P.
LICENS N B
BY,
TITLE: PRO C ION MANAGER
DATE: SEPIENABER 30, 2004
I;
De"l
ENERGY . s., A o E
�ce8
.S .
PO. Box 621 Ph/Fax (760) 564-2044
Rancho Mirage, CA 92270 Cell: (7601250-1852
Email: DESNRG OAOL.COM
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R
LA QUINTA DEL ORO O9 3O O4
Project Title Date
FRED WARING & CLINTON ST, INDIO CA LENNAR HOMES
Project Address Builder Name
NACHO CASTENADA 760-578-6968 PLAN 2-Y 2 UNITS
Builder Contact Telephone Plan Number
ALAN WEAVER 7610-880-5504 GROUP 1
HERS,Rater Telephone . Sample Group Number
L, #CCNAW183226 09-29-04 6.4-2
Certifying Signature Date Sample Lot Number
Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS
Street Address: P.O. BOX 621 City/State/Zip; RANCHO MIRAGE, CA. 92270
Copies to: 'Builder, HERS Provider
HERS RATER COMPLIANCE STATEMENT
The house was: ❑ Tested ® Approved as part.of sample testing but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form comply
with the diagnostic tested compliance requirements as checked on this form.
❑ The installer has provided a copy of CF -6R (Installation Certificate.
❑ Distribution system is fully ducted(i.e., does not use building .cavities as plenums or platform returns in lieu of ducts)
❑ 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 duct connections.
❑ MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION ,COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct -Leakage)
Measured
Duct Pressurization Test Results (CFM @ 25 Pa) values
Test Leakage Flow in CFM
If fan flow is calculated as 400cfrrilton x number of tons enter calculated
value here
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) _
Check Box for Pass or Fail (Pass=6% or.less) 1:1 ❑
Pass Fail
❑ THERMOSTATIC EXPANSION VALVE (TXV)
❑ Yes ❑ No Thermostatic Expansion Valve is, installed and Access is ❑ ❑
provided for inspection