0403-233 (SFD)LICENSED CONTRACTOR DECLARATION t
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
?6fl .K B .1 7/3 V03
Date y� Lf 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 the 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).
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:
O 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:
Carver AMERICAN CASUAI, Policy No.
(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: "P; L/ 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) �� 7'�� ✓ Date4
BUILDING PERMIT PERMIt�T44#��nn,��q+�
DATE VALUATION LOT 62 TRACT 30521
ADDRESS�€'ji��jA,(t� s �1
APND`:-�.b�
OWNER
CONTRACTOR /DESIGNER /EN 1NEEER
LEN,AR CKAMVST�ES
{{CMpqR OMO[l'IM
24800 C.frW3W. �'r..f�DYdVL? MO
�4�i00 CE�Rfw!t�.�I�fls l��iN1? #�66
basaXW L XTO CA 92691
2vffa .91014,V21J0 CA V2691
(�d9 )5gT3�(3 sUf3 G" +I 3 3434
USE OF PERMIT 7
BF0,143T 62 P1,AN 1 RD. P ROUT DORS NOT iI+iC1,L) DE BU?C1: WA1,4
P001t ZPA, OR =Yis•WAY A.PI�;ROACK
TRACT CONDI UC Tf 4IN 2"A aeo SF
GARAWCARPORT
PwW-11:51ATZ WAramn
PLAN CHOCK FE& 101 _0()0'r 49-3 l a $66:3.66
MECHOICA1 YKE ao����o•4a�-o�u ��n�
:'
,
LLIr,CTR1CA.L FEE 101-000-420-600" $123.75
3''LkJMB NCIt ME 1011-0004 1 9.000
ST1x.ONC6MOTIObi FEE = RESID ' 101=006-241-000
ORA.t�' NOS I71>.. 10 A.000-123-0iYd 1S,Osi
DZVELCIPITR IMPACT "Z Z
n•+ air• '
OUR- t7P ?c=27RL1CT` OW AND P7 AW Cff4F
$4,263. 8.0
ID ._(jF')
Ll ,11.
I�1C3CAr
✓6,2.a�M".
-APR 06 2004. -
004.CITY
CI -1 YOF LA CW pA
FINAk ICE DEPT.
RECEIPT
DATE
BY / I
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
olUnderground Ducts
Forms & Footings
Ducts
Slab Grade
Ji t
Return Air
Steel
Combustion Air
Roof Deck
_
Exhaust Fans
F.A.U.
O.K. to Wrap
Framing
Compressor
Insulation-
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
?X ® s
Final
POOL -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 APPROVAL
Gas Test
Electric Final
Waste LinesHeater
Water Piping
Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
log .D
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final l/ 2 0
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)
}
CITY OF LA QUINTA
F S� BUILDING & SAFETY DEPARTMENT
F^�OFrN�� 777-7012 .. "
INSPECTION REQUEST LINE
777-7153 .
Owner = r ENN c_AIIWORNIA
Contractor
Permit Number -z3 a
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES .
.JOB ADDRESS, 44470 VIA MIRABEL
SFD LOT 62 PLAN IRB' PERMIT DOES NOT
,INCLUDE BLOCK WALL, POOL, CPA OR
^ DATE INSP.
TEMPORARY POWER
SETBACKS . r:
U/G PLUMBING / WASTE'117
U/G ELECTRICAL/ GROUNDING
,FOOTINGS/ STEEL i
i CONCRETE SLAB .
DO NOT POUR CONCRETE-OMTILABOVE.SI '
ROOF NAIL / ORE -ROOF
OKAY TO WRAP ... d
I FRAMING COMBINATION
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL_ - A . _�,
INSULATION
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP. BD. DRYWALL
I. EXTERIOR LATH
GAS TEST Q
SEPTIC ABANDONMENT
- SEWER CONNECTION. •., �o-- S'O
SEPTIC /GREASE INTERCEPTOR
' 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 INSPECTIONS
TEMP. USE OF PERMANENT POWER 4 0 r
ELECTRICAL
PLUMBING +
MECHANICAL
PUBLIC WORKS DEPARTMENT l -0
COMMUNITY DEVELOPMENT DEPT.
FINAL / JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
,, TURN ON UTILITIES OR.00CUPY BUILDING
10/27/2004- 08:28 9515868786 WESTERN -INSULATION .. PAGE 05!07
XN
• - . 'f a ... .. -
UL I ,
4211 Latham Street, Riverside, California 92501
Tel. (951) 686-8760 Fox (951) 686-8766 ,
CF6R INSULATION, GERTTIFY��iT'E
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE; CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24,
STATE OF CALIFORNIAJN THE BUILDING LOCATED AT:
TRACTIPHASE: LA WU TA DEL ORO I PHASE 2 ,
LOT 62
SITE ADDRESS: 44-870 VIA MARABEL - LA QUINTA, CA
-------------------------- ------ - -
CEILINGS ft PLANS 2 & 4: BLOWN INSULATION
MANUFACTURER: GREENFIBER ° THICKNESS: 10.3" R- VALUE: R-38
CEILINGS 9-D PLANS 2 & 4: BATTS
MANUFACTURER:. JOHNS. MANVILLE THICKNESS: 13" R- VALUE: R-38
CEILINGS: BLOWN INSULATION'
MANUFACTURER: GREENFIBER t' - THICKNESS: 8.1!' R- VALUE: R730
CEILINGBATTS
S:
MANUFACTURER: ` . JOHNS MANVILLE THICKNESS:. 11" R- VALUE: R-30
EXTERIOR WALLS: BATTS
MANUFACTURER:, 'KNAUF THICKNESS: 3 112° R -VALUE: R-13
GENERAL CONTRACTOR. LENNAR HOMES `
18Y: - -
TITLE:
DATE:
Ima L 10N QGNTid�l� (C�1 : VkSTERN INSULATION, L.P.
- rasp
LICENSE 7 484
BY:
TITLE:. PR TION MANAGER
r DATE: SE EMBER 30,'2004.
P0. Box 621 Ph/Fax (760) 564-2044
Rancho Mirage, CA 92270 Cell: (760) 250-1852
Email: DESNRG RAOL.COM
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R.
LA QUINTA DEL ORO - 09-30 =04
Project Title Date
FRED WARING 8. CLINTON ST INnin CA LENNAR HOMES
Project Address Builder Name
NACHO CASTENADA 760-578-6968 PLAN 3-Y 2 UNITS
Builder Contact a. Telephone Plan Number
ALAN WEAVER 760-880-5604' GROUP 1
HERS Bater Telephone Sample Group Number
#CCNAW183226 09-29-04 62-2 1 OF 2
Certifying Signature Date Sample Lot Number
Firm: DESERT ENERGY SERVICES LLC Y' 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 -613 (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)! G values
Test Leakage Flow in CFM r 83
If fan flow is calculated as 400cfm/ton x number of tons enter calculated
value here 1400
If fan flow is measured entermeasured value here
Leakage Percentage (100 x •Test Leakage/Fan Flow) 5.928
Check Box for,Pass or Fail (Pass=6%o' or less) ® El
Pass Fail
®THERMOSTATIC EXPANSION VALVE (TXV). f
® Yes ❑ No . Thermostatic Expansion Valve is installed and Access is-. ® ❑
provided for inspection
i
3 ✓
Doi _
ENERGY s�� a E
services
X77 i
PO. Box 621 Ph/Fax (760) 564-2044
Rancho Mirage, CA 92270 Call 7601250-1852
Email: DESNRG aOAOL.COM,. .
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R .
M LA QUINTA DEL ORO ' s . 09-30=04
43n^d 4
Project Title Date
FRED WARING A CLINTON ST, INDIO CA • - LENNAR HOMES
Project Address It° Builder Name
NACHO CASTENADA 760-678-6968 PLAN 3-V 2 UNITS
Builder Contact t Telephone PlanNumber
ALAN WEAVER 760-880-5504 GROUP 1
HERS ter Telephone • Sample Group Number
•e-oma-°') #CCNAW183226 09-29-04 62-2 2 OF 2
Certifying Signature Date Sample Lot Number
Firm: DESERT ENERGY SERVICES LLC} HERS'Provlder:, 'CHEERS
. • 1
Street Address: P
.O: BOX 621. _ City/State/Zip: yRANCHO MIRAGE; CA. 92270
Copies to: ' Builder, HERS Provider '
HERS.RATERCOMPLIANCE- STATEMENTS{:.
The house was: N Tested . ❑, Approved as part of sample testing butwas 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 drawtiands 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) f
_ . Measured
Duct Pressurization Test Results (CFM @ 25 Pa) i values
S'..
u 94.,
Test Leakage Flow in CFM
If fan flow is calculated as 400cfm/ton x number of tons enter calculated
E value here 1600
x
If fan flow is measured enter measured value here
Leakage. Percentage. (1.00 x Test Leakage/Fan Flow) = 5.875
Check Box for Pass or Fall (Pass=6% or less) ® El
Pass Fail .
® THERMOSTATIC EXPANSION VALVE (TXV)
® Yes ❑ No Thermostatic Expansion Valve is installed and Access is ® ❑
provided for inspection ,