0403-230 (SFD)r
rrr 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.
License # Lic. Class Exp. Date
dAA f1 r gi7l311t73
Date �✓ �t�/ 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:
( ) 1, 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).
O I am exempt under Section B&P.C. for this reason
Date ' Signature' of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penaltyrof perjury one of the following, declarations:
() 1 -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.
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
permit is issued. -My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
A&MRICAN CASIU L L C1Z� Oz1 1
(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 sall forthwith comply with..thosQ'provlsions�./
rDate: .,7' fr '✓r/ ,Applicant .'L.fu'! // lt; t
Warning: Failure to secure Workers' Compensation coverage is.unlawful and
shall subject an employer to criminalpenalties 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 Directorof 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) �` 6 ° Date y°
BUILDING PERMIT PERMIT"
DATE VALUATION LOT_^�� ., TRACT
01-V t# 77.CrI2.90 59 -4os.7 t 1
JOB SITE
ADDRESS
APN
44�8!& 5 VJA WRA .
OWNER
CONTRACTOR/DESIGNER/EN (NEER
in.. Comvwi nes
MEMO, CC+.IwiNwrij.a
2 4600 0-MMANTA D1 IVE #100
2A ON C 1RID.NNUA.DF{M 4200
W3131CO1+3 VW0 CA 97,691
1 irs.9r JIl 19C..1O CA 92691
(90)598-8500 CBL 304
USE OF PERMIT I
rg0, LOT 59, PLAN 4Y. P.2,11U IT WKS NOT INCLUDE Su -,CK WALL,
P004 VlPA..Oi -DR1',''ZVVA Y APPROACH, ISIv REDUCTION T O ?[,.All CHECK
I',DUE'1`t1 MUL7'IPLF, ISSUANCE OIC u.AMI F PLAN TYPE, ^
.' t •
TRACT CONSTRUCTION V46.09 or,
Pe:oRCHIPLATIO 273.00 SP
(WRACtF3C'ARPORT 424,06 VIF
MA 'T OF COMMUCTION
QOb
VkTA& 9° 11'311 RUMMMly .
CONSTRUCTION M. 101.000-x} 18.000 $912,50
PLAN CHFZ ' FEN 1 �1-c ifo0_139 3'•I 815 T.29
• �a�1,'ra'k;C,f13dIC°,Ai. TT��'L. 1(31 Ai3ti0�4�' 1. � Jfl�r $5��,�t1
ELECTRICAL 1'rY, =141-400-420.000
PLiJMBRIG ITE 101-000-419.000 aI`i'A,d0
STRONG POTION ME . RSSI[D 103 -000-241.-000
GRAt`.INO HE 701.1000-4.13.000
IDFSEP'f.i 0Pn, T1rIPACT FFY,
SUB -TOTAL COMM AND Pi" LIZ, G
$3,924,19
FBW
50.00
F -M T I'i13 h K J;`iOW.-
13,92 4,39
APR 0 72001
CITY OF L4 QUINTA
RECEIPT DATE.BY
2/ e., . 0 V
DATE FINALED
INSPECTOR r
-
//1V
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings
_
Underground Ducts
Ducts_01
-
_
Slab Grade
_
Re "t
Steel
_
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
_ _
F.A.U.
Framing
ft -OA,_
Compressor
Insulation
Vents
Fireplace P.L.
_
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - IM. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPR VAL
Gas Test
Electric Final
Waste Lines
_
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
,.7—
Encapsulation
Gas Piping
Gas Test
Appliances
14.
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
—,$"O
EsT RN INSULATION9
4211 Latham Street, Mverside, California 92501
flcl. (051) 686-8760 Fo,-. (05.1) 656-8786:
CF6R YY11SULATICN' CERTIFICATE `
THIS IS TO CERTIFY THAT. INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLr 24,
STATE OF CALIFORNIA, IN THE. BUILDING LOCATED'AT:
TRACT/PHASE: LA QUINTA DEL ORO ! PHASE 2
LOT 59 ,
SITE ADDRESS_455'UfA.MARASEL ` `LA QU)NTACA_ _ - - - - -
CEILINGS lb PLAN2 4::. J 13LOWN INSULATION
MANUFACTURER: GREENFIBER THICKNESS: 10.3" R- VALUE: R-38
CEIIwIRIG PLANS 2 &fes: BATTS
MANUFACTURER: JeCHNS MANVILLE THICKNESS: 13 R. VALUE: R-33
CEILINGS: ; BLOWN INSULATION
MANUFACTURER: GREENFIBER THICKNESS: B-1" R- VALUE: R-30,
CEILINGS, BATTS
MANUFACTURER; JOHNS MANVWLE THICKNESS: 11' R- VALUE: R-30
EX'PIOR MPALLfs: } ' BATTS .
MANUFACTURER: KNAUF THICKNESS: 3 1!2" R- VALUE: R-13
GENERAL CONTRACTOR: LENNAR HOMES -
BY:
TITLE: —
DATE: ; t
CONTRACTOR.. WESTERN INSULATION, L.P.
LICENS NUMB
TITLE: PRO I N ANAGER •,
DATE: 'SEP BER 30, 2004 -
�fr-n Q91.1RAAC;TQh T.4:?C1 tOOZ/To/oT..
i.
ENERGY A E
S amcas
PO. Box 621 Ph/Fax (760) 564-2044. ,
Rancho Mirage, CA 92270 Cell: (760] 250-1852
Email: DESNRG na AOL.COM
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7), CF -4R
LA QUINTA DEL ORO 36 .+d
Project Title Date
FRED WARING & GLINTON ST, INDIO CA L IENNAC HOMES
Project Address Builder Name'
NACHO CASTENADA 760-578-6968 PLAN 4-Y 2 UNITS
Builder Contact Telephone Plan Number
kALAN WEAVER 760-880-5504. GROUP 1
HERS RALer Telephone Sample Group Number
-r L #CCNAW183226 09-29-04" 59-2
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 orplatform• returns in lieu of ducts)
❑ Where cloth backed, rubber adhesive duct tape is installed; mastic and drawbands are used in combination with cloth r
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) 4, • values
Test Leakage Flow in CFM
If fan flow is calculated as 400cfm/ton x number of tons enter calculated
value here
F ,
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) ❑ ❑
Pass Fail
❑ THERMOSTATIC EXPANSION VALVE (TXV)
❑..Yes ❑ No Thermostatic Expansion Valve is installed and Access is ,' El
provided for inspection