0403-219 (SFD)LICENSED CONTRACTOR DECLARATION
iI hteby 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.
t License # Lic. Class Exp. Date
766241. ! a 'a., 1/( )3
Date� Signature of Contractor`s/��
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).
( ) 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 for which this permit is issued.
nr I have and will maintain workers' compensation insurance, as required by
Seciion 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 AMPIYiC:.r H C:ASilAL. Policy No. W(1113320101'
(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 forthwi h comply with t dse �royyisioris,.
Date: U42 2' Applicant—
Warnings
pplicantWarnings 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 PERMIT#
DATE VALUATION LOT �1 TRACT
48 30321.
JOB SITES a1
AD DRESS
.t��V
APN
t°)'���•�
OWNER
CONTRACTOR/DESIGNER/ENGINEER
NyyNVFR rrlppJVl�7MMry
8
4ENAR. CaNiWZ,
24800 C.( SPON ;CAADRIVVE92.00
24800 CEIR.MA1TADIME#2 0
"SONVIYU0 CA 92691.
Mds,810W VIRJ J (:.t1. 92691
(949)598-8500 CRL4 3434
-
USE OF PERMIT
SDI GLLF1111A l..X1y+WItLLxT.�G
SIVA LC)T Po PILAkd W.M. P-L?RVill- DOP-S I40T 11401 UDE 131..1?L:K WALL,
,P0014 SPA Oft DRIV EMAY APPROACH,
TRACT CUPST'RUC:TI" Z900-SD15 SF
POItCHY'PAT IO S?
s 1►tiAC"1riCARPOR,T 637,00S F
yyEMMUFEM 8TAIMAf.^y4�f9p
CONSTRUCTION ME 101-1130.0.418.000 593�.�11
PLAN CHECK FILL?
SSS f G'.t`�w1C Z.!. nE 101.000.421.000
LLECT IMCA1, 1,01-000-420-000
PLUM90 FEE 1t?l�t�pb.419--t1i0C) $433,25
S7' ONCI MOTION FEE • RP -031D 101-000-241-000 $17.30
(JFtADINA0 FEE 101-000423.000 $15,00
riEVELOPEIM IMPACT FEE $4405.430
ON' AIS PLAM CIBECT.
:4,52, 19
4 A%,l . ill YMES DIDE 140A,
$4,5V.79
APQ 0 6' 200
Dr !,,A f1,MU BTA
*12
RECEIPT
DATE
BY
DATE FINA ED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs Jzf
Underground Ducts
Forms & Footings
Ducts
_
SI rade _ _--Return
It I _ _
f Deck
Air
Combustion Air
Exhaust Fans
O.K. toll
o Wrap
F.A.U.
_ _ _
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
Final m d
BLOCKWALL A PROVALS
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 APPROVALS
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 ,p
Encapsulation
Gas Piping
Gas Test _ _Al3
Appliances
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) g — �—
COMMENTS:
La(�a
c
O�
CITY OF LA QUINTA
.BUILDING & SAFETY DEPARTMENT
FyOF rte° 777-7012
INSPECTION. REQUEST LINE
777-7153
Owner LENNAR HOMES OF CALIFORNIA
Contractor
Permit Number 0403-219
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST -SIGN ALL APPLICABLE SPACES
` JOB ADDRESS 60 �7TUSCANY
SFD, LOT 48 PLAN 3XZB. PERMIT DOES
NOT INCLUDE BLOCK WALL, POOL, SPA
OR DRfVEWAY APPROACH,
TYPE OF INSPECTION ' DATE INSP.
TEMPORARY POWER
SETBACKS
U/G PLUMBING /WASTE
U/G ELECTRICAL / GROUNDING
FOOTINGS / STEEL i
CONCRETE SLAB j
DO NOT POUR CONCRETE UNTIL AB IG
ROOF NAIL / PRE -ROOF
OKAY TO WRAP I
FRAMING COMBINATION
'd 11A
ROUGH ELECTRIC I I lorI
.I
ROUGH PLUMBING
ROUGH MECHANICAL r
{
INSULATION +
COVER NO WORK UNTIL ABO E SIGVtD
INTERIOR GYP. BD. DRYWALL I
EXTERIOR LATH
GAS TEST C _• c% f/
SEPTIC ABANDONMENT
SEWER CONNECTION �� •{ S
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
ELECTRICAL ==
r PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT.
FINAL / JOB COMPLETED'
H {• o
'43 l ] Latham Street, Riverside, California 92501
TeL (951) 686-3760 Fax (951) 686-6786 '
CF6R INSULATION CERTIFICATE
THIS IS TO CERTIFY 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''
TRACT/PHASE: LA OUINTA CEL ORO / PHASE 2' ,
LOT 48 '. .' .1
SITE ADDRESS. 78-360 TUSCANY — LA QUINTA, CA
CEIUNGS ja PLANS Z& 4: BLOWN INSULATION
MANUFACTURER: GREENFISER THICKNESS: 10.3" R- VALUE: R-38
CEILINGS �3t PL.Arou'4: BATTS' ;
MANUFACTURER: JOHNS MANVILLE THICKNESS: 13' R- VALUE; R-�S
CEILINGS., BLOWN INSULATION
MANUFACTURER: o GREENFIBER THICKNESS: 8.1" R- VALUE: R-30
CEILINGS: BATTS
.MANUFACTURER: JOHNS MANVILLE THICKNESS: 91 R- VALUE: R -3C ,
EXTERIOR UVALLS BATTS
- MANUFACTURER: KNAUF ^ THICKNESS: 3112" R- VALUE: R-13
GENERAL QQNTRACTOR: LENNA,R'HOMES
BY:
TITLE:: ,
DATE:
INSULATION CONTRACTOR: WESTERN INSULATION, L.P.
LICEN R: 7 4484
- BY:
TITLE: P C71 N MANAGER
DATE: SE EMBER 30, 2004
• `
Desen
ENERGY
P0. 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 09?nmOd
Project Title Date
FRED WARING A CLINTON ST, INDIO CA LENNAR HOMES
Project Address - -Builder Name
NACHO CASTENADA 760-578-6968 CASITA I UNITS
Builder Contact Telephone Plan Number
ALAN WEAVER - 760-880-5504 GROUP 1
HERS Raker Telephone Sample Group Number
1CCNAW183226 09-29-04 48 AOF'1
Certifying Signature Date Sampl of Number
Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS
Street Address: P.O. BOX 621City/State/Zip: RANCHO MIRAGE, CA. 92270,
Copies to: Builder, HERS Provider 78- 3 60 0,q 'TJS eA4-7
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 48
If fan flow is calculated as 400cfm/ton x number of tons enter calculated
value here 800
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) 6
Check Box for Pass or Fail (Pass=6% or less) ®. ❑
Pass Fail
t� ® THERMOSTATIC EXPANSION VALVE (TXV) `
®, Yes ElNo Thermostatic Expansion Valve is'installed and Access is ® ❑
provided for inspection
FROM -:PD-EP PALM DESERT :FAX NO. :1-760-674-5742 Jul. 28 2004 04: 00PM fP3
f �
C oaT)crativr_ Red Ant Project.
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