0403-227 (SFD)LICENSED CONTRACTOR DECLARATION
I11iereby 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
766241 A.B 7/33103
,`Date � ��? 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 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). Y
O I am exempt under Section' B&P.C. for this reasoA
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. .
S 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:
Carrier ARhL'RIC#'1i �'°ASL1A1, Policy No. rC1,:€ (09199.
(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 fo thwltji•comply with�th se%pr6vislons.
,Date: %• b7 G . 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. '
g
inature (Owner/Agent) Date
PSL/
`. f 4'%t:
BUILDING PERMIT PERMITS#II''//��' qq,
i
DATE VALUATION 4ya v LOT
<-1 . w.� 77,1.1«+�.*� �� , .: , :��a �,,
_°/ • r�- '� .
JOB SITEAPN
R�
ADDRESS.A;�iC-6/eb.4'�%VW'`•...._..•�� r
,'.l'.PSF•fw.3'.�L-i�
OWNER
CONTRACTOR/DESIGNER/EN (NEER
.L.iM'AIR C:'OMfattZ3'`MMM
1"Nlut 010MMUMI .a
2450G CIMARIADEM-1. 2,11, t)
24800 C IMISANTA DRAT, �I-pOU
s” 4�•'rii°dll �O CA 92.691
MINION V 0 CA 9;691
0491598-850o CM -0 3434
USE OF PERMIT
r
MGM F,l I: jr a91d>p'.E,?J. SIO•
SPI), LOT36'PLAN 4'YO. PERMIT WES'NOT 047CLU.0E SLOCK'WAL4
$4(X014 3PA--0R DRIVEWAY APPROACH,
T'RAC.T CONSTRUCTION OF
}�i, tC1�11% it1 T13.00 SP
C RAOUC'.ARPORT 439.00 SF
ES' IA:C>? D CO a'I• ov, conlsrrRUMM
177, 0
00148MUC'TJON FEE 101-000-418000 5911s4
PLAN Cli(ECTC FEE 1Q3-ilOa�bSf!»310 �'k24.16
WWHAM AY.1 3 D1 »U0�+421 •gOfl - °�G(i.50
Sd.-1'.C'1'RUCA1. FZR 101-00"20-000 $145.40
?UUMBB,443 FEE 1131.000419-!301'9 $172.00
3'tl OW0.MrYr10N _1?KZ - RR-S1D 101';000-241,-000 $17.70
t; j;;;Af INO FEE 101.000-423.0(3 • $15.00
DWE,LOPM, IMAPICT PY11 Lk�,40:5.00
40 -.
4
$4,496.26
` 1?+ 3s
TOS' ' YlVdrrMr-91,1 DMNOW
$C.00
APR 0 6 2004
CITY OF LA enl!!NTA
FINANCE DEPT.
RECEIPT
DATE
/.. -%�/
BY
I, J
DATE FINALED
/d Z% o�
INSPECTOR
�
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs I
Underground Ducts
Forms & Footings I
Slab Grade
Ducts
Return Air
_
_
Steel
Combustion Air
_
Roof Deck
Exhaust Fans
_ _
O.K. to 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
1107;--' 7 6 Y
Final aG
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
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 Lines
Water Piping F rr
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Gas Piping 14
Encapsulation
Gas Test
Appliances
Final
Final !d 6
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring i
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final /d A7 dG
Utility Notice (Perm) :S .69-
COMMENTS:
f !
_",f.. •fir
"'CITY OF LA QUINTA
,BUILD',I.N . & SAFETY DEPARTMENT
�. 777 ;7012
INSPECTION REQUEST LINE
'' ., " . • 7-7153
Owner LENNAR HOMES OF CALIFORNIA
Contractor
Permit Number 0403-227
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS
78-365 VIA TUSCANY uyX.
'
SFD, LOT 56 PLAN 4YB. PERMIT DOES NOT
INCLUDE BLOCK WALL, POOL, SPA OR
TYPE OF INSPECTION DATE INSP.
TEMPORARY POWER. / r
SETBACKS %
U/G PLUMBING / WASTE /` r
U/G ELECTRICAL/ GROUNDING '
FOOTINGS / STEEL '
CONCRETE SLAB
DO NOT POUR CONCRETE LOKIL,AAPVE SI E
ROOF NAIL / PRE -ROOF
OKAY TO WRAP
FRAMING COMBINATION F
ROUGH ELECTRIC %
ROUGH PLUMBING Avj I Ii
ROUGH MECHANICAL
INSULATION /
K UNTIL ABOVE SIClNE
INTERIOR GYP. BD" DRYWALL '
EXTERIOR LATH
GAS TEST /
SEPTIC ABANDONMENT
SEWER CONNECTION 73--D
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 f D' S •O S 7
ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT.
FINAL / JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
Ay
WESTERN
C
42U l Latham Street, Riverside; California 92501
Tz.1. (951) 686-8760 Fax (951) 686-8786
�. CF 6R 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:
4
TRACT/PHASE: LA QUINTA DEL. ORO PHASE 2 ,
LOT 55
SITE ADDRESS: , 78-345 VIA TUSCANY - LA QUINTA, CA
CEILINGS 0i�LANS 22 4' BLOWN INSULATION
MANUFACTURER: ' GREENFIBER THICKNESS: 10.3" R- VALUE: R-38
CEILINGS CryPLANS 2 & 4: BATTS
MANUFACTURER: JOHNS MANVILLE, THICKNESS: 13°' R- VALUE: R-38
CEILING: BLOWN INSULATION
MANUFACTURER: GREENFIBER THICKNESS: 8.1" R- VALUE: R-30
CEIL� INGS:BATTS
MANUFACTURED: JOHNS MANVILLE THICKNESS: 11" R• VALUE: R-30
EXTERIOR WALLS' BATTS
MANUFACTURER:. KNAUF • THICKNESS: ' 31/2" R- VALUE, R-13
GENERAL CONTRACTOR: LENNAR FOMES
BY:
TITLE:
DATE: I
IMUL_ATIgN CONTRACTOR: WESTERN INSULATION, L.P.
LICENSJPR
R:7 4 f
BY: t
TITLE:C I N . NAGER
DATE: MBER 30, 2004 `
_ _ .� Gin' I N-1nr_KIT KIV1 1 CZ7M ` G 89893 Z!;G 19 :Z0
De"lr*`
ENERGY" A a E
ServiC98 —
PO. Box 621 Ph/Fax (760) 564-2044
Rancho Mirage, CA 92270 Cell: (760) 250-1852
Email: DESNRG (a)AOL.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 & CLINTON ST, INDIOuCA- LENNAR HOMES
Project Address Builder Name
NACHO CASTENADA 760-578-6968 PLAN 3 2 UNITS
Builder Contact Telephone , Plan Number
ALAN WEAVER 760-880-5504 GROUP 1
HERS &qter Telephone Sample Group Number
#CCNAW183226 09-29-04 54-2
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,.) 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.
.a
❑ 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 400cfm/ton 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 Boz for Pass or Fail (Pass=6% or less) ❑ ❑
Pass' . Fail
❑ THERMOSTATIC EXPANSION VALVE (TXV)
❑ Yes ❑ No Thermostatic Expansion Valve is.installed and Access is ❑
provided for inspection .
,07/.12/04 16:12
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Mold M�vrQ to U ael Site Cb::ked � WIL_ .
SCIEDVLE NSFECTioN DAA it /"-"D
Dzt�7rappco:� of Treps:� iroxti b�':
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