The URL can be used to link to this page

0309-237 (SATT)'r ' L;GENSED CONTRACTOR DECLARATI®N =y' I hereby affirm 'under.penalty of; perjury that'l am licensed under provisions of chapter 9,,(commencing with Section 7000) of Division 3 of the Business and P'rofession`als Code, and my License is in full force and effect. License # Lic. Class Exp. Date Date±!� r'' 17 Signature of Contractor 4.J .+ + ""V 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 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. 1(t) 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 ;STNrit FuNI) Policy No. 1583906-02 (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 tho p' rovisions. > ,pate: //j >r Applicant— Warning- 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/Q_ 3 l"' ' ' BUILDING- PERMIT PERMT# DATE VALUATION • LOT; TRACT JOB SITEAPN ADDRESS :�1IZ-:1 V ..i�'�CCI �-�G OWNER O(NEERG WYAOANI LIC RJCDMaLG-5i l`Vw. .• PQ Box 810 .1425E,. U'AylV .1 1i' D MVE 1A QU.NfA CA.. 92253 YHORIOX AZ 85034 (6.02)251.1656 C L# 4990 USE OF PERMIT tAdO1'X FAMILY XMICAM SM a LOP a E9;-I>I• AN f JA.- PFRYA T DOM NOT INCLUDE H'iXXX WAL .% POOL,'SPA OR DAdVEWAY APPROACH ' x 1. TRACT CO14S'I'RUCTION 2,3.94.00 mm PPO • 99697p w . l08 yR�CpHryIPAolk"IpO�J� r 6xt91'.RD1JSIC AA�a.C�`:R 457;00 2F Esmul-ED COST Mr CONSMUMOA, ff'ER ' VE FEN''C)'IW,RY' . CONSTRUCTION, ", .101.OM418-01D 1 PLAN t';1-IW.Y FEF MECHANICAL M. 101-000.431,400 ELWTRICAI. ".8, .1.01-000,420-000. �:. $135.43 nLUMB1140 PER . 101-000-419-000 STRONQMIDTION' a—RE$liD •1{11'•000-241.-000 $17.94 0MV40 FEE T)EVELORER IMPACT FEZ: ",. -2m ' SUB,M �'�� 'C6'.i.>rC.`�C?I+7 ABED p�t�. C111� �:F{ �q.,.202.0 .. j+ -+Usi�pn.?-PAJD FtES so,00 0.1 6 2 a ,�Yr A' ''f►'1 191�'Ii NC9W Q,rT OT RECEIPT DATE ' BY' DAT FINALED INSPECT y``r INSPECTION RECORD OPERATION DATE j INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 Footings Slab Grade - - Ducts Return Air Steel 1/ y - 3 Combustion Air Roof Deck 3 Exhaust Fans O.K to Wrap - - F.A.U. Framing - Z .- Compressor Insulation - 4 - y 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 BLOCKWALL APPROVALS 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 ep Heater Final Water Piping - Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection _ Encapsulation Gas Piping Gas Test Appliances _ Final Final Utility Notice (Gas) '",g 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) c� COMMENTS: .rf /iZ/py�03 _ •,� �� _ �� • �r CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R PALMILLA 5-A 05-11-04 Project Title Date 50 TH & JEFFERSON R J T BUILDERS. Project Address Builder Name DARRELL MORGAN 760-275,8230 OCOTILLO P-1 3 UNITS Builder Contact Telephone Plan Number RICHARD KROWN 760-250-1852 GROUP 2 HERS r Telephone A. �&p /0��N - #CC RD 13292 05-24-04 LOT # 119 " Cerfffylng S gnat a Date Sample House Numb Firm: DESERT ENERGY SERVICES HERS Provider: CHEERS Street Address: P.O. BOX 621City/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 tae is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal lea�Cs 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 400cfin/ton x number of tons enter calculated value here If fan flow is measured enter measured value here Leakage Percentage (I 00 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 provided for inspection ❑ Yes is a pass Pass Fail .....:..,«..^^rrr^n•r��..:�:;�:c^'r.^.'v.+•✓.'v'rrf•'...:ri•..ci...'r.-v..r.'•...r..,%r,^.�i,'vrr••r•rtvr'/r/ - .. • %-•r•.,,ra%rn•n� �•HY.'.Irr>%!i'n.'n-i.`%iY..Y.•/rn•»•!.^.^:'lir'Ir•Y. vr%r%r/••�.•%•.:N`r`r.../'. .,. � 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 Califomia In the building at 50-210 VIA SIMPATICO LOT 119, LA QUINTA CA CEILINGS: TYPE: BATTS MAUNFACTURER:'Certainteed THICKNESS: R-38 WALLS: TYPE: MANUFACTURER: Certainteed THICKNESS GENE=RAL CONTRACTOR: 'RJT HOMES" LICENSE # BY: TITLE PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE'# 22151.7 BY: TITLE: ACCOUNT REP.RESENTIVE DATE: .. - .< �:'•' �,•^i.. r .. :•:✓'r rla.w.rifymue;�or�rvarrr fa....«w.vw. ,.»•.r.•v.•rav yryv ar `oa, . �>rrtv;r.'nrr„r..yr.•rtavvrmm•r/r'wr✓�ry a � .. i . � .... :. :.. r. r. . r.•!//,'/'•.rrr.rr/tn•iv/r%✓/.'/'/.•'N.:.I..ir1../'.r..%r/'JJI.•/rY.'Jr.�.rV:�.A'/.'Nr-ir,!•/Y!✓: /.�/„/Yf iiiP%/r/Y/.'Y.:/r?R%^/l'H'n'Y.JrAI'h'I'•/ %. /: /.•/vI !///..,. .,.!.. r�r..�././r/, .. r , INSULATION CERTIFICATE This is to certify that insul ion has been installed. in conformance with the current energy regulation, California Admi 'strative Code, Title 24, State.of California, in the building located at CEILINGS: TYPE: BLOW MAUNFA URER: Certainteed,; THICKNESQ,3$ WALLS: _ TYPE: ' BATTS MAUNF TI RER: ertainteed THICKNESS: R713 GENERAL CONT OR: LICENSE # BY: TITLE: PARAGON SCHMID BUILDING PRODUCTS A-MASC Company LICENSE # 221517 - BY. TITLE;; ACCOUNT REPRES NTIVE DATE: • _ wr%f'AJw!Yrr•�l/r/.//✓•''F, •r./s•re.P:L`:/Nn�'/..I'Y"/'l/.'rr;Yr/••.r7nrlYJ's/'<T,r./%/:!/✓:M•i•%:Y/nr �n;.r ,. .. .� /'it✓rrr•�..�'r��ar,'..irwrM.r.%irr-.`r.�a./•�-,r:r^...,r•:.r.,,•.,•�;r � t i IN ALLATION CERTIFICATE s r , ` (Page 3 of 13). CF-6R Site Address, Permit Number _ �I r DUCT LEAKAGE AND DESIGN1 DIAGNOSTICS Sp ,2� - S ! µpA " DUCTLEAKAGE REDU.C110N PreSSurizalion1esi'Result3 (CFM Q 25.PA) Test.Lcakoge (CF,vt) ' t` , Fan Flow ir.Fan Flow is Calculated as 400 dhVtoo x number of tons, or as 21.7 xHeating Capacity t In Thousands of Btu/hr, •enter calculated value here -If fan (low Is measured, enter measured value here ' :Leakage"Fraction = Test Leakage/(Measured or Calculated Fan Flow). 0. Pass:if)eakage fraction < 0..06 " Pass Fall O For AEROSOL .TYPE SEALANTS ONLY -The following diagnostic testing was.completedr Duct Fan Pressurization at'rough-in'measured leakage (CFM) , CHECK AFTER: FINISHING WALL`.. O Yes O No 0 Pressure pan test or House "pressurization test " - ' O Yes ' ❑ No;: 0 visual,Inspection of Duct Conneetions o " o Pass Fall g THERMOSTATIC EXPANSION VALVE (TXV) gYes '0 No : Thermostatic Expansion Valve is installed and Access is -:provided for'inspeciioti . Yes is a pass D Pass Fail. O DUCT DESIGN .. .. . ACCA Manual D Design calculations have been ' 1 O Yes ❑ . .No completed, Duct Design Is'on the plans and duct Installation " matches plans. 2. O Yes 'O No, TX V is instellod.or Fan ltow hus beenverifed. if no TXV, - 0 o • ; verified'fan flow matches: design from CF-IR. Pass' Fall w Measured Fan Flow= Yes for both I'and 2 is a Pass 0: I, the undersigned, verify that the above diagnostic test results and the'work'I performed associated with the test(s) is in conformance with'the requirements for'compliance credit:-[The builder shall provide the HERS provider a copy of the CF•6R signed by the builder employees or sub-contractors certi f ing that diagnostic testing and instailation.meet the requirements for compliance credit. ] . Tests.: t ri, Date 1' sta g Subcoritractor(Co.'Name) OR. r ' Performed General Contractor (Co. Name) COPY TOE Building Department HERS. Provider (if applicable) , Building Owner at Occupancy Compliance Fortis August 2001 - A-25 • •i • _ ' � ' .. .. a ': ` . - �r �D N INSTALL!#TION CERTIFICATE (Page 3 of 13) CF-6R tilte Address 5 tt L l v Permit Number DUCT LEAKAGE AND DESIGN• DIAGNOSTICS DUCT LEAKA 'E REDUCTION Pressurizatlou Test Results (CFM 25 PA) Test L.ealage (CFM) Fan Flow If Fan Flow is Calculated as 400 efm/ton x number of tons, or as 21.7 x Heating Capacity in Thousands of Btu/hr, enter calculated value here If fan flow is measured, enter measured value here Leakage Fraction m Test Leakage/(Measured or Calculated Fan Flow) iy O Y Pass if leakage fraction < 0.06 Pass Fail u For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed: Duct Fan Pressurization at rough-in measured leakage (CFM) CHECK AFTER FINISHING WALL: 0 Yrs ❑ No 0 Pressure pan test or House pressurization test 0 Yes ❑ No 0 Visual Inspection of Duct Connections o 0 Pass Fail ❑ TBERMOSTATIC EXPANSION VALVE ❑ Yes 0 No Thermostatic Expansion Valve is installed and Access is - provided for inspection Yes is a plass t7 0 ❑ DUCT DIESLO Pass Fall 1. O Yes ❑ j�jo RCCA Manual D Design calculations have been. completed, Duct Design Is on the plans and duct installation matches plans. 2. ❑ Yes ' ❑ No TXV is installed or Fan flow has been verified. If no TXV, , 0 13 vcrificd an flow matches design from CF-IR Pass - Fail " Mcasut'cd Fan Flow m ' Yes for both 1 and 2 is a Pass ❑ I, the undersigned, verify that the ubove diagnostic test results and the work l performed associated with the tesgs) is in conformance , with the requirements for compliance credit: (The buildrr shall provide the HERS provider a copy of the CF-6R signed by the builder em to ccs or sub-contractors certifying s, P y d}+ing that diagnostic testing and installation meet the requirements for compliance credit. Tests �maturc, bate Installing Subcontractor (Co. Name) OR Pare°rrtwd Gcneral Contractor (Co. Name) COPY TO: 13uilding Department HERS Provider (if applicable) Building Owner at Occupancy Compliance Forms August2001 A-25 Z0 39dd 17ZGZ88Z 91:to b00Z/9Z/90 r -42 INSTALLATION CERTIFICATE (Page13 of 1s)SCF-6R ?_x�o lieu �4 Site Address Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS _ DUC'Y' LEAKACGE REDUC CION Pressurization Test Results (CFM Q ZS PA) Test Leakage (CFDq)•� Fan Flow If Fan now is Calculued as 400 cfm/ton x number Of tons, or as 21-7x Heating Capacity in Thousands of Stu/hr, enter calculated value here If fan -flow Is measured, enter measured value hem Leakage Fraction m Test Leakagc/(Measured or Calculatcd Fan Flow) _ 13 Pass if leakage 9 oction < 0.06 Pass Fall ❑ For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed: Duct Fan Pressurization at rough -in measured leakage (CFM) CFMCK AFTER F1bMHING WALL: q Yes O No 17 Pressure pan test or House pressurization test 0 Yes O No 17 Visual Inspection of Duct Connections + o a Pass FaU ❑ THERMOSTATIC EXPANSION -VALVE ❑ Yes 0 No Thermostatic Expansion Valve is installed and Access is - provided for inspection Yes is a pass a o ❑ DUCT n giy Pass Fail ACCA Manual D Design calculations have been I. ❑Yes ❑ No completed, Duct Design Is an the plans and duct installation + # matches plans. 2. la Yes ❑ No TXV is inatallcd or Fan flow has been verified. If 0o TXV, o t7 vcai5ed fan flow matehcs design from CF-lk Pass Fail Mi:aewed Fan Flow Yes for both 1 and 2 is a Pass . ❑ L the undersigned, verify that the above diagnostic test resulu and the we* I performed associated with the test(s) is in confon nmcc with the requirCmcnts for compliance credit. [The builder shall providt; the I-Iii1tS provider a copy of the CF -6R signed by the builder employees or sub -contractors certifying that diagnostic testing and installation u= the requirements for compliancc credit ] op,L- �- Toots Signature, Date Ins�ubcontractor (Co. Name) OR Performed general Contractor (Co. Name) COPY TO: Building Depmtneat HEM Provider (if applicable) Building Owner at Occupancy r Compfience Fomes _ August2001 A -a5 ZO 39Vd bZ6Z88Z 91:L0 b00Z/9Z/90' i 14712 SW SchoIIS Ferry Rd # 328 BeavertokOR 97007 X503-524-8268 !� 503-213-6222 (fax) SIP Engineering Consultants,LLC i 14712 SW SchoIIS Ferry Rd # 328 BeavertokOR 97007 X503-524-8268 !� 503-213-6222 (fax) z , e' {i - - �y, � ��y'. ' t.. , \.� "•✓ -�_l ems- .- rf �t ��. � •Y ., r _ ` � � ` .. �' r } .c `,fir i � ,. � .. r „ , y `. i k.:�• !t. - •� + � . i � `� � _ ,a r ccupanY INcnraoantsn 4 OFIL'� I i. u� drug Y afety p .' . ,� . This Certificate- is issued pursuant to .#h"e requirements of Section 109 of . the California: Builaling r Code;...certifying- that, -'a t., th e. time of issuance, this` ttructure was in- compliancewith, thea ` -provisions' of 'the -Building Code =and ' the 'various .ordinances of 'the City regulating building.,- construction and/or usesY BUILDING ADDRESS ,50-210 VIA SIMPATICO. L -OL Use,classiflcation S:F.D:- F ` '� ° a _ �" rBuilding Permit: No0309-237 �- n, _ .Occupancy:Group: R-3",-- Type of Construction: N -V ' = Land Use Zone:`^R-L --Owner of Building \rRJT HOMES,LLC Address: rP0 BOX 810 City; ST-�ZIP 'LA QUINTAXA 92253 B'G: y' SHOWALTER . -.Date: 06/01/04. Building Official I' 1 7 y t ..a .• , ' `POST INA CONSPICUOUS PLACE.. ` � � ` .. �' r } .c `,fir i � ,. � .. r „ , y `. i k.:�• !t. - •� + � . i � `� � _