0402-288 (SFD)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 # tic. Class Exp. Date
6906-ty Ari � 1 f � C313OY04 .
--% "'4 'Signature
Datell of Contractor �� � gyp•• !`�-
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).
() 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.
, ( ) 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 Policy No.
STATEFUND 1S011906-01
(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: �i "' q f 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 pursuantito—
any permit issued as a result of this applicaton agrees to, & shall, indemn
& hold harmless the City of La Quinta, its officers, agents and employee
'2. Any permit issued as a result of this application becomes null and voi [if
work is not commenced within 180 days from date of issuance of su ch
permit, or cessation of work for 180 days will subject permit to cancellatic n.
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 buildi g
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes. ,., '
Signature (Owner/Agent) Date�f"-%'
PERMIT PERMIT#
..BU1ILDING
DATE 1 }jjII1' VrALUATION �v LOT 6,402.2M TRACT
�! � �� �/.x.
11�Ae37/iyw�.��iS•dQ� tia A's���al Va'S
JOB SITE y f
APN
ADDRESS 1 � 11
7.711 370.013
OWNER
CONTRACTOR/DESIGNER/ENGINEER
VT ZTO 'S I='
%.3'fi' t�1 S€ s i .114c.
POB QX 810
;125 F. 11MVtRMY DME,
IAQT-TiWTA CA 92253 '�
11,11i011WT: J, 850U
(G02)357.1656 CBVi- 4990
USE OF PERMIT
S1Y+1i:3.11 RA10i 4+IF D' J:IM
SFD •• 110T e3, PLAN SM(A, 2�Ef.ttfi "fJONS :2f7'f''d�fCt.Ii.D PGtO
SPA4 DIX)CK W AI,.L% Chi:01-VI SWAY APPROACH
TRACT VOUSTRUCT1614 8R'
I�Cai Ck£lir�t�`1'ICi" �f39.t10 SP
GARA.CSR, C WORT 7,14,00 31'
'C'I1bZAWD d.:OSIF Or, a:C+Mi:RUC' ON
201NA1 ,3
Ca?SMUCTION 11;-1? 101-000-4181-000 $1121 IDO
PLAN C;HfrL K KEE $1,037.33
M3'CH1+►.td1CAL FEE 101-000--421-000 $150100
ZL,E r'TR1C9.L FZZ 101-000-420-000 $249.7.?
PUMINQFLL 1.01-0070-419.1700 $299.011
-
TRJN'O MOTION IjE E - RE,`;ID 101.0004A1-000 $26.26
GRADING FrE 01.0300.4*41.00.0 �93,OG
DEVY.rC)PER 004PAC'•7' PZZ $2,40.00
ART N PUBLIC P"CSS - RE -311:. 270-060-4455-000 $196.43
,
•" �•AZ>:°C3AIa, 1}C't1CJ1�T r�1tiC% C +3C:f CT3
't
•$5,-,38:76
G J 1.103 1afiE-F'a41 C? M0,
S0100
APR 41 2004 IrorAL PIUMRIV YKEN DUF. NOW
CITY OF LA OWN TA /
t
�
4, FINANCE DEFT. ( "• ,
''lbroii
RECEIPT
DATE J' " f f' `( �I
BY �, h 7
DATE FINALEDINSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
et Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
_ 4-
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.
Final—
Final —
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 APPROVALS
Gas Test
Electric Final
Waste Lines 7.7
41-24--1
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
.2 G
Encapsulation
Gas Piping
Gas Test
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) -� _
COMMENTS:
exert -
NERGYeC
A 0 E
Seemcm _
•.
•
M Box 621 Ph/Fax (760) 564-2044
Rancho Mirage, CA 92270 Cell: (760) 250-1852
Email: DE-SNRG OAOL.COM,
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Pagel of 7) CF -4R
tt
t PALMILLA PH 7 DATE TESTED 11-9-04
Project Title Date
79-61.0 VIA SIN CULDADU LA QUINTA, CA. 92253 RJT HOMES
„yProject- Address Builder Name
t CHAD MEYER 760-5646555 PALO VERDE SF2C4 3 UNITS
#' Builder Contact Telephone Plan Number
RICHARD KROWN 760-250-1852 GROUP 5
HERS Rater Telephone Sample Group Number
#CCNRK613292 11-18-04'' LOT 23 I OF 3
. Certtfying,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. 9.2270 '
` Copies to: Builder, HERS'Provider
fq'
s" HERS RATER COMPLIANCE STATEMENT f
The house was: ® Tested ❑ Approved as part of sample testing but was not tested
i
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.
I
® The installer'has.provided a copy of CF -6R (Installation Certificate.
Distribution system is fully ducted(i.e., does not use building cavifies 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 97--.-
7:"._If
Iffan flow is calculated as 400cfm/ton x number of tons enter calculated
y value here 2000
If fan flow is. measured enter measured value here
I -
ir•
Leakage Percentage (100 x Test Leakagc[Fan Flow)— 4.85
i
Check Box for Pass or Fail (Pass =6% or less) " . ® ❑
Pass ,-Fail
I.
® THERMOSTATIC EXPANSION. VALVE JXV)
• ® -Yes ❑ No Thermostatic Expansion Valve is installed and Access is
.
provided for inspection _` ❑
+I
®esen,
ENERCI� S,, - A E
•
P0. Box 621 Ph/Fax (760) 564-2044
Rancho Mirage, CA 92270 _ , Cell: (760) 250-1852
Email: DESNRG-OAOL.COM-
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page ]:of 7)'C F -4R
'
- PALMIL•LA PH 7 DATE TESTED11-9-04
r
Project Title' Date
79410. VIA'SIN CULDADO LA QUINTA, CA. 92253 RJT HOMES
Projectress CHAD MEYER 760-564.6855 Builder Name ,
PALO VERDE SF2C4 3 UNITS',
'
Builder Contact Telephone Plan Number
RICHARD KROWN 760450-1852 GROUP 5
HERS Rater: Telephone Sample Group Number
#CCNRK613292 11 -I8 -L14 LOT 23 2 OF 3
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
##ii
Copies to: Builder; HERS Provides
'
HERS RATER COMPLIANCE STATEMENT ..�.
t
The house was: ® Tested ❑ Approved as part of sample testing but was not tested
I
As the HERS rater` providing diagnostic,testing and field "verification, I certify that the houses: identified on this form comply
with the diagnostic tested compliancerequirements as checked on this form.
The installer has•provided a copy of CF -6R (Installation Certificate.
i
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
it
backed, rubber adhesive duct tape to seal leaks at duct. connections.
® MINIMUM REQUIREMENTS FOR. -DUCT LEAKAGE. REDUCTION COMPLIANCE CREDIT
i.
Duct Diagnostic Leakage Testing :Results: (Maximum 6% Duct Leakage)
Measured.
Duct Pressurization Test Results (CFM @ 25 Pa) values -
.
I
Test Leakage Flow in CFM 93`
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
.651
Leakage Percentage (100 x Test Leaka;e/Fan Flow) = 4.651-
CheckBox for Pass or Fail (Pass =6% or less) 1z ❑ S
Check
Pass' Fail -
® THERMOSTATIC EXPANSION VA.LVE..(TXV)
t
'
®'Yes El No Thermostatic Expansion Valve -is installed and Access 'is,.
1z"0
provided for inspection ,
�.
P0. Box 621 Ph/Fax (760) 564-2G44
Rancho Mirage, CA 92270 Cell; (7601250-1852
�•
Email: DESNRG &AAOL-COM
CERTIFICATE: OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Paged of 7) CF -4R
PALMILLA PH 7 DATE TESTED 11-9-04 -
Project:Title Date
1 79-610 -VIA SIN CULDADO LA QUINTA,.CA 92253 RJT HOMES
Project Address Builder Name
CHAD MEYER 760-564-6555 PALO VERDE SF2C4 3UNITS
Builder Contact Telephone Plan Number.
RICHARD KROWN 760-25014852. GROUP 5 "
HERS Rater, Telephone Sample Group Number
. .
" #CCNRK613292 11-18-04 kLOT 23 3 OF 3
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
t
Asahe.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.
r
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 36
If fan flow is calculated as 400cfrn/ton x number of tons enter calculated
"
value here 600
Lf fan -flow is measured enter measured value here
LeakageTercentage (100 x Test Leakage/Fan Flow) = 6
Check Box for Pass or Fail (Pass =6%'or less), ® ❑
S
Pass Fail.
1
® THERMOSTATIC EXPANSION. VALVE;('i'XV)'
:® Yes ❑ No Thermostatic. Expansion Valve is installed'and Access is
®_ ❑ '
provided for inspection :
79-610. Via Sin'Cuidado
Site -Address
CF -6R
1-C7 � a 3 •
Permit #
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided an this form is
required; however, use of this form to provide the information is optionl.) After completion of final inspection, a copy must be provided to the building
department (upon request) and the building owner atoccupancy, per section 10-103(b).
HVAC SYSTEMS:
Heating Equip-ent
Equip. Type: # of Efficiency Duct Duct or Heating Heating "
` (pkg. heat CEC Certified Mfr, Make & Identical (AFUE.ctc.)' Location Piping Load Capacity
pump. eta) Model Number Systems . [2CF-1 R value] (attic, etc.) R -value (]3tu/hr) (BTU/Hr)
"FA.UY "" :zCARRIER 58STX110122 2 80.0°% ATTIC R-4.2 110,000.
COIL FIRST CO 24 HXO
tooling Equipment
Equip. Type # of Effeciency Duct Cooling Cooling
(pkg. heat CEC Certified Compressor Unit -Identical' (SEER, etc)' Location Duct Load Capacity
pump, etc.) — Mfr.: Name and Model Number Systems [aCF-I R value] (attic, etc.) R -value (Btu/hr) (BTU/Hr)
'A/C COND. .-'CARRIER 38BRC060000 2 12 ATTIC R4.2 60,000
1 a reads greater than or equal to.
1, the undersigned; verify that the equipment listed.above is: I) is the actual equipment installed. (2) equivalent to or more efficient than that specified in -the
ifeitificate of compliance (Form CF -1 R) submitted for compliance with the Energy' Efficiency Standards for. residential buildings, and (3) equipment that meets'
or exceeds the appropriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable.
A,MPA.M LDI Mechanical
Diana Coria 10/8/2004 HVAC Subcontractor (Co. Name) ,
OR General Contractor OR Owner
WATER HEATING. SYSTEMS:
Water CEC Certified Distribution If Rccir- Rated Input Tank. Efficiency Standby " External
Heater Mfr Name & Type (Std, . culation, # of Identical (kW or volume: (EF, RE) :Loss.(%o). Insulation.R-
Type)# Model;Number• Point-oPUse) Control Type Systems Bt&hr) (gallons) value
FAUCETS & SHONVER HEADS:
All faucets and showerheads installed are'lisied in the Commisions Directory of Certified Faucets and Showenccads,
pursuant to tide -24, Pan, 6, Subchapter 2,'Section 1.11.
I, the undersigned,.verify that the equipment listed in the category above my.signature is the actual. equipment installed and that theequipment meets.or exceeds
the requirements of the Appliance Efficiency Standards. In addition. I have verified that the equipment is equivalent to or more efficient than the equipment
specified on the Certificate of Compliance submitted. to demonstrate compliancewith the Enemy Efficiency Standards for residential buildings.
RCR COMPANIES
Signature, Date Plumbing Subcontractor (Co.'Name)
-.OR General Contractor OR Owner
COPY TO: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy
INSTALLATION CERTIFICATE (Page 3 of 13) CF -6R
kkl PJ- 7 LUT 'z3
Site Address Permit Number
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
DUCT LEAKAGE R DUU110N
Pressurization Test Results" (CFM @ 25 PA) Test Leakage (CFM) (ZC)
Fan Flow
If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity 1 Z
In Thousands'of Stu/hr. enter calculated value here
If fan flow is measured, enter measured value here
Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow)
Pass if leakage fraction < 0.06 Pass Fail
0 For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed:
Duct Fan Pressurization at rough -in measured leakage (CFIvi)
CHECK AFTER FINISHING WALL
❑ Yes ❑ No 0 Pressure pan test or House pressurization test
0 Yes ❑ No ❑ Visual Inspection of Duct Connections o o
Pass - Fail
❑ THERMOSTATIC EXPANSION VALVE M,CV)
❑ Yes: ❑ No Thermostatic Expansion Valve is installed and Access is - provided for inspection
Yes is a pass w
❑ DUCT DESIGN Pass Fall , ,•
ACCA Manual D Design calculations have been
1. ❑ Yes ❑ No completed, Dud Design is on'the plans and duct installation rr s
matches plans
2. ❑ Yes ''❑ No TXV is installed or Fan flow has been verified.. If no TXV, ° p
verified fan flow matches design from CF -IR Pass Fail '
Measured Fan Flow -
' Yes for both I and 2 is a Pass
O 1, the undersigned, verify that the above diagnostic test results and the work I performed associated with the tests) is in conformance _
with the requirements for compliance credit (The builder shall provide the ITERS provider a copy of the CF -6R signed by the builder
employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit
sly ,
Tess Signature," Datc Installing Subcontractor (Co. Name) OR
Performed General Contractor (Co. Name)
COPY TO: Building Department _ f
HERS Provider (if applicable)
Building Owner at Occupancy
i
Compliance Forms August2001: A-25
INTST .• CATION CERTIFICATE (Fa;e 3 of 13)
CF-6R
7 lei 2�
' Site Address Permit Number
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
D1.JC'1' LIQ.KAGE REDUC1'lUN
• Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM)12—C)
Fan Flow
If Fan Flow is Calculated as 400 cfrWton x number of tons, or as 21.7 x Heating Capacity
` in Thousands •o( Btu/hr, enter calculated value here ,
If fan flow is measured, enter measured value here
.�
• - Leakage Fraction =Test Lpkage/(Measured or Calculated Fan Flow) =
Pass if leakage fraction <0.06 Pass
Fail `
O For AEROSOL TYPE SEALANTSONLY -The following diagnostic testing was completed:
Duct Fan Pressurization at rough-in measured leakage (CFIvn
CHECK AFTER FINISHING WALL:
O Yes ❑ No O Pressure pan test or House pressurization test
❑ Yes O No ❑ Visual Inspection of Duct Connections p
Pass
Fail
O THERMOSTATIC EXPANSION VALVE PI'XV1
O Yes ❑ No Thermostatic,Expansion Valve is installed and Access is -provided for inspection
,
Yes is a pass b
p
• O DUCT DESIGN Pass
Fall
RCCA Manual D Design calculations have been
1. O Yes ❑ No completed, Duct Design Is on the plans and duct Installation
matches plans.
`
} f 2. O Yes O No TXV is installed or Fan flow has been verified. If no TXV, q
p f
verified fan flow matches design from CF-11L Pass
Fail
Measured Fan Flow=
Yes for both 1 and 2 is a Pass
O . I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is in confomtiartce
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 certifying that diagnostic testing and installation meet the requirements for compliance credit J
Tau Signature, Date Installing Subcontractor (Co. Name) OR
- - Performed General Contractor (Co. Nana)
COPY M., Building Department
4
HERS Provider (if applicable)
;
Building Owner at Occupancy
Compliance Forms August2001
A-25
A.
INSTALL HON CERTIFICATE (rage 3 of 13)
PA
Site
... Address Permit Number
J�ESIN DLDUCT 1iAGJ
Zi
DUCT LE -A L&GE REDUCTION
Pressurization Test Results (CFM Q 25 PA) Test Lealtage (CFM)
Fan Flow
If Fan Flow is Calculated as 400 chnhon x numbe: of tons, or as 21.7 x Heating Capacity
In Thousands of Btulhr, enter calculated value here
If fan flow Is measured, enter measured value here 3b
Leakage Fraction = Test LealagKMeasu ed or Calculated Fan Flow) _
Pass if leakage fraction < 0.06 ass Fail
O For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed:
Duct Fan Pressurization at rough -in measured leakage (CFM)
CHECK AFTER FI MUNG WALL:
O Yes O No O Pressure pan test or House pressurization test
O Yes O No. O Visaal.Inspection of Duct Connections o 0
Pass Fail
❑ THERMOSTATIC EXPANSION VALVE (TXV)
Yes O No Thermostatic Expansion Valve is installed and Access is - provided for inspection
Yes is a pass
Y QDICT DESIGN Pass Fail
..
ACCA Manual D Design calculations have been
1. O Yes O No completed, Duct Design Is on the plans and duct installation
matches plans
a w-
2. O Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV, Pass Fail -
verified fan flow matches design from CF -IR.
Measured Fan Flow '
Yes for both T and 2 is a Pass
C! 1, the undersigned, verify that the above'diagnostic test results and the work I perforated associated with the tests) is in conformance
with the requirements for compliance credit (The builder shall provide the HERS provider a copy of the CF -a signed by the builder
employees or sub-contracittrs certifying that diagnostic testing and installation meat The requirements for eomplimre credit. J
J., 10-24--p,4
^s- L
'Tests etiditure, Date Installing Subcontractor (Co. Name) OR `
Perfomed General Contractor (Co. Name) -
COPY To: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy :
Compliance Forms August,2001 A- 25
,`. _ . 3.. , rte... "`. -� Y o r � ' - .i _ t . - �' =} - {. ?kms. ` � ^ '.. .. , � � a \• �- ,, � .� . "� ` ' , J �,.�. v • '"� C f 3
ejtificateccypanpy,-�
.-Z.%z
�6`
r,?.' '�• - I�cosvoaAnv .+ *
9 `, & Safety Dep-artment.'
,Building q
This Certificate is_ issued -'pursuant -to-- requirements of Section 109 _of 1he California'Building '
Code, certifying that; at ahektime of issuance,, , this. structure -=was ;in compliance with' the.
provisions. of, the Building Code_ arid., the, various ordinances `of `the •: City - regulating building(,
construction and/or use.,' = j
- - BUIL DING`ADDRESS 79=610' VIA SIN CUIDADO r�-
��-
Use classification S. f ' \ `_ `Building Pe mit:No.` :0402-288 ,
"Occupancy Group: R-3 �` �- �,� Type -,of Construction. V -N _ ` Land Use Zone: R -L'
.. .! .. .1..
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J� v sr.Ir =-•
� . y . ,. �•. � �� - � ^•. Y ]s. V `
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Owner of Building. RJT HOMES LLC' _ a ° Address: PO BOX°810
City; ST,21P: LA QUINTA CA:' 92253
µ
�; �� -"� '. By.^G. SHOWAL-TER 4- •"'`
Y_r
✓'.kms
- ! �>. r ..>> �� ; • Date: 11/04/04
`�
.w,Bullding,Offi I , -
U� ,
P, i^
:POST IN A CONSPICUOUS PLACE
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