0402-349 (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
WProfessionals Code, and my License is in full force and effect.
O :D M License # Lic. Class Exp. Date
rl LLJ
72810F3;filG %130/13
Z r,- Date 1/4-1W Signature of Contractor
6p OWNER -BUILDER DECLARATION
J
W LLIJ I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z_ ( ) 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).
M ( ) I am exempt under Section B&P.C. for this reason
LO
N Date gignature of Owner
O�
Q 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 LLD REPUBLIC INSU Policy No. WWII oo
(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 /all forthwh th
� �provisions.
i/pyDDate: �
'l
''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 appli�aton 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. J
Signature (Owner/Agent) f f'l '�'� Date
..r
BUILDING PERMIT PERMIT#
04C -349
DATE , ` VALUATION $.129,1'x} 2.10 LOT TRACT q�
r
ADDRESS` -i-15 t�6F.%1°1 . DMINE —� . JOB SITE
APN 60. -MO-074 l
OWNER
CONTRACTOR / DESIGNER / EN (NEER
L E101.'.w R H01a--S OF Cdsa.lx KM&
78.401 C MC-1-INVAY 111
78.40i C IRGH AY 111
LA QUltT A CA 92253
LA QI(MV.IA. CA 9225:1
(7600,7` -0131 CBL4 3434
USE OF PERMIT
ODIrrLE PAWLY i.MEE7Q,MG
S?D . IM i9, P. "N 4R. PERMIT DOMS1"OT INCLUDE BLOCK 1V'ALWI,
P00411PA C5I'. DRi'l 1r"f�'AYAI'f RO. iCH
'11RAC:T CC?T�STRUC`1°ION 2,225,0D SF
PIORMPATIQ 33.06 SP
CARACtI'iCM.AFt7RT 42.1%,00 21F
ES , `WA'�i'M COST OF iCOi��'.k UC'I701i
129,W,2,40
��yy���y,yy��ll{j yp �y ,y��
MARY
CONSTRUCTION FEE 101-000-418-000 VM4. Vit+
PLAIN CHECK FEZ 101-000-439-31-8 $610.73
MECHANICAL FEE 101.000.421-000 547.00
x;.92
FAXCT:V=A1, ME, 101-00-4210-000 $10.92
PLUMB1140 YEE 101.000.4194000 $146,73
TfRI Oi O A11 YMN F&E . RLQ: 10 101 -Gilt) -241-000 $112.99
OR3ADENO FKZ 101.000.423.000 $15103
rs>vVEWPEE IMPACT FZ9 $2,405.00
SIM TO'T AL CONTO (AMOK KND Fi:." C-f=11C
$4,101.85
U33 PRE - PAID FRW
$:0.00
nn
i t'I'i7.C'AL PY..RMr FI S.DUE NOW
10.1x5
ffAPR2001--
r
_-I 1
CITY OF LA QU:NTA
FI.NA_NCE DEPT.
RECEIPT
DATE
/
ByDATE
FINALED
/0_j--,0
INSPECTOR
• • ,''r
'14.1111
50/
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROV �.S
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings ��
Ducts
Slab Grade
Retum Air
_
Steel
Combustion Air
_
Roof Deck
au st 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 G
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 PPROVA
Gas Test
Electric Final
_
Waste Lines , jj
Heater Final
Water Piping ✓1D
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
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)
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 1 of 2 CF -6R
Site Address: 79-815 Viento Drive Permit Number:
Tract Number: 29323 Plan #: 4&4X Phase: 5
Lot Number: 19 Project: Esplanade Builder: Lennar Homes
An installation certificate is required to be posted at the building site or made avalible for all appropriate inspections.
Atter completion of final inspection, a copy must be provided to the Building Department (upon request) and the building
owner at occupancy, per Section 10-103(b). ,
HVAC SYSTEMS:
Heating EauiDment
of Efficiency Duct Heating Heating
Equip. CEC CertifiedName Identicle (AFUE, etc.) • Location Duct Load Capacity
Type and Model Name Systems (>= CF -1 R) (attic, etc.) R -value (BTU / Hr) (BTU / Hr)
USAirFC attic ---4.7--
US
Air 310JAV036070 attic
Cooling Eauioment
- I# of Efficiency Duct
Equip. CEC Certifiedr Name Identicle (SEER, etc.) Location
Type and Model Number Systems (—CF -1 R) (attic, etc.)
Cooling Cooling
Duct Load Capacity
R -value (BTU / Hr) (BTU / Hr)
---4–.T—
TV— US Air 5 attic
USAir 563CNX036 SEER7T attic
4.
t e un ersigne , verify that equipmM liste a ove is: is the actual equipment installed, equivalent to or more
efficient than that specified in the cefi of compli;(Form CF -1 R) submitted for compliance with the EnergyEfficiency Standards for residential uil n 3) ent that meets or exceeds the appropriate requirements for
manufactured devices (from the Ap Iia ce i ' ctions or Part 6) where applicable.
Team Heating & Air
Signature, Date Installing Subcontractor(Co. Name
OR General Contractor (Co. Name) OR Owner
MINIMUM REQUIREMENTS FOR DUCT LEAKAGE COMPLIANCE CREDIT.
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
CFA:
System of
Indicate the maximum aowa le Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
x 400 x (Cooling Capacity in Nominal Tons) x (0.06) 96 fan flow 1600
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow x .06
uct Pressurization Test Results 62
100 x Test Leakage / Fan Flow = % Leakage 3.88%
Check Box for Pass or Fail (Pass = 6% or Less) Pass xFaill
�T-24 Compliance Credit was Taken for TXV TXV was installed
ystem M of
Indicate the maximum a owa le Dud Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
x 400 x (Cooling Capacity in Nominal Tons) x (0.06) 72 fan flow �2
21.7 x (Heating Capacity in Thousands. of Output BTU per hour) x (0.06)
Measured Fan Flowx .06
ud Pressurization Test Results 5
100 x Test Leakage / Fan Flow = % Leakage 4.58%
Check Box for Pass or Fail (Pass = 6% or Less) Pass xFail
OT -24 Compliance Credit was Taken for TXV TXV was installed
PAGE 1
F2001-01 (4-02) Action Now T-24CF6-RTD&TXV macro
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage r& TXV Page 2 of 2'CF-6R
Site Address: 79-815 Viento Drive Permit Number: 0
Tract Number: 29323 i Plan #: 4&4X Phase: 5 ,
Lot Number: 19 . * Project: Esplanade ' Builder: • , ,Lennar Homes
System [� of , I
Indicate the maximum a owa le Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for'Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow x'.06 .
uct Pressurization Test Results
100 x Test Leakage / Fan Flow = % Leakage y
Check Box for Pass or Fail (Pass ,= 6% or Less)
�T-24 Compliance Credit was Taken for TXV TXV was
System � of t
Indicate the Eii mum allowable;Duct Leakage and the calculation used: y
0.7 x Floor Area x (0.06) for Climate Zone 8 throughl5 r
0.5 x Floor Area x (0.06)' for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow I x .06
uct Pressurization Test Results (CFM go 25
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass =•6% or Less)
T-24 Compliance Credit was Taken for TXV i ' TXV wa:
ystem � of ` •* r - -
Indicate'the maximum allowable,Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for,Climate Zone 8 through 15
0.5 x Floor Area x (0.06) for Climate Zones 1 through 7 & 16
400 z (Cooling Capacity in Nominal Tons) x (0.06)
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06) ,
Measured Fan Flow • x .06
uct Pressurization Test Results
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass 6% or Less)
�T-24 Compliance Credit was Taken for TXV ` TXV wa:
ystem [::::] ofR'.
Indicate the maximum allowable Duct Leakage and the calculation used:
0.7 x Floor Area x (0.06) for Climate Zone 8 through 15
0.5 x Floor Area x (0:06) for Climate Zones 1 through 7 & 16
400 x (Cooling Capacity in Nominal Tons) x (0.06) • '
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow I x .06
uct Pressurization Test Results
100 x Test Leakage / Fan Flow =�%' Leakage
Check Box for Pass or Fail' (Pass = 6%"or Less)
r --1T-24 Compliance Credit was Taken for TXV TXV•wa:
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 re
quirements.fo mpliance crg it. (The builder shall provide the HERS provider a copy of the
CF -6R signed by the builder employ or a rs rtifying that diagnostic testing and installation meet the
requirements for compliance credit.)
fan flow .
0
fan flow
0
0
fan flow
fan flow
• �t I 0 -r -Team Heating & Air
ester— Installing Subcontractor(Co. Name
Performed OR General Contractor (Co. Name) OR Owner
COPY TO: Building Department
HERS Provider (if applicable)
Building owner -at Occupancy-
' e PAGE 2
} F2001-01 (4-02) Action Now T-24CF6-RTD&TXV macro
4 e f '• b•
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-
...
.. . •.
Cerfille'ate o Ins'ulatloft
Your Rome has been insulated with CertainTeed Fiberglass Insulation products, wraith arse desintned "
for today's safety standards and tomorrow's energy requurememts.
Fiberglass is inorganic and therefore permanently noncornbustibte, so it does not have to be treated
r`ni
with fie -retardant chemicals that will liltely lose their effectiveness over time. It has not be+erv'arelted e
with chemicals that can corrode wiuimg or metal. Fiberglass will not absorb moisture nor will it j -
' settle over time as may other insulation materials.
This also certifies that CertainTeed Fiber Glass InsuLition has been professionally installed in this home
,
to provide the follow. ing thermal perfortmAnce:
-.Dob Name: Tapestry Qr Esplanade Tract: 29323 - Phase:
fi
Lot it'.: � � � Plan: 411 - . ,address: _ 79 - 015 Vieru o Dr., Ln Quinti, CA - <
'=
Ceiling Area:R-3& Blo%vo - GaragetCeiliog: - - .anterior -Wails:
With Living Above
Overhangs: Exterior Walls: R -l3 Unfaced Batts
Ceiling: Garage Wall: Cantilevered
4
. . ,
dnaccessible to Blow Floors Vry'/i.hing .Above ,
Sub"actor. OJ Insulation Co., Inc.
-
y
600 . t" Azuo 91702 626 �1 o License +9463709
r
Signed ,
Conchita Ortiz, SecretaryAllreasure'r -mole-= R. Stott JenAcins, President --or_
` }°
_ Lou Meroia, Direcltor of Operations Officer
U) `
R- means resistance to heat flow. The higher the R- value, the greater the insulating power. ,
a
Ask your builder for the fact sheet. on IR- values. IKctp O s certificate with yourother
valued papers. If you ever sell this haine, this certificate should be passed an to the buyer.
• • .. .. _ .
0 ------
it-OF-L-A QUINTA
—
OF-L-AQUINTA
BUILDING-& SA_FETY. DEPARTMENT
c�Ar OF 777-7012
K
k INSPECTfON REQUEST LINE
,a ..777-7.153
Owner
LENNAR ;HOMES OF CALIFORNIA
Contractor i,F.NNAR HOMES OF CALIFORNIA
Permit Number 0402-349
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-815 VIEN'I'O DRIVE
SFD - LOT 19, PLAN 4R. PERMIT DOES NOT
INCLUDE BLOCK WALLS, POOL, SPA OR
DRIVEWAY APPROACH
TYPE OF INSPECTION I DATE I INSP.
TEMPORARY POWER
SETBACKS
U/G PLUMBING /WASTE
U/G ELECTRICAL / GROUNDING
FOOTINGS/ STEEL
CONCRETE SLAB
DO NOT POUR CONCRETE VINTIL PyBOVE SI RD
ROOF NAIL / PRE -ROOF
OKAY TO WRAP 11 ✓
FRAMING COMBINATION
ROUGH ELECTRIC
ROUGH PLUMBING `
ROUGH MECHANICAL
INSULATION -
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP. BD. DRYWALL
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT yl
SEWER CONNECTION 6i
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 b
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT. o
FINAL / JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
�i
R
!akage & TXV Page 1 of 2 CF -6R
Permit.Number.
Plan #: 4&4X Phase: 5
oject: Esplanade Builder: Lennar Homes
ralible for all appropriate inspections.
partment (upon request) and the building
of Efficiency Duct Heating Heating
Identicle (AFUE, etc.) Location Duct Load Capacity
Systems (— CF -1 R) (attic, etc.) R -value (BTU / Hr) (BTU / Hr)
attic —4
attic
oEfficiency Duct
Identicle (SEER, etc.) Location
Systems (—CFAR) (attic, etc.)
Cooling Cooling
Duct Load Capacity
R -value (BTU / Hr) (BTU / Hr)
attic
4.
attic
4.
hent insta e , 2 egwva ent to or more
fitted for compliance with the Energy
:xceeds the appropriate requirements for
here applicable.
Team Heating & Air
Installing Subcontractor o.Name
OR General Contractor (Co. Name) OR Owner
,NCE CREDIT
-eakage)
x .06
x .06
P
TXV was
TXV wa!
PAGE 1
F2001-01 (4-02) Action Now T-24CF6-RTD&TXV macro