0402-358 (SFD)(S d Lf)
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LICENSED CONTRACTOR DECLARATION
.1 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 # Lic. Class Exp. Date
7��1G2 � I�� } �I13p1r14•
Date l � �/' �i Signature of Contractor kj��� ` f/0-1
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 andwill 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.
(]l) 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:
Cartier OLJ 71'L1131,1.0 1 v Policy No. PAW(A0u"r, 600
(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 shalllforthwith comply with th/ seprovi's ion`s. ,
e - Date: 'CT t/' °r`/ 1✓ Applicant -
Warning;
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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, 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. t
,—,Signature. (Owner/Agent):- � _ Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT
$12127 aC 160 20a 29M
JOB SITE
ADDRESS '79 -WI 'QgpTJTJ'o ffla E E
APN
609^380.0241
OWNER
CONTRACTOR/DESIGNER/ENGINEER
L-MINAaZ i=aO1:AES OF CALIFORNIA.
! •K 1?WAR RCjM09 OF CALWOR:MA
78.401 C ERGHWAY 111
111
LA (,Iuan & CA V2253
L�k QT.e" l'4q .p. CA. 92233
(76O'j177.0131: � I LO 34.34
USE OF PERMIT '
1fD - LOT 28, PLAN 2. PERMIT DOES NOT INCLUDE 1II,0C.XWALIZ, �
11004 SPA cal; ]DRVid'SWAY APPItOACH. 7$% j<IFNXICTIC' N TO PLAN Clirkc=
ig
FEE DUE TO MULTIPLE TIPLE' ISSUANCE OFSAME PLAN TRIPE i "
i:i.'3C l' wcii:vTI3U 1 t'CvA1 'Z083100 lip
POPWI-;.fi ATIO ' 43.03 SIS
0ARAOE1G:AfiPORT 447.00 Vt
C OIT C�k C":€3,E�3'E'9.�2UCTI+(N
3.22,4666,61)
��{�;�w,,�dd��In� Yq yy,,����; ����q pp��}��ggy99`91t1+��!'1?ED
PLRJ;4'. Yir I}�A9.E MM,ftC6i7V37AP Y.
COMURUC=TiON FEE 101-000.41€-000 1=00
PLAN CHECK MM3 101-000-439-318 $147:24
MECHANICAL FEE 101-00042'1-000 440.311
ELECTRICAL PFY, lot -000-9120-000 $11S. f3
PLUI�UNI l FES;- 101-000-4-19-000 S140.74
ST O rD t C}"Ilfii+t ITE, RE -91D 101-000-241-000
a3iIADINO +fis`E $15.00
W,VrJA)PJNZ IMPACT ITEF.
TIMA1s MRTH-PAID 1112.
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APR 06 2004
L:ITY OF LA Qti11y TA
F'I��Af�fCE D�P•r. .
RECEIPT
DATE /
BY s
DATE FI ALE
INSPE R
1p .
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
TINSPECTOR
BUILDING APPROVA :'
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
/ f
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 UT
Final
d
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 I
Gas Piping
PLUMBING A PROV
Gas Test
Electric Final
Waste LinesHeater
Final
Water Piping
Plumbing Final
_
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool over
Sewer Connection
Encapsulation
Gas Piping 7-1
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:
�L
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 1 of 2 CF -6R
Site Address: 79-802 Viento Drive Permit Number:
Tract Number: 29323 Plan #: 2&2X Phase: 5
Lot Number: 28 Project: Esplanade Builder: Lennar Homes
An installation certificate is required to be posted at the building site or made avalible for all appropriate inspections.
After 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:
Heatinq Equipment
of Efficiency Duct Heating Heating
Equip. CEC Cerh ed Mfr Name Identicle (AFUE, etc.) Location Duct Load Capacity
Type and Model Name Systems (>= CF -1 R) (attic, etc.) R -value (BTU / Hr) (BTU / Hr)
FC it 310JAV066110 attic
Coolinq Equipment
of Efficiency Duct Cooling Cooling
Equip. CEC Certifiedr Name Identicle (SEER, etc.) Location Duct Load Capacity
Type and Model Number Systems (-CF -1 R) (attic, etc.) R -value (BTU / Hr) (BTU / Hr)
TFF— US Air 563CNX060 attic ----4.T--
1,
.
I, the undersigned, verity that equipment listed above is: 1) is the actual equipment instaiiea, z) equwaient to or more
efficient than that specified in the ce ca f co liance Form CF -1 R) submitted for compliance with the Energy
Efficiency Standards for residential ildin , n 3) qu' nt that meets or exceeds the appropriate requirements for
manufactured devices (from t ian i ncy guion r Part 6), where applicable.
Li
Team Heating & Air
Signature, Date
Installing Subcontractor(Co. Name
OR General Contractor (Co. Name) OR Owner
MINIMUM REQUIREMENTS FOR T LEAKAGE COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
CFA:
System of I 1�
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
x
400 x (Cooling Capacity in Nominal Tons) x (0.06)
fan flow
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow x .06
D—u-a Pressurization Test Results 5
5
100 x Test Leakage / Fan Flow = % Leakage
4.25%
Check Box for Pass or Fail (Pass = 6% or Less)
'Passl x Faill
�T-24 Compliance Credit was Taken for TXV
TXV was installed
System of
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)
fan flow 0
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow x .06
uct Pressurization Test Results 5
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
Passl Faill
QT -24 Compliance Credit was Taken for TXV
TXV was installed
PAGE 1
F2001-01 (4-02) Action Now T-24CF6-RTD&TXV macro
Tests Signature, D4ty
Performed
COPY TO: Building'Department
HERS Provider (if applicable)
Building Owner at Occupancy
f
Team Heating & Air
Installing Subcontractor(Co. Name
OR General Contractor (Co. Name) OR Owner
' PAGE 2.
F2001-01 (4-02) Action Now T-24CF6-RTD&TXV macro
Page 2 of 2 CF -6R
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV
Site Address: 79-802 Viento Drive Permit Number:
0
Tract Number: 29323 Plan #: 2&2X
Phase: 5
Lot Number: 28 Project: Esplanade Builder: ,
Lennar Homes
System of
,
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)
fan flow
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow x .06
uct Pressurization Test Results 2
J
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less) Passl Faill
I
T-24 Compliance Credit was Taken for TXV TXV was installed
ystem - of
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)
fan flow 0
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow x .06
uct Pressurization Test Results 5
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less) Pass Faill
�T-24 Compliance Credit was Taken for TXV TXV was insta e
'
System E=J of
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)
fan flow
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow x.06,
uct Pressurization Test Results 5 '
100 x Test Leakage / Fan Flow = %,Leakage
'
Check Box for Pass or Fail (Pass = 6% or Less) Passai
T-24 Compliance Credit was Taken for TXV TXV was insta e
ystem C� of
µ
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)
fan flow' 0
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) Passl I Faill
QT -24 Compliance Credit was Taken for TXV TXV was installea
I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is
6
in conformance with the requirements r c mpliance credit. (The builder shall provide the HERS provider a copy of the
`'
CF -6R signed by the builder employ s or nco7,Jor1rtifying that diagnostic testing and installation meet the
requirements for compliance credit.)
;
Tests Signature, D4ty
Performed
COPY TO: Building'Department
HERS Provider (if applicable)
Building Owner at Occupancy
f
Team Heating & Air
Installing Subcontractor(Co. Name
OR General Contractor (Co. Name) OR Owner
' PAGE 2.
F2001-01 (4-02) Action Now T-24CF6-RTD&TXV macro
Cleertificate Of Insulatio n*
Your Holme has been insulated with CertainTeed Fiberglass insulation products, winich are designed
for today's safety standards and tomorrows energy mquirermernts.
CD Fiberg0ass is inorganic and therefore permanently noncombustible; so i¢ does not have to be treated
with fire -retardant chemticals that will Lilly lose their effectiveness over time. Lt has not been. treated
with chemicals that can corrode wiring or meta4 Fiberglass will not absorb moisture nor willl it=
settle over time as may other insulation tnaterials.
C.
'This also certifies that CertiuiTaod Fiber Glass lesulation has been professionally installed iar this home
to provide the following thermal perfonmsmce: ,
- ,4 Job Nante: Tapestry @ Esplanade Tract: • 29323 Phase: � -
Lot N.: °-M Plan-. 2 Address: ' 79 802 Viento De.. La Quinta. CA
' Ceiling Area: ' R-39 Blown » Garage Ceiiling: " Interior Walls:
�.`. With LiAng Above
Overhangs: Exterior %Aalls: R-13 Un faced $alts
Ceiling: Garage Wall: Cantilevered
Inaccessible to Blow Floors NVAAving Above
Subco cior.. ®.I Insulations Co., .Inc. .
600 S. ine Azusa 002 (62 ) �t ti0 mase.11465709 '
Go
Signed f '
Cons-claida ®trtiz, SecretarYlTreastirer --0 -- R �colt :Yenkins, Presidene -o_ r•--
Lou Merola, Direct®r'of perailovss Officer `
W
t��R- means aeaastance' to heat 'flow, •The higher 'ahe R= value,; the greater tlhe insulating p'ow'er'
Ask your builder for: the fact sheet ort .R- valines:. Keep this certificate with your other
Q valued papers. If you ever sell this home_ this cenificat'e • should, be passed on to the. buyer.
®
Q ,
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CABEC
ENERGY
130. Box 621 Ph/Fax (760) 564-2044
Rancho Mirage, CA 92270 Cell: (160) 250-1852 �+ a
Email: DESNRG (cDAOL.CO'Vi `
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) { CF -4R
TAPESTRY•@ESPLANADE PH 5 - {
DATE. TESTED 10-11-04
Project Title Date
t 79-802 VIENTO DRIVE LA,QUINTA CA. 92253 ' LENNAR HOMES
roct Address Builder.Name -
JIeONY PASCANITE 909-275-0204 PLAN 2 1 UNIT
Builder Contact Telephone • Plan Number
ALAN WEAVER 760-880-5504 GROUP " 1
HERS_Rater Telephone Sample Group Number
#CCNAW183266 10 Q4 LOT • 28-5 1 OF 1
~ Certifying Signature Date Sample Lot Num�ier
'r' • 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, I certify that the houses identified on this form comply
with the diagnostic tested compliance requirements as checked on this form. 4
0 The installer has provided a copy of CF -6R (Installation Certificate.
® Distribution system is fully ducted(i.e., does not use building cavities as pienums 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 68
If fan flow is calculated as 400cfm/ton x number of.tons enter calculated
value here 2000
If fan flow is measured enter'measured'value here
°4 Leakage Percentage (100 x Test Leakage/Fan Flow) 3.4
Check Box for Pass or Fail (Pass=6% or less)
Pass Fail
I� THERMOSTATIC EXPANSION VALVE (TXV)
IN Yes ❑ No Thermostatic Expansion Valve is installed and Access is r.
provided for inspection. El
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ti c0ivv!! Certificate of Occu ancj
9
ot 4V COPY
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OFTBuilding & Safety Department
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This Certificate is issued pursuant to the requirements of Section 709 of the California Building
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Code, certifying that, at the time of issuance, this structure was in compliance with the
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provisions of the Building Code and the various ordinances of the City regulating building
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construction and/or use.
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BUILDING ADDRESS: 79-802 Viento Drive
5
Use classification: Single Family Dwelling Building Permit No.: 0402-358
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Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
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Owner of Building: Len nar Homes of California Address: 78-401 C Highway 111
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City, ST, ZIP: La Quinta, CA 92253
.�� By: Daniel P. Crawford Jr.
;
Date: 10/13/04y
Building Official
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POST IN A CONSPICUOUS PLACE
tam •� ,', , , - -
anc
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INCOMFOROM
of .-Building&r:safety Department:
This, Certificate is.is sued pursuant:tollie'requirpments,of'Section.109 of. the tC lifbrnia'Building
r5 Code, certifying. that, at the * time of issuance, - this ,structure was: in:';cor pliance, with the -,--
9
provisions. of the Building Code. and the :various }ordinances of the"'City,' regulating building a
construction�and%r use. i - w .
- r
_ - BUILDING ADDRESS: 79=802-Viento Drive-
.
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"'• Use -"classification: Single'Family Dwelling`.Building Permit No.: 0402-358r
�., ` ' .1 jpe•of Construction: VN � _ �
Occupancy Group: R-3 'Land -Use Zone: RL
. �
Owner. of Building: Lennar, Homes:of California- . _ �, s - Address: 78,401 C Highway' 111
City; ST, ZIP: La.Quinta, CA 92253 {
By: Daniel .'P.yCrawfor`d'Jr
-'Date:-10/13/04,
Building Official
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POST, IN A. CONSPICUOUS PLACE.