0402-360 (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 # Lic. Class Exp. bate
�'2iitf32 Y3 MC 9M/04
Date �/ �l L 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).
() 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 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 OL1.) I qI5J13d�If' Pi3SL!' Policy No. °I0�7i�00
(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 becot3ie
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply wit �pse,pov islonsy
Rate: 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 Labof 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).f -Date
BUILDING PERMIT PERMIT#
0402^366
DATE VALUATION LOT TRACT
JOB SITE
ADDRESS
APN
OWNER
CONTRACTOR/DESIGNER/EN (NEER
UNWAR 1101VM OF CAU �Y3i? IA
7.,IMNAR 1.10MU OF C T t" ORNI]'A
7Sw401 C MICH WAY I11
.76-401 C x.UC1 A_Y 111
LA QIJBITIlk Ok 92253
LAQIIMTA CA 92253
060)777-0131 CSIX .3434
USE OF PERMIT
Me w F'ANiiLY .DV9MLWG
'
Sf;D-WT 31), ,P'E,AN 4. PERMIT, DOES NOT t•i+fC)AXE'BLOCK '9JAI.l..,S,
POOL, SPA,OR0RNV4,WAY.`1PPi?.0ACH.. 75%ftEDUCTION`I'O PLAN CHF-€,
;Eta DUZ TO MULTIPLE ISSUANCE OF SANIZ !'.L„AN TYPE
TRACT irL.`CWl7TRUCTIOP 422s,99'soF •.
QA,ItAWEICAA..3YCJ, I 423,00 ff
/
WNS'TRUCTION FEIN 101-0004M-0 00 ilt7451D
PLAN C•tsFC .M, S.15e.0s9
NIECI'IAAC A1, .IEE 101-000-421-000 547.00
932=91CALFEE, 1Q1-t3ti�i-x•263-L'�1J $It�.es
FL13T�1�'Tl�C3PF3? I01af�QElrLi•19«C!F3f3 �i�4b,`t5
S,.R.OTJ0 ,MCITJ€ N F29 11J 1101-000-241-0t* ;.9U
GRADINOHAR 10 1400-423-000 51103
!�` ZW,1,= )PXR. IMPACT FEE �g40J.lsC►
3U COMMIRUCrI0.1,T,AND MAU MIXe ,
(ii;TAL
1TAYL
P.MWE ME- S DUE now
APR 0 6 2004
CITY OF LA OUNTA
FINANCE DEPT ?�
RECEIPT.
DATE
BY jf
DATE AL
INSPECT
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
--%— y S
Ducts
Slab Grade
Return Air
_
Steel
_iV
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
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
I I
Gas Piping
PLUMBING APPR90VA S
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
_ _
Plumbing Final
Plumbing Top Out
_
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Pil 41
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final f T14W(Xv 409L
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole -
Underground Conduit
Rough Wiring
_
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
:. A
A
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 1 of 2 CF -6R
Site Address: • 79-834 Viento Drive Permit Number:
Tract Number: 29323 Plan #: 4&4X Phase: 5
Lot Number: 30' 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
o Efficiency Duct
Equip. Certified Name Identicle (AFUE, etc.) Location
Type and Model Name Systems (— CF -1R) (attic, etc.)
eating eating
Duch Load Capacity'
R -value (BTU / Hr) (BTU / Hr)
FC Ir attic: -
----4-f—
USIr 31 OJAV036070attic
uoollna i==Dment
of Efficiency Duct Cooling Cooling,
Equip. CEC Certifiedr Name Identicle (SEER, etc.) Location Duct Load Capacity
Type' and Model Number Systems '(>=CFAR) (attic, etc.) R -value (BTU / Hr) (BTU / Hr)
HP US Ir 5 attic ---4-T—
LIS
Ir 563GNX036 attic
---------------
I, L11C U11UC1SKg11CU, VC111y 111211 CljulpfflClll IMMU dUUVC IJ. 11 15 1110 dL:tUdl CL{UINIIICIIL II1JLd11CU, L) CyU1Vd1U11L LU UI MUM
efficient than that specified in the ce to of compliance orm_CF-1 R) submitted for compliance with the Energy
Efficiency Standards for residential ildi g , and ui m nt that meets or exceeds the appropriate requirements for
manufactured devices (from the p ian cie cy e s or Part 6), where applicable.
Team Heating & Air
Signature, Date Installing Subcontractor(Co. lqame
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 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
x 400 x (Cooling Capacity in Nominal Tons) x (0.06) 96 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
100 x Test Leakage / Fan Flow = % Leakage o
1.
Check Box for Pass or Fail (Pass = 6% or Less) Pass IFal
�T-24 Compliance Credit was Taken for TXV TXV was insta e
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
x 400 x (Cooling Capacity in Nominal Tons) x (0.06) 72 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 ,
100 x Test Leakage / Fan Flow = % Leakage 5. TN.—
CheckBox for Pass or Fail (Pass = 6% or.Less) Pass I x FaI
=T-24 Compliance Credit was Taken for TXV TXV was installed
r
PAGE 1
-RTD&TXV macro
F2001-01 (4-02) Action Now T-24CF6
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 2 of 2 CF -6R :
Site Address: 79-834 Viento Drive
Permit Number: 0
Tract Number: •'29323
Plan #: 4&4X•,- Phase: 5
Lot Number: 30 ' 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 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)
Pass Faill
PT -24 Compliance Credit was Taken for TXV
TXV was installed
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) +
r fan flow
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow x.06
,
ME Pressurization Test Results
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 i ' '•
TXV was installed
System E_Z] 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 z .06
uct Pressurization Test Results
, ..
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail.(Pass = 6% or Less)
Pass IF ai
[PT -24 Compliance Credit was Taken for TXV
TXV was installed
r y
System of
Indicate the maximum allowable Duct Leakage and the calculation used:
ti
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 7A 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
Duct Pressurization Test Resu is
100 x Test Leakage / Fan Flow = %.Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
Passl I gaill
OT -24 Compliance Credit was Taken for TXV
TXV was installed
I, the undersigned, verify that the above iagn stic test results and the work I performed
associated with the test(s) is
in conformance with the requirements f comp • ce credit. a builder shall provide the HERS provider a copy of the '
' CF -6R signed by the builder employees r su tr ors rti ing that diagnostic testing and installation meet the
requirements for compliance credit.)
JOpt
' =
��DD 11
+
Team Heating & Air
Tests ignature, ate
Installing Subcontractor(Co. Name
Performed
OR General Contractor (Co. Name) OR Owner
COPY TO: Building Department
'
HERS Provider (if applicable)
Building Owner at Occupancy
'
PAGE 2
•
F2001-01•(4-02) Action Now T-24CF6-RTD&TXV macro
IT
JL
Q_
yof InsWation
Ctertificate
• Your Home has been insulated with CertainTeed Fiberglass Insulation products, which are designed,
for today's safety standards and tornotrow's energy regmu'etnents..`"'
G
Fiberglass is inorganic and therefore perrnaneatly noncombustible, so it daes riot have to be treated s
rej,
with fire-retandant chemicals that will likely lose their efl`ectiveness over [bine. It has not been treated
with chesmicals that can corrode wiring or metal. Fiberglass will not absorb, moistctre nor wdl it
settle over time as may other insulation materials.
ot ' ,
This also certifies that CertainTee+d Fiber Glass Insulation has been professionally installed in this home
to pro Ade the following aherrnal performance:
Job Name: Tapestry (g Esplanade Tract: 29.123 Phase: S ,
'
Lot #.: yl- 3o Plan: 4 Address: 99 - 834 Vienao Dr., La Quints,; CA
Ceiling Area: . R-38 Blown Garage Ceiling: - Friaeruor Walls. - � -
. With Living Above -
Overhangs: Exterior Wills:' R-13 Uafacedf3atts
t -
Ceiling: Garage WaUl: r Ca®tillevesed
Ilngccessible to Blow Floors Wrtiviing Above
Subs actor.. • OJInsulation Co., Inc.
600 'im C Azus iC' 91702 (6 b)>kl 6[17 [,ieemseA463;09.
/
.'
•:. s Signed
COnchitQ Ortiz, .SecpetaerylTreasurer --or-- R con Jenkins, Fresidernt--oir-=
,5
o
Lou Merol�a, director of Operaztions tOj�cer r
M
R- means' resistance to heat flow. The higher the R; -value, the gmamr, the insulating power.
v
Ask your builder for the fact eet on R= values. Keep this certificate with your ocher
sh
_
* valued papers. lfyou_ ever sell this home, this certificate should be! passed on to the buyer.
rr
,
rMu.
Dmart IN -
ENERGY
®rviceis —
` P0. Box 621 Ph/Fax (760) 564-2044'
;A Rancho Mirage, CA 92270 Cell: (7601 250-1852
€ Email: DESNRG aa)AOL.COM
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Pue l of 7) CF -4R
TAPESTRY @ ESPLANADE PH 5
• z DATE TESTED 10-11-04
` Project Title Date ,
` 79-834 VIENTO-DRIVE LA QUINTA CA. 92253 LEN_NAR HOMES ,
roect Address Builder Name
TONY PASCANITE 909-275-0204 PLAN,4 2 UNIT , e ..
-
Builder Contact Telephone Plan Number
Al'_AAN WEAVER •. 760-880-5504 'GROUP � 1
HERS ter Telephone Sample Croup Number,
#CCNA1/11183266 10-12-04 LOT • 30-5 2 OF 2
Certifying Signature Date _ Sampie Lot Number. y
- i ..
•
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 pproved 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 tape is.installed, mastic and drawbarlds are used incombination with cloth
'backed, rubber adhesive duct tape to seal leaks at duct connections.
' N MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT ' •= .�
' Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
'I I IMeasured �.
t Duct Pressurization Test Results (CFM @ 25 Pa) , . values
- Test Leakage Flow in CFM 61
If fan flow is calculated as 400cfm/ton x number of tons enter calculated
'
• value here 1600
If fan flow is measured enter measured value here ,
Leakage Percentage (100 x Test Lcakagc/Fan�Flow) _ 3.8125 ti t
Check Box for Pass or Fail (Pass=6%o'or less) N ❑ r
Pass Fail,
x
® THERMOSTATIC EXPANSION VALVE JXV)
®„ Yes ❑ No Thermostatic Expansion Valve is installed and Access is
.
' provided. for inspection ® '. ❑
• _ •+1 if n.%. yam' '� .. • • - .. w F
[ Lt • r _
ENERGY
4
P0: Boz U1 Ph/Fax (760) 564=2044
Rancho Mirage, CA 92270 Cell: (7601250-11852
Email: DESNRG eAOL.COM
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R
TAPESTRY @ ESPLANAbE PFI 5 i
_DATE TESTED 10-11-04 ,
Proe.ct Title • Date J
79-834' VIENTO DRIVE LA QUINI'A CA. 92253 LENNAR HOMES
roct Address Builder Name
TONY PASCANITE 909-275-0204 FLAN 4 2 UNIT
Builder Contact
Telephone Plan {lumber
ALAN WEAVER 760;880-5504 GROUP 1
HERS "` z' �`" `-°'•" "? Telephone Sample Group Number
#CCNAW183266 10-12-04 LOT 30-5 l OF 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, 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.. t {
w ® Distribution system is fully ducted(i.e., does not use building cavities as plenums or platform returns in lieu of ducts).
Where,cloth b"acked, 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.' '
* -
1 11
® MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct.Leakage) , `
' � - .1s Measured
Duct Pressurisation Test Results (CFM @ 25 Pa) values
N 4
-Test Leakage Flow in, CFM 50
$ If fan flow is calculated as 400cfm/ton x number of tons enter calculated -
t value here 1200 ,
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) = 4.1667 ;
Check Box for Pass or Fail (Pass= 6% or less) ®, 7
Pass - Fair r
* A •® THERMOSTATIC EXPANSION VALVE (TXV)
®Yes ❑ No Thermostatic Expansion Valve is installed and Access is
i' provided for inspection
certiffrApimcate :sof �Occu p Y.
.anc .
::
G�oF9 �,tBu�ld�n & SafetDepartment -
, 'This ' Certificate is` issued pursuant 1d"the requirements of Section 109sof .the.California Building
r Code; .certifying that, at the time �;of _ issuance, `this 'structurd' , was in. compliance .with' ,the.
provisions of -the . Building.rCode and the various _ordinances of the ;;City, regulating,,building -
cons'truction and/or use.711
-
'
= BUILDING- ADDRESS: 79-834',
Viento Driver •'-:�
-
• � ., � L, _ M,, .r .. . a ]w �,. s • r . •_ ,� r_a.!-` �' . ` f, . '.{
Use classification: Single Family Dwelling 1� : , Building Permit No '0402-360'
`Occupancy Group": •R-3 ,. �T Type of Construction. VN r Land Use Zone: RL
Own`e� of Building: Lennar Homes 64,Californias t Address:78-401 C'Highway 111
`'"t,' �= City, ST, ZIP: La Quinta;'CA 92253+/
By::Maniel P. Crawford Jr.
Date: " [Date'of Firial Inspection]"� T
��.rBuilding,Official.
��
'~
POST IN A CONSPICUOUS PLACE