0402-347 (SFD)LICENSED CONTRACTOR DECLARATION
"l 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
72,03102. t C / � % 9130/04
Date �� Signature of Contractor f
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.
()2) 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 OLD. REPUBLIC INDL Policy No. MWBM609
(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 sub iect 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 thosg provisions.
Date: �' /�' �� Applicant-
Warning:
pplicant '' "'/'
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's, fees.
IMPORTANT Applicatioh is hereby, made to the Director of Building and Safety
for a permit subject to the conditions -and restrictions set forth on his
application. ~
1. Each persohupon whose behalf this application is made & each person at
whose request`and for whose,benefit work,is performed under or pursuant to
any permit issued as a result of this°applicaton agrees to, & shall, indemnify
& hold, harmless the City of La Quinta, its officers, agents and employees.
2: Any permit •issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enterWu ,on
the above-mentioned property.for inspection purposes.
Signature (Owner/Agent) Fy� '�fi • Date
J r ¢
BUILDING PERMIT PERMIT#
0402- � t
DATE VALUATION LOT TRACT '
I4 11 29321
JOB SITE APN
ADDRESS '79-"7 YJ�$ -1, Tio mun. -W-024
OWNER CONTRACTOR/DESIGNER/EN (NEER
I.IOMA12 T-1:0 MES OF CIPAJMi NdInA T-.% .gP►RH014MI a QiT'9,,10RNU
7$-401 C I3IGlRVAY 111 78.401 C HIGI•M-kY ? 11
LA QUI71+NTA. CA 1:;'22.53 LA Ql "Ii TA CA 92253
(760)77.7-0131 CBLH 3434
USE OF PERMIT , r
SW LOT 11; PLM4 4YkVPSRM1T 17OE,'S'NDT Po"CUUM S•LOCIC W'ALI,S,
Pt 01.,;.'t1Pd+,, (JR. O`t I EW'AYA,PPROAS%1i
MACT CijN,STRUC'fIOM x,911.00 SI+
P0.R.( 13fPAT10 53.00 S>:
UATZAGEICARPCIW� 423,00 QF
EMM.Alren Con OF comsnexTION
IWAO"rlcy
1k.
CONSTRUCTION PEE
101.OM-418.000
xINN54
PLAP? C;MC -1.' FEE,
39
MECHANICAL "T?
101.000421-000
$53.50
EL.WMITCAL. ate '
10111-000-420 -000
$129.89
t�IrL�kU1 c'I 115
101
$164.
STT;OOWO IMOT!L' N iii n��.'�',iL�
101-000.1.41-000
$14,54
i%AllI?d►if :t
101.000-423-009
$15.00
r1 :L' * ?•i.0!'. 1t. lArf P.t~"!' 1r i
$;+1nba
$4•;242.57
$0,W
2AIJ a, # 4p8..f'S.;V..1. IrSlsk:S�.4✓UE NOW
APR 0 6 2904
CIT`! OF L A-QUNINJTA
PINANCE UEPT.
RECEIPT • DATE / / , BY 1 DATE FIN ED / IN PE OR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROV LS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
_
Ducts
Slab Grade
_
Return Air
Steel
_ _
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Vents
Grills
_
Insulation i
Fireplace P.L.
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
jf
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 APPOVALS
Gas Test
Electric Final
Waste Lines_
Heater Final
Water Piping
_
Plumbing Final
Equipment Enclosure
Plumbing Top Out
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
99 avy
Appliances
Final
COMMENTS:
Final 107X474V
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels It
Exterior Receptacles ej
G.F.I.
Smoke Detectors
Temp. Use of Power
LZQ
Final
Utility Notice (Perm)
1.
n
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 1 of z CF -6R
Site Address: •• 79-847 Viento Drive Permit Number:
Tract Numbe: 29323 Plan #: 4Y Phase: 5
Lot Number:17 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:.
I-Icntinn Pnllinmant
v# of Efficiency Duct
Equip. CEC CertifiedName Identicle (AFUE, etc.) Location
Type and Model Name Systems (>= CF -1 R) (attic, etc.)'.R-value
Duct
Heating Heating
Load Capacity
(BTU / Hr) (BTU / Hr)
Ir, ; a Ic
4T—
USIr attic
4.
(`nnlinn Fnllinmant
V# of Efficiency Duct
Equip. CEC.Certified Mfr 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—
HP ]US Ir 563CNX048j attic
----4-2—
USIr ` attic
i,
I, tilt: UIIUCIJIyllUU, VUllly ural cyulNlncnl IIQMU Cull!. w. 1r w 111. Q. - G4—F... —L ,n.a as u.,.., —1 ..y............ — — ...v
efficient than that specified in th certificate of compliance (Form CF -1 R) submitted for compliance with the Energy
Efficiency Standards for resid ntia uildin , and uipment that meets or exceeds the appropriate requirements for
manufactured devices (from t e A p n E iciaAcy egulations or Part 6), where applicable.
Team Heating & Air
Signature, Date nsta mg 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 hf-I
Indicate the maximum a` oilowa 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 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
100 x Test Leakage / Fan Flow = % Leakage
.4.13%
Check Box for Pass'or Fail (Pass = 6% or Less). Passl x Faill
PT -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,l through 7 & 16 1200
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 I x .06
uct Pressurization Test Results 5
100 x Test Leakage / Fan Flow = % Leakage 4.92%
Check Box for Pass or Fail (Pass = 6% or Less) Pass FaI
OT -24 Compliance Credit was Taken for TXV TXV was insta
PAGE 1
F2001-01 (4-02) Action Now T-24CF6-RTD&TXV macro
•
1 .
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV r.
Page 2 of 2 CF -6R
Site Address: 79-847 Viento Drive Permit Number:
0
Tract Number: 29323 Plan #: 4Y
Phase: 5
- Lot Number: 17 Project: Esplanade , Builder:
LennarHomes.
• System E:::] 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) - f
fan flow 0
21.7 x (Heating Capacity in Thousands of Output BTU per hour) z (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) PassF Fail
[PT -24 Compliance Credit was Taken for TXV TXV was installed
ystem F -1 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
0.5x Floor Area x (0.06) for Climate Zones 1 through7 & 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
ai
�T-24 Compliance Credit was Taken for TXV TXV was installed
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
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
�T 24 Compliance Credit was Taken for TXV TXV was installed
System [� 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
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) PassE Fai
=T-24 Compliance Credit was Taken for TXV TXV was installed
I, .the undersigned, verify that the above diagnostic test results and the work l performed associated with the test(s) is
in conformance with the requiremen r compliance credit. (The builder shall•provide the HERS provider a copy of the "
CF -6R signed by the builder emplees
u ntra certifying that diagnostic testing and installation meet the
requirements for compliance credit
����•
Team Heating & Air
Tests igna ure, to 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
4L �� � �� �- o Insulation.
Your Hoine Inas been insulated with ConainTeed Fiberglass tasulatioe products, which are designed
for todays safety standards and tomorrow'senergy requirements.
CD
Fiberglass is inorganic and therefore permanently noncombusin-ble, so it does not have to be ureaaed
%kith dire -retardant cheaucals that will likely lose their effectiveness over tinge. rt has not been treated
CD
with chemicals that can corrode wiring or tnetal. Fiberglass will not absorb moisture nor will it
r-
settle overtime as may other insulation materials.
m
This also certifies that CertainTeed Fiber GUss Iaswlation' bas been professionally installed in this home
to pro,.^ide the followitag thermal performance:
Job Name: Tapesery Esplanade Tract: 29323 Phase: 3
Lot ft.: $` -Plan: 4YR address: 70 - 947 Viento Dr.; La Quints, CA
Ceiling Area: R-39 Bloom Garage'c6ung: Interior Walls:
With Gsulag<:�boVe
over) engs: Exterior `'Valls: R-13 UnfacedBatts
Ceiling: Garage Wall: Cantilevered :•
Inaccessible to Blow Floors .W/Lioing Above
ondra o .. Uj Ifntiova a✓o., liar
600 -in a s Ca 70212-6070 License#465704
5t edConchila
®rtit, SeCf etar� 1freasurerR. Scott JeY kips, President—or-
0'- `-
Lora Mei-oda, Director of Operations Officer
R- means resistance to heat flow. The higher the'R- value, the greater' the insulating power.
v
Ask yowr builder for the fact sheet on R- values. Keep this certificate with your other_
valued papers. If you ever sell this home, this certificate sbould be passed on to the buyer.
m
m
ru
tb ,
• V S
_. L
'a wwat l __ C d C
ENERGY
• . �.
71.
' P0. Box 621 Ph/Fax (760) 564-2044
• Rancho Mirage, CA 92270 Cell: .(760j 250-1852
Email: DESNRG Ca�AOL.COM
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) y CF-4R
TAPESTRY @ ESPLANADE PH s , DATE TESTED 10-11-04
Project Title mate
79-847 VIENTO DRIVE LA QUINTA CA. 92253 LENNAR HOMES
Project Address Builder Name ,
+ TONY PASCANITE • 909-275-0204 PLAN 4X 2 UNIT
Builder Contact Telephone Plan Number
ALAN WEAVER 760-880-5504 GROUP I
HERS_ R t Telephone Sample Group'Number
LOT 17-5 I ®F 2 • . '
#CCNA1iif183266 10-12-04
Certifying. Signature Date Sample Lot Number '
Firm: DESERT ENERGY SERVICES LLC HERS Provider: "CHEERS
y 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 fhe houses identified on this form comply
with the diagnostic tested compliance requirements as checked on this form. - -
N 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) ;
N Where clothibacked, 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 67
If fan flow is calculated as 400cfm/ton x number of tons enter calculated
value here , 1200
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) = 5.583
Check Box foi• Pass or Fail (Pass=6% or less) ® FT '
1
Pass- Fail
N THERMOSTATIC EXPANSION VALVE (TXV) "
N Yes ❑ No Thermostatic Expansion Valve is installed and Access is
N
provided for inspection ❑;
-4 rt
YC A 0 E C: l____
arvicas _
P0. Box 621 Ph/Fax (760) 564-2044
Rancho Mirage, CA 92270 Cell: (760! 250-1£352
Email: DESNRG (a)AOL.COM
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Pagel of 7) CF -4R
TAPESTRY @ ESPLANADE PH 5 ®ATE TESTS® 10-11-04 ,
Project Title . Date
79-817 VI ENTO DRIVE LA QUINTA CA. 92253' LENNAR HOMES
roc Address Builder Name
TONY PASCANITE 909-275-0204, PLAN 4Y 2 UNIT
Builder Contact Telephone Plan Number
ALAN WEAVER 760-890-5504 GROUP 1 :i
HERSRa�"e Telephone Sample Group Number
#CCNAW183266 10 04 LOT 17-5 201`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. cS
® 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 CFM84.
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 s Test Leakage/Fan Flow) 5.25
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 ® ❑
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t This `Certificate; is' issued. " rsuant'to -the requirements- of Section 109'of the California Building
Code, 'certifying that the; time- of;issuance; this structure was in�`compl ancewith the
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' `provisions of the Building ,Code and ,the various: `,ordinances hof the Cit re ulatin building,
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construction;and/or use.
z _ _ BUILDING ADDRESS: 79-847 Viento Drive
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Use classification Single Family Dwelling, Building -Permit No. `0402-347r
y
".
Occupancy Group:'R-3^ ,` ' Type of. Construction: VN '., ' Land UseJZone: RL
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Owner=of Building: L'ennar. Homes of.Califocnia - ; - Address: 78-401 C Highway 111
City, ST, ZIP: La Quints, CA 92253 ;
By: D n el P. Crawford Jr.
..
Date: -510/13/04
Building Official'
POST IN A CONSPICUOUS PLACE
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