0402-361 (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. Date
Date t� Signature of Contractor1'41j /`
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:
O I have and will maintain a certificate of consent to self -insure for workers'
compensation, as providedi for by Section3700 of the Labor Code, for the
performance of the work for 1which 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 1?.l l PT _1C SSU Policy No. VWC1081171�
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) `!,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 s all forthwith comply with those provision
,Date:% Applicant / I � (
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 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) ! J/!� !/. ��%i� Date
BUILDING PERMIT PERMIT#
DATE VALUATION S.120,292.40LOT 31 TRACT 29323
JOB SITE t��yy:T�t� qpt�y
ADDRESS •r.-' v j''xr..7..J. �e9.#: �r�
tom,
APN C0 `, .51) Cs.�'i
Y�
OWNER
CONTRACTOR/DESIGNER/EN (NEER
7 ]�aNW& T�C'.P.vMS OF CAU1�:3�i2+i A
IX-D�.1�AR H"O:I'✓1.1WS OF CSA: FOPt 11%
78-401 C 1-31011WAY 1 I 1
78401 C173ICr 1'WAY 111
L,k ( ))tdtP v% CA 92253
LA QUWTA CA 92253
(760) 777-0'131 CBIX :3434
USE PERMIT
��OFF��� NNOLY q
319D n 1.401 31, Al.AW IYR. PPRY211' DOES NOT 1'NCIAll VE H. LOCK `WAi i.»;,,
IP004 SPA -Olt DRIVLWAY APPROACH
TRACT 0c NSTRUCTION Z0141.00 Sp
PDXC'13/1'A310 53,60 SF
QA A(YEJCfiLR1°tZT€f: 447,04 SI'
3:ab9.IIldg.:C.'e'�'.ar.E/ .r4✓L73 ti.Td', Yai 6Y ,7:w6E y7.S.L.F �'Q�
3,20,292AO .
�����yy��RRyy,,,,��yy''..yy yy�� pq;;yy��yy k � 7-y �ry��y,�
,PALdY�V.Li9, 2�.D4.T F9thAlI !' AR
.
CO3d"RU'C:TI(N PRE 101-000-418-000 $?13109
PLAir C14FICK FEM? 101-000-439-318 $391.33
MIECxiAINICA1.r, E '101'000-421=000 153.10
ELi'�trTRICAL RZE 1011-000-420-000 $113,98
t LUIMBTRO HP, 101.000419.000
3TROXG IIMOTJON FES? _ RESID 101-000<241-000 $12.03
(}!21.115 40 PZZ 101.000423.000 5
87It:VSI.,OPF.R 11VIAA T FEE
31a't'E7TA f 10.N A14 -D Pa, AW CHECK K
$4,062.49
APR 0 6 2004- PEPR 91 FnS DUE DOW
$4.062A9
CIT!/ OF LA QUawu
FINANCE DEPT
RECEIPT
DATE "' <
BY
D F L
INSPE TO
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS _
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
- ?_
Ducts
Slab Grade
Return Air
Steel
Roof Deck
O.K. to Wrap
Framing
Z - -
_/
47
Combustion Air
Exhaust Fans
F.A.U.
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
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste LinesI
c7
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral4
IA
Pool Cover
Sewer Connection
e i�/
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:
HVAC INST TION CERTIFICATE for T sted Duct Leakage & TXV Page 1 of CF -6R
Site Address: 79-850 Viento Drive Permit Number:
Tract Number: 9323 Plan #: 1Y Phase: 5
Lot Number: 3 Project: Esplanade Builder: Lennar Homes
An installation certificate is require os a 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 Equipment
# of Efficiency
Equip. CEC CertifiedName Identicle (AFUE, etc.)
Type and Model Name Systems (>= CF -1 R)
Duct eating Heating
Location Duct Load Capacity
(attic, etc.) R -value (BTU / Hr) (BTU / Hr)
FC US Air 31 OJAV0661 10 AFUE 8
attic
L.uuuny Uquiprrnen[
# of Efficiency •
Equip. CEC L;ertitiea Mtr Name Identicle (SEER, etc.)
Type and Model Number Systems (—CF -11R)
.... u...-. �.y......,
Duct Cooling Cooling
Location Duct Load Capacity
(attic, etc.) I R -value (BTU / Hr) (BTU / Hr)
HP US Air SEER 12
attic 4.
---y...
-4 -..., � — a..1 IQ I — 0-01 cyuiFnncnt niatancu, c] cyurvaicnt to ui nwlc ,
efficient than that specified in t ce i to of com rice (Form CF -1 R) submitted for compliance with the Energy
Efficiency Standards for reside fial b ldin , a d uipment that meets or exceeds the appropriate requirements for r
manufactured devices (from th Ap is ce ffic c eg ations or Part 6), where applicable.
Team Heating & Air
Signature, ate Installing u contractor(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 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) 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 6
100 x Test Leakage / Fan Flow = % Leakage 4.730%
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 � of I� •
Indicate the maximum a rowwaable 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
u Pressurization Test Results
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less) Pass I Faill
=T-24 Compliance Credit was Taken for TXV TXV was insta e
PAGE 1
F2001-01 (4-02) Action Now T-24CF6-RTD&TXV macro
HVAC INSTALLATION CERTIFICATE for Tested Duct Leakage & TXV Page 2 oft CF -6R
Site Address: 79-850 Viento Drive Permit Number: 0
Tract Number: 29323 Plan #: 1Y Phase: 5
Lot Number: . 31 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
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less) Pass Fail,
ysteT-24 Compliance Credit was Taken for TXV TXV was installed.
mof
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
21.7 x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow x .06
uct Pressurization Test Results 25
100 x Test Leakage / Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less) Pass Fail
�T-24 Compliance Credit was Taken for TXV TXV was a installed
System l of
Indicate.the maximum allowable 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 l�
21.7x (Heating Capacity in Thousands of Output BTU per hour) x (0.06)
Measured Fan Flow x .06
ud 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 F__J of
Indicate the maximum aowa 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
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 Fail
QT -24 Compliance Credit was Taken for TXV TXV was installed
I, the undersigned, verify that the above di nostic test results and the work I performed associated with the test(s).is
in conformance with the requirements fo co pliance credit. (The builder shall provide the HERS provider a copy of the
CF -6R signed by the builder employeesr s con ctors egrtifying that diagnostic testing and installation meet the
requirements for compliance credit.) ' ��
est�' s ignature, a
Performed
COPY TO: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy
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
. L,.
LO
CertHicate
Your Home has berm insulated vtritb CenainTeed Fiberglass Insulation products, which are designed
for todar s_safet�' standards and tOmorrovv's energy requirements.
CD
Fiberglass is inorganic and therefore permanently noncombusttt le, so it does not have to be treated
It has not been (reatad
W
µnth fire retardant chemicals that will likely lose their effectiveness over time.
not absorb moisture nor will it
vrith chemicals that can corrode wiring or metaU. Fiberglass will
settle over time as may other insulation materials.
o
This also certifies Chao CertainTe ed Fiber Glass Insulation has been pro£essiomally installed in this borme
to provide the following thermal performance:
Job Name:. Tapestry @ (Esplanade Tract: _29323 1Pbese:
Lot #.-�95�g ( Plan: lYit ess: 79 - 850 Viento Dr., La Quints, CA
Ceiling Area: R-38 Blown Garage Ceiling: Interior Walls:
WEth Living Above
Exterior Walls: R-13 UnfavA Batts
®aer6angs:
Garage WRM: Cantilevered
Ceiling: !Floors W/Living Above
Inaccessible to Blow
Subc—Opstractor.. Oi Insudadon Co., ue.
CMD S. Vincent, Azusa Ca 91102 (6208 U -607D Liceose Ne 709
7
G
&gme d
Conchita Ortdz, SLcretarylTreaSu!re'r --or—"J?. Scorn Jeuikins; President--or--
J
Qf
Lou Meroda, DireCgor of ODeaions Officer
• ,
rca ►
IR -meatus resistance to beat flow. The higher the R value the greater the uuulating power.
Q
Ask your builder for the fact .sheet on R- values. Keep this certificate U th Your other
should be passed. on to tlhe buyer.
R.'
•valued papers., If you ever sell this home, this cer4aficate
•
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'CITY OF'LA QVINTA
F - BUILDING & SAFETY DEPARTMENT
O F 1'N�' OV .777-7012
INSPECTION REQUEST LINE
i 777-7153
Owner 1,ENNAR COMES OF CAL9FORNIA •
Contractor LENNAR HOMES OF CALIFORNIA
`
Permit Number 0402-361 '
POST ON JOS IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 797850 V1ENTO D1'IVF;
SFD - LOT 31, PLAN IYR. PERMIT DC? LS NOT - y
e ,
INCLUDE BLOCK WALLS, POOL, SPA. OR
DRIVEWAY APPROACH
TYPE OF INSPECTION DATE INSP.
TEMPORARY POWER
SETBACKS !'
U/G PLUMBING /WASTE •}
U/G ELECTRICAL/ GROUNDING
FOOTINGS / STEEL
CONCRETE SLAB L'
DO NOT POUR CONCRETE U liAELOV, IG D. ,
ROOF NAIL / PRE -ROOF
OKAY TO WRAP
` FRAMING COMBINATION
.ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL
INSULATION
COVER NO WORWLINTIL ABOVE SIGNED `
INTERIOR GYP. BD. DRYWALL
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION -�
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
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT1j p '
COMMUNITY DEVELOPMENT DEPT'
FINAL/ JOB COMPLETED,
ABOVE APPROVALS,DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
Mart
- 'MJ to A D E • �.
Po. Box 621 Ph/Fax (760) 564-2044
Rancho Mirage, CA 92270 Cell: (760) 250-1852
Email DESNRG AOL.COM
- ; CERTIFICATE OF FIELD VERIFICATIOI\T AND DIAGNOSTIC TESTING (Page 1 of 7) CF-4R `
TAPESTRY @ ESPLANADE ` PH 5 DATE TESTED
.1043-04 `
Project Title ..Date,
79-850 VliENTO bRIVE LA QUINTA CA. 92253 _LENNAR HOMES' !
LL Builder Name
Pro
PASCAINITE 909-275-0204 PLAN Ili' fl
UNIT -
Builder Contact Telephone Plan Number '
ALAN WEAVER ' 760-880-5504 GROUP 1. Y
HERS
Vf�r ) Telephone Sample Group Number
#CCNAW183266 10_1��04 -LOT- 31-5 I OF I
f Certifying Signature�.�Date Sample.Lot Number
Firm: 'DESERT ENERGY SERVICES LLC - HERS Provider: CHEERS
Street Address: P.O. BOX 621 F 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: I `
® Distribution system is 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'
1 Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
' Measured
Duct Pressurization Test Results (CFM @ 25 Pa). = - values
Test Leakage Row in CFM 85 ,
If fan flow is calculated as 400cfni/ton x number of tons enter calculated -
val ue here 2000
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow)_ 4.25
r Check Box for Pass or,Fail (Pass=6% or less) ® El
• r ass. Fail `
4
® THERMOSTATIC EXPANSION VALVE~(TXV)
®' Yes ❑ No Thermostatic Expansion Valve is installed and Accless is
provided for inspection ❑',
�' ._ r
Certifica to Yof
,- yO.CCupancy ,
' ' •�- - '
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Tl�s Certificate is issued pursuant to "the -requirements of Section _109 of,. the California Building
_, °Code, certifying that, at the time of issuance, this ..structure was, "in. compliance with' the. r
y g
ro,, signs yof the Building Code . and the various ,ordinances `'of --the ' Cit re iilatin b iildin .
P _ g
construction and/or use.
_. .
BUILDINGADDRESS: 79-850 Viento Drive
Use,classificatiori: Single Family -Dwelling V. `Building Permit No.: 0402-361
i
Occupancy�Group: R-3 ' " Type -of. Construction:"VN - -Land Use Zone: RL,` .
,
9
Owner ofBuilding: Lennar Homes of California`` " ' �' ,_ Address: 78-401:C Highway�111
"' s • t f7 '. ry . :City; ST, ZIP: La Quirta, CA 92253 .
y F By: Daniel P. Crawford Jr.
"�•
Date: 10/20/04
=� Y. -,-Building Offici I _`
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;'� ��
POST IN A CONSPICUOUS -PLACE �" '
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