0402-357 (SFD)LICENSED CONTRACTOR DECLARATION
j:: 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
739102 13 MC ?/30/04
�Date th, "O(/ Signature of Contractor X�
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).
O 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.
(.,.) I have and will maintain workers' compensation insurance, as required by
Seption 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 1%,Ep 133L1C IN,, YJ Policy No. PAWC1087709
(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 shall forthwith comply with tho§e'provisio,�s.
Date: 1� /i i5/� Applicant ,� �� ���f��( 7) V1.
r
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
whose. request and for whose. benefit work is performed under or pursuant to
pt D
any rmit 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 i
work is not commenced within 180 days from date of issuance of suc
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 informatio *Yi
correct. I agree to.bomply 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. '
II i
Signature (Owner/Agent) A �r'�/` �f/"v'�% Date �/ fir- ,2'%
BUILDING PERMIT PERMIT"
DATE VALUATION LOT TRACTJOB SITE
ADDRESS •--.�5,.-%-�.�a 1 APN ,r-r•�rna.p�ii^w�`�r
OWNER
78.401 C IR011WAY I I 1
LA QT MT...t',,. CA 92253
USE OF PERMIT
CONTRACTOR / DESIGNER / ENGINEER
CAUF
.1; DOUR HOMES 01, FOMMA
7B.401 C~ MOURW Y,11.1
LA Qy'�i.P7�1.1�'S % W ♦ C A ��?12t � a0434
3FD-'LL't'C 27, j -1,A14 H:,. PERMIT .DOES 1403' 1'NC1.UDZ 81,C.h`o'1CVTA1 "S.
POOL, SPA Or: blf�ri?WAY A.PPROACli. 75MMUCTION TO PIAN 'CAHEGX
FFE rXYZ TO MULTIPL .ISSUANCE OF SAME? PLA14 TYPE
3%ORsr HiP.at"No 33186 Sip
• 0A!A0 F1ClaTil''OR.`1' ' 425:00 SF
Ea—MMILD COST OF CCIMMETWIM-1
C Q1J vThft1CTMq 1-%R
101.000.418-000
$667,51
PI.Aiq CHLrdk '1+EE
101-000-439-318
$17/.63
M f7X:'I3.MIC .A16 FEE
101.000-421.1300
947.0
A�LiiC 'I'I�1C,AL.IFFE1C1
0'JG-42`,1-t>{?n
$11135 1
PLL M1+40 FEZ
101 -000-419-000
MOM
S T N.OHO MOTIC14 PEE • REx112
101-000-243-000
$ I0471
(1P.&DR40F'E.E,
101.004.413.000
sill o
DZVZ1..OP9R 1111APrsCT FRe
91405.01)
,A •3 °Il=r . ,LitsiQML.i' 5 TC_)1T,i-i.3vdJ.L`.I., W [-UX_*K
d �'6t1 � ;d?:1�1�'41�d11:'ia Ts�L'I•���
APR 0 6 200 TOT&L, FERM ORES V SOW
CITY OF i.A 1A 'ITA
RECEIPT DATES BY' DATE I LE �j,/ INSPEC R
1071100.70
ggVVyy qq,,
MOO
'W.i+si7�t9r5Y�
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs gyp
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
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
Gas Piping
PLUMBING APPROVA
Gas Test
Waste Lines
Electric Final
Heater Final
_ _
Water Piping
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 loe
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 oft CF -6R
Site Address: 79-786 Viento Drive Permit Number:
Tract Number: 29323 Plan #: WX Phase: - 5
Lot Number: 27 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:
Heatina Eauioment -
of Efficiency Duct Heating Heating
Equip. CEC CertifiedName Identicle (AFUE, etc) Location Duct - Load Capacity
Type and Model Name Systems (—CF -1R) (attic, etc.) •R -value (BTU / Hr) (BTU / Hr)
rr attic
cooling tqulpment
of Efficiency Duct
Equip. ,CEC Certifiedr Name Identicle (SEER, etc.) Location 'Duct
Type and Model Number Systems (::;=CF -1 R) (attic, etc.) R -value
Cooling Cooling
Load Capacity
(BTU / Hr) (BTU / Hr)
Air 563CNX060 SEER 12 attic 4.
1, u,e unuersiyneu, ""lly L11!L Cqurpn Cllr uarCu duUVC w. 11 ,a LIM dLwm CquiPn,Cni a Wuancu, c/ V4U-G.—L IV .. I --
efficient than that specified in the rti to of co' (Form CF -1 R) submitted for compliance with the Energy
Efficiency Standards for resident I buil g , n 3) equl ment that meets or exceeds the appropriate requirements for .
manufactured devices (from the pplia ce Ici n R a " ns 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
Duch Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
CFA: {
System of
Indica'te'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) 120 fan flow
21•.7x (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 6 FO—
Check
Check Box for Pass or Fail (Pass = 6% or Less) Pass x ai
�T-24 Compliance Credit was Taken for TXV s TXV was installed
System E� of s
Indicate the maximum a owa Ie 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
QT -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 & TXV Page 2 of 2 CF -6R
Site Address: 79-786 Viento Drive
Permit Number: 0
Tract Number: 29323
Plan #: WX Phase: , 5
Lot Number: 27 Project:.
Esplanade Builder: Lennar Homes
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 T& 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 Fai ,
�T-24 Compliance. Credit was Taken for TXV
TXV,was insta e
System of
i
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 FanFlow 5 x.06
uct Pressurization Test Resu s 2
-
1 o0 x Test Leakage) Fan Flow = % Leakage
Check Box for Pass or Fail (Pass = 6% or Less)
Passl I Faill
�T-24 Compliance Credit was Taken for TXV
TXV was installed
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 Fai
pT-24 Compliance Credit was Taken for TXV
TXV was insta e "
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
uc Pressurization Test Results
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
I, the undersigned, verify that the abov iagnostic test results and the work I performed
associated with the test(s) is ;
in conformance with the requirements or mpliance
dit. (Te builder shall provide the HERS provider a copy of the '
CF -6R signed by the builder employe4s o
cont
rs R 'rig that diagnostic testing
and installation meet the
requirements for compliance credit.)
r
r
Team Heating & Air
esi s-- :-" ignature, Dqto
nstalling 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
uIeTtIlleate ®f lath®
Your House has been insulated with CeriainTeed Fiberglass.Insulation products, which are designed
for today', safety standa.rds.and tomorrow's energy requirements.
m
Fiberglass is inorganic and therefore permanently moncosnbusdble, so it does not have to be treated
rn
with fire -retardant chemicats that will likely lose their effectiveness over time. it has.not been treated
with chemicals that can corrode wiring or metal.. Fiberglass will not. absorb moisture nortivill it
settle over fume as may other insulation materials.
This also certifies that CertainTeed Fiber Glass Ilrtsulation has been professionally installed im this home
to provide tlhe following thermal performaace:
Job Name: Tapetary a@ Esplanade Traci: 29323 Phase: y
Lot €F.: -142-7. Pian: 111 Address: 79 - 786 Viento Dr., La QmiaM CSL
c;
41
Ceiling Area: R-38 Blown Garage Ceiling: laterior Walls: .
With Living Above
Overhangs: Exterior Walls; R-13 Unlaced Batts
Ceiling: Garage Wall: Cantilevered
Inaccessible to Blow, -' Floors NV Living Above
Su tractor.. OJ Insulation Co., Ina
S. ent, Azu 91702 (626) 1 License #365709
Sigtnedl_
..
Conchita O'rdiz, Secretary. 7Freasurerrk-tions
Scott Jenkins, President -or --Lou
Alerola, Directorof aOfficer
M
R- means resistance to heat flow. The higber . the R- value, the greater the insulating power.
-R-
v
Ask your builder for the fact sheet on values. keep this certificate with your other
valued papers. 'If you ever sell this home, this certificate, should be passed on to the buyer.
CO
.. . .. _.
• i . • ' - ,ins . fir.. • . .
Bush
P CA'DE-C
� t
P0. Box 521 _ Ph/Fax (760) 564-2044 y
" Rancho Mirage, CA 92270 + Cell: (760],250=1852
Email: DESNRG C�AOL.COM
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I,of,7) CF=4R ,
TAPESTRY @ ESPLANADE PFI 5
;DATE -TESTED 10-11-04
Pro;ect Title Date +
79-786 VIENTO 6.11RIVE LA QUINTA CA. 92253 LENNAR HOMES',
Pro ct Address Builder Name
+
ONY PASCANITE 909-275-0204 •PLAN 1 4 UNIT
Builder Contact Telephone Plan Number
ALAN WEAVED 760-880-5504 _GROUP 1"• r
HERS26er Telephone Sample Group Number
LOT 27-5 1 OF I ;
Certifying Signature Date Sample Lot Number ,
rtw
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 ' r
HERS RATER COMPLIANCE STATEME1�TT ;
.The house was: ® Tested ❑ Approved as part of sample testing but was not t6sted
.' 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 drawbands are used in combination with cloth
backed, rubber adhesive duct tape to seal leaks at r 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 77,
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 her,
Leakage Percentage (100 s Test Leakage/Fan Flow) _ 3.85 '
Check Box for Pass or, Fail (Pass=6% or less) _ ' ®`•
�. Pass Fail
• ® THERMOSTATIC EXPANSION VALVE (TXV) '
0 -Yes El No 'Thermostatic Expansion Valve is installed and Access is
provided for inspection
I
f0i
000,
rt�fica toOccypanc.of
a
a � ,d
� � . � ' v �•'
7 InooRroantm�
' 1981
of F Bu'lding - & ,.Saf6ty Department ^
_
This -Certificate,h issued. pursuant to', the -requirements of Section 109.0f the California Building ,
:.
Code, certifying-_- that,'- at the time-,of issuance, :,this structure was,. compliance' with the. =�
_ , ,
provisions of ;the Building "-Code :and , the, various ,ordinances. of the ' City • regulating building.;
construction and/oruse_ PY, t T
�
f I c • 1, `• �
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-, a�
.I+ '; � • . '•
L. a , .. w .,. 1'
14 ..
BUILDING`ADDRESS: 79-786Viento. Drove
Use-classification-Single.Family Dweller g - ,. Building Permit No : 0402=357
rc '
`
� r �` r "'Type of,Construction:VN ;, r '^ Land UseZone: RL
Occupancy Group: R-3 yp
_ _.
• � r
Owner of Building: LennarMoit es of California . _ Address: 78-40'1,0 Hi_ hwgy 111 �.
;.. -City, ST, ZIP: La'Qunt �CA.92253- }=
By: Danie1,P: CraWford,Jr-.` '
10/21/04 y
Date:
Building Official
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