04-7899 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Applicant:
C�
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
------------------
LICENSED CONTRACTOR'S 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 C a s- B, \ icense No.: 672285
/Date: ontractor: \i`{,�`
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OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).:
1 _ 1' 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 and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed
pursuant to the Contractors' State License Law.). '
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: I'
IIIIIII VIIIIII VIII IIII 37
LQPERl111T IE
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/20/04
Contractor: JtDEC
e
SHEA HOMES, INC.
81260 AVENUE 62
LA'QUINTA, CA 92253
(760)777-600S 2 3 200%
Lic. No.: 672285 T
CITY
OFLA QU
INTAFIHI
------------------
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
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 Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier NTL UNION INS Policy Num r 6436568
_ I certify that, in theAsto
work f which this permit is issued, I shall not employ any
person in any mes ) ct to the workers' compensation laws of California,
nd agree that, i ' t the workers' compensation provisions of Section
7 0 f the Labwith omply with those provisions.
ate: scant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this 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 application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for /issionfission related to the work being
performed under or following issuance of this permi
2. Any permit issued as a result of this application becvoid if work is not commenced
within 180 days from date ofissuAofsuchron of work for 180 days will subject
permit to cancellation.
I certify tha I have read this application and staes correct. 1 agree to comply with all
city and co �inancesstate laws relatiae yau resentatives
of t is u tabove-mentionnoses.
DatApplicant or Ag
Application Number.
4W.2-5-0-0-118,9_9
Property Address:06
181 ALOE CIR
APN:
764-270-999-169 -300233-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
6355
Applicant:
C�
c&4t 4 4a
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
------------------
LICENSED CONTRACTOR'S 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 C a s- B, \ icense No.: 672285
/Date: ontractor: \i`{,�`
Pft
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).:
1 _ 1' 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 and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed
pursuant to the Contractors' State License Law.). '
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: I'
IIIIIII VIIIIII VIII IIII 37
LQPERl111T IE
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/20/04
Contractor: JtDEC
e
SHEA HOMES, INC.
81260 AVENUE 62
LA'QUINTA, CA 92253
(760)777-600S 2 3 200%
Lic. No.: 672285 T
CITY
OFLA QU
INTAFIHI
------------------
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
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 Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier NTL UNION INS Policy Num r 6436568
_ I certify that, in theAsto
work f which this permit is issued, I shall not employ any
person in any mes ) ct to the workers' compensation laws of California,
nd agree that, i ' t the workers' compensation provisions of Section
7 0 f the Labwith omply with those provisions.
ate: scant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this 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 application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for /issionfission related to the work being
performed under or following issuance of this permi
2. Any permit issued as a result of this application becvoid if work is not commenced
within 180 days from date ofissuAofsuchron of work for 180 days will subject
permit to cancellation.
I certify tha I have read this application and staes correct. 1 agree to comply with all
city and co �inancesstate laws relatiae yau resentatives
of t is u tabove-mentionnoses.
DatApplicant or Ag
�r-
Application Number . . . . . 04-00007899
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 90.00
Plan Check
Fee
00
Issue Date . . . .
Valuation
. . .
. 6355
Qty Unit Charge Per
Extension
BASE
FEE
45.00
5.00 9.0000 THOU BLDG
2,001-25,000
45.00
----------------------------------------------------------------------------
Special Notes and Comments
155 L.F. 6' GARDEN WALL, 155 L.F.
3'
RETAINING WALL, BOTH ORCO SYSTEM
Fee summary Charged
-----------------
Paid
Credited
Due
--------------------
Permit Fee Total 90.00
----------
.00
----------
.00
90.00
Plan Check Total .00
.00
.00
.00
Grand Total 90.00
.00
.00
90.00
LQPERMIT
•
•
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Pagel of
TRILOGY @ LA QUINTA- PH- 9A (Partial)
Project Title _
60181 Aloe Circle, La Quinta, CA 92253
Project oe inor 760-535-2192
Builder1klclPiA Henson (CCN #CC2004076) 7��_ 50-7022
HERS Rater
Testing
Street Address: PO Box 50575
Copies to: Builder, HERS Provider
;CER
6-15-05
Date
Builder Native ( V --r— V—,1
Plan 45`20 Box Bay @ Mbr
Telephone Sample Group Numbe
6-15-05 169 (ph 9A)
Date Sample House Numb
HERS Provider:
TS
City/state/zip: Phoenix, AZ 85076
HERS RATER COMPLIANCE STATEMENT
The house was: -Q 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.
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)
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
values
Test Leakage Flow in CFM
If fan flow is calculated as 400cfin/ton x number of tons enter calculated
value here )(00.0
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow)
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 ❑
Yes is a pass Pass Fail
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1 ❑ Yes ❑ No 'ACCA Manual D Design requirements have been met (rater has
verified that actual installation matches values in CF -1R and
design on plan.
2. ❑ Yes ❑ No TXV is installed or Fan flow has begs verified. If no TXV,
verified fan flow matches design from CF -1R.
Measured Fan Flow =
Yes for both 1 and 2 is a Pass
Compliance Forms August 2001
IIIIIII VIII III I III IIII 38
IE
❑ ❑
Pass Fail
A-16
i
•r
JCM Inspections
39725 Garand Lane Suite F
Palm Desert, CA 92211
TIONS Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS
COMPRESSION STRENGTH TEST RESULTS
Client: Shea La Quinta, LLC
Date: 5/19/05
Project: Trilogy @ La Quinta - Shea Homes
Project No: 02-1109
81-260 Avenue 62
La Quinta, CA 92274
Set ID Structure
Age of Test
Compression Strength
JCM ID Location Date Cast
Cylinder ID
(days)
(psi)
Set A Phase 9A - Lot # 3169 Slab on Grade 3-15-05
Concrete
273464 Great Room
Required psi: 4000
Q�9311
V / Lc' t (f
9312
7
28
4330
6100
9313
28
6050
py=.
CERTIFIED:
u
Page 1 of 1
JCIWrnspections supplies the service
of compression strength test results only.
Per ASTMC39