04-6303 (RPL)79777 Ambassador Cir
04-6303
I IIIIIII VIII III VIII IIII 04
1E
_ S
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504
(760).777-7012
OF'9 C%' 78-495 CALLE TAMPICO " FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . . C-04=0=0-0-0_ 53`03- -) Date 9/14/04
Property Address . . . . . . 79777 AMBASSADOR CIR
APN: 604-520-013-13 -24197 -
Application description POOL - RESIDENTIAL
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 30000
Owner Contractor
------------------------ ------------------------
CULLINAN JAMES E GATTUSO POOL CORPORATION
79777 AMBASSADOR CIRCLE 667 S. EUGENE ROAD
LA QUINTA CA 92253 PALM SPRINGS CA 92264
(760) 327-7592
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Permit . . . . BLDG POOL PERMIT
Additional desc
Permit Fee . . . . 284.50 Plan Check Fee 184.93
Issue Date . . . . Valuation 30000
Expiration Date . . 3/14/05
Qty Unit Charge Per Extension
BASE FEE 252.00
5.00 6.5000 THOU BLDG 25,001-50,000 32.50
------------------------------------------------=---------------------------
Permit . . . . MECH POOL
.Additional desc
Permit Fee . . . . 24.00 Plan Check Fee 6.00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 3/14/05
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K 9.00
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Permit . . . . . . ELEC POOL PERMIT -RES
Additional desc
Permit Fee . . . . 45.00 Plan Check'Fee 11.25
Issue Date . . . . Valuation 0
Expiration Date 3/14/05
Qty Uni,taCha-r-ge Per Extension
BASE FEE 15.00
1! 0"0 --"" - 30.00011EA ELEC PRIVATE SWIMMING POOL 30.00
-------- Y Y _ NNNuI -----------------------------------------------
--- S ' 2.2004
C17Y u L C':I c.1
P.O. Box 1504 • 4 / VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-701 I
LA QUINTA, CALIFORNIA 922534 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: ( Cj - ('o,3O3 Date: 1.0
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
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
de, and my License i ai ll force and effect.
License Class ' 5 license No.1 01
Bate (Z ntractor
NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exem fro a Contractors' 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, i ve, 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 p sions of the Contractors' 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 ($500).):
U 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 or 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.).
U 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 contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Date
WORKERS' 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.
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 ins ce carrier and I' y number are:
mem&4= fIA icy Number LZ`7( 11
_ 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 Califo nd agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those p visi ns.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIN COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($ 00,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTO EY'S FEES.
C!g$& LICTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction I mg agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name /
Lender's Address 44
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 Ouinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes nu9 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 infoion is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to nter upon the above-mentioned property for inspection purposes.
,, e L Z/ Sig/ nature (Applicant or Agent):
Page 2
Application Number . . . . . 04-00006303
Date 9/14/04
Permit . . . . . . PLUMBING
Additional desc . .
Permit Fee . . . . 33.00
Plan Check Fee
8.25
Issue Date . . . .
Valuation . .
. . 0
Expiration Date . 3/14/05
Qty Unit'Charge Per
Extension
BASE
FEE
15.00
2.00 6.0000 EA PLB
FIXTURE
12.00
1.00 3.0000 EA PLB
WATER INST/ALT/REP
3.00
1.00 3.0000 EA PLB
GAS PIPE 1-4 OUTLETS
3.00
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Special Notes and Comments
POOL/SPA. ALARMS/BARRIERS SHALL
BE IN
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged
----------------------------
Paid Credited
Due
----------
Permit Fee Total 386.50
----------
.00 .00
----------
386.50
Plan Check Total 210.43
.00 .00
210.43
Grand Total 596.93
.00 .00
596.93
09/14/2004 08:00 1784920 GATTUSO FOOL CORPORT PAGE 02
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INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
=regulation, California Administrative Code, Title 24, State of California, in the building located at:
79-777 Ambassador Circle, Lot 13, La Quanta, California
CEILINGS:
TYPE: BLOW MANUFACTURER: Certainteed Thickness: R-38
WALLS:
TYPE: BATTS MANUFACTURER: Certainteed IThickness: R-13
GENERAL CONTRACTOR: CENTURY CROWELL COMMUNITIES LICENSE#
BY: TITLE:y --
ARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072
BY: TITLE: ADMINISTRATIVE ASSISTANT DATE: 11/26/2002
i CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF -4R
rl >ki TiL. oG
Pr ject Title
Project Address
Joe r"0610SOd
Builder Contact ,
-
HN Rates /
Q . u,
LA QLJ I d-1
Telephone
G4-2o
Telephon
C N Q1C& (wn
enifying Signature Date
F1rm: E SE LIE ki ea ( Py I c -E-5
Street ,,\ddress: i c7. E ox oZ
Copies to: Builder, HERS Provider
T 5 Te r>►" 1/ 4-/0
Date
6-F–: tJ 1 n t E
Builder Name
5 8 l o d 2 S
Plan Number
v
eTr— Sample Group Number
l"o T # 13 19-727" tBassar .
Sample House Number
HERS Provider: 4° ry 1✓ . E. R. s
City/State/Zip: KA Kld Ho
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.
Kistribution 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.
h1INIMUM 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 60
If fan flow is calculated as 400cfm/ton x number of tons enter calculated
value here 00
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) = 3.750
/
Check Box for Pass or Fail (Pass=6% or less)
C ' ❑
Pass Fail
ErITHERNIOSTATIC EXPANSION VALVE (TXV)
Lel Yes ❑ No Thermostatic Expansion Valve is installed and Access is
/
provided for inspection
[j ❑
Yes is a pass
Pass Fail
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
❑ Yes ❑ NO ACCA Manual D Design requirements have been met (rater has
verified that actual installation matches values in CF -I R and
design on plan.
Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV,
verified fan flow matches design from CF - IR.
Measured Fan Flow =
Yes for both I and 2 is a Pass
Pass Fail
ComQhance Forms August 2001
A-16