05-2915 (PAT)79762 America Ct
05-2915
IIIIIIIIIIIIIIIIVIIIIIII 52 W
P.O. BOX 1504 _ - _. 4_
782`4.95 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
Application Number:
Property Address:
APN':
Application description
Property Zoning:
Application valuation:
05-00002915 .
79762 AMERICA CT
604-502-017-22 -24197 -
PATIO COVER - RESIDENTIAL
LOW DENSITY RESIDENTIAL
5985
Architect or Engineer:
010
BUILDING PERMIT
D
I NL 13 2005
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.
Lice Class: B1 License No.: 510847
Datei
Cyr+ ractor.
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 ($500).:
(_ 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.).
(_) 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.). '
(_) 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 R
LQPERMIT
Owner:
STAHL BRYAN E
79762 AMERICA COURT
LA QUINTA, CA 92253
HAWKINS CONSTRUCTION
77850 DELAWARE PLACE
PALM DESERT, CA 92211
(760)413-3017
Lic. No.: 510847
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/13/05
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 Section 3700 of the Labor
Code, for the performance df the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EXEMPT Policy Number EXEMPT
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 Codshall forth 1th comply with those provisions.
✓ 7 0/ 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 ($100,000) 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 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 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 county ordinances and state laws relating to building construction, and hereby authorize representatives
of th' county to enter upon the above-mentioned property for inspection purposes.
✓// S
Signa Applicant or Agent):
}
Application Number
. . . . . 05-00002915
Permit . .
. PATIO COVER
PERMIT
Additional desc .
.
Permit Fee . . .
. 81.00
Plan Check
Fee
52.65
Issue Date . . .
.
Valuation
. . .
. 5985
Expiration Date
1/09/06
Qty Unit Charge Per
Extension
BASE
FEE
45.00
4.00 9.0000
----------------------------------------------------------------------------
THOU BLDG
2,001-25,000
36.00
-
Special Notes and
Comments
450 S.F. ALUMAWOOD
PATIO COVER
----------------------------------------------------------------------------
Other Fees . . .
. . . . STRONG MOTION (SMI)
- RES
.59
Fee summary
-----------------
Charged
--------------------
Paid Credited
Due
Permit Fee Total
81.00
----------
.00
----------
.00
81.00
Plan Check Total
52.65
.00
.00
52.65
Other Fee Total
.59
.00
.00
.59
Grand Total
134.24
.00
.00
134.24
LQPERMIT
Bin #
777F
Petmh # .0 `(„
Project Address:
A. P. Number:
Legal Description:
Contractor:
Address: O
City, ST, Zip: Z -
Telephone: ,
State Lic. # : O eyl
Arch., Engr., Designer: .
Address:%C.
City, ST, Zip:
Telephone- 06
Stale Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
City of La Qurnta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit APPlication and Tracking Sheet
CSV G% Ow'ner's Name. S
77411
Address: y 6
1 41q e, G,
City, ST, Zip:
Project Description: l
City Lic. #:
N Submittal Rcq'd Rec'd
Plan Sets
Structural Ca1cs.
TXuss'Calcs.
Title 24 talcs:
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
II.O.A. Apliroval
IN 110USE:-
Planning Approval
Pub. Wks. Appr
School Fees
C_
Total fermi( Fccs
Construction Type:
Pc.
c
O cu P ancv:
Pr o '
ect type (circle one):.
New Add'n Altcr Rc air
P Demo
Sq. Fl.: S O
# Stories:
# Units;
Estimated Value of Project:
'LICANT: DO NOT WRITE BELOW THIS
LINE
TRACKING
PERMIT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
.Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2"' Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.11i.1.
Plans. resubmitted
Grading
Revien• ' eady for corrections/issue
Developer Impact Fee
Called Contact Person
A.I.P.P.
Date or permit issue
—
Total fermi( Fccs
Ij I I AA.-- - "1 _
OF LA QUINTA
MG & SAFETY DEPT.
PIJKtJv t:LJ
; CONSTRUGYMN
RE -INSPECTION FEE OF $30
ILL BE CHARGED; IF D
ANS AND JOB CARARE NOT ON
THE SITE FOR A SCHEDULED
jSp-LCTION.
/o fi_o EXCEPTIONS!
o
TS
171 --
9 IAew"
14
IIIIIII VIII III VIII
IIII 53
IE
- --------- - J 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:
79-762 America Court, Lot 22, Monticello -Classics, La Quinta, California
CEILINGS:
TYPE: BLOW MANUFACTURER: CERTAINTEED THICKNESS: R-38
WALLS:
TYPE: BATTS MANUFACTURER: CERTAINTEED THICKNESS: R-13
GENERAL CONTRACTOR: CENT U Y CROWELL COMMUNITIES LICENSE
BY: TITLE: t/
PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 632072
.4
BY: TITLE: ADMINISTRATIVE ASSISTANT DATE: 12/5/2002
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF -411
Joe 9L96 1 1 SD O77-2- 3 15 0
Builder Contact / Telephone
I N R 2 r 6 Rov.f d (76o)564',P-o4-4-
Z
R ' Telephone
L°c#J6Klol z'15 2 z
o
enSignature Date
F 5 Tj r . r I/ 4-/o 2
Dat—te --
JT Li E5
Builder Name
_FLA,d 3(2.
Ian Number
20 Li P ,
Sample Group Number
Lo T x"22
7f-'7&2. Ane -A eA
C Sample House Number
Firm: ESET E 2I,I F -Z- y i c-F=HERS Provider: L°, ►-I <_ . E. fZ, .
Street Address:Py.F-LoX(o2I City/State/Zip: A kIP_hlo rjit A4t, eA,")'2L7o
Copies to: Builder, HERS Provider
HERS RATER COMPLIANCE STATEMENT
The house .vas:. Tested ❑ Approved as part of sample testing, but was not tested
As (lie HERS rater providing diagnostic testing and Field verification, I certify that the houses identified on this form comply
+ ith the diagnostic tested compliance requirements as checked on this form.
Q"'The installer has provided a copy of CF -6R (Installation Certificate.
Er Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts)
12' 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.
d 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 64 --
If fan flow is calculated as 400cfm/ton x number of tons enter calculated
value here 2000
If fan now is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) _ ¢• z0/0
Check Box for Pass or Fail (Pass=6% or less)
LTJ THERMOSTATIC EXPANSION VALVE (TXV)
L'J Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection
Yes is a pass
❑ iIMINIn1UM 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 - IR 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- I R.
Measured Fan Flow =
Yes for both I and 2 is a Pass
Pass Fail
2 ❑
Pass Fail
❑ ❑
Pass Fail
Compliance Forms August 2001 A-16