04-4097 (SFD) IIIIIIIIIIIIIIIIIIIIIIIII 72
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BUILDING & SAFETY DEPARTMENT
P.O',.'--.Pox 1504 (760) 777-7012
OFTt�9TAMPI'co FAX (760) 777-7011
LA QU,INT,A, CALIFORNIA 92253 INSPECTION REQUESTS (760).777-7153
e P�
BUILDING PERMIT
Application Number . . . . . X04-00004097-_ Date 5/17/04
Property Address . . . . . . `80938 CALLE AZUL
APN: 762-240-003-28 -300961-
Application* description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . MEDIUM DENSITY RES
Application valuation . . . . 97152
Owner Contractor
------------------------ ------------------------
PUERTA AZUL PARTNERS DAVIS/REED CONSTRUCTION INC
17700 SW UPPER BOONES FERRY RD 169 SAXONY ROAD, STE #105
SUITE 100 ENCINITAS CA 92024
PORTLAND OR 9.7224 (760) 634-2350
WCC: STATE FUND
WC: WC298892003 06/12/04
CSLB: 813480 10/31/04
CCC: B
-------------------------- Structure Information ---------------7---------
Construction Type . . . . . TYPE V - NON RATED
Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10
Flood Zone . . . . . . . NON-AO FLOOD ZONE
Other struct info . . . . . CODE EDITION 2001 CRC
# BEDROOMS 2 . 00 '
FIRE SPRINKLERS NO
GARAGE SQ FTG 255 . 00
PATIO SQ FTG 267 . 00
NUMBER OF UNITS 1 . 00
FIRST FLOOR SQ FTG 1549 . 00
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Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee 630 . 50 Plan Check Fee 409 . 83
Issue Date Valuation . . . . 97152
Qty Unit Charge Per Extension
BASE FEE 414 . 50
48 . 00 4 . 5000 THOU BLDG 50, 001-100, 000 216 . 00
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Permit . . . . . . MECHANICAL
Additional desc
Permit Fee . . . . 85 . 00 Plan Check Fee 21 . 25
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
P.O. BOX 1504 •
VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT //
Application Number: O�- 4U 9 '7 Date: (O.4-0
Applicant: chiteit r Engineer• /`
Applicant's Mailing Address: Arc It �t o gine 'r's A dress:
�0,k—
Li . No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed un er provisions of Chapter 9(�Inencing with Section 7000)of Division 3 of the Business and Professionals
Co e,and my License is in full force and effect.
icense Class License No.
/ Date ctor ✓ .S ( �� -��`
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the 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,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 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 Owner
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.
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
iss-ed. ((Ay worlye�s compensation ins rance carrier and polio, umber are: (�
Cartier -�1GiG�`'� �/�71i J t�t�+� y Nrfmber
_I certify that,in the performance of the work for which this s Permit is iss d,fshall 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 wo Qrs'compensation provisions of Section 3700 of the Labor Code,I shall
forthwith comply with those provisions.
ate ra)—,V1-6��nnlirnnt �� a?.��
WARNI G: 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.
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
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,indemnity and hold harmless the City of La Ouinta,its
officers,agents and employees for any act or omission related to thel,,,dunder or following issuance of this permit.
2. Any permit issued as a result of this application becomes null a d oTi id if work is not commen thin 180 days from date of issuance of such permit,or
cessation of work for 180 days will subject permit to cancel) ion.
I certify that I have read this application and state that the above into ation is co I a ith all city and county ordinances and state laws relating to building
construction,an.,d/he by authorize representatives of this county to a er up abov operfy for' Srpection purposes.
ate / ignature(Applicant or Agent):
Page 2
Application Number . . . . 04-00004097 Date 5/17/04
Qty Unit Charge Per Extension
BASE FEE 15 . 00
1 . 00 9 . 0000 EA MECH FURNACE <=100K 9 . 00
1 . 00 9 . 0000 EA MECH B/C <=3HP/100K BTU 9 . 00
7 . 00 6 . 5000 EA MECH VENT FAN 45 . 50
1 . 00 6 . 5000 EA MECH EXHAUST HOOD 6 . 50
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Permit . . . . . . ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee . . . . 74 . 32 Plan Check Fee 18 . 58
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15 . 00
1549 . 00 . 0350 ELEC NEW RES - 1 OR 2 FAMILY 54 . 22
255 . 00 . 0200 ELEC GARAGE OR NON-RESIDENTIAL 5 . 10
------------------- ---------------------------------------------------
Permit . . . . . . PLUMBING
Additional desc
Permit Fee . . . . 151 . 50 Plan Check Fee 37 . 88
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15 . 00
14 . 00 • 6 . 0000 EA PLB FIXTURE 84 . 00
1 . 00 15 . 0000 EA PLB BUILDING SEWER 15 . 00
1 . 00 7 . 5000 EA PLB WATER HEATER/VENT 7 . 50
1 . 00 3 . 0000 EA PLB WATER INST/ALT/REP 3 . 00
1 . 00 9 . 0000 EA PLB LAWN SPRINKLER SYSTEM 9 . 00
1 . 00 3 . 0000 EA PLB GAS PIPE- 1-4 OUTLETS 3 . 00
1 . 00 15 . 0000 EA PLB GAS METER 15 . 00
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Permit . . . . . . GRADING PERMIT
Additional desc
Permit Fee . . 15 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15 . 00
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Special Notes and Comments :
SFD - LOT 28 . PLAN 2B. PERMIT DOES NOT
Page 3
Application Number . . . . 04-00004097 Date 5/17/04
------------------------------------7---------------------------------------
Special Notes and Comments
INCLUDE BLOCK WALL, POOL, SPA OR
DRIVEWAY APPROACH.
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Other Fees . . . . . . . . . ART IN PUBLIC PLACES-RES . 00
DIF COMMUNITY CENTERS-RES 97 . 00
DIF CIVIC CENTER - RES 366 . 00
ENERGY REVIEW FEE 40 . 98
DIF FIRE PROTECTION-RES 97 . 00
GRADING PLAN CHECK FEE 00
DIF LIBRARIES - RES 225 . 00
DIF PARK MAINT FAC - RES 5 . 00
DIF PARKS/REC - RES 502 . 00
STRONG MOTION (SMI) - RES 9 . 71
DIF STREET MAINT FAC-RES 15 . 00
DIF TRANSPORTATION - RES 1098 . 00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 956 . 32 . 00 . 00 956 . 32
Plan Check Total 487 . 54 . 00 . 00 487 . 54
Other Fee Total 2455 . 69 . 00 . 00 2455 . 69
Grand Total 3899 . 55 . 00 . 00 3899 . 55
IIIIIIIIIIIIIIIIIIIIIIIII
IF •
,- Certificate of Occupancyf
Lumouis�4�
G� OF �ti Building & Safety Department
This 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
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 80-938 CALLE AZUL
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-4097
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RM
PUERTA AZUL PARTNERS LLC. Address: 17700 SW UPPER BOONES FERRY
City, ST, ZIP: GARY HARTMAN
Date: JANUARY 28, 2005
Building Official
POST IN A CONSPICUOUS PLACE
JAN-28-2005 08 :01 AM IIIIIIIIIIIIIIIIIIIIIIIII 74 P. 07
IE
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CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R
p J
Project-T. Date.
Project Add r s Builder Name
Builder Cont t Telephone Plan Number
�Isr-$l 9 3
HERS ter Teleph ne Sample Group Number
C ing Signature Oster Sample House Number
Firm: -7-6. HERS Provider,
StreetAddress: -7 ',4ta 4y�� n-1 C/j%GLe Clty/State/Zip; L N Ow/n g ('e ?;;,:�=3
Copies to: Builder, HERS Provider
HERS RATER ggMELIANCE STATEMEN
The house was: X 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
com�py with the diagnostic tested compliance requirements as checked on this form.
Distribution system is fully'ducted (I.e,, does not use building cavities as plenums or platform returns in lieu
f 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.
INIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum B% Duct Leakage)
Measured
• Duct Pressurization Test Results (CFM Q 25 Pa) values
Test Leakage Flow in CFM
If fan flow is calculated as 400cfm/ton x number of tons enter ��
calculated value here v'!
If fan flow is measured enter measured value here
Leakage Percentage(100 x Test Leakage/Fan Flow)- '5; D
Check Box for Pass or Fail (Pass=6% or less) ❑
Pass Fail
THERMOSTATIC EXPANSION VALVE (TXV)or Commission approved equivalent _
V-
es ❑ No Thermostatic Expansion Valve(or Commission approved T
equivalent) is Installed and Access Is provided for inspection ❑
Yes is a pass Pass Fail
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1. 0 Yes O No ACCA Manual 0 Design requirements have been met
(rater has verified that actual installation matches values in J
CF-1 R and design on plan.
2. 0 Yes ❑ No TXV Is installed or Fan flow has been verified. If no TXV,
verified fan flow matches design from CF-1 R.
Measured Fan Flow=
Yes for both 1 and 2 is a Pass Pass Fail
•
01/20/2005 08:17 17603401819 PAGE 07/09
r \
INSULATION CERTIFICATE
• This N to certify that insulation has been installed in conformance with the current energy
regular on, California Administrative Code, Title 24, State of California, in the building at
80-938 CALLE AZUL, LOT 28, PHASE 3, LA QUINTA CA
CEILINGS:
TYPE: BLOW MANUFACTURER: Certainteed THICKNESS: R-38
WALL::
TYPES"BATT;i MAUNFACTURER: Certainteed THICKNESS: R-19
GENET; AL CONTRACTOR: DAVIS-REED CONSTRUCTION LICENSE#
BY;—. TITLE:
PARAi!ION SCHMID BUILDING PRODUCTS A MASCO Company LICENSE#221517
BY: ;ITITLE, ACCOUNT REPRESENTIVE: DATE:
•
INSULATION CERTIFICATE
Th�!: certify that insulation has been installed in conformance with the current energy
regulatk n, alifornia Administrative Code, Title 24, State of California, in the building located
CEILINGS:
TYPE: I: LOW MAU CTURER: Certainteed NESS: R-38
WALLS:
TYPE: 3ATTS MAUNFACTUR wens Corning THICKNESS: R-13
GENER,11 CONTRACTq _-L�SE#
BY TITLE:
PAR�AG ON SCHMID BUILDING PRODUCTS A MASCO Com LICENSE#221517
BY: TITLE: ACCOUNT REPRESENTIVE D :TE: