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SFD (04-5922)53210 Avenida Madero 04-5922 t: S P.O. Box 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760)777-7012 "FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number f04 0.000-5=922 = ----.. Date 9/08/04 Property Address . . . . .. 532.1.0_--AVENIDIA MADERO APN: `-774-032-010-13 -000000- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . COVE.RESIDENTIAL Application valuation . . . . 1039.45 Owner- Contractor ----------------------- DELIO PAUL G.. -------------------------~ PGD DEVELOPMENT - 81715 HIGHWAY1111 STE 302 81715 HIGHWAY 111 INDIO CA 92201 INDI0 CA 92201 (760) 218-4160 WCC: STATE FUND WC: 1090912 03/01/05 CSLB: 520268 11/30/05 CCC: B --------------------------- Structure Information -------- ----------------- Construction Type . . . . . TYPE V - NON RATED 0-Uppancy, ype KI DWELLG/LODGING/LONG <=10 F iood_Z.©:ne_L ._. . . . NON -AO. FLOOD, ZONE Other struct info CODE EDITION 2001 CBC U SES' 10 2004 # BEDROOMS 3.00 FIRE.SPRINKLERS NO CITY OF LA QUINTA r GARAGE SQ FTG 484.00 FINANCE DEPT. PATIO SQ FTG 36.00 NUMBER OF UNITS •1.00 FIRST FLOOR SQ FTG 1643."00 Permit . . . . BUILDING PERMIT Additional desc Permit Fee 653.50 Plan Check Fee 106..20 Issue Date . . . Valuation' 103945 Expiration Date 9/08/05 Qty 'Unit Charge Per Extension BASE FEE 639.50 4.00 3.5000 ----------------------------------------------------=----------------------- THOU BLDG 100,001-500,000 14.00 Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 97.19 Plan Check Fee 6.08 Issue Date Valuation 0 Expiration Date 9/08/05 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: L,— o — I Date: %t a Applicant: Applicant's Mailing Address: Architect or Engineer: 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 Code, and my License is i II force and effect. License Class License No. Date 0 ® Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 1, 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. , B.& 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 issued. My, work ,rs' com ensation insurance carrier and off) y'nt r per r : Carrier C.)t% Policy Number C'%U J _ I certi that, in the performance of the work for which this permit i issued,'l 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 those provisions.. ak Date 1 t9wv pplicantF 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. 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, 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 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 this county enter upon the above-mentioned property for inspection purposes. b Date Signature (Applicant or Agent): Page 2 Application Number . . . . 04-00005922 Date 9/08/04 ,Qty Unit Charge Per Extension BASE -FEE 15.00 1643.,00• .0350 ELEC NEW RES - 1 OR 2 FAMILY 57.51 : 484.00 .02001, ELEC.GARAGE OR NON-RESIDENTIAL 9.68 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15:00 Permit . . . . . . •GRADING PERMIT Additional desc Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date . 9/08/05 Qty Unit Charge Per Extension ,. BASE FEE 15.00 Permit . MECHANICAL Additional desc Permit Fee, 52.50 Plan Check Fee ". 3.28 Issue Date . . . . Valuation 0 Expiration Date 9/08/05 Qty Unit Charge Per Extension BASE FEE 1.5.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 2.00 6.5000 EA MECH VENT FAN 13.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . . PLUMBING Additional desc Permit -Fee 123.00 Plan Check Fee 7.69 Issue Date . . . . Valuation 0 Expiration Date 9/08/05 Qty Unit Charge Per Extension BASE FEE 15:00 9.00 6.0000 EA PLB FIXTURE 54.00 1.00. 1-.0.000 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 9.00 Page 3 Application Number . . . . . 04-00005922 Date 9/08/04 Qty Unit Charge Per; -Extension 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 15..0000 EA PLB GAS METER 15.00 Special Notes and Comments' 1643 S.F. SFD PERMIT DOES NOT INCLUDE BLOCK WALL POOL/SPA'OR DRIVEWAY ' APPROACH. 75% REDUCED PLAN,CHECK FEE, -FOR MULTIPLE PLANS OF SAME TYPE ------------------------------------------------------------------------------ Other Fees . . ..... . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00. DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 10•.62 DIF -FIRE PROTECTION -RES 97.00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC- RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 10.39 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 .Fee summary Charged ----------------- Paid Credited _ Due ------------ Permit Fee Total 941.19 ------------------------------ 143.80 .00 797.39 Plan Check Total 123.25 106.20 .00 17.05 Other Fee Total 2426.01 00 .00 2426.01 Grand Total 3490.45 '250.'00 00 3240.45 Date 9/9/04 No. 26416 Owner Paul Delio Address City La Quinta Zip 92253 Tract # Type Single Family Residence CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune, Palms Road La Quinta, CA 92253 (760)7 71-8515 Q BERMUDA DUNES r rn RANCHO MIRAGE INDIAN WELLS PALM DESERT- y LA QUINTA r QINDIO i O APN # 774-032-010 Jurisdiction La Quinta I Permit # Study Area No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 53210 Avenida Madero 1643 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments Cert #26416 and #26417 are both in check number 319637. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the.above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.24 X 1,643 . S.F. or $3,680.32 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By CCNIB-Paul Dello Check No. 319637 Name on the check Telephone 760-218-4160 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Vanessa Robles Payment Recd $3,680.32 OvelUnder Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting 'r' f AWR F,- N b N_I tlt1i 00Ep ea ^,lA sbj9--[tGae m, R-77Q — { SPACE t.EOva TNIe LINE FOR RECORD/A'111 USE GRANT DEED L THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAXIS i-33-A5 u . jq computed nn full value of prupelty conveyed. or ❑ computedonfuilva'•uelessvalueofliensorancumbrancssremainingattimeofWe. ❑ unincorporated area city ofauinta AND y i FORA VALUABLE CONSIDERATION, receipt of which is herebyacknow)edge d, JAY G. TRUBEE and JUNE N. TRUBBS ` Husband and knife as Joint Tenants hereby GRANT(s) to pA% G. DELTO, A Single Han as to an undivided A interest and DANIEN A. UELSO, r— " A Single Nan as to an undivided 4 interest ( the following dascrlbad real property in the city of La guinea = County of Riverside State.uf CRlifornle: _ ?:7 aLots 22", 23, and 24 in BIock fit' of Santa Carmelite at Vale - La Quintal Unit A25 as per Nap recorded in Book 19 Page 51 of maps in the office of the County Recorder of said County F T_NIS IS BEING RE-RECORDED_TO CORRECT THE BLOCK NUMBER IN 1"8E LEGAL DESCRIPTION. _ J Oated AP.Silr1Z. I3fl8- — Ja uL• .e STATE OF CALIFORNIA J e M. Trubee COUNTYOF` RiversirtR J - On mIs --Ot ham— day of _-----Apr-U I In tha )var _19.22, boforo mo. tho undarelgned, a NotaryPubllo In end Nr oald State, perianally — sppnored ju G. TRubee and June M. Trubee , - [7 personally known to me )Wroved to mo on the bails of aetisfictory evidence - to be the person whose name Is aubaedbed to this Initruntenl, and aoknowl. - edged to me that he (she or they) executed 11. -- 01111[L1L»iIl ISL: L INX011 "I NWAR"-CAL%V4XA ta OaiM'. IL 10 Sipn C /.✓ TARfPYSLIC IN AND FOR SAID STATE tTAh arts far 01`11910aoUdJ 6641) r ran MAIL TAX STATIMINTS AS IDAEcrFD ABOYE.. . CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING:" CF -4R v Project -Title Date Proje,Adgress Builder Name t. S Builder Contactpp Telephone Plan Number J Ph, cgk- Da/q HERS ater . , Tele hone Sample Group Number . ;7 • l „t ifyinggSigna ure t to Sample House Number . Firm: J1, L-. HERS Provider: C HEt /Q S t Street Address: .71q,11016 ff r4l1.:&Vd C/YL /lel City/State/Zip:_ 1—u 4,1#7,71 j1 l 6/9 Copies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: Tested ❑ Approved as part of sample testing, but was not tested Ash ERS rater providing diagnostic. testing and field verification; I certify that the houses identified on this form cI y with the diagnostic tested compliance requirements as checked on this form. istribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu f ducts) XJ 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) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM If fan flow is calculated as 400cfm/ton x number of tons enter calculated value here If fan flow is measured enter measured value here ' l Leakage Percentage (100 x Test Leakage/Fan Flow) _ Check Box for Pass or Fail (Pass=6% or less) OF❑ ass Fail THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent Yes ❑ No Thermostatic Expansion Valve (or Commission- approved equivalent) is installed and Access is provided for inspection Yes is a pass ❑ 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 -1 R and design on plan. 2..: _-_ ❑ 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 ass Fait, ❑ ❑ Pass Fail I -Q . Crtifieca to of Occupancy., -Twit OFBuilding & 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.- se.BUILDING BUILDINGADDRESS: 53-210 AVENIDA MADERO Use classification: SFD Building Permit No.: 04-5922 Occupancy Group- R3 Type of Construction: VN Land Use Zone- RC Owner of Building- PGD Address.- 81715 HWY 111 City, ST, ZIP: INDIO CA 92201 By: KIRKLAND - Date: 10-6-05 Building Offfcial POST IN A CONSPICUOUS PLACE