SFD (0307-321)LICENSED CONTRACTOR 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 # Lic. Class Exp. Date
520268 .F3 118O/"e;t
Dat
��An..0,3
Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct .the,p4roject (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section, B&P.C. for this reason
Date Signature of Owner
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,wiil maintain workers' compensation insurance, as required by
Section 3700 of•"the Labor Code, for the performance of the work for which this
permit is issuetd. My workers' compensation insurance carrier & policy no. are:
Carrier S A,`1'?';- U1SI .:Policy No. ID90912-02
(This section need not be completed if the permit valuation is for $100.00 or less)'.
() 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' compensation4provisions of Section 3700 of the Labor
,Code, I hall forthw11t_"omply with those'pr Islo ns�
✓ Date:y,Applicant "'^� f�"
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 pursuantto
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
,,,.construction,
the �above- mentioned property for inspection purposes.
Signature "(Owner/Agent) F (." �`��+� Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT.
,-
.JOB SITE
ADDRESS 11 7-•= i`A,.�.LE 11: 0 fP.RFY
APN -.774-032-011
OWNER
CONTRACTOR / DESIGNER / ENGINEER
PAUL DFU0
PAUL C+. DELIO DBA PGD alrvnornvzwr
81-715HWY 1`11
81-115HWY111
INDIO CA, 92201
IEvMIC) CA 92201
C760)324-8515 C'B 1311
USE OF PERMIT
MOLS, FAWLY DW. ,.i:.LWL%^
1703 V. S.frPERMIT DOES'' NOT INCLUDi: S'LOC.K UD.¢.i:Tt POOU aP OR
E)RIV�' AY APPROACH
TRACT CONSTRUCTION !;993,00 SOF
tD:F1RADWC,A.I PORT 449.00 SF
EfTnMAT D COST ,OF CO.N.",i"#r'UC1710N
10I,273. 0
CONSTRUCTION! FEE 141-000-118.000.
PLAN CHECK FEE _ 101-000-43 9-318 $5s"4: 15
FEE DMIOSIT 101-000-439-318, 4250:00
It!lSC HANICAL FVZ 101-000-421-000
XLECTliIt;ALAS $111,09
FLt,9PJif3I'?iGi .f J O I-000-,419,000
S'rltqNC9MOTION M -.RV91Cf 1 +` 1-00476241.OW $19.13
GRADING PEP, '101.-000-�2,3-000 $15.00
7 V- 8I10PEFI 31V PACT 1"r; 2�4Q3. 0
106.09
k') IXIS1!,PLAN 101-000.441-345 4106.09-
T
r, 00A1R.'r YC1101,�, AM JPLAK S. MRC;F.
$3,998.37
De - 1H�SS YRE-PAID AWS
-$210.00
f, OCT 2 3..2003 P ?Mff Y 98 DUD Prow
1
$3,7 .37
Cl IN OF LAQUINTA '
FINANCE: QF_PT.
RECEIPT
DATE'
BY
D FJi�IAt§D� OL
INSPECTO //
s, "'
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
-
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air f
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
- O
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
Comments Certs #25121 and 25122 used for CC#297831 in the amount of $7,288.84
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 $2.14 X 1,703 S.F. or $3,644.42 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 CC/Valley Independent Bank - Paul Delio Check No. 297831
Name on the check Telephone 760/324.8515
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon MCGllvrey Payment Recd
$3,644.42 Over/Under
Signature c
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.
CERTIFICATE OF COMPLIANCE
Desert
Sands Unified School District
J�1FI�S�
47950 Dune Palms Road
Q BERMUDA D� UNES O
Date
10/22/03,
p q
La Quuinta, CA 92253
rn RANCHOMIRAGE (�
No.
25122
(760) 771-8515
INDIAN
�J
PALM DESERTy�
LA QU
D
INIO
O0 1p
O
Owner
Paul Delio
APN #
774-032-011
Address
81-715 Hwy 111
Jurisdiction
La Quinta
City
Indio Zip 92201
Permit #
0307-321
Tract #
Study Area
Type
Single Family Residence
No. of Units
1
Lot # No.. Street
S.F. Lot # No.
Street S.F.
Unit 1 12
77220 Calle Monterey
1703 Unit 6
Unit 2
Unit 7
Unit 3
Unit 8
Unit 4
Unit 9
Unit 5
Unit 10
Comments Certs #25121 and 25122 used for CC#297831 in the amount of $7,288.84
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 $2.14 X 1,703 S.F. or $3,644.42 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 CC/Valley Independent Bank - Paul Delio Check No. 297831
Name on the check Telephone 760/324.8515
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon MCGllvrey Payment Recd
$3,644.42 Over/Under
Signature c
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.
14-02 02:38pm From -OLD REPUBLIC TITLE TSOT732111 T -49T P"05/05 F -lig
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TAX STAT0V- M TQ ` 1
aWe __._ _. am.ar�rtap. ♦ � :.
Description: Riverside,CA Document-Year.DOCID 1998.317444 Page: 1 0f 1
order.- nJ-11-144002 02-25-19 PM Comment:
- r
CHARLES D GARLAND
c„f,
Architecture, Interiors, Space and Land Planning
Structural Calculations
26 March 2004
The City of La Quints
Department of Building and Safety
78.495 Calle Tampico
La Quints, CA 92253
Project: Single Family Residence for:
P. G. D.
77-220 Calle Monterey
La Quinta, CA
Regarding: Project Observation
r
To Whom it May Concern,
On this date I visited" the noted project site to perform code required structural observations. At
the time'l noted only minor issues that were resolved at the time of. my visit.
Therefore, in light of the record construction documents I hereby certify that the noted
single family residence is in substantial, conformance with design intent of said record
construction documents and is hereby declared ready to wrap.
If you have any further questions regarding this project please do not hesitate in contacting me.
Sincerely _
Iggoll
QHS D.cc
yk ® .
Charles D. Garland No. C1999110/3 VV
AfChlteCt N� EXP. DATE �N�
F CA0F®
74854 Velie Way, Suite 5 ❑ Palm Desert, CA 92260 ❑ Phone: (760) 340.3528 o Facsimile: (760) 340.3728
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC ,TESTING CF -4R .
Project Title Dath
Proje�y.Ad ess Builder Name
Builder Con Telephone Plan Number
HERS ater T Io e - Sample .Group Number
fying Signature Date Sample House Number
Firm:1SC. 4-14WOG/1�&s c HERS Provider: J-6/,4�-A5.o6/iZ_5S.
Street Address'. -7 I'4(,f �OYI CYGLa� City/State/Zip: Lg
Copies to: Builder, HERS Provider
HERS.RATER COMPL ANCE STATEMENT
The house was: jo 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
co ly 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
of ducts)
UCWhere 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.
0�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 r,
calculated value here
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) 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
Pass Fail
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1. O 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.
41)"A
2.• O Yes .O 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 =
O. D
Yes for both 1 -and 2 is a Pass
Pass Fail
' z
Certificate of Occupancy.
U = •
G
OF 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
constructionand/or use.
J ,
BUILDING ADDRESS: 77-220 CALLE MONTEREY
Use classification: SFD
Occupancy Group: -R3
Owner of Building: PAUL. DELIO
jBuilding Offici
Building Permit No0310-321
Type of Construction: VN Land Use Zone RC
Address: 81-715 HWY 111
City,'ST, ZIP: INDIO CA 92201 _
By: KIRK KIRKLAND
Date: 6-23-04
POST IN A CONSPICUOUS PLACE
G