05-0614 (RPL)F E3 9 2 2005IL
ow 0 LA QUINTA
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760),777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number . . . . . !05-00000614 Date 2/17/05
Property Address 57820 BLACK DIAMOND
APN: 762-370-026- - -
Application description . . . POOL - RESIDENTIAL
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 20000
j
Owner Contractor
------------------------ ------------------------
MOORE MCINTYRE POOLS & SPAS, INC.
57-820 BLACK DIAMOND 83695 AVENUE 45
LA QUINTA CA 92253 INDIO CA 92201
(760) 342-3612
WCC: STATE FUND
WC: 1769111 01/01/06
CSLB: 614611 09/30/05
CCC: C53
---------------------------------------------------_7------------------------
-Permit . . . . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 207.00 Plan Check Fee 134.55
Issue Date . . . . Valuation . . . . 20000
Qty Unit Charge Per Extension -
BASE FEE 45.00
18.00 9.0000 THOU BLDG 2,001-25,000 162.00
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Permit . . . . . . MECH POOL
Additional desc
Permit Fee . . . . 24.00 Plan Check Fee 6.00
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K 9.00
---------------------------------------=-----------------------------------'-
Permit . . . . ELEC POOL PERMIT -RES
Additional desc
Permit Fee . . . . 45.00 Plan Check Fee 11.25
Issue Date . . . . Valuation . . . . 0
.Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00
---------------------------------------- -----------------------------------
Permit . . . . . . PLUMBING
Additional desc . .
Permit Fee . . . . 33.00 Plan Check Fee 8.25
P.Q. BOX 1504 • VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: rJj— 06 1 Date: .2 •aa -os—
Applicant:
Applicant's Mailing Address:
n (V% A,AC off
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
/ode, and my License is in full force and effect. e�
icense ClassC_ License No.
5 -Contractor /�( 4' h A
OWNE -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 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 1 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:
_ 1 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 hav and ill maintai work ' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ssu My ork co ensation insurance carrier d policy number are:
C r' r i- f Policy Number
_ I rtif that, ipAe perf6rmance 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'
compens ion laws of California, and agree that, if Ibject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date _ r Applicant / X,�;Z
.41
WARNING:_FAILURE TO SECURE WORKERS' OMPENSATION OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUS D 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
IF
i
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 pernit
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 correq I agree to comply with all city and county ordinances and state laws relating to building
construe on, and hereby authorize representatives of this count =to enter upon ove-mentio d property for inspection purposes.
Dated — ZZ Gl Signature (Applicant or Agent):.41
Page 2
Application
Number . . . . . 05-00000614
Date 2/17/05
Issue Date
. . . . Valuation . .
. . 0
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 PRIOR
TO PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED IN
PERMIT.
Fee summary
Charged Paid Credited
Due
-----------------
Permit Fee
------------------------------
Total 309.00 .00 .00
----------
309.00
Plan Check
Total 160.05 .00 .00
160.05
Grand Total
469.05 .00 .00
469.05
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DAiE? /1-7 /0S BY
,
Desert e
ENERGYC A D E C
Services_ -
PO. Box 621
Rancho Mirage, CA 92270
Email: DESNRG roDAOL.COM
Ph/Fax(760)564-2044
Cell: (760) 250-1852
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R
PASADERA PH -4
Project Title
P.G.A. WEST LA QUINTA
Project Address
STEVE VAN LUE II
03-12-04
Date
ASHBROOK COMMUNITIES
Builder Name
760-801-3981 PLAN 1 2 UNITS
Builder Contact Telephone
GRANT RICH 760-250-20841
HERS Rater Telephone
_0940.e� �� #CCNGY207439 03-19-04
ng S"idnalffie a I Date
Firm: DESERT ENERGY SERVICES
Street Address: P.O. BOX 621
Copies to: Builder, HERS Provider
Plan Number
GROUP 3
Sample Group Number
LOT 70 7-820 OL14"4 J_)1gMo•10
Sample Lot Number
HERS.Provider: CHEERS
City/State/zip: RANCHO MIRAGE, CA. 92270
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.
❑ Distribution 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.
❑ 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
Leakage Percentage (100 x Test Leakage/Fan Flow) = .
Check Box for Pass or Fail (Pass% or less) ❑ ❑
Pass Fail
❑ THERMOSTATIC EXPANSION VALVE (TXV)
❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection
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