04-8366 (SFD)Lt•
01,
P.O. Box 1504
APR 21 2005
T-Vf 4 4 Q"
BUILDING & SAFETY DEPARTMENT
(760).777-7012
Pico FAX (760) 777-7011
)RNIA 92253 INSPECTION REQUESTS (760)-777-7153
BUILDING PERMIT
NT
�j
EPT.
Application Number
Date
4/05/05
Property Address
54485-EAST`RESIDENCE CLUB
DR
APN:
775-390-999-28 -31627 -
Application description
DWELLING - SINGLE FAMILY
DETACHED
Property Zoning
MEDIUM DENSITY RES
Application valuation ... .
. 287914
Owner
Contractor
NADADOR, LLC
JACOBS HOMES INC,
PETER
78120 CALLE ESTADO, SUITE 203
P.O. BOX 692
LA QUINTA CA 92253
LA QUINTA
CA 92247
(760) 777-9921
WCC: HRH INSUR
WC: 176983304
06/01/05
CSLB: 799449
04/30/05
CCC: B
-------------------------- Structure
Information ---•----=--------------=--
Construction Type
TYPE V - NON RATED
Occupancy Type . . . . . .
DWELLG/LODGING/CONG <=10
Flood Zone
NON -AO FLOOD ZONE
Other struct info . . . . .
CODE EDITION
2001 CBC
# BEDROOMS
3.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
531.00
PATIO SQ FTG
422.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
3365.00
-------------------------------------------------------=--------------------
Permit. . . . _ . BUILDING PERMIT
Additional desc
Permit Fee . . . . 1297.50
Plan Check Fee
210.85
Issue Date
Valuation . . .
. 287914
Qty Unit Charge Per
Extension,
BASE FEE
639.50
188.00 .3.5000 THOU
BLDG 100,001-500,000
658.00
---------------- -----------------------------------------
Permit . . . . . . MECHANICAL
--'=='---------------
Additional desc
Permit Fee 171.50
Plan Check Fee
10.•72
Issue Date . . . .
Valuation
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
4.00 9.0000 EA
MECH FURNACE <=100K
36.00
4.00 9.0000 EA
MECH B/C <L3HP/100K BTU
36.00
12.•00 6.5000 EA
MECH VENT FAN
78.00
lei
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: 644 _ $ 340 (c Date: �• ,2 •05
Applicant: Architect or Engineer:
Applicant's Mailing Address: chitect or Engineer's Address:
on
LIP
JI ic. 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 ulI force and effect. C1(��r
�Cicense Class LN `�6 cense No. (
/Date 2� Q ontractor 7t5 -i-(=4 P8--eDel"A(D ti G
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt frcm 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.
r I have and will maintain workers' compensation insurance, as required by Section 3700 f the Labor Code, for the performance of the work for which this permit is
lissiled My workers' compensation i nce carrierand ,�S�ligyy nu rare,
arner t� l -E 1 !�f UZAt sr olicy Number ^f-f� SO
_ I certi 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 Code, I shall
forthwith comply with those provisions.
ate l l Z ( 140' - Ant
WARNING: FAILURE TO SECURE WORKERS' COMPEVSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL4RS ($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 Q
Lender's Address A
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 1 have read this application and state that the above information is corfe94 I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to t upon t ve-mentioned property for inspection purposes.
�te?— t Or ignature (Applicant or Agent):
Page
2
Application Number .
. . . . 04-00008366 Date
4/05/05
Qty Unit Charge
Per
Extension
1.00 6.5000
EA MECH EXHAUST HOOD
6.50
--------------------,----------------------
Permit . . . .
----------------------------------
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee . . . .
•145.60 Plan -Check Fee
9.10
Issue Date . .
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3365.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
117.78
641.00 .0200
-ELE'C GARAGE OR NON-RESIDENTIAL
•12.82
Permit . . . . . .
PLUMBING
Additional desc
Permit Fee
185.25 Plan Check Fee
11.58
Issue Date
Valuation . . . .
0
Qty - Unit Charge
Per
Extension
BASE -FEE
15-.00
18.00 X6.0000
EA' PLB FIXTURE
108.00
1.00 .15.0000
EA PLB BUILDING SEWER
15.00
2.00 7.5000
EA PLB WATER HEATER/VENT
15.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000
EA PLB LAWR SPRINKLER SYSTEM
9.00
7.00 .7500
EA PLB GAS PIPE >=5
5:25
1.00 15.0000
----------------------------------------------------------------------------
EA PLB GAS METER
15.00
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
Special Notes and Comments
SFD - LOT -28, PLAN A.
PERMIT DOES NOT
INCLUDE POOL, SPA,'BLOCK
WALLS, OR
DRIVEWAY APPROACH. 75%
REDUCTION TO
PLAN CHECK FEE DUE TO
MULTIPLE ISSUANCE
OF SAME PLAN TYPE
7 ---------------------------------------------------------------------
Other Fees . . .
ART IN PUBLIC PLACES -RES
222.74
DIF COMMUNITY CENTERS -RES
97.00`
R
Page 3
Application Number
. . . . .
04-00008366.
Date
4/05/05
--------------------------------------------------------------------7-------
Other Fees . . .
. . . . . .
DIF CIVIC CENTER -
RES
366.00
ENERGY REVIEW FEE
21.09
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
28.90
DIF STREET MAINT FAC
-RES
15.00
DIF TRANSPORTATION
- RES
1098.0.0
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
----------
1814.85
--------------------
.00
----------
.00
1814.85
Plan Check Total
242:25
.00
.00
242.25
Other Fee Total
2677.73
.00
.00
2677.73
Grand Total
4734.83
.00
.00
4734.83
R
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF4R
Dated� 11
Project Address Builder Name
Builder Cnntact Telenhnn
e Plan Number
Sample Group Number
Sample House Number
HERS Provider: �?�c�,u� //•%�'�
City/Statetzip:
H
Finn:
Street Address: ��� ���► ��
Copies to: Builder, HERS Provider
ERS RATER COMPLIANCE STATEMENT
The house was: 13 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 dud connections.
11NMW' MUM 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 400cfin/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) _
Pass Fail
rft
THERMOSTATIC EXPANSION VALVE (TXV)
Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection] [�
Yes is a pass
MIIVIMUM 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 -IR and
design on plan.
2. 11 Yes ❑ No TXV is installed or -Fan flow has been verified. If no TXV,
verified fan flow matches design from CF -IR
Measured Fan Flow
Yes for both- 1 and 2 is a Pass
Compliance Forms August 2001
Pass Fail
13❑
Pass Fail
A-16
- Certificate of Occupancyo
�.�� Safet p artment
ID f g & Y Department
This Certificate is issued pursuant to the requirements of Section 1u9 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.
i
1
BUILDING ADDRESS: 54-485 EAST RESIDENCE CLUB DRIVE
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-8366
Occupancy Group: R3 Type of Construction: V -N Land Use Zone: RM
Owner of Building: NADADOR, LLC Address: 78-120 CALLE ESTADO, STE. 203
City, ST, ZIP: LA QUINTA, CA 92253
By: GARY HARTMAN
Date: MARCH 29, 2006
Building Official.
POST IN A CONSPICUOUS PLACE