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04-7186 (SFD)Tdf P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (160).777-1012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . 40-0007 81 6 Date 11/17/04 Property Address . . . . . . -54200 WEST RESIDENCE CLUB DR APN: 775-380-999-5 -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 "2P.O. BOX 692. LA QUINTA CA '92253�..�'� LA QUINTA CA. 92247 �'- (760) 777-9921 WCC: EXEMPT WC: EXEMPT 04/30/05 CSLB: 799449 04/30/05 CCC: B -------------------------�S-tructure 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 FIRST FLOOR SQ FTG 3365.00 ---------------------------------------7------------------------------------ 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 PermitFee . . . 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 <=3HP/100K BTU 36.00 12.00 6.5000 EA MECH VENT FAN 78.00 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 q — 7 i ho Date: Applicant: Applicant's Mailing Address: Archlt�ct oy Engineer- A��/i .—Architect or Engineer's dr 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 C and my License is in full force and effect. icense Class ti -cense No -22 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 I, as owner of the property, am exclusively contracting wish 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 ssu d. workers' compensatio2jvurance car ier and clicy number are: arrier (�¢' /policy Number / �y, !� % 7 ZA4 I certify that, in th performance of the work for which t itis permit is istued, 1 `9hhall rfot 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 / 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.). Lenders 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, end 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 om,ssion 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 ' 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 to enter n e above- entioned property for inspection purposes. Date IMfig`onature (Applicant or Agent): �--' Application Number . . . . . 04-00007186. Page 2 Date 11/17/04 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 ELEC 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 6.0000 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 LAWN 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 4, PLAN BR. 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 Other Fees . . . . . . . ART IN PUBLIC PLACES -RES 222.74 DIF COMMUNITY CENTERS -RES 97.00 Page 3 Application Number . . 04-00007186 Date 11/17/04 ----------------------------------------------------------------------------' 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 1098.00- 098.00Fee Feesummary ----------------- 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 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF4R Project Title Date7— Project Address Builder Name Builder Contact Telephone Plan Number / Firm: Street Address:.= 9P3 Copies to: Builder, HERS Provider .. Sample Group Number Sample House Number HERS Provider: City/State/Zip: 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 -611 (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) Duct Pressurization Test Results (CFM @ 25 Pa) Measured values l 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) _ Gk -RAX . for PA AS or. Fail (Pass -656 or less) ❑ THERMOSTATIC EXPANSION VALVE (TXV). 09 0� Pas Fail ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection 0 Yes is a pass ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT Passim Fail 1' ❑ Yes 0 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 ❑ Yes ❑ No TXV is installed or.Fan flow has been verified. If no TXV, verified fan flow matches design from CF -IR. t`. Measured Fan Flow = ❑ ❑ Yes. for both -.1 and 2 is a Pass Pass Fail Compliance Forms August 2001 A-16 J"ql Certificate,,of Occupanc y s 4QUM& �i j L a•�,e,ro 4 OF IBuilding & 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: 54-200 WEST RESIDENCE CLUB DR. Use classification: SFD Building Permit No.: 04-7186 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RM Owner of Building: NADADOR LLC Address: 78-120 CALLE ESTADO #203 City, ST, ZIP: LA QUINTA, CA 92253 By: GARY HARTMAN _ Date: January 25, 2006 Building Official POST IN A CONSPICUOUS PLACE