05-2132 (SFD)4
.P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/16/05
Application Number: 05-00002132 Owner:
Property Address: 52690 AVENIDA JUAREZ POWER FINANCE
APN: 773-281-028-13 -000000- P O BOX 134
Application description: DWELLING L SINGLE FAMILY DET D 0 LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL
Application valuation: 146991 cCp 1 C
'SEP 1 3 2005 Contractor:
Applicant: Architect or Engineer: Com'®F L AQUI ITA CONTEMPORARY HOMES INC
��NC�BEPT. 75271 STARDUST LANE
INDIAN WELLS, CA 92210-
(760)568-1404
Lic. No.: OOR SQUARE -FOOT Lic. No.: 736920
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: 13 License No.: 736920 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
q issued.
te_9' (3'�S oni tractor: / I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
7 Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1576408-2005
-. following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, -
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the L*Code,shal orthwth comply with those provisions.that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by • ,11 -any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500):• App
(_) 1, 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. _ IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed - 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application,
( 1 1 am exempt under Sec. , B.&P.C. for this reason 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
Date:
Owner:
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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPER.1111T
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 t the above information is correct. I agree to comply with all
city and county ordinances and state laws relator to b ' ding construction, and hereby authorize representatives
O�of this ounty to enter upon �.t�heaa/bove-mentione ropert for inspectio pu oses.
! tO SiS na:Ze-(Applicant or Age
r
Application Number . . . . . 05-00002132
Permit
. . .
BUILDING PERMIT
Additional
desc .
Permit Fee
. . . .
804.00
Plan Check Fee
522.60
Issue Date
. . . .
Valuation . . . .
146991
Expiration
Date
2/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
639.50
47.00
----------------------------------------------------------------------------
3.5000
THOU BLDG
100,001-500,000
164.50
Permit
. . .
MECHANICAL
Additional
desc .
Permit Fee
. . . .
77.00
Plan Check Fee
19.25
Issue Date
. . . .
Valuation
0
Expiration
Date
2/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00
9.0000
EA MECH
FURNACE <=100K
18.00
2.00
9.0000
EA MECH
B/C <=3HP/100K BTU
18.00
3.00
6.5000
EA MECH
VENT FAN
19.50
1.00
----------------------------------------------------------------------------
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit
. . .
ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Fee
122.43
Plan Check.Fee
30.61
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
2/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2363.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
82.71
486.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
9.72
1.00
----------------------------------------------------------------------------
15.0000
EA ELEC
TEMPORARY POWER POLE
15.00
Permit
. . .
PLUMBING
Additional
desc .
Permit Fee135.75•
Plan Check Fee
33.94
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
2/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
11.00
6.0000
EA PLB FIXTURE
66.00
LQPERMIT
Application Number .
. . . . 05-00002132
Permit . . . .
PLUMBING
Qty Unit Charge
Per
Extension
1.00 15.0000
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
9.00
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
Expiration Date
2/12/06
Qty Unit Charge
Per-_
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
2363 S.F. SFD PERMIT
DOES NOT INCLUDE
BLOCK WALL, POOL/SPA
OR DRIVEWAY
APPROACH
=
-----------------------------------
Other Fees . . . . .
----------------------------------------
. . . . ART IN.PUBLIC PLACES -RES
20.00
DIF COMMUNITY CENTERS -RES
97.00
'DIF CIVIC CENTER - RES•
366.00
ENERGY REVIEW FEE
52.26
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
.00
- _ - -
DIF LIBRARIES -.RES
225.00.
DIF PARK MAINT FAC - RES
5.00
STRONG MOTION (SMI) - RES
14.69
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total
1154.18 .00 .00
1154:18
Plan Check Total
606.40 250.00 :00
356.40
Other Fee Total
1989.•95 .00 .00
1989.95
Grand Total
3750.53 250.00 .00
3500.53
LQPERMIT
JUN—.27-2006 07:16 AM
1 ,
N�CERTIFICATE OF FIE
w
r^i0
Project Title -
,e-
TI
Firm: ,J., C , f "9'04'/a7i?-S
Street Address: 7F4610
Copies to: Builder, HERS Provider
P.01
Date
6umer Name
Plan Number
Sample Group Number
Sample House Number
tiERS Provider: / y�k Rs
City/StatelZlp: L a aia,1 194 '7;U-::CL-
Copies
.21::CL
HERS RATER 'CgMPLIANCE STATEMENT
The house was: ested ❑ 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
comps 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)
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.
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
5
Test Leakage Flow In CFM,
If fan flow is calculated as 400efm/ton x number of tons enter LIlV
calculated value here
If fan flow Is measured enter measured value here
1
_ Leakage Percentage (100 x Test Leakage/Fan Flow) _ � v D
Check'Box for Pass or Fall (Pass=6% or less)
❑
ass Fail
j HERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent
❑ No Thermostatic Expanslon Valve (or Commission approved
,;t'�Yes
equivalent) Is Installed and Access is provided for inspection13Yes
415's
is a pass
Fail
❑ 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 now 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
Pass Fall
Y -