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0306-363 (SFD)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 Date ;' %+ - 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 c6ntractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section B&P.tiC. 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 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 issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. (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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.; Date , "'a i' .. ' y Applicant !i /r l' 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 Si f&ty 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 pursuant to 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 the above-mentioned property for inspection purposes. Signature (Owner/Agent) / lar. '�a' . '^+ . Date'' BUILDING KAMM - PERMIT# f DATE VALUATION LOT' _ 1,159 .- TRACT BLK 64 JOB SITE ADDRESS, %'I AVENU`,��A VMASCO APN ��Ywv� ri}gi. R1-�ioX/ OWNER CONTRACTOR / DESIGNER / EN (NEER • c� 1IR IT 72,,,96 *FRY.DVI,f Nt3 DR #j >.t I D.17,9KX tC"A 92215110 USE OF PERMIT f i ):ip0/µtg PI�C?T...3�iC:,':.14t:13 F.iLe TC �T1.A2.3:� IJ£'1I1a1?.t�4, ' �L^�4�y9fi,P�'.ya'."tr�J>{�lal'?•!aw[4�`JI,'ip TRACT t" NSTRUOMCN M09100 8F (I-kRA 113e`CATt.PORT KI" MMAM.D COST UAB t; ra,)Ti•;rftTT(,7rJ,O t' cu--+di"mifE::1'iom II,& 101_0001-118.003 PJAN CH-: , ; lc ki;1 ? C31 • (Y0 <13 �J-s 1 ;r;30S. � i FE, L1€?_ =I'P 101-000.439.316 •$2$Mlo rar�tv:.d,a�::�t, r41t; 109-000-421-000�.c�,, FEE., 1-.0'. --0420.000 fAL&fh>t f 1�i Ft� 101-000-419-000. l im STR(WO MOTION FRE- R0,31D 10d-000.241.000 $9,92 `. ..ter F'1i .ltiht•:'`''7g.Pl.Y� 101.0,00-1+41"345 •. $100.00 r �« s, uB-7bTAT, cansimi- 'S"ifa4I AY11).Pi.PiN MIMIC «!3,92:3-21 :p EW TIRTg--PAM MEN _Wi1.00 JUL 16 2003. CITY OF LA QUINTA RECEIPT y _ DAT FIN ED INSPECTOR .y k -x%.% INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs d Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap - - F.A.U. Framing U 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 Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines - 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 D Underground Conduit Rough Wiring Low Voltage Wiring Fbdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice .(Perm) Comments I At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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 1,498 S.F. or $3,205.72 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/Palm Desert National Bank - Milo Doran Check No. 087640 Name on the check Telephone 760/413.2693 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Sharo MCGilvrey Payment Recd $0.00 $3,205.72 Over/Under. Signature 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 a CERTIFICATE OF COMPLIANCE �Fsc Desert Sands Unified School District 47950 Dune Palms Road zQ�o ¢ BERMUDA DUNES r Date 7/15/03 La Quinta, CA 92253 RANCHO MIRAGE CJ � INDIAN WELLS -. No. 24711 760 771-8515 ) d PALM DESERT y LA QUINTA Q IN©O y7 Owner Milo Doran APN # 773-085-014 Address 72960 Fred Waring Dr. #1 Jurisdiction Palm Desert City Palm Desert Zip 92260 Permit # 0306-363 Tract # BLK 64 Study Area Type' Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 2 51275 Avenida Velasco 1498 Unit 6 Unit 2 Unit 7 Unit 3 • Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments I At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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 1,498 S.F. or $3,205.72 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/Palm Desert National Bank - Milo Doran Check No. 087640 Name on the check Telephone 760/413.2693 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Sharo MCGilvrey Payment Recd $0.00 $3,205.72 Over/Under. Signature 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 a B- 7� CITYSUB-CONTRACTOR OF LA QUINTA SU CONTRACTOR LIST JOB ADDRESS' �?S� U6_tVA.UePERMIT NUMBER OWNER NIL m A,,6R4' J BUILDER W14-0 X1, �01 This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in 'a stoppage of work and/or the vdidance of buildina permit_ For each annlirahle trariP- all infnrmatinn rPmiPCtPfI hPln\A/ m11ct hP Pr%MnlPtarl by nnnlir-nnt "r1m C:1,11 ;^ ----- . Trade / Classification Contractor State Contractor's License -r- -r-• Workers Compensation Insurance City Business License Company Name Classification (e.g. A,, B©, C-8) License Number Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx//xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) CONCRETE (C -8)U 7 - o(xxxxxx) IV FRAMING (C-5) � "�Gl alert x'11 � . �-`�� �� lob' a l 4 p v � Ti4-Tdf Gt µ Z z l • oa I � Z8 ll 0 �V \ , p�' STRUCT. STEEL (C-51) AJ 1pi/k_ MASONRY (C-29)- /� ��� C•t �.� �`7 �t�%-"� {{�: �? Y; %/so PLUMBING (C-36) SGD T r � �j��v G ?% py r 8 -6� 1 ' �, I�% , i':`'� � CC � " -4 0,14( / l LATH,.PLASTER (C-35) P46A f DRYWALL (C-9) Zwof'%i 6oU Vn_ - t E _X,5;%a7— 'HVAC (C-20) lGlt/%'i� G ¢`�"�A% C, 2 t ;� 40- Ila :�� � ,e-, �' - ..�`�L'� ter.. •f,�1 ~� I l © . ELECTRICAL (C-10) - J (/1 21 O tel! moi'' '1�� ���J X &A, P 7'_ �I6°�i� b�'r �0fO! D `1 l 88?' ROOFING (C-39) f ` ''1 U/o-i -5r_ SHEET METAL (C-43). PZ� 1tln9 FI . ' FLOORING IC -151 -3L t ( T k-r--rL- dt 0� 40 -a- b% �` D GLAZING (C-17) \ l P (A'� e'z r % �I. Q'¢ ° '%rte 1l Z I O i3 �7j ?i +G':M/Eu INSULATION 1C-21 pvt t 7 ! ' G _ / C_ ' � (p � �' 0 7 2- �L.�O�O 1j �Y' '� (( � 'Wit' ( Z&P� �/ 4 a Owl,' }` SEWAGE DISP. (C-42) ,o� C© C.uy 'j 8R� o ` dali!�/C�.I,I% 7i✓ �i7- e I 2.6 �T / Zd 0 '- PAINTING 1C-33) �I ,U iMwe- , . CERAMIC TILE (C-54) (/.0 t�i S� I `> �O Z� S� 9 1 ?/ �2: O 7I z A G3 CABINETS (C-6) �f 6* /A)r'r AL—r G �` -7tP -7 Z � U l9 O 3 O FENCING (C-13) �f r(J �11,G-- /�(`f} /l► ,�- /.1 p_ /VA- /0 ,Q- /11,1r LANDSCAPING (C-27) /�, ��✓ _ �I ^��l`� r�--�� - �� r �, j �r �r `,. POOL (C -53)/b- 0 y ♦� 'ham-. n - CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R Project Title Date 5/-,2 7 >� L/C�%s �/� ;�///�) I�IJY�r� Project Aress Builder Name &/4 Builder Cont ct Telephone Plan Number o2/Sl�57�3 HERS ater Telephone Sample Group Number C ifying Signature Date Sample House Number le Firm:SC. d',C%SS'OGi /J'%S HERS Provider: �G,�f i�SSoG/rl%S Street Address: %���Q �i'9Gi TOY C,IYG�.� City/State/Zip: L y 0L(/vr /�c Ce q, -2, 3 Copi'es to:' Builder, HERS Provider 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 com 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) iWhere 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. C 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) hA values Test Leakage Flow in CFM If fan flow is calculated as 400cfm/ton x number of tons enter lculated value here-Alhj 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) ED 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 El MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1. O Yes O No ACCA Manual D Design requirements have been met (rater has verified that actual installation matches values in CF -1R and design, on plan. 2. 0 Yes O No TXV is installed or Fan flow has been verified. If no TXV, J' verified fan flow matches design from CF -1 R. Measured Fan Flow = Yes for both 1 and 2 is a Pass Pass Fail O O Pass Fail J.C. & ASSOCIATES Duct Testing 78660.Bractford Circle JOB INVOICE, 320,67 La Quinta, CA 92253 (760) 218-57D CUSTOMERS ORDER NO. -3RDER TAKEN BY DATE OF X ERED R-ZT 44 '- OWJj6EDbA.M. 0 P.M. BILL TO PHONE ADDRESS rMECHANIC CITY HELPER JOB NAME AND LOCATION Cj DAY WORK CONTnACT [-J qXFRA DESCRIPTION OF WORK 04 Jae- OUANI. DESCRIPTION OF MATERIAL USED PRICE AMOUNT Ae;1-7-63-r 571-2 75' A110- "e HOURS LABOR AMOUNT TOTAL MATERIALS MECHANICS @ HELPERS @ TOTAL LABOR r 2� I hereby acknowledge the Satisfactory completion of the above described work. TOTAL LA BOR TAX SIGNATURE -T DATE COMPLETED TOTAL REPORT OF FIELD COMPACTION TESTS....:...,... p.. �OUR-REPORT'NO.: LJ7,,.:J '..'!` }C'"?i�''7�;:• I CUE!!T: .00(w ID .. �i4✓F .. . ' _ .: c4 � :'. ... p `` . . a _ \•r+ - - .. yam; PROJECT: V Z� ✓' 4'.c'.'-... .c�:.S c'l.. - ' i. NUCLEAR GAUGE INFORMATION AND DAILY STANDARD CALIBRATION NUMBERS VARIATION, PERCENT,+/- GAUGE ADJUSTMENT -A VARIATION FROM - MOISTURE CALIBRATION'';�-�.,,� COUNTS FROM SHEETS NO 4 - SUBBASE LAST USE ID NO. GAUGE TYR�""-..PBELL MOISTURE MOISTURE MOLSTURE MOISTURE . . .MODEL NO_ DENSITY: DENSITY: DENSITY: DENSITY: ' PCF PROCTOR INFORMATION SOIL ID " VISUAL CLASSIFICATION OF SOIL MAX. DRY DENSITY, PCF OPTIMUM MOISTURE. % TEST ELEVATION MOISTURE WET/DRY PERCENT COMMENTS I NO 4 - SUBBASE COMPACTION MOISTURE REQUIREMENTS, % '71 -Z>. REQUIREMENTS, GENERAL LOCATION: Se/ TEST READING QUOTIENT/ SOIL TEST ELEVATION MOISTURE WET/DRY PERCENT COMMENTS I NO 4 - SUBBASE PCF ID NO. DEPTH, IN OF TEST CONTENT, DENSITY, COMPACTION D- PCF D - Z- M- I ri 7 4 i 2. I I f TECHNICIAN: COMMENTS: ILL TERGAL , ES7 RESULTS COMPLY WITH SPECGFICATIONS 2 BAC LL B_COMPACTION PERCENTAGE. DOES NOT COMPLY WITH SPECIRCATIONS J - BASE COURSE C - RETEST OF PFCEV US TEST 4 - SUBBASE D - MOGSTURE IN EXCESS OF SP'£CxRCATIONS ' •., - S : SOIL CEMEJiT ' E- MOISTURE BELOW SPECIFICATIONS M- l D- D - f TECHNICIAN: COMMENTS: ILL TERGAL , ES7 RESULTS COMPLY WITH SPECGFICATIONS 2 BAC LL B_COMPACTION PERCENTAGE. DOES NOT COMPLY WITH SPECIRCATIONS J - BASE COURSE C - RETEST OF PFCEV US TEST 4 - SUBBASE D - MOGSTURE IN EXCESS OF SP'£CxRCATIONS ' •., - S : SOIL CEMEJiT ' E- MOISTURE BELOW SPECIFICATIONS y'� 6 - OTHER l • �'- � + u timet S`.�w. . • ^ � Y"' • .. ~Y� Y r�fcate-o f an� t ,Ce L: O1�y .' ;.s � MS:I 1-- �* .r�^P s y • �r i`• ^ r - ✓�. 1 �j f f t � ��• f • [�� Lr '� -,�� f • C SYS` •:.�• `ry _ _— 4-4 {i.. s � �r �� � ` �� �T..� Building:&`"Sat`efy `Qo' tlmen�t } r r .-oF;� . :Certificate is��ssrued pursuanf,>to} lie�requ�r."ements of�Section 109W the Californid Building ,This Code, "certifying that, at the :mune `ofR iss-trance, 'this r str ' cture was -in -,compha'nce with - the,,. � of he�4Butlding RCode sand} {tlie war`ious::ordcriances of the <C�ty= regulating b'ullding .:.'sprovisionsT <�` construction and/or use. }L"BUILDING ADDRESS: 51-275 AVENIDA VELASCO t • S .a`� \.t � -'" y �.Py, yn,�] t;� �e.Y a. � -, - .. ,Y' F +•'t 1 ,• - Y `t Use classification `SINGLE`FAMILV,'6ii LUNG x" � `' 'Building Permlt;No ,0306-363 •- � - k .ro + .. G�� - a � t rte.. •i _ � ti t t :. .Occupancy GroupaR=3 ;' �� Type°of 'Construction V -N s ; ":Land ,Use zone: 'RC r x� Owner of Building:•MILO�DORAN . � � ' � '�� `''. � Address: 72=960 FRED WARING DR .1 y , . ST `ZIP PAL77 Y MYDESERT: CA 92260.; +S •S, ``•Jfw . - i^ }' "! ''�� . v _ 1'� R �1 �,4 - �. �, - � .P%. -. Y Wil. 'KIRK .B KIRKLAND, Y` -s � 6 ♦ �• 1. - k. 'ft � Date: January -28,'i0041 Buildirig.Offcial . .. -; , ^ 1 ., t •` }-M1 wl ! . r C* Bim: + `� ' '- ^ C G h - • ' �•A� • POST INA CONSPICUOUS .PLACE - • �'- � + u timet S`.�w. . • ^ � Y"' • .. ~Y� Y