04-3905 (SFD)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-70.12
78495 CnLLE TAMPICO FAX (760) 777-'7011
LA QUINTA, -CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 .
BUILDING. PERMIT .
.. Application.Number 04-00003905 Date 5/07/04
PropertyAddress .-... . . 5.0345 VIA AMANTE'
APN: 772-390-.039-136.-29858 -
Application description DWELLING. -.SINGLE FAMILY ATTACHED
Property,'Zoning LOW DENSITY. RESIDENTIAL
Application valuation 209259
Owner _ -Contractor
-_-- c�-------------------------
R J - T :HOMES �' RJT HOMES LLC
1:425 E UNIVERSITY DR c� b-1425 E. UNIVERSITY' DRIVE
PHOENIX. AZ 85034.. �--+ O'QPHOENIX. AZ 85034
-� .ate]
>- ®IJWCC: STATE FUND . .
Q .�.
_..SWC: 1583906. 10/01
SLB"/04
C.., . 690645 0.6./30%04
...
CCC: B -
A
Structure .Information SATT
Construction Type. TYPE V - NON RATED
Occupancy Type DWELLG/LODGING/CONG <<=10
Flood Zone . . .. NON -AO FLOOD.ZONE
Other struct 'info CODE EDITION 2'001 CBC
GARAGE SQ FTG 568.00
PATIO SQ..FTG 773:00
TOT ELIGIBLE NO
NUMBER OF.UNITS.. 1.00
FIRST FLOOR SQ FTG 3284.00.
Permit BUILDING PERMIT
Additional desc
Permit Fee 102,4.50 Plan Check Fee 665.93
Issue Date, Valuation:'209259
Expiration Date .. 5/07/.05
Qty Unit Charge Per , Extension
BASE FEE 63.9.50
110.00 3.500.0 THOU BLDG 100,001-500,000 385.00
Permit ELEC-NEW RESIDENTIAL:
Additional desc. ..
Permit Fee 141.30 ..Plan 'Check Fee 3.77
Issue Date. Valuation 0
.:Expiration Date .. 5/07/05.
Qty - Unit Charge'. Per, Extension
P.O. BOX 1504 l�G�
78-495 CALLE TAMPICO VOICE (760) 777-7012
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253. INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
�-9ZC2
G ed1 l rnit/77`� g21 3
Date:
Architect or Engineer:
-L<-
Architect or Engineer's Address:
,y/ n/Tt/ ST �Sai �-►�' /C�3
QLIJL�QEiP, C0 fjp C3
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S.DECLARATION
I tlereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of ft Business and Professionals
Code, and my Licen,�e n full fort and effete
License Class (riVE-iC L IS License No.
Date5`-7Contractor .
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractor;' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a pertmit 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 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 f6r the purpose of sale.).
UA. 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 contractors). 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
hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self4nsure 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. Mie workers' tom ensation insurance carter and
Cartier 5TJ1
-k Cl�✓� Policy Number _ / J J (�• ('p
_ 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 Applicant
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.).
Lender's Name _�Al;;Al
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, 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 pernilt 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 inforination is 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 upon the above{nentioned property r inspection purposes.
Date �� Signature (Applicant or Agent): C
_T4Q4 VV fie
Page .
2
Application
Number
04-00003905
Date
5/07/04
Qty.
Unit Charge
Per
Extension
BASE
FEE
15.00
3284.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
114.94
568.0'0
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
11.36
--------------------------------------------------------
Permit
. . . . .
-------------------------
GRADING PERMIT
Additional
desc
Permit Fee
. . . .
15.00
Plan Check Fee
.00
Issue Date'
Valuation
0
Expiration
Date
5/07/05
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
Permit
MECHANICAL
Additional
desc
Permit Fee
73.00
Plan Check Fee
18.25
Issue Date..
Valuation
0
Expiration
Date
5/07/05
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
1.00
9.0000
EA MECH
FURNACE <=100K
9.00
1.00'
16.5000
EA MECH
B/C >3-15HP/>100K-500KBTU
16.5.0
4.00
6.5000
EA MECH
VENT FAN
26.00
1.00.
------------
6.5000
EA MECH
EXHAUST HOOD
-
6.50
---
Permit .
-----------
. . . . .`
-----------
PLUMBING°
---------------------------
-----------
Additional
desc
Permit Fee
. . . . .
183.00
Plan Check Fee
45.75
Issue Date
Valuation,
0
Expiration
Date
5/07/05
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
19.00
6.0000
EA" PLB
FIXTURE
114.00
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
6.00
.7500.EA.
PLB
GAS PIPE >=5
4.50
I
Page 3
4�
04-00003905 Date
I
Page 3
Application Number . . . . . .
04-00003905 Date
5/07/04
Qty Unit,Charge Per
Extension
1.00 15.0000 EA PLB
---------------------7------------------------------------------------------
GAS METER
15.00
Special Notes and Comments
SFA. LOT 136.•PLAN P3A. PERMIT
DOES NOT
INCLUDE BLOCK WALL, POOL, SPA
OR
DRIVEWAY APPROACH.
------------------------------------------------------------------------
Other Fees . . . .
ART IN PUBLIC PLACES -RES
----
23.14
DIF COMMUNITY CENTERS -RES
68.00
DIF CIVIC CENTER - RES
229.00
ENERGY REVIEW FEE
66.59
DIF FIRE PROTECTION -RES
78.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
`158.00
DIF PARK MAINT FAC - RES
3.00
DIF PARKS/REC - RES
352.00
STRONG MOTION (SMI).- RES
20.92
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total 1436.80
00 .00
1436.80
Plan Check Total 733.70
.00 .00
733.70
Other Fee Total 21.11..65
.00 .00
2111.65.
Grand Total 4282.15
.00 .00
4282.15'
;. Dese>rt
- -
ENERGY(.
-- c 'A o E c _
entices
S
—
•
PO'. Box 621•
Ph/Fa.x (760)•564-2044
Rancho Mirage, CA 92270
Cell: (7601250-1852
Em a11:;DESNRG gDAOL:COM
CERTIFICATE OF FIELD VERIFICATION AND
DIAGNOSTIC TESTING (Page I of 7). CF -4R
PALMILLA.... PH 8
DATE TESTED, '1-13=05 .
Project Title
Date
50-345 VIA AMANTE LA QUINTA, CA. 92253 RJT HOMES
Project ressBuilder
CHAD MEYER
Name
760=564-6555 PALO'BREA P-3 2 UNITS
Builder Contact
Telephone Plan Number
1112M, RD KROWN,
760-250-1852 GROUP 6
HERS Rater
Telephone Sample Group Number
#CCNRK613292
01'-(14 LOT '136
Certifying Signature
Date Sample Lot Number
Firm: DESERT ENERGY SERVICES LLC
HERS Provider: CHEERS
Street'Address: P.O. BOX 621
City/State/Zip: RANCHO MIRAGE, CA. 9,227-0.
Copies to: Builder,•HERS Provider
HERS RATER COMPLIANCE STATEMENT
The house was: . El Tested ® Approved as part of sample testing but was not tested
As the HERS raterproviding diagnostic testing and field verification; I certify that the housesidentified 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 adhesi.Ve duct tape is iristalled., 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)
Test Leakage Flow in CFM
If fan flow is calculated as 400cfmlton x number of tons enter calculated
value here
If fan flow i.s measured enter measured value here
Measured
values
Leakage Percentage (100 x Test LeakagcfFan Flow) _
Check Bos for Pass or Fail (Pass =6% or less) ❑ ❑
Pass Fail
❑ THERMOSTATIC EXPANSION VALVE (TXV)
0 yes ❑ No Thermostatic Expansion Valve is installed and Access is ❑ ❑
provided for inspection*
LNSTALLATION CERTIFICATE' :. ..(Page 3 of 13)
CF -6R
2a l VVI 1,1/0, PA .R L o f- get /36
Site Address Permit Number
DUCT LEAKAGE AND DESIGN DLA,GNOSTICS
Duct LiKAKAGE REDUCI'IQN
Pressurization Test Results (CFM'Q 25 PA) Test leakage (CFM) $�
Fan Flow
If Fan.Flow is Calculated as 400 cfmhon x number of tons, or as 11.7 x Heating Capacity
In Thousands of Btu/hr, enter calculated value here
If fan flow is measured, enter measured value here _oar
Leakage Fraction =Test Leabge/(Mewured or Calculated Fan Flow) - y. L61
❑
Pass if leakag: fraction < 0.06 Pass
Fail
O For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed:
Duct: Fan Pressurization at rough -in measured leakage (CFM)
CHECK AFTER FNSHING WALL'`.
❑ Yes O No ❑ Pressur6 pan test or House pressurization test
.❑ Yes ❑ No ❑ Visual Inspection of Duct Connections o
❑ .
Pass
Fail
THERMOSTATIC EXPANSION VALVE (TXVI
t Yes O'No Thermostatic Expansion Valve is installed and Access is - provided for inspection
Yes is a pass
Pass
Fail
O )DUCT DESIGN
` ACCA Manual D Design calculations have been _
1. [3 Yes 13 No completed, Duct Design Is on the plans and duct Installation
matches plans.
0
2. ❑ Yes ❑ No -TXV is installed or Fan flow has been verified. If no TXV, pass
0
Fail i
t • verified fan flow matches design from CF -IR
t Measured Fan Flow =
Yes for both 1 and 2 is a Pass
❑ I, the undersigned, verify that the above.diagnostic test results and the work I perforated associated with the tests) is in conformance
with the requirements. for compliance credit. (The builder shall provide the HERS providera. copy of the, CF -6R signed by the builder
employea or sub-eontractmtt certifying that diagnostic testing and installation meet the requirements for compliance credit )
Tess S titre, Date Installing Subcontractor (Co. Name) OR
Performed General Contractor (Co. Name) - .
COPY TO: Building Department .
HERS Provider (if• applicable) -
-
Building Owner ai Occupancy , '
t .Compliance Forms August2001
A -2S
INSTALLATION CERTIFICATE (Page 3 of 13)
CF -6R
Site Address Permit Number .
DUCT LEAKAGE: AND DESIGN DIAGNOSTICS
DUCT LEAKAGE REDUCTION
Pressurization Test Results (CEM @ 25 PA) Test Leakage (CFM) -Yl
Fan Flow.
If Fan Flow is Calculated as 400 cfm(ton.x number of tons, or as 21.7 x Heating Capacity
- in Thousands of Btu/hr, enter calculated value'here
If fan flow is measured, enter measured value here moo
Leakage Fraction = Test Leakagd(Measured or Calculated Fan Flow) = S • a 0
Pass if leakage fraction < 0.06
Pass Fail,
O For AEROSOL,TYPE SEALANTS ONLY -The following diagnostic testing was completed:
Duct Fan Pressurization at rough -in measured leakage (CFM)
CHECK AFTER FINISHING WALL:
O Yes O No O Pressure pan test or House pressurization test
O Yes, O• No, O Visual Inspection of Duct Connections
.
Pass Fall
A THERMOSTATIC EXPANSION VALVE fTx%n
XYes O No Thermostatic Expansion Valve is installed and Access is - provided for inspection
Yes is a pass
C'
) DUCT DESIGN
t
Pass Fail
RCCA Manua]Design calculations have been
,D
1. 0 Yes O No completed, Duct Design Is on, the plans and duct installation
matches plans..
2. O Yes O No TXV is installed or Fan flow has been verified. If no TXV,
' verified fan flow matches design from CF -IR
Pass Fail
Measured Fan Flow =
Yes for both 1 and 2 is a Pass
0 I, the undersigned, verify that the above diagnostic test results and the work I performed• associated with the tests) is in conformance
with the requirements for compliance credit.' Me builder shall provide the HERS provider a copy of the CF -6R signed by the builder
employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit. ]
o s L rJ
Tests _SJ15nature, Date Installing Subcontractor (Co. Name) OR
Performed General Contractor (Co. Name)
COPY TO: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy
Compliance Forms August 2001 A -2s