04-3902 (SFD)P.O. Box 1504
78-495 CALLE TAMPICO
LA QUIN TA, CALIFORNIA 92253
BUILDING. PERMIT
BUILDING & SAFETY DEPARTMENT
(760).777-70.12
FAX (760) 777=7011
INSPECTION REQUESTS (760) 777-7153
Application Number .
. . . 04-00003902
Date 5/07/04
Property,Address_..
50325'VIA AMANTE
APN:772-390-038-137
-29858 -
Application description
. . . DWELLING - SINGLE FAMILY
ATTACHED
Property Zoning . . .
. . . LOW DENSITY.RESIDENTIAL
.Application valuation
197233
Owner`—®-�s
Contractor
R.J T'HOMES
----------------
v " RJT HOMES LLC
-------
1425 E UNIVERSITY DR
N 1425 E.. UNIVERSITY
DRIVE
PHOENIX
AZ 85034. �. PHOENIX.
AZ 85034
WCC: STATE FUND
WC: 1583906
10/01-/04
CS LBi 690645
06/30/04
CCC: B -A
------ Structure Information-
nformationConstruction
ConstructionType ..
TYPE V - NON RATED
Occupancy Type .
. . . DWELLG/LODGING/LONG <=10
Flood Zone . . . . .
NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2001 CBC
GARAGE SQ FTG
538.00
PATIO SQ .FTG
.313:00
TOT ELIGIBLE
NO
NUMBER OF UNITS.
1.00
FIRST FLOOR SQ FTG
3191.00
Permit . . . . ..
BUILDING PERMIT
Additional desc
Permit Fee
982.50 Plan Check Fee
638.63
Issue Date
Valuation
197233
Expiration Date
5./07/05
Qty Unit Charge
Per
Extension
BASE FEE
63.9.50
98.00 ,3.5000
THOU BLDG 100,001-500,000 '.
343.00
Permit
ELEC-NEW RESIDENTIAL
Additional desc. ..
Permit Fee
141.30 Plan Check Fee
3.76
Issue Date..
Valuation
0
Expiration' Date
5/07/05
Qty . Unit Charge Per Extension
P.O. BOX 1504 • �IIIG
i1Y7 � VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253. INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date:
Architect or Engineer:
f)) I MS �&62f_ 1 -
Architect or Engineer's Address:
C�OtJID EiP, C C>
Lic. No.: 3 to o -
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 i n full force and effect
License Class <r AA RI L 1S License No. p
Dete S'�a �JGj Contractor
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 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 I 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:
_ 1 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. M�[ workers' compensation insurance carver and p i u , er.�re•
Carrier s77i J r r= Q,, Its Policy Number
_ 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, 1 shall
c /forthwith comply with those provisions.
Date J d —O(7 Applicant
v
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
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 �I
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 Quinta, 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.
1 certify that I have read this application and state that the above information 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-mentioned property for inspection purposes.
Date �� �� Signature (Applicant or Agent):
Page
2
Application
-Number .
. . . . 04-00003902 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
568.00
-----------------------------------------------------------------------------
.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
105.00 Plan Check Fee
26.25
Issue Date
Valuation
0
Expiration
Date
5/07/05
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
2.00
9.0000
EA_ MECH FURNACE <=100K
18.00
2.00
16.5000
EA MECH B/'C >3-15HP/>100K-500KBTU
33.00
5.00
6.5000
EA MECH VENT FAN
32.50
1.00
-----------------------------------
6.5000
EA MECH EXHAUST HOOD.
6.50
Permit
. . . . .
------------------------------
PLUMBING
-----------
Additional
desc
Permit Fee
214.50 Plan Check Fee
53.63
Issue Date
. . . .
Valuation
0
Expiration
Date
5/07/05
Qty
Unit Charge
Per.
Extension.
BASE FEE
15.00
24.00
6.0000
EA PLB FIXTURE
144.00
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
8.00
.7500'
EA PLB GAS PIPE >=5
6.00
Page 3
Application Number.
04-00003902 Date 5/07/04
Qty Unit Charge Per.
Extension
1.00 15.0000 EA PLB
--------------------------
GAS METER
15-.00
Special Notes and Comments
-------------------------
SFA. LOT 137. PLAN P2A. PERMIT
DOES NOT
INCLUDE BLOCK WALL, POOL, SPA
OR
DRIVEWAY APPROACH.
Other Fees . . . . . .
----------- ----------------------
ART IN PUBLIC PLACES -RES
.00�
DIF COMMUNITY CENTERS -RES
68.00
DIF CIVIC CENTER - RES_
229.00
ENERGY REVIEW FEE
63.86
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
19.72
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098'.00
Fee summary Charged.
Paid Credited
Due
Permit.Fee Total 1458.30
------------------
.00 .00
1458.3'0
Plan Check Total 722.27
.00 ..00.
722.27
Other Fee.Total .2084.58
.00 .00
2084.58
,Grand Total 4265.15
..00 .00
.4265.15
Dmm>i
- -
ENERGY �� _
C•A D E C
ces
PO'. Boz 821
Ph/Fax (760) 564-2044
Rancho Mirada, CA 92270
Cell:.(760) 250-1852
Email: DESNRG'CdIAOL.COK9
0
n '
CERTIFICATE OF- FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7) CF -4R
PALMILLA PH 8 DATE TESTED, 1.13=05.
Project Title Date
50-325 VIA AMANTE LA QUINTA, CA. 92253 RJT HOMES
rojec ress Builder Name
CHAD MEYER 760-564-6555 -ACACIA
07.2 3 UNITS
Builder Contact Telephone Plan Number
'RICHARD KROWN 760-250-1852 GROUP 6
HERS Rater / Telephone Sample Group Number
#CCNRK613292. 01-17-04 LOT -137
Certifying Signature Date, Sample Lot Number
Firm: DESERT ENERGY SERVICES LLCHERS: Provider: . CHEERS .
Street Address: P.O., BOX 621'_Cry/State/Zip: RANCHO MIRAGE, CA. -92270
Copies to: Builder,.HERS Provider.
HERS RATE_ R 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 ho uses, 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.1InstallationI 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)
Measured
Duct Pressurization Test Results (CFM @ 25 Pa) values
Test Leakage Flow in -CFM
if fan flow is calculated as 400cfm/ton x number of tons enter calculated.
,value here
If fan now is measured enter measured value here
Leakage. Percentage (100 x TestLeakao6fFan Flow) _
Chock Box for PassorTail (Pass =6% or less) ❑ ❑
Pass . Fail
❑ THERMOSTATIC EXPANSION VA'LV.E (TXV)
❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for'inspection ❑
taS 4<x
INSTALLATION .CERTIFICATE (Page 3 of 13)
palm Il d cl' Ph - R G o f er /3
7
Site Address 1 Permlt Number
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
DUCT' EAKAG1 REDI1C•1` 00
` Pressurtzation Test Resuite (CFM ® 25 PA) Test Leakage (CFM)_�3_0 {
Fan Flow .
If Fan.Flow is Calculated as 400 cfm/ton x number of tons, oras 21.7 x Heating Capacity
: In Thousands of SM/hr; enter calculated value here
If fan flow Is measured, enter measured value here $G1D
Leakage Fraction m Test Leakage/(Meawed or Calculated Fan Flow) -
Pass if leakage fraction < 0.06
Pass 'Fail
s
O For AEROSOL.TYPE SEALANTS•ONLY -The following diagnostic testing was.completed:
Duct Fan Ptrssufization 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
o _ ' 0
Pass Fail
A THERMOSTATIC EXPANSION VALVE t"PXVI
XYes- O No Thermostatic Expansion Valve is installed and Access is - provided for inspection
j Yes is a pass..
y
� . l7
DICT DESIGN
Pass Fail
ACCA Manual D Design calculations have been
1. O Yes. O No completed, Duct Design Is on the plans and duct Installation
matches plans. .
2. O Yes O No 'TXV is installed or Fen flow has been verified. If no TXV,
o
Pass Fail
verified fan flow matches design. from CF-IIL
Measured Fan Flow =
Yes for both 1 and 2 is a Pass
O, L 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: [The builder shall provide the HERS provider a copy of the CF -6R signed by the builder
..employees or sub- mttractors certifying that diagnostic testing and installation meet the requirement for compliance credit ]
Tests _Srpaturej Date Installing Subcontractor (Co. Name) OR
Performed General Contractor (Co. Name)
i
coPY m: Building Department
HERS Provider (if :applicable) :
Building Owner at Occupancy :
Compliance Forms August 2001
A-25
t - -
. INSTALLATION CERTIFICATE (Page 3 of 13)
CF -611
pal �, tl�a Ph - R- 4- -,0 137
Site Address Permit Number
DUCT LEAKAGE AND DESIGN DLAGNOSTICS
llUCT LEAKAGE REJ)UC'1'1QN
Pressurization Test Results (CFM Q 25 PA) Test Leakage (CFM)__Ag
Fan Flow
13Fan.Flow is Calculated as 400 cftn/ton x number of tons, or as 21.7 x Heating Capacity
In Thousands of Btwbr, enter calculated value here
If fan flow Is measured, enter measured value here
Leakage Fraction Test Leakagc!(Measured or Calculated Fan Flow) = s•6 °/, . �' (
❑
Pass if leakage fraction < 0.06 Pass
Fall
O For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed:
Duct Fan Pressurization at rougii-in measured leakage (CFK:
CHECK AFTER FMSHING WALL:
O Yes O No O Pressure pan test or House pressurization test
O Yes O No O Visual Inspection of Duct Connections a
c
Pass
Fail
MMOSTATIC EXPANSION VALVE (TXV)
XYes O'No Tbermostatic Expansion Valve is installed and Access is - provided for inspection '
j
Yes is a pass K
t7
Pass
Fail '
O DUCT DESIGN
t
1 ACCA Manual D Design calculadorrs have been
j 1. O Yes ❑ No. completed', Duct Design Is on the plans and duct Installation
'
matches plans. •C3
2. O Yes O No -TXV is installed or Fan flow has been verified. If no TXV,
Pass
0
Fail
verified fan flow matches design from CF -.UL
Measured Fan Flow =
Yes for both 1 and 2 is a Pass.
O L the undersigned, verify that the above diagnostic test rtsults,and the work I performtc! associated with the test(s) is in conformance
with the requirements for compliance credit: (The 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. J
Tem S Date Installing Subcontractor (Co. Name) OR
Performed General Contractor (Co. Name)
COPY TO: Building Department
HERS Provider (if applicable).
Building Owner at Occupancy
i Compliance Forms August 2001
A-25
A
INSTALLATION -CERTIFICATE (Page 3 of 13)
CF -6R
RAI MaLo, PA R Go f- *: X37
Site Address Permit Number
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
DUCTLEAKAGE RED. C1"10N '
Pressurization TestResults (CFM Q 25 PA) Test. Leakage (CFM)
Fan Flow ..
If Fan.Flow is Calculated as 400 cWton x number of tons, or as 21.7 x Heating Capacity
In Thousands of BW/hr, enter calculated value here
'if fan flow fs measured, enter measured value here • /6en
Leakage Fraction .= Test Leakagd(Measured or Calculated Fan Flow)
-
Pass ifleakage fraction <0.06 Pass
Fail
o For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed:
Dud Fan Pressurizadon 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 Q Visual Inspection of Duct Connections o
i Pass
' Fail
A THERMOSTATIC EXPANSION VALVE f TXVl
X Yes .O No Thermostatic Expansion Valve is installed and Access is - provided for inspection -
Yes is a pass K
J
Pass
Fail
O DUCT DESIGN
a
ACCA Manual D Design calculations have been
1. O Yes, O No complited, Duct Design Is on the plans and duct Installation
matches plans.
2. O .Yes . O No -TXV is instilled or Fan flow has been verified. If no TXV, ,
Pass
Fail
verified fan flow matches design from CF -IR
Measured Fan Flow
Yes for both 1 and 2 is a Pass
O I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is in conformance
with the requirements for compliance credit. [ne builder shall provide the HERS provider a copy of the CF -6R signed by the builder
employees or sub�ortttactors certifying that diagnostic testing and installation meet the requirements for compliance credit.)
Tab S tune, Date Installing Subcontractor (Co. Name) OR
Performed General Contractor (Co. Name)
COPY TO: Building Department ,
HERS Provider (if applicable) -
Building Owner at Occupancy
,4 Compliance Forms August 2001
r - 2 5
1
1.