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08-0308 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T, &t'4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 08 00000308 Property Address: 52965 HUMBOLDT BLVD APN: 767-200-091-4 -34968 - Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 508083 Applicant: Architect or Engineer: -------------------------------------------------- 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 is in full force and effect. License Class: B C10 License No.: 746198 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).: I _ 1 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 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.). (_) 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 contractor(s) licensed pursuant to the Contractors' State License Law.). 1 _) I am exempt under Sec. , B.&P.C. for this reason 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 (Sec. 3097, Civ. C.1. Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/11/08 Owner: EAST OF MADISON LLC PO BOX 1482 LA QUINTA, CA 92247 ° Contractor: f MAR 12 A & M CONSTRUCTION �u® P.O. BOX 366 CIN°f �6AQU1A17 LA QUINTA, CA 92247 FIAIgA1C °4 (760) 564-4832 EDEPr. Lic. No.: 746198 ------------------ 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 and policy number are: Carrier STATE FUND Policy Number 044-0028137-07 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 , I shall Io�With comply with those provisions. /Date 3 3 C' pplicant: 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. 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 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. 1 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 uponthe ove-mentioned F-- for insp pu;p ! te: �) Z—�—Si ture (Applicant or Agent): C Application Number . . . . . 08-00000308 Permit . . . . BUILDING PERMIT Additional desc Permit Fee 2066.50 Plan.Check Fee 1343.23 Issue Date . . . . Valuation 508083 Expiration Date 9/07/08 Qty Unit Charge Per Extension BASE FEE 2039.50. 9.00 3.0000 • --------------------------- THOU BLDG ----------------------------------------------- 500,001-1,000,000 27.00 Permit . . MECHANICAL Additional desc . Permit Fee . . . 192.50 " Plan Check'Fee 48.13 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/07/08 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 11.0000 EA MECH FURNACE >100K 44.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 4.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 66.00 8.00 6.5000 EA MECH VENT FAN 52.00 1.00 6.5000 ------------------------------------------- EA MECH EXHAUST HOOD --------------------------------- 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 239.37 Plan Check Fee 59.84 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/07/08 Qty Unit Charge Per Extension BASE FEE 15.00 5831.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 204.09 1014.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 20.28 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 285.00 Plan Check Fee 71.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/07/08 Qty Unit Charge Per Extension BASE FEE 15.00 34.00 6.0000 EA PLB FIXTURE 204.00 LQPERMIT LQPERMIT Application Number 08-00000308 ' Permit . . . . . PLUMBING Qty Unit Charge Per Extension 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 12.00 .7500 EA PLB GAS PIPE >=5 9.00 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 9/07/08 Qty Unit Charge Per Extension BASE FEE - 15.00 -------------------------------------------------------------7-------------- Special Notes and Comments SFD - LOT 4, PLAN 2-i/CASITA, 5831 SF. PERMIT -DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2001 CBC, CMC, CPC, 2004 CEC, 2005 ENERGY CODES ------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 770.20 DIF COMMUNITY CENTERS -RES 74.00 DI -F CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 134.32 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES -'RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 50.80 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Paid Credited ----------------- Due ---------------------------------------- Permit Fee Total 2798.37 .00 .00 2798.37 Plan Check Total 1522.45 .00 .00 1522.45 Other Fee Total 5430.32 .00 .00. 5430.32 Grand Total 9751.14 .00 .00 9751.14 LQPERMIT Certificate of Insulation Your home has been insulated with Knauf or Guardian insulation products, which are designed for today's safety standards and tomorrow's energy requirements. All products used meet current standards for safety and effectiveness and were installed in a professional and proper manner. This certifies that insulation has been professionally installed in this project to provide the following thermal performance as required by California Energy Standards, Title 24. A & M Construction Job Name: The Villas at Madison Club Tract: Plan# 2 Phase: Lot No: 4 Job Address: SFR - 52-965 Humboldt Blvd., La Quinta, CA Ceiling Area: R-30 Batt Insulation Exterior Walls R-19 Batt Insulation Raised Floor: Signed: ("A Garage Ceiling: R-19 Batt Insulation Other C/A: With Living Above Overhangs: R-19 Batt Insulation With Living Above _ Interior Walls: Mike Dickerson Access Attic: Pro Insulation, Inc. 2983 W. Lincoln St., Ste. 304, Banning, CA 92220 R -means resistance to heat flow. The higher the R -value, the greater the insulating power. Ask your builder for the fact sheet on R -values. Keep this certificate with your other valued papers. If you ever sell this home, this certificate should be passed on to the buyer. APR -21-2009 10:04 AM P. 01 CF -4R CERTIFICATE OF_FYEL,D VERIFICATION.&_DIAGNOSTIC TESTI oGns II ame Project -Addy si '.`,� �..` '/U� -�� urldg %d'' CAMS Y� ow Telephone PIan/Permit(Additions or Alterations) Number Builder -or Installer Comet tHE5 Rater Telephone Sam to Grou Number zClimate Zone Banco Method eacriive to Sample House Number Certifying Signature �� 0 _ — HERS Provider Firm G "Ek S .T o - city/Sts Zip: Street Address; : l<'...,,i.�,.�i �ivi. �t: L� /"I Ies to: EUILDVJK, r zj%D r m j v HERS RATER WY PLIANCE STATEMENT The house was: ✓ Tcsted 4'0 Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verificetion I certify that the house identified on this ffty t complies with the diagnostic tested compliance requirements as cJtedted ✓ ort this j(asn. The }IERS rater must checMjW k and bat the new ut . The HERS distribution system is fully ducted and correct tape is used befare a CF -4R m be released on every rater must not release the CF -4R unfit a properly completed and signed CF -6R has been received for a sample and tested buil' gshe. Tinstaller has provided s copy of CF -6R (bu tattation Certificate ew ducts are fully ducted (i.e., does not use building cavities as plenum' or platform returns in lieu of ducts). New ducts whit cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with It cloth backed. tubber adhesive duct tape to goal leafs at duct connections), ✓ MINIMUIII REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPL1ANL:'J LKLur t Ptocedures for field verification and diagnostic testing of air distribution systems are available in RACM. Appendix RC4.3. Duct Diagnostic Leakage Testing Results NEW CONSTRUCTION: Measured Duct Pressurization Test Results (CFM ® 25 Pa) Values — 1 Enter Tested Leakage Flow in CFM: 3 Z Fan Flow: Calculated (Nominal' ✓ Q Cooling ✓ 0 Heating) or Measured e7M Enter Total Fan Flow in CFM: 3 Pass if Leakage Percentage < 6% [ 100 x (Line # I) / � (Line # 2)]] ► � ass ❑Pail ALTERATIONS: Duct System and/or HVAC E uipmenc Chan c -Out 4 Enter Tested Leakage Flow in CFM from CF -6R: Pre*Test of Existing Duct Syster Prior to Duct System Alteration and/ot Equipment Change -Out Enter To Leakage Flow in CFM: Find Test of New Duct System or tared D Syst 5 for Duct System Alteration and/or Equipment Chan e -Out Enter Reduction in Leakage for Altered Duct System [_(Line # 4) us (L' # l 6 (Only if Applicable) 7 Enter Tested Leakage Flow in CFM to outside (Only if Applicable) Entire New Duct System • Pass if Leakage Percentage < 60A ❑ Pass Q Fail 8 100 x I ltine* 5 / I-ine # 2 TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Eq pmeat ".,.0ut vac wrc v4 W. ,w ........ ...... . _. _. ---------- 9 Pass if Leakage Percentage < 15% 1100 x L_�(Line # 5) / ( no # 2)]j E3 Pass O Fail t0 Pass if Leakage to Outside Percentage < 10'K 1100 x [(L # 7) / ( e p Pass ❑ Fail Pass if Leakage Reduction Percentage > 609'0 ( 100 x L—__.._( ine 6) ine 4) p pass O Fail I 1 and Verification by Smoke Test and Visual Inspection Pass if Sealin of all Accessible Leaks and Veriftcatioa b Smoke Test and Visual Inspection ass C3 Fail Pass If One of Lines 0 9 through # l2 pass to Pass ❑ Fail ResidenrialCuotphance.Po1d, rmrr'�r��� 7 b �f �'7 ��. /o December 2005 APR -21-2009 10:05 AM P.02 117 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING Q CF4R Project Address _2 'o/ Buil Nam -- Buildei Contact Tel hone � Plai Number HERS Rater Compliance Method (Prescriptive) Telephone . Sample Groug Number Climats Zone 5 Certifying Signature 72, to Sample House Number Firm �^ /� v, f7 S <aL F?.S HERS Provider C_- L'� c Street Address / Gf YL i city/state/Zip: " n Conies to: BUU.U&R, HKKD rKUvwn.K ANU BUsa,ulAty uLrAn►mwc.a _ HERS RATER CQMPLIANCE STATEMENT The house was: VJM Tested ✓ 13 Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the di ostic tested compliance requirements as checked on this fort, ✓'The installer has provided a copy of CF.6R (Installation Certificate), ,/O—rHERMOSTATTC EXPANSION VALVE (TXV) 67 4.e, 1)%7 /'Ts Af l l ,PASS-. Pmcedares for field ver4ficadon of thertaoarattc wpanrtan uvhws are availabk in RA(V, Apprndix RL N ,,,'E3 REFRIGERANT CHARGE MtARMEMENi< Verification for ,Re aired Refri Brant Char a for Split System Space Cooling Systems without Thermostatic Expansion Valves Outdoor Unit Serial # Location � Outdoor Unit Make _ OutdoorUnit Model Cooling Capacity !3 , Date of Verification Date of Refrigerant Gauge Calibration (must be checked monthly) Date of Thermocouple Calibration (must be checked monthly) Note: The system should be installed and charged in shall be documented on CF.6R before starting this p Charge Measure Procedure with the m ufacntrer s spec eons and installer verification outdoor a' dry-bulb is bolo SA 7 rater shall use the Alternative Procedures for DatermininA Refrigerant Char a usinst the SianddW Meg& are avolabIlEin B6LC21 Appendix RD2. O Yes No A copy of CF -6R (Installation ertifi u s been 'd with r rigerant charge ✓ - -- ---- --- ' - -. -- ----J Residential Cornpliamv Fonns April 2005 Access is provided for inspection. The procedure shall consist of ✓ 690yes 0 No visual verification that the TX'V is installed on the system and installation of the ific equipment shall be verified. Yes is a Paas Pail ,,,'E3 REFRIGERANT CHARGE MtARMEMENi< Verification for ,Re aired Refri Brant Char a for Split System Space Cooling Systems without Thermostatic Expansion Valves Outdoor Unit Serial # Location � Outdoor Unit Make _ OutdoorUnit Model Cooling Capacity !3 , Date of Verification Date of Refrigerant Gauge Calibration (must be checked monthly) Date of Thermocouple Calibration (must be checked monthly) Note: The system should be installed and charged in shall be documented on CF.6R before starting this p Charge Measure Procedure with the m ufacntrer s spec eons and installer verification outdoor a' dry-bulb is bolo SA 7 rater shall use the Alternative Procedures for DatermininA Refrigerant Char a usinst the SianddW Meg& are avolabIlEin B6LC21 Appendix RD2. O Yes No A copy of CF -6R (Installation ertifi u s been 'd with r rigerant charge ✓ - -- ---- --- ' - -. -- ----J Residential Cornpliamv Fonns April 2005 0 APR -21-2009 10:05 AM 1 �d Cpl P.03 As the HERS rater oviding diagnostic testing ones treses verrnc�►uvn, , w,..., - the di vatic testXcornpliance requirements as checked on this form. ✓ The installer has provided a 00 of CF -6R (Inabtllation Certificate), ✓ ❑ ADEQUATE AIRFLOW VERIFICATION sire a►wlluA& fn RAC,appendix PY,4, I. 1'1ticedures r veld veri icati0n anti dlo rho testis n ode trate ur rnv C7 Yes Q No 1Hethod For Airflow Measurement ✓ Q Yes ❑ No O Yea I © No I Duct design exists on plans ✓ Q Yes ❑ RE4. 1.1 [-I)iganostij Pan Flow Using Flow eaftwe Cod Ci Yes d RE.4,1.2 Diagnostic Fan Flow Usinit Picown Press Ma i ❑ RE4.1,3 Diagnostic Fan Flow Using Flow Grid Total CFM Acted Toast cfm/ton ✓ (� No Measured airflow is Beater than the criteria in Table Q Ya .. _. m Fol ./ n m.&vrwr%4 COOLING CAPACITY •, , ,�• ,� 1 ✓ C7 Yes Q No 2 ✓ Q Yes ❑ No 3 ✓ Q Yes O No 4 ✓ Ci Yes Q No 5i✓I C]Yes j 0 N frnum coolhig load cq=6 are available in 1:, A Adequate airflow va►fied (see adequate ai o Credit) Refrigerant charge or TXV Duct leakage reduction credit verified Cooling capacities of installed systems indicated on the Perform& tce's CF•1R If the cooling capacities of installed sy capacity in the CF -1R, then the elec-tri( ✓)Z HIGH EER AIR CONDITIONER of --r.— i;——,40;,v rinn are available in No I EER ✓ 1 O'Yes 1 0 No 1 Time Delay t�RF-3 t�—thanma"xs�tnum ing capacity -- are cooling �/ y 1/input fsystems must ❑ Q RF•4. d 3: and Yes to either 4 or 5 is a ass Pass Fai .5 pG r�►Ir� ��r ,�� `M Ap pendix Rl. installed systems match the CF- I R t, indoor coil is matched to outdoor coil Jay Verified Qf Required) December 2003 lirsidenriul C_ ompliance !'orms Certificate of Occupancy0 0 �w C OFT9� Building & 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: 52-965 HUMBOLDT BLVD Use classification SINGLE FAMILY DWELLING Building Permit No.: 08-308 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: EAST OF MADISON LLC Address: P.O. BOX 1482 City, ST, ZIP: LA QUINTA, CA 92253 By: KIRK KIRKLAND Date: APRIL 9, 2009 Building Official POST IN A CONSPICUOUS PLACE Jimenez 41-590 Alligator Pond Rd. S peCial Bermuda Dunes Ca. 92203 Inspections 760-250-o884 fax 760-200-o679 DAILY REPORT OF INSPECTION Building Permit No.: OOT o 0�1 y oo Date of Inspection: Project Name: S 0 �✓ �� ✓ ✓S Job No.: /.2 /' 0 Project Address: X / , .9 7 X4 ©, i . r4 , Architect: Structural Engineer: 5'/1,71�07 o, C S f IFac-I I'll�j General Contractor: ef�/V Sub Contractor. TYPE OF INSPECTION: Concrete Masonry, Steel Epoxy Welding Operators & Certification Numbers: Others Description of Work Inspected: F—/>„ yy f0 14,'1;,` .(/pf 4--"1.97'f 7- 3/ o� ao X / 0 (� /i� S !.� i�� �idrLJ /SUS!% C�-✓ , / tr/ ` �4 X / .. Lam- 4W.- -w, P,,,/ , /a- T- L", / f. S G'f/ , G • &`�/ !,4 lam'• (//4%?/GUS ©� f¢/�l�.• �iJ1.� Y�/ .� �0 'i1-UA%z lic��r�c ��4t✓ .� f�ir72 41 -PA—- Lf,42 Unresolved Items: I hereby certify that I have inspected all of the above reported work, unless ortherwise noted, and to the best of my ability I have found this work to comply with the approved plans, specifications & applicable building laws. Final report issued at project completion. c-o9G%/ Inspector's Name/No. /,t /�/T, j- 2� Inspector's Signature All inspections based on a minimum of 4 hours: over 4 hours will be 8 hours minimum Contractor's Representative A&M mss- ucliON TRADES: i LOCATION: DATE: WEATHER: TEMPERATURE: DAY: 3PM oil MEi Md ME m P.O. Box 366 • La Ouinta, CA 92253 • Office )760) 564-4832 • Fax (760) 564-0406