08-0620 (SFD)P.O. BOX 1504 n ^�
ALLE TAMPI
78 495 C CO
LA QUINTA, CALIFORNIA 92253 O BUILDING & SAFETY DEPARTMENT
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
08-00000620
81670 DE SOTO AVE
767-200-091-1 -34968 -
DWELLING - SINGLE FAMILY
LOW DENSITY RESIDENTIAL
467734
Architect or E
DETACHED
BUILDING PERMIT
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 '
Date: Contractor:
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 ISec. 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).:
(_ 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.).
1 _ 1 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: ne,: _
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.I.
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
EAST OF MADISON LLC
PO BOX 1482
LA QUINTA, CA 92247
Contractor:
A & M CONSTRUCTION
P.O. BOX 366
LA QUINTA, CA 9224
(760)564-4832
Lic. No.: 746198
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/28/08
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
�C 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 tha ome subject to the markers' compensation provisions of Section
3700 of Labor Code, I sfthII rt wi comoW %4ith those orovisions.
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 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.
I 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// my to enter upon a above -mention Heol �tv�-/r�nspecrposes. 1001
atea�—� gnature (Applicant or Agent): \,t
Application Number . . . . . 08-00000620
Permit
. . .
BUILDING PERMIT
Additional
desc-. .
Permit Fee
. . . .
1927.50
Plan Check Fee
1252.88
Issue Date
. . . .
Valuation . . . .
467734
Expiration
Date
10/14/08
Qty Unit Charge
Per
Extension
BASE
FEE
.639.50
368.00
----------------------------------------------------------------------------
3.5000
THOU BLDG
100,001-500,000
1288.00
Permit
. . .
MECHANICAL
Additional
desc
Permit Fee
. . . .
143.00
Plan Check Fee
35.75
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
10/14/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3.00
11.0000
EA MECH
FURNACE >100K
33.00
3.00
16.5000
EA MECH
B/C >3-15HP/>100K-500KBTU
49.50
6.00
6.5000
EA MECH
VENT FAN
39.00
1.00
-------------------------------------------------------------
6.5000
EA MECH
EXHAUST HOOD
---------------
6.50
Permit
. . .
ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Fee
. . . .
223.32
Plan Check Fee
50.78
Issue Date
. . . .
Valuation
0
Expiration
Date
10/14/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
5296.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
185.36
1148.00
----------------------------------------------------------------------------
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
22.96
Permit
. . .
PLUMBING
Additional
desc .
Permit Fee
. . . .
223.50
Plan Check Fee
55.88
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
10/14/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
25.00
6.0000
EA PLB FIXTURE
150.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
LQPERMIT
Application Number . . . . . 08-00000620
Permit . . . . . . PLUMBING
Qty Unit Charge
Per
Extension
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
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 . .
10/14/08
Qty Unit Charge
Per
Extension
-._
BASE FEE
i
15.00
---------------------------
Notes and Comments
SFD - LOT 1, PLAN 1R,
5296 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
569.52
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
125.29
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
42.78
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930..00
Fee summary Charged Paid Credited
-------------------------------------------------=-------
Due
Permit Fee Total
2532.32 .00 .00
2532.32
Plan Check Total
1395.29 .00 .00
1395.29
Other Fee Total
5212.59 .00 .00
5212.59
Grand Total
9140.20 .00 .00
9140.20
LQPERMIT
- (*UG— 17-2009 02:31 PM
HERS Rater-
Compliance Meths
Certifying Si
Firm G.
y.
Street Address: _
ooles to: $V>Q.,D11
)F FIELD VERIFICATION 8c
�ntect
Prescriptin)'
41-5
OLi
Pao
HERS PROVMER AND BUILDING
P. 02
DIAGNOSTIC TESTING a CF -4R
Builder or In Il Name �•
Talephone Plan/Permit (Additions or Alterations) Number
z2-� 3
HERS RATER COMPLIANCE STATEMENT
The house was: ✓ �rTested ✓ 17 Approved as past of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field voficati 1 oerdf� that the house identified on this form complies with
the diagnostic tested eom liance requirements as checked ♦ oo this arm. 'Phe KERS rater must check and verify that the new
distribution system is fully ducted and correct tape is used before a CF -411 may, be released on avers IuW building, The HERS
rater must not release the CF -4R until a properly completed and signed CF -6H has bees received for two sample aad toted
buil ' the installer has provided a copy of CF -6R (Installation Certificate).
New ducts are fully ducted (i.e., does not use building cavities as plenums or platfoat returns in lieu of ducts).
New ducts with cloth backed, rubber adhesive dud tape is ipablled, nustie and draw bands are used in combination with
cloth backed, rubber adhesive duct tape to seat lesks at duct oomections.).
✓ P5 MINIMUM IiIEOUMEMENTS FOR DUCT LEAKAGE REDUCTION COMPL ANCE CMM'T
Procedures for field verification and diagnostic testing of air distribution systems are available in RACK Appendix RC4.3.
t]uct Dittannatic Leakage Testing Results
NEW CONSTRUCTION;
Duct Pressuri=tion Test Rmultr (CFM ® 25 Pa)
I�ad
Vasltestues
I
Enter Tested Leakage Flow in CFM:
2
Fan Flow. Calculated (Nominal: -'0 Cooling ✓ O Healing) or ✓ Measured
Enter Total Fan Flow in CFM:
� tr
✓
Pau O Fail
3
Pass if Leakage Percentage < 6% (100 x (Line # 1) /,g�=, (Lina # 2)1)
ALTFXATIONS: Duet System and/or HVAC Egelpmeas Change—Cut
4
Enter Tested Leakage Flow in CFM from CF -4R: Pr&Tut of Existing Duct System Prior to
Duct System Alteration and/or Equipment Change-0uc
S
Enter Tested Leakage Flow in CFM: Find Test of N Duct 5 Altered Duct System
for Duct System Alteration and/or ui ent C t.
Enter Reduction in Leakage for Altered Duct Sys no us (Line # 5)J
(Only if Applicable)
6
9
Enter Tested Leakage Flow in CFM to Outaida Only if A livable)
✓ ✓
6
Entire New Duct System • Paas if Leakage Percentage < 6%
100 x ine # 5 / kine # 2�
O Pass D Fail
TEST OR VERIFICATION STANDARDS: For ANered Duct S m and/or HVAC Equipmeet Change -Out
Use one of the following tour Test or Verilieatbn StqWsrdj for ce-
✓
9
Paas if Leakage Percentage < 15% [ 100 x no # Y/ (Line # 2)1]
0 Pass O Fail
10
Paas if Leakage to Outside Percentage < 100!0 [# x ins h 7) / (Line # 2)1]
p pees Q Fail
11
Pass if Leakage Reduction Percentage > 6 t10 x ine # 6) / (Line # 4)11
and Verification b Smoke Test and Visual ion
(� Pass D Farl
Pass if Sealinn of all Accessible Leaks and Verification by Stroke Teat and Visual Inspection
O Pass 13 Fail
Pass if One of Lino # 9 through # 12 pus
0 Pass O Fail
Residential Compliance Forms ;L 6# — /;-00 - I t.,!Ifq December 2003
3 f/ —/6
A4 dl 5*0' ^ /a-0 "
AUG -17-2009 02:31 PM
P. 03
CERTIFICATE OF FIELD VERIFICATION &DIAGNOSTICTESTING
; CF -4R
Project Address
E/-- . 0 60k Aov1�
Builder Nam
i -
BuilderContect J
`
Access is provided for inspection. The procedure shall consist of
Telephone
Plan Number
da Yes
lum Rater
M �HI'M a�
760E72
Telephone
Sample Grow Number
Compliance Method (Prescriptive)
installation of the syglific, Sguipment shall be verified.
Climate Zone Z5,
Certifying Signature
Yes is a 1pass
l 1,0Data
Sample House Number
Firm y
X OZ I
P
HERS Provider
A6;0,?S
Street Address:
S,ai)
City/Stat Zip:
Cavies to: BURDER. HERB PROVIDER AND NVAM U MrAK1 LUZZI l
HERS RATERMPLIANCE STATEMENT
The house was: #' Tested V ❑ Approved as pert 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
thed, ii tic tested compliance requirements as checked on this form.
✓ I(O The installer has provided a copy of CF -6R (Installation Certificate).
viff TmRMOSTATiC EXPANSION VALVE (TXV) t.! NG Un rr-s ,ofw ows
Povwdures forfield verocalion of drennoararrfc wepamion valyst an availobk in R404 Apps ix R
✓ ❑ REFRIGERANT CHARGE MEASIJR'
Verification for Required Refri Brant Char a for SA S tea+ SpIce Coohma System without Thermostatic Expansion Valves
Outdoor Unit Serial #
Location
Outdoor Unit Mahe
Outdoor Unit Model
Cooling Capacity Hfulhe
Date of Verification
Date of Refi igerant Gauge Calibration (must be checked monthly)
Date of Thermocouple Calibration (must be chedted monthly)
Note: The system should be inatalled and
shall be documented on CF -6R before eta
Charge Measure Procedure
manufacturer's spe iicatious and installer verification
air dry-bulb is below SS °F rater shall use the Alternative
Procedures for Determining Refrigerant Ch Aird the Spkdaid Method are available in RACK Appendix RD2.
✓ d Yee d No A copy of Cly- (TrisMiationCertificate) has been provided with refrigerant charge
Residential C'omphanty Forms April 2005
Access is provided for inspection. The procedure shall consist of
�/
da Yes
O No
visual verification that the TXV is installed on tha rye+ and
❑
installation of the syglific, Sguipment shall be verified.
Yes is a 1pass
Paas Fail
✓ ❑ REFRIGERANT CHARGE MEASIJR'
Verification for Required Refri Brant Char a for SA S tea+ SpIce Coohma System without Thermostatic Expansion Valves
Outdoor Unit Serial #
Location
Outdoor Unit Mahe
Outdoor Unit Model
Cooling Capacity Hfulhe
Date of Verification
Date of Refi igerant Gauge Calibration (must be checked monthly)
Date of Thermocouple Calibration (must be chedted monthly)
Note: The system should be inatalled and
shall be documented on CF -6R before eta
Charge Measure Procedure
manufacturer's spe iicatious and installer verification
air dry-bulb is below SS °F rater shall use the Alternative
Procedures for Determining Refrigerant Ch Aird the Spkdaid Method are available in RACK Appendix RD2.
✓ d Yee d No A copy of Cly- (TrisMiationCertificate) has been provided with refrigerant charge
Residential C'omphanty Forms April 2005
RUG -172009 02:32 PM
P.04
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING u C 4
Project Address
O Yes
Builder Nam�.
Builder Contact J
f'1 �
Telephone Plan Number
HERS Rater
O Yes
Telephone
Sample Group Number
3
Certifying Signature
0 Yes
Data
Sample House Number
4
✓
!
(3 No
Firm
� C• � � c 1b r
=V,
HERS der
t. -s✓ s
Street Address;.,
Ag.
,,� ,e , cid
✓ ✓
City/ tate/Zip:
,� r c- -
Copies to; BUILDER, HERS PROVIDER AND BURVI1NU DLPAK1 MLN i
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 house identified on this form complies with
the diostie tested compliance requirements as checked on this form.
✓ i T_he installer has roviaed a copy of CF -6R (Inst;uation Cettifioate).
✓ 0 ADEQUATE AIRFLOW VERIFICATION
Procedures for field verification and d0zwslic to rim
✓ C3 Yes 1 0 No Duct design exist; on plans
0
RFA, 1,1 Di ostic Fan Flow Usin
b RF.4,1, 2 Diagnostic Fan Flow Using
d R94.1.3 Diaguostic Fan Flow using
✓ 0 Yes O No Measured airflow is greater
than the criteria in Table RE -2
,RA CAI, Appendix RE4.1.
✓ ❑ MAXIMUM COOLING CAPACITY
Pmeadurae frit Ap►e►nunino ninrimum rnn inv lnnd cenaeiN ere euadah/p in RA(!W Annend►r RF3.
Total CFM
cfm/ton
1
✓
O Yes
D No
Adequate airflow verified (see adequate airflow credit)
2
✓
O Yes
0 No
Refrigerant charge or TXV
3
✓
0 Yes
0 No
Duct leakage reduction credit verified
4
✓
❑ Yes
(3 No
Cooling capacities of installed systems aro s to maximum cooling capacity
indicated on the Performance's CF -1R and RF -3.
=V,
_
es
0 No
If the calling capacities of installed systems are > than maximum cooling
capacity in the CF -IR, then the electrical input for the installed systems must
bo s to electrical input in the CF -1 R and RF -4. _
✓ ✓
❑ ❑
You to l 2 and 3• and Yes to either'4 or 5 is a pass
Pass Fail
VO—HIGH EER AIR CONDITIONER /- ' A C. V h )
Pin vdlires fra veil Nemion are available in RACM Appundix lu.
1 as 0 No EER values of installed system match the CF -IR
2 ✓t 9f Yes O No Fors lits stem indoor coil is matched to outdoor coil
3 ✓ P"Ves ❑ No Time Delay Relay Verified (if Required)
Yes to I and 2: and 3 (Tf Required
kr,ridenlial Cornpliance Forme Devember 2005
,- Certificate of Occupancy0 o
C
OF Building Y p & 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: 81-670 DE SOTO AVE
Use classification: SUNGLE FAMILY DWELLING Building Permit No.: 8-620
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: SEPTEMBER 11-09
Building Official
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