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08-0623 (SFD)4 P.O. BOX 1504 ^' 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 08-00000623 Owner: Property Address: 81710 DE SOTO AVE - EAST OF MADISON LLC APN: 767-200-091-3 -34968 - PO BOX 1482 Application description: DWELLING - SINGLE FAMILY DETACHED LA QUINTA, CA 92247 Property Zoning: LOW DENSITY RESIDENTIAL D Application valuation: 467734 4 ontractor: Applicant: Architect or Engineer://H 1 & M CONSTRUCTION J v P.O. BOX 366 LA QUINTA, CA 92247 �C 0� (760) 564-4832 �iygNCF ��/HT,� Lic. No.: 746198 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 (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).: (_ 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.). (_) I am exempt under Sec. , BAP.C. for this reason Date: wner: 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 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 1 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 orkers' co nsation provisions of Section �7 3700 of the r Code I shall fert3 compl with tho pr isions. D—� f+ plicant: 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 th ve information is correct. I agree to comply with all city and county ordinances and state laws rel atin wlding con truction and hereb uthorientatives offtth/is�_ unty to enter upon the above -menti d property for ' pectin p oses. aoD t6a7 I2 U O ature (Applicant or Agent): 1 Application Number . . . . 08-00000623 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 1927.50 Plan Check Fee 313.22 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 8.94 Issue Date Valuation . . . . 0 Expiration Date*. 10/14708 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 >3715HP/>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 12.70 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 13.97 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 . . . . . 08-00000623 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 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 3, PLAN 1R, 5296 SF. PERMIT DOES.NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 75% TO PLAN CHECK FEES DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE. 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 31.32 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 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 348.83 .00 .00 348.83 Other Fee Total 5118.62 .00 .00 5118.62 Grand Total 7999.77 .00 .00 7999.77 LQPERMIT AUG -17-2009 02:33 PM ►.a CL 0_1z VCU -14's L107 S P. 06 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING a CF -4R Project.Address J 4/1 Builder or Irusttllor Name , Builder or Installer Contact Telephone Plan/Permit (Additions or Alterttions) Number Rater Telephone Sample Group Number Fan Flow. Calculated (Nominal: ✓ i7 Cooling O Heating) or ✓ e—cured Enter Total Fan Flow in CFM: Compliance Method Ttescri 've Certifying Signature C v Date Climate Zone Sample House Number Firm `.- HERS Provider Street Address: res v -.rien s.�ar�ena ♦�e� neer 'titVf- fame At•TM�*1T CitySta ip: %-UPW8 %Y• OV WLLA1 saws -P a aav aaa�s� .ver reser - . HERS RATER CQMPLIANCE STATEMENT The house was: ✓ Tested ✓ 0 Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification. I cert4 that the house identified on this form complies with the diagnostic tested compliance requirement; as checked ✓ on this forst. The HERS rater must check and verify that the new distribution system is fully ducted and correct tape is used before it CF4R may be released on every t building. The HERS rater must not release the CF -4R until a properly completed std signed CF -6R has bereceived for t e sample and tested buil !ft gs. The installer has provided a copy of CF -6R (Installation Certificate). New ducts are Hilly ducted (i. a, does not use building cavities as plenu= of pladbrm returns in lieu of ducts). New ducts with cloth backed, rubber adhesive duct We is installed. mastic and draw bands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections,1 AMINIMUM REQUMEMENT9 FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Procedures for field verification and diagnostic testing of sir distribution systems are available in RACK Appendix RC4.3. rhiet niaonnatic Leakeae Testina Results NEW -CONSTRUCTION: Duct Pressurization Teat Results (CPM ® 25 Pa) Measured Values 1 Enter Tested Leakage Flow in CFM: l 2 Fan Flow. Calculated (Nominal: ✓ i7 Cooling O Heating) or ✓ e—cured Enter Total Fan Flow in CFM: �7 3 Pala if Leakages Percentage < 6°rG [ 100 x (Lane # 1) / 1D(Line # 2))] Pass O Fa11 ALTERATIONSt Duct System and/or HVAC Equipment Chi t 4 Enter Tested Leakage Flow in CFM from CF -611: Pro -Tat of )ear' Wng Duct System Prior to Duct System Alteration and/or Equipment Change -Out 5 Enter TOW Leakage Flow in CFM: Final Test of New ct Sys or ct system for Duct System Alterntion and/or Eguiement 6 Enter Reduction in Leakage for Altered Duct System L # 4) (Line # 5)] (Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) ✓ ✓ 8 Entire New Dud System - Pass if Leakage Percentage < 6% 1 oo x(Line # 5 l Line # 2)11 C Pass o Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Chang&Out Use one of the fullowina four Tat or Verification Standagils for doer lance: ✓ ✓ 9 Paas if Leakage Percentage < 15% 1100 x [__ne # 5) / ins 2)]] O Peas O Fail 10 Pass if Leakage to Outside Percentage < 10% [100 x the # 7 if (Line # 2)11 O Pass O Fail 110 11and Pass if Leakage Reduction Percentage > 60% [100 [ ins # / (Line # 4)11 Verification b Smoke rest and Visual Ina on Pass 0 Fain Paas if Sealinstof all Accessible Leaks and Verification by Smoke Tact and Visual Inspection O Pass O Feil Plus If One of tines 0 9 through # 12 pass O Poses 0 Fail Residential Cornpliancvr Forms ;2 7 /.Z-0 -'-,S 4A, December 2005 AUG -17-2009 02:33 PM P. 07 HERS RATER gMPLIANCE STATEMENT The house was: VA Tested ✓ Q Approved as part of sample testin& but was not tested As the HFdtB rater providing diagnostic testing and field verification, I ecrtifY that the house identified on this farm complies with the d' osde tested compliance requirements as checked on this form ✓ YJ The installer has provided a copy of CF -6R (Installation Certificate), VJ3 THERMOSTATIC EXPANSION VALVE (TXV) 60716 1111,AWAP Pr+vicedums forfield ver0callan of thewsostarfc vspanaton rahW one available in RACAer: Apfienft Rl, ✓ 13 REFRIGERANT CHARGE MEASIJ> UMONT Verification for Required Rotiiaerant Charge for Split System Space Cooling Syetemswithout Ther,t a Expansion Valves Outdoor Unit Saial # Location Outdoor Unit Make Outdoor Unit Model Cooling Ca i B Date of Verification Date of Re igermit Gauge Wbration (must be checked monthly) bate of Thermocouple Calibration (mutt 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 th cturer,s specifications and installer verification outdo -bulb is below SS OF rater shall use the Alternative o D A copy of CF -6R (Inatnillation Certificatb) has been provided with refrigerant charge I ✓ ❑ Yes N�._a IfesidenNal Compliance fiorm# April 2005 ✓ -'Oe Access is provided for inspection. The procedure shall consist of ✓ Yes Q No visual verification that the TXV is installed on Ste system and 13 installation of the specific equitirrignt shall be verified Yea is s pus Pees Fail ✓ 13 REFRIGERANT CHARGE MEASIJ> UMONT Verification for Required Rotiiaerant Charge for Split System Space Cooling Syetemswithout Ther,t a Expansion Valves Outdoor Unit Saial # Location Outdoor Unit Make Outdoor Unit Model Cooling Ca i B Date of Verification Date of Re igermit Gauge Wbration (must be checked monthly) bate of Thermocouple Calibration (mutt 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 th cturer,s specifications and installer verification outdo -bulb is below SS OF rater shall use the Alternative o D A copy of CF -6R (Inatnillation Certificatb) has been provided with refrigerant charge I ✓ ❑ Yes N�._a IfesidenNal Compliance fiorm# April 2005 AUG -17-2009 02:33 PM T' r CERTIFICATE OF FIELD Project Address 5r/ — "7l V 6 lA? T Rater P. 08 CF' Certifying Signature Date Sample House Number Firm HERS Provider T � c. ' l i r' " J City/ tate/Zip: Street Address: ,7� �,�`� ��6/ ,•;tit !lam � �� �'+ . Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER C MPLIANCE STA'T'EMENT 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 d' 106.60 tested compliance requirements as checked on this form. ✓ e installer has provided a co of CF-6R(Installation Certificate . DEOUATE AIRFLOW VERIFICATION Pr V I a Yes 1 O No ' Duct design exists oil plans r\ RA('M, Appendix REQ. !. Total CFM cfm/ton ✓ 1 D Yea 1 O No I Measured airflow is greater dun the criteria in Table RE -2 I © 1 U I ✓ ❑ MAXIMUM COOLING CAPAcrff Prnendurat fnr doterminina maranum ennbno load canaein) are available in RA(!W.. Ap1%ndlx ice' 3. I ✓ ❑ Yes D No Adequate airflow verified (a dequate airtl w credit) 2 ✓ ❑ Yes D No Refrigerant charge or TXV 3 ✓ D Yes D No Duct leakage reduction credit ver lied 4 ✓ D Yea D No Cooling capacities of instal indicated on the Perfor d sya rns ar 5 to max' cooling capacity `s CF• d RF•3. 5 ✓ O Yes L7 No If the cooling capacities o installed systetts are > lhan maximum cooling capacity in the CF -11t. th4h the electrical input for the installed systema Must be:r. to electrical input in the CF -IR and RF4. ✓ ,� ❑ ❑ Yea to 12 and 3, and Yes to either 4 or 5 is a pao Pass Fail ✓ HIGH EER AIR CONDIT10NER Procedures for wil cwdon are available in RACbI &pendix lu I MYes I O No E'ER values of installed systems match the CF -I R 2 ✓Ct Yes 1 D No Fors lits stem indoor coil is matched to outdoor coil ✓ ✓ 3 ✓ Yes 1 D No rime Delay Relay Verified (If Required) E3 Yes to 1 and 2. and 3 (If Required) is a pass Pass Fail _. ltesidentiol Compliunce Forms December 2005 A) _ • Certificate O*f Occupahcy0 o � 5w C OF 'T1 9� 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: 81-710 DE SOTO AVE Use classification: SiNGLE FAMILY DWELLING Building Permit No.: 08-623 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL i Owner of Building: EAST OF MADISON LLC Address: P.O. BOX 1482 City, ST, ZIP: LA QUINTA, CA 92253 r ' By: KIRK KIRKLAND Mme, ! Date: 09/28/09 Building Official 'POST IN A CONSPICUOUS PLACE