04-7874 (SFD)oJAN 10 2005
IATY OF LA QUIN
FIN ANCEOEPT.TA BUILDING. & SAFETY DEPARTMENT
.'BOX 150 (760).777-7O
OFTttti9 78-495 CALLE TAMPICO. FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION. REQUESTS (760) 777-7153
BUILDING PERMIT
App.lication,Number 404=0007874 Date 12/29/04
Property. Address . . . _;7'7_8 -2140 -"VIA PAVION
APN:. 604 -03 -2=9 -9 -9=9J305212 -
Application description . . DWELLING SINGLE FAMILY DETACHED
Property Zoning . . . . . . LOW .DENSITY RESIDENTIAL
Application valuation 151968
Owner Contractor
LENNAR HOMES OF CALIFORNIA LENNAR�HOMES OF CALIFORNIA INC
78.401 HIGHWAY 111, STE C 78401 HIGHWAY 111, SUITE C
LA QUINTA, CA LA QUINTA, CA 92253
LA.QUINTA,.CA 92253 WCC:. AON RISK SRVC
WC: :MWC11114500 11/01/05
CSLB: 728102 09/30/06
CCC: B
P.O. Box 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO TAt �r FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT -
Application Number: (} (A - 7 FS % Date: L' /0.0§
Applicant: Archil
Applicant's Mailing Address:—Architect
Ic. o.
Eri i r:
or Engineer's Address:
'BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirmunder p natty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
e, and Licens i II force and effect. l
incense Class ss rcense No.__ u v
mate U) .nn I � .
U OWNER-BUILDERDECLARATION
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 worts, 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.).
(, 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.):
U I am exempt under Sec. , B.& P.C. for this reason
Date Owner
WORKERS' 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.
hhay and will maintain workers' compensation insurance, as required by Section 370 of the' Labor Code, for the performance of the work for which this permit is
i e orkers' compensation inks trance came gppli�y u r a :
artier o�licv Numbery V
_ I ce mtymat, in the performance of the work for which this permit is issue ,.1 s II not employ, any person in any manner so as to become subject to the wo*ere'
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 — W -O pplicant
((( WARNING: FAILURE TO SECURE WORKERS' CO SATION 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 Perfornance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name p.
Lenders Address r7
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, indemnity 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.
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.
ate 1 1 Signature (Applicant or Agent):
1 -------=-----------------------------
Application
-----------------------------------------------------------------------------
Number .
. . . . 04-00007874
------ Structure,
Information
SFD
-----
Construction
Type
TYPE V - NON RATED
Occupancy
Type . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone
. . .
. . . NON -AO FLOOD ZONE
Other struct
info
CODE EDITION 2001, CBC
FIRE SPRINKLERS NO
GARAGE SQ.FTG•
462.00
PATIO SQ FTG
488.00
NUMBER OF UNITS
1.00
1ST'FLOOR SQUARE FOOTAGE
2385'.00
Permit .
. .
BUILDING PERMIT
Additional
desc
Permit Fee
821.50 Plan Check Fee
533.98
Issue Date
Valuation
151968
Qty ,'
Unit Charge
Per
Extension
BASE -FEE
639.50
52,00
3.5000
THOU BLDG 100,001-500,000
182:00
Permit
. . . . .
MECHANICAL
Additional
desc
Permit Fee
. . . .
65.50 Plan Check Fee
16.38
Issue Date
Valuation
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
1.00
9.0000
EA MECH FURNACE <=100K
9.00
1.00
9.0000
EA MECH B/C <=3HP/100K BTU
9.00
4.00
6.5000
EA MECH VENT FAN
26.00
1.00
6.5000
EA MECH EXHAUST, -'HOOD-
6.50
Permit
. .
ELEC-NEW RESIDENTIAL
Additional
desc
Permit Fee
. . . .
.107..72 Plan Check Fee
26.93
Issue Date
. . .
Valuation-
0
Qty
Unit'Charge
Per
Extension
BASE' FEE
15.00
2385.00
.0350
ELEC NEW RES -:l OR 2 FAMILY
$3.48
462.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
9.24 .
Permit .
. . . . .
PLUMBING
..Additional
desc
Permit Fee
-171.00 Plan Check Fee
42.75
Issue Date
. . . .
Valuation . .
0
'Qty
Unit Charge
Per
Extension
BASE FEE
15.00-
17.00
6.0000
EA PLB FIXTURE
102.00
.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
9.00.00
EA PLB LAWN.SPRINKLER SYSTEM
9.00
6.00
.7500
EA PLB GAS PIPE 5=5
4.50
----------------------------------------------------------------------------
;' Application Number . . .
•
04-00.007874
----------'-=-----------------=--=------=----------•-------=------------------
Permit . . . . PLUMBING
Qty Unit Charge Per
Extension
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
Qty Unit. Charge Per
Extension
BASE FEE
15.00.
Special Notes and Comments
SFD - LOT 9. PLAN 1, 2385 SF.
PERMIT
DOES NOT INCLUDE -BLOCK WALL,
POOL,.SPA`
OR DRIVEWAY APPROACH..
Other Fees . . . . . . . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
53.40
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
00
DIF LIBRARIES - RES
225.00,,
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC.= RES
502.00
STRONG MOTION (SMI) - RES
15.19
DIF STREET-MAINT_FAC-RES,
15.00
DIF• -TRANSPORTATION - RES
1098.00
Fee summary Charged
Paid''-- Credited
Due
Permit Fee Total 1180.72
.00 00
'1180.72
Plan Check. Total,. 620.04
..00, .00
620..04
Other Fee Total 2473.59
.00 .00
2473.59
Grand Total 4274.35
.0.000
4274.35
Certificate of Insulation ;
Your home has been insulated with John Mansville Fiberala_s insulation products, which are designed
' for today's safety standards and tomorrow's energy requirements.
Fiberglass ls.inorganic and therefore permanently noncombustible, so it does not have to be treated
with fine -retardant chemicals that will likely lose their effectiveness overtime. It has not been treated
with chemicals that can corrode wiring or metal. Fiberglass will not absorb: moisture nor will it, -
` settle over time as may other Insulation materials.
This also +certifies that insulation have been professionally installed In this home to provide the
- following thermal performance. .
Lennar Homes
Job Name:. Ls Quint& Del -Oro < Tract: 30521 Plan# 1R Phase: 8
Lot No:. Job Address: SFR - 78-240 Via Pavilion, La Quints, CA -
Ceiling Area, R-30 blown and batt Insulation Garage Ceiling: Non -Access:
With Living Above & Sloping Areas - >
Exterior Walla R-13 batt insulation Overhangs.Access Attic: With Living Above -
Between Floors: interior Walls:: -
Subcontractor ...0 J Insulation, Inc. -
F 72-227 Adelaid St, Thousand Palms, CA 92276 ,
QQ ,(� Jt2 Q 111Zyt
Signed:' M Ba
Mike Dickerson, General Manager - Paley Springs Division -
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 thebuyer.
Street Address: PO Box 50575 City/State/Zip: Phoenix; AZ 85076
Copies.to: Builder, HERS Provider
HERS RATER COMPLIANCE STATEMENT
The house was: ❑ TestedApproved as part of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the houses 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 (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 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 400cfin/ton x number of tons enter calculated
value here
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) _
Check Box for Pass or Fail (Pass=6% or less) ❑ ❑
Pass Fail
❑ THERMOSTATIC EXPANSION VALVE (TXV)
❑
Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection
❑
❑
`CERTIFICATE
OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page 1 of 7)
�;
Pass
LA QUINTA DEL ORO PH- 8
❑
6-14-05—j
Project Titl
I
Date
2Mia_P.avion La Quinta, CA 92253
M_%7_8 4 0
LENNAR
verified that actual installation matches values'in CF -1R and
Projec!;AddressBuilder
Name
design on plan.
Nacho Castenada
760-578-6968
Plan 1R (pg. 1 of 1)
❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV,
Build e o tact
koi yianl Henson (CCN #CC2004076)
Tele hone
760-550-7022
Plan Number
Group 6
verified fan flow matches design from CF -IR.,
HERS Rater
Telephone
Sample Group Number
Measured Fan Flow =
�
144)�irr`.�
6-14-05
9 (ph 8)
Certifying Signature
Date
Sample House Number
Yes for both I 'and 2 is a Pass
Firm: BCI Testing
ITERS Provider: CALCERTS
Street Address: PO Box 50575 City/State/Zip: Phoenix; AZ 85076
Copies.to: Builder, HERS Provider
HERS RATER COMPLIANCE STATEMENT
The house was: ❑ TestedApproved as part of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the houses 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 (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 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 400cfin/ton x number of tons enter calculated
value here
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) _
Check Box for Pass or Fail (Pass=6% or less) ❑ ❑
Pass Fail
❑ THERMOSTATIC EXPANSION VALVE (TXV)
❑
Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection
❑
❑
Yes is a pass
Pass
Fail
❑
MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
I
❑ Yes ❑ No ACCA Manual D Design requirements.have been met (rater has
verified that actual installation matches values'in CF -1R and
design on plan.
2.
❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV,
verified fan flow matches design from CF -IR.,
Measured Fan Flow =
o
-a
Yes for both I 'and 2 is a Pass
Pass
Fail
Compliance Forms August 2001
A-16
f Southwest Inspecti®n and Testing, Inc.
�k 10826 South Norwalk Blvd., Santa Fe Springs, CA 90670
(562) 941-2990 • (714) 526-8441 • Fax (562) 946-0026
WIT Job No.
REGISTERED INSPECTORS'S DAILY REPORT
Date
1 Z -4l oS
TYPE OFReinforced Concrete 13Struc'turol Steel Assembly ❑ Quality Control
INSPECTION 0 Post Tensioned Concrete ❑ Fire Proofing ❑ Other
REQUIRED ❑ Reinforced Masonry ❑ Asphalt
p�. G
OF1V1/ 6LO1.0r"CityL'4 C )L',���me
rJobdre
& 4Perrnii
N .
Issuggd BB
Structurer Lf
sour
Architect /
Material Description (Typerode. e)
Engineer
Contractor / Eti N * Rk( o ^I E5
InspectorTs) Name
Subcontractor
AJ
TESTS PERFORMED
TYPE OF SAMPLE
SLUMP
QUANTITY IN SET
ADDITIONAL REMARKS ON SAMPLES
CI
o A)r-,
7—
INSPECTION SUMMARY — LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETC.
INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED, NUMBER, TYPE & IDENT. NO'S OF
TEST SAMPLES TAKEN: STRR.UCTT�. CONNECTIONS (WELD MADDElH.T. BOLTS TORQUED) CHECKED, ETC.
S 1Z U G / D A/ < Ggqs�Ge
L4
U
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.C5C 1 O e ho e .mac oued l�G ,L; S
A,i d S ec ,ccs. T Ll o 7A-
CERTIFICATION OF COMPLIANCE CONTINUED ON NEXT PAGE ❑ PAGE �_ OF
I HEREBY CERTIFYTHAT I HAV SERVED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED TIME IN TIME OUT REG. HOURS O.T. HOURS CYLINDERS
WORK UNLESS OTHE TED. I HAVE UND THIS WORK TO C PLY WITH THE APPROVED PLANS, / 30'1,*
�
SPECIFICATION D LICA B SE I NS OF THE ILDING LAWS. V /`` l , �L✓' .
All inspections based on a minimum of 4 hours and over 4 hours - 8 hour
minimum. In addition, any in a ion extending past noon hour will be an'8,
SIGNATURE OF REGISTERED INSPECTOR hour minimu
�0 Z- 7 3 Approved by
SPECIALTY NO. AGENCY Project Superintendent
WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR'S COPY, GOLDENROD - JOB SITE COPY