05-2160 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: T05--0 0-0-02 16 0_.
Property Address: 81810 FIORI DEL DESERTO
APN: 764-010-011-18 -30092 -
Application description: DWELLING - SINGLE FAMILY
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 190928
Applicant:
/Architect or
c&ty/ 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DR K. HOVNANIAN FORECAST HOMES
4240 E. JURUPA ST. STE. 402
DETACHED CHINO, CA 91710
D U
Contractor:
[JUN 16 2005 K. HOVNANIAN FORECAST HOMES
4240 E. JURUPA STREET
CITY OF LA QUINTA ONTARIO, CA 91761
FINANCE DEPT. LiC. No..: 91761(90 9) o: 770
700788
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/06/05
-----------------------------------------------------------------------=-------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professi nals Code, an my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B Li nse 700788
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date ontrac' r:
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
e___
Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier ZURICH INS Policy Number WC343666302
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers'. compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become sLibiect to the w rkers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor C de, I shall f ,vit p1 ith those provisions.
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).:
Dat��......//////������licant:
(_ 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
' SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , 8.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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.).
Lender's Name:
Lender's Address:
LQPERMIT
of La Oumta, 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 's correct. I a e to comply with all
city and county ordinances and state laws relating to building construction• d he by aut r e representatives
of this county to enter u on a above-mentioned property r inspection
Dom: gnature (Applicant or Agent):
I
Application Number . . . . . 05-00002160
Structure Information
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/LONG <=10
Flood Zone . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. CODE EDITION
2001 CBC
FIRE SPRINKLERS
NO
GARAGE SQ FTG
687.00
PATIO SQ FTG
858.00
NUMBER OF UNITS
1.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
2903.00
Permit . . .
BUILDING PERMIT
Additional desc . .
Permit Fee
958.00 Plan Check Fee
155.68
Issue Date . . . .
Valuation
190928
Expiration Date ..
12/03/05
Qty. Unit Charge
Per
Extension
BASE FEE
639.50
91.00 3.5000
-----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
318.50
Permit . . .
MECHANICAL
Additional desc .• .
Permit Fee . . . .
90.00 Plan Check Fee
5.63
Issue Date
Valuation . .
. . 0
Expiration Date
12/03/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K
18.00
2.00 9.0000
EA. MECH B/C <=3HP/100K BTU
18.00
5.00 6.5000
EA MECH VENT FAN
32.50
1.00 6.5000
----------------------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
Permit . . .
Additional desc .
Permit Fee . . . .
Issue Date . . . .
Expiration Date .
Qty Unit Charge
2903.00 .0350
687.00 .'0200
LQPERA11T
ELEC-NEW RESIDENTIAL
130.35 Plan Check Fee .
Valuation
12/03/05
Per
BASE FEE
ELEC NEW RES - 1 OR 2 FAMILY
ELEC GARAGE OR NON-RESIDENTIAL
8.15
0
Extension
15.00
101.61
13.74
Application Number . . . . . 05-00002160
Permit
. . . PLUMBING
Additional
desc . .
Permit Fee
. . . . 173.25 Plan Check Fee
10.83
Issue Date
. . . . Valuation . . .
. 0
Expiration
Date 12/03/05
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
9.0000 EA PLB LAWN SPRINKLER SYSTEM
9.00
9.00
.7500 EA . PLB GAS PIPE >=5
6.75
1.00
-----------------------
15.0000 EA PLB GAS METER
:
15.00
. . . GRADING PERMIT
Additional
desc .
Permit Fee
15.00 Plan Check Fee
.00
Issue Date
. . . . Valuation . . .
. 0
Expiration
Date 12/03/05
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes
and Comments
SFD - LOT 18,
PLAN 2C/858 SF PATIO(2903
SF). PERMIT
DOES NOT INCLUDE POOL, SPA,
• BLOCK WALLS
OR DRIVEWAY APPROACH. 75%
REDUCTION TO PLAN CHECK FEES DUE TO
MULTIPLE ISSUANCE
OF SAME PLAN TYPE
----------------------------------------------------------------------------
Other Fees
. . . . . . . ... ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
15.57
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
19.09
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged Paid Credited
Due
LQPEINiIT
s
,.gilt 1
Application Number . . _ . . 05-00002160
Permit Fee Total 1366.60 .00 .00 1366.60
Plan Check Total 180.29 .00 .00 180.29
Other Fee Total 2439.66 .00 .00 2439.66
Grand Total 3986.55 .00 .00 3986.55
LQPERMIT
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CIsRTIFICATU Ole FIELD VERIFICATION AND DIAGNOS'I'IC'I'LSTING (['art 1)
Pi2Zzq Serena,.
Project itle
81-810 Fieri 17el Q(LCc'Jn_I7r.
Project Addrenr.
Scott Adams (909) 3220.8953
Builder Contact Telephone,
Forecast I lomcs
Builder Name
—2-S
Plan Numbcr
Tim Tooham 951 780-7265 6
HERS Rater Telephone? Sample Group Number
18
�e Eying S r :lure l6ate Sample House Number
Firm: Enerpv Gale Sorv_icra, Inc HERS Provider; C 14FFRS
Street Address: 16551_ Mockingbird Cvn. Rd. City/Statc/Lip: Riverside,QCA 9250a-9638
(:ollie. to:Builder,..HF.ttti Provider _. _ _•
HERS RATER COMPLIANCE STATEMENT
The house wits: ❑ 'Tested ❑ Approved as part ol's;nnrlc testing, but was nul IVstvd
As the 1113, KS rater providing diagnostic test ifig and field verification, I certify that the houses identified on this form
comply with the ding.,ioslic Icsled compliance requirenu•nts as checked on this lorm,
0 The instiller has provided a copy of CF -61t ( Installation Certificate)
❑ Dislrihulion system is fully ducted (*Ise., dues not use building; cavities as plenum, or pl;(lbrnr
returns in lieu of ducts)
Q Where cloth backed, tubber adhesive duct tape is installed, mastic and draw bands arc used in
combination will) clolb backed, rubber adhesive duel tape to seal leaks at duct connections,
❑ MINIMUM RFQUilRcmENTS FOR DUCT I.A4,AKAGE REDACTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 611/9 Duct Leakage)
Measured
Duel Pressuriiuion 'I'ust Resells (CPM (u), 25 11a) values
Test I.caka;:e Flow in CFM
If lain flow is calculaled as 400clin/Ken x number of -tons enter
calculated value here
If fan flow is measured entor measured value hero
Leakage Percentage (100 x Test Leakage/Fan Flow = _
Check Box for Pass or Fail (Pass=6% or less) ❑ ❑
Pass Fail
THERMOSTATIC EXPANSION VALVE (TXV) or Cpmmis :inn pp ro_v_r d ;.gili_v_ ►Ir nt
El Yes ❑ No Thermostatic Expansion Valve (or Commission approvod
equivalent) is installed and Access is provided for inspection Q ❑
Yes is a pass Pass Fail
January 5, 2001
05/03/2006 08:24 9096052958 KHOVNANIAN HOMES PAGE 08/12
05/02/2006 15:55 FAX PARAGOWSCHIMID Q� 007/011
— i
INSULATION CERTIFICATE
This is to eertify that Insulation has been installed in conformenoe with the current energy
regulation, California Administrative Code, Title 24; State of California, In the building at
61-810 FIORI DEL DESERTO, LOT 16, PHASE 4, LA QUINTA, CA
CEILIN
TYPE: BLOWS MANUFACTURE=R: Certainteed THICKNESS: R-39
WALLS:
TYPE: BATTS MAUNFACTURER: Owens Corning THICKNESS: R-13
GENERAL CONTAACTOR: FORECAST HOMES LICENSE 0
BY: TITLE:
PARAGON SCHMID BUILO!K PRODUCTS A MASCO Company LICENSE # 221617
BY:14�e:".TITLE: ACCOUNT REPRESENTIVE DATE: 5"7`-/`"