04-4784 (SFD)BUILDING & SAFETY DEPARTMENT
P.O. 1504. (760),777-7012
C 8-49 LLE TAMPIC.O FAX (760) 777-7011
U , CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
C
(of LA a BUILDING PERMIT
EINpN�E
cation Number . . . . . 04-0.0004784 Date 6/23/04 .
Property Address . . . . . 51425 CALLE GUATAMALA
APN: 770-162-009- - -
Application description DWELLING - SINGLE FAMILY DETACHED
Property Zoning LOW DENSITY RESIDENTIAL .
-Application valuation 119370
Owner Contractor
BUFFIN,-WILLIAM THOMAS CONTEMPORARY HOMES INCORP
P 0 BOX 134 P.O.'BOX 1141
LA.QUI.NTA CA 92253 LA QUINTA 'CA.92253
WCC: STATE .FUND
Vd.C:; 1;5;7,6 4 9 8 07/01/04
CSLB: 736920 03/31/05
CCC... B
--==--------------=-- Structure Information ---=----------------------
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
BEDROOMS 3.00..
FIRE.SPRINKLERS NO
GARAGE SQ'FTG 480.00
PATIO SQ FTG 19.00.
NUMBER OF UNITS i.00
FIRST FLOOR.SQ FTG\ 1918.00
Permit BUILDING PERMIT
Additional desc
Permit Fee 709.50 Plan Check Fee 461.18
Issue Date Valuation 119370
Qty Unit Charge Per- Extension
BASE FEE 639.50
20.0.0 3.5000 THOU BLDG 100,001-500,000 70.00
Permit . . MECHANICAL
Additional desc
Permit Fee 59.00 Plan Check Fee 14.75
Issue Date Valuation . . . 0
Qty Unit Charge Per Extension
.i
P.O. Box 1504 • VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Oq 4*7 Date: 6
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
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 License No. Z G % Z (D
G� C
Date L Contractor
OWNER -BUILDER DECLARATION
I hereby, affirn and r 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 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 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.).
U 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. , BA P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
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 numbbe�r are:
Carrier Policy Number /7r) 6 -,,- .2/ Y
_ 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 sho become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwit70APplica y with those provisions.
Date 1'
WARN G.
FAIATHE
TO SE RE WORKER OMPEN TION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UPNE HUNDRED THOUSAND DOLLA S ($100,000), IN ADDITION T�TME-COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 LABOR CODE, INTEREST, AND TTORNEY'S FEES_
CONSTRUCTION LENDING AGENCY
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.).
Lenders Name
Lender's Address
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 t hall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the w inornad under or following issuance of this permit.
2. Any permit issued as a result of this application becomes nulla id if w s not commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to canc ion.
I certify that I have read this application and state that the abov ' ormation1stborrect. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby autho 'ze/(representatives of this my to ente on the above-mentioned property for inspection purposes.
Date z
i1ature (Applica or Agent):
a
Application Number
. . . . 04-00004784
Page 2
Date 6/23/04
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
3.00
6.5000
EA
MECH
VENT FAN
19.50
1.00
6.5000
EA
MECH
EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit . . .
. . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee .
. . .
106.73
Plan Check Fee
26.68,
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00'
1918.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
67.13
480.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
9.60
1.00
15.0000
EA
ELEC
TEMPORARY POWER POLE
15.00
---------------------------------------------------------------------7------
Permit . . .
. . .
PLUMBING
Additional desc
Permit Fee .
. . .
129.00
Plan Check Fee
32.25
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
10.00
6.0000
EA
PLB
FIXTURE
60.00
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
6.00
.7500
EA
PLB
GAS PIPE >=5
4.50
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
1918 S.F. SFD
PERMIT
DOES NOT INCLUDE
Fee summary Charged
Permit Fee Total 1019.23
Plan Check Total 534.86
Other Fee Total. 2463.05
Grand Total 4017.14
Paid Credited Due
---------- ---------- ----------
.00 .00 1019.23
.00 .00 534.86
.00 .00 2463.05
.00 .00 4017.14
Page
3
Application Number . . . . .
04-00004784 Date
6/23/04
----------------------------------------------------------------------------
Special Notes and Comments
BLOCK WALLS, 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
46.12
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
11.93
DIF STREET MAINT FAC -RES
15.00
DIF 'TRANSPORTATION - RES
1098.00
Fee summary Charged
Permit Fee Total 1019.23
Plan Check Total 534.86
Other Fee Total. 2463.05
Grand Total 4017.14
Paid Credited Due
---------- ---------- ----------
.00 .00 1019.23
.00 .00 534.86
.00 .00 2463.05
.00 .00 4017.14
CERTIFICATE OF COMPLIANCE S ,)FIEs�,
Desert Sands Unified School District z4�4
47950 Dune Palms Road Q BERMUDA DUNES t,
Date 7/21/04 La Quinta � INDIAN WECA 92253 RAN AN WELLS LSMIRAGCJ
N ti
No. 26205 (760) 771-8515 �, PALM UIANTS �y
QINDIO
Owner
Power Finance
APN # 770-162-009
Address
51425 Calle Guatemala
Jurisdiction La Quinta
city
La Quinta Zip 92253
Permit #
Tract#
Study Area
Type
Single Family Residence
No. of Units 1
Lot # No. Street S.F.
Lot # No. Street S.F.
Unit 1
51425 Calle Guatemala 1918
Unit 6
Unit 2
Unit 7
Unit 3
Unit 8
Unit 4
Unit 9
Unit 5
Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garagestcarports, covered patiostwalkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 1,918 S.F. or $4,296.32 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By CC -Valley Independent Bank -Power Finance Check No. 319541
Name on the check Telephone 564-6470
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Beth Schieferstine
Signature Jffl
�Llvr�'
r r
Funding Residential
Payment Recd 1$0.00
$4,296.32 Over/Under
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to colied them on the Districtfs) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
MAY -02-2005 01:03 PM P.02
•J H�H .
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING, CF -4R
Protect Title
'
Pro' ct Address Builder Name
r��
Bulld Cre oMactTelephone Plan Number
p
ueoe oo*ew Telephone Sample Group Number
i -
�PhIfying Signature to 14 Sample House Number
Firm: /%rOCzali— S HERS Provider: C H/�� t S
Street Address; -% �a D �YAt�d`Orit C�YL City/State/Zip: a Y✓/✓! (51 -1 2.2 r —
Copies to: Builder, HERS Provider
ER RA ER CQMPLIANCE JTAfEMEN
The house was: ested ❑ Approved 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.
Distribution system is fully ducted (Le., does not use building cavities as plenums or platform returns in lieu
f 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 L
10
If fan flow Is calculated as 400cfm/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) _ o
Check Box for Pass or Fall (Pass=B% or less) ❑
Pass Fail
(,"THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent
Yes ❑ No Thermostatic Expansion Valve (or Commission approved
equivalent) Is Installed and Access Is provided for Inspection
Yes Is a pass
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1. ❑ Yes ❑ No ACOA Manual D Design requirements have been met
(rater hes verified that actual installation matches values in
CF -1 R 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 -1 R.
Measured Fan Flow
Yes for both 1 and 2 is a Pass
❑
Pass
Fail
N/77
Q
❑
Pass
Fall
AUG 04 '04 14:21 FR
TO 956464'
^OUR REi'OAT NO..
DATE- *% -- 3 B — o
REPORT OF FIELD COMPACTION "TES'T'S
•IL S*' 61 7 is • . _le_
P. 04i0'r
%UCLEAR GAUGE UIFORIMATION AND DAAT STANDARD CAWRATION HUNG lS VARIATION. FERCWI.4N Q"GE AD AlSTTtAt � ° % v,MarON FROr ,
CAURPATION COUNTS FROM SHEETS / c LAST USE
L+
GAUGE Tr OX AFAPGELL MOtSTUiLEI Sv MOISTURE M017TURE: MOISTURE 'I� -
r
MODEL NO,: 2_ki
-] I otNsm: � 5 DENSln': o6Nsrrr: oENsrrv:
KOCTOR INfINAMATiOA
SOIL 10 #
VISUAL CLASSIFICATION OF SOIL
MAX. DRY DENSITY, PCF
n .-'OMMUMMOIS�
.3+
COMPACTIONL� MOISTURE
GENERAL LOCATION: j' 4 Z S CA t1 e-
vq e �Ck Cl <
REQUIREMENTS. % l
REQUIREMENTS.
LOA:�, Q V
TEST
READING
OUOTIENT/ SOIL TEST ELEVATION MOISTURE WET DRY
r
PERCENT COMMENTS
NO.
PCF 10 NO. DEPT", IN OF TEST
CONTENT, DENSITY, DENSITY.
' COMPACTIONy
% PCF Pct;
D_
L4 .
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D-Z 933
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--
1
I TECHNICIAN:
t 2 - AACKFILL 9 - COIMPACTION pEACFNTACE DOFS NOT cOMOLr VytT11 ypl*,ICATIONS
3 - BASE COURSE C - RETEST OF PREVIOUS TEST
4 . SURAASE 0 . MOISTURE IN EXCESS OF SPECIFIC?TIONS
5 SOIL CEMENT E . MOISTURE AELOW SPECIFICATIONS
6 - OT4ER
WHITE -OFFICE YELLOW -INSPECT, PINK -FIELD CILE