04-4783 (SFD)T4Af 4 4 a"
BUILDING & SAFETY DEPARTMENT
1504. (760),777-7012
kLLE TAMPICO FAX (760) 777-7011
A, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
�r
Property Address
APN:
Application description
Property Zoning . . . . .
Application valuation
BUILDING PERMIT
Owner
------------------------
BUFFIN WILLIAM THOMAS
.P 0 BOX 134
LA QUINTA CA -92253-
04-0.0004783
A 92253
04-0.0004783 Date 6/23/04
51445 CALLE GUATAMALA
770-162-010- - -
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL .
119596
Contractor
------------------------
CONTEMPORARY HOMES INCORP
P.O. BOX 1141
LA QUINTA CA 92253`
WCC: STATE FUND
WC: 1576498
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
36.00.
NUMBER OF UNITS
i.00
FIRST FLOOR SQ'FTG�
1918.00
------------------------7---------------------------------------------------
Permit . . . . .
BUILDING PERMIT
Additional desc
Permit Fee
709.50Plan Check Fee'.
461.18
Issue Date
Valuation
119596
Qty Unit Charge
Per
Extension
BASE FEE
639.50
20.00 3.5000
THOU BLDG 100,0017500,000
70.00.
------------------------------------------=---------------------------------
Permit . . ... . .
MECHANICAL
Additional desc
Permit Fee . .
59.00 Plan Check Fee
14.75
Issue Date
Valuation . .
0
Qty Unit Charge
Per
Extension
P.O. Box 1504ICE VOICE (760) 777-7012
78-495 CALLS TAMPICo .44QFAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)'777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: o V - A{ 783
Applicant:
Applicant's Mailing Address:
Date: to •A 3 -0 fZ
Architect or Engineer:
Architect or Engineer's Address:
tic. 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 nse No. / (7
Date � Z �Con6-ctor
OWNER -BUILDER DECLARATION
1 hereb 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 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.).
(--) 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 projec 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
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
nce carrier and policy number are: / / —� /
Carrier Poli Number
1 certify that, in the performance of the work for whic ermit is issue , shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and a r if I should beco ubject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
fortco ly with those provi
,trMthX
Date � Applicant
WARNIN :FAIL RE TO SECURE WORKERS' COMPENSATION CO RAGEil�ONTO
UL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'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
Lenders 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 to, and shall, defend, indemnity and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the ing performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and4oZd if rk 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 i rrect. I agreC rfi j yi7with all city and county ordinances and state laws relating to building
construction, an hereby thorize representatives of this county to enter on the ab entio d property�inspectionpurposes.
t�/nature
Date 2/ Si (Applicant or Agent):
t
Page
2
Application
Number .
. .
. . 04-00004783 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
----------------------------------------------------------------------------
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 2463.07
Grand Total 4017.16
Paid Credited Due
---------- ---------- ----------
.00 .00 1019.23
250.00 .00 284.86
.00 .00 2463.07
250.00 .00 3767.16
Page
3
Application Number . . . .
. 04-00004783 Date
6/23/04
----------------------------------------------------------------------------
Special Notes and Comments
BLOCK WALL, POOL/SPA OR DRIVEWAY
APPROACH
----------------------------------------------------------------------------
Other Fees . . . . . . . .
. ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
c 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
11.95
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 2463.07
Grand Total 4017.16
Paid Credited Due
---------- ---------- ----------
.00 .00 1019.23
250.00 .00 284.86
.00 .00 2463.07
250.00 .00 3767.16
Date
7/21/04
No.
26204
Owner
Power Finance
Address
51445 Calle Guatemala
City
La Quinta Zip 92253
Tract #
Type
Single Family Residence
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
APN #
Jurisdiction
Permit #
Study Area
No. of Units
q�13 DIED
z c� 5�7 N" o
Q BERMUDA DUNES r
rn RANCHO MIRAGE d
�_A INDIAN WELLS ti
PALM DESERT y
LA QUINTA
�. QINDIO y�
O
770-162-010
La Quinta
1
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 51445 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 garageskarports, 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
Funding Residential
By Dr. Doris Wilson
Superintendent �
Fee collected /exempted by Beth Schieferstine Payment Recd
$4,296.32 Over/Under
Signature 4�4' )444aal�'
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above Will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the Districtfs) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
RECORDING REOUE$TE6AY:
First American Title
AND WHEN RECORDED MAI! TO;
William Thomas Buffxn
P.O. BOX 134
WRo.o M265§ 11113.
Escrow No., PPM73-KC .R'
A.P.N.: 770-162:207-6 —
DOC " 2003-786541
11e/05/2ee3 ea;OeA Fre:27.ee
Pegs I of l Doo T Tax Paid
Recorded In Offlaijl Records
Caunty of Rlveralde
Cary L. Oreo
Assgasr, County Clork 4 Recorder
IN PHI 111111111
nnE,
MMMM
'm
WMERNOWN1
seeliiemme�i
GRANT DEEP
Tilt~ UNDERSIGNED GRANTOR(S) DECLAFt=(S)
DOCUMENTARY TRANSFER TAX IS $259.60
[ x ] computed on full value of property corweyed, or
[ ] computed on fun valueless value of Uens or etx=brances remaining at time of sale.
v [ ] uninoorporated area ( x I City of Lt Qukita
FOR A VALUABLE CONSIDERATION, receipt of Which is hereby adu> w=edged,
Nan Glennon, Trustee of Nan Glennon L.iving`Trust Dated 811TH
herebyGRANT(S)to William Thomas Suffin, a married man .ai$ his sole and seperate
property , and Power Finance Associates, Inc., a.Califoxnia Corporation
the following described real property in the Cotnty of Riverside. State of California
Lot 1, 2 and S of Block 6 of Unit 2 of Desert: Club Tract,. In the City of La Qulrna, County of
Riverside, State of CaRfornla, as per n=ap recorded In Book 20, Pago(s) 6 of Miscellaneous
Maps, In the office of the County Recorder of said County.
Dated: August 26, 2003
STATE OF CAUFORNIA q
COUNTY OF L.Q S I�niL�' QtQ s, SS.
On - A a e w j, -r 900 3 b6fore me
NferyPePFared bl� r said County and/ Stale, personally
proved to rte on the basis of .
sa.WaLiory evidence) to be. erso Erase 9*
=bed to the within Ins merd acid acknoMedged
to me thalAQ460thoy executed the same In NaMilbaip
authorized a e hat —by kiSIhs' tiro
on the Instrurn or•the entity upon be tot
whlc h the , acted. eweouted Itie Instrument
WITNESS my ha o I
stgr�ature _ '
!gn uro ol Wary
(This area for official f+otary seal)
MAIL TAX :iTATEMENTS AS DIRECTED ABOVE
Nan Glennon Living Tnlst Dated 8117199
W. Nan Glennon. Trustee
E ftAWbi& *'— a
1✓6 Q
CorrrrtlrOn 6Aae1DP6
I=Y Any" COrORMO
I�►Comn ,C"O r
RPI
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■ �yf 4�IN
■
■ CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING! CF -4R
■ Glr
Project Title Da
tg�
�5'/�-4el 6- ��i��Ton ��� L_ q fit✓ ev
Pro' ct A ess Builder Name
14
Builder Co tact �aoTelephone Plan Number
HERS -Rater I Telephone Semple Group Number
cA
CjAifyoinug Slgnaturie ateV Sample House Number
F)rm: TLC. �' �57+~ S r/ HERS Provider: lyEt
Street Address: g ��n �rQ�v.+! (...IYG �� City/State/zip:
Coplos to: Builder, HERS Provider
HERS RATER COMP1,11ANCE STAT ENT
The house was: Tested ❑ Approved as part of sample tasting, but was not tested
As the HERS rater providing diagnostic testing and field verification, 1 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 (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 drawbande are used in combination
with Cloth backed, rubber adhesive duct tape to seal leaks at duct connections,
R MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
Measured
Duct Pressurization Test Results (CFM Q 25 Pa) values
Test Leakage Flow In CFM
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) = - r b /n
Check Box for Pass or Fall (Passr-6% or less) ❑
ass Fail
HERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent
grYes ❑ No Thermostatic Expansion Valve (or Commission approved -
cquivalent) is installed and Access Is provided for Inspection❑
Yes Is a pass ass Fail
CI MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1. O Yes M No ACCA Manuel D Design requirements have been met
(rater has verified that actual Installation matches values in
CF -.1 R and design on plan.
2. ❑ Yes D 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 beth 1 and 2 Is a Pass
Cl Cl
Pass . Fall
Z 'd I9EZ'ON NIdd119 NVI11IM NVW01 9002 'LZ'add