05-2318 (SFD)P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
05-00002318
O
Owner:
Property Address:
52280 AVENIDA HERRERA
POWER FINANCE
APN:
773-264-002-21 -000000-
4
PO BOX 134
Application description:
DWELLING - SINGLE FAMILY DETACHED
A�^
LA QUINTA, CA 92247
Property Zoning:
COVE RESIDENTIAL
U /"
Application valuation:
119117
FAN ?®�ss
A.
ntractor:
Applicant: Architect or Engineer:
Lic. No.: ---------------
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 License No.: 736920
Datee.��ontractor:
OWNER•BUILD ECLARATION
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 f
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: f
(_ 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.).
(_ 1 1, as owner of the, property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State Lice6se 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.).
1._ 1 I am exempt under Sec. , B.&P.C. for this reason
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:
LQPERDIIT
,CONTEMPORARY HOMES INC
75271 STARDUST LANE
INDIAN WELLS, CA 92210
(760)568-1404
Lic. No.: 736920
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
------------------
WORKER'S COMPENSATION DECLARATION
Date: 9/17/05
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 Sectionz37,00 of'the Labor..
Code, for the performance of the work for which this permit is issued. My w_ orrke s."compensations
insurance carrier and policy number are: _
Carrier STATE FUND Policy Number 1576408-2005
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 should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I hall forthwi omply with those provisions.
Dat •�Z ' ®SZplicant:
WARNING: FAILURE TO SECURE S' COMPENSATION VERAGE 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 nuli 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 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 pro r inspection ses.
Dat' T 'dtlignature (Applicant or Agent):
Application Number . . . . . 05-00002318
Permit
BUILDING PERMIT
Additional
desc .
Permit Fee
709.50
Plan Check Fee
461.18
Issue Date
. . . .
Valuation . . . .
119117
Expiration
Date
•3/16/06
Qty Unit Charge
Per
Extension
BASE
FEE
639.50
20.00
--------------------=--------
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
Expiration
Date
3/16/06
Qty Unit Charge
Per
Extension ,
BASE
FEE
15.00
1.00
9.0000
EA MECH
FURNACE <=100K
9.00
1.00
9.0000
EAMECH
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
as
Permit Fee
. . . .
106:73
Plan Check Fee
26.68
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
3/16/06
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
. . . .
135.00
Plan Check Fee
33.75
Issue Date
Valuation
0
Expiration
Date
3/16/06•
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
11.00
6.0000
EA PLB FIXTURE
66.00
LQPMNIIT
Application Number . . . . . 05-00002318
Permit . . . . . . PLUMBING
Qty. Unit Charge Per
Extension
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
Expiration Date 3/16/'06
Qty' Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
1918 SF. SFD PERMIT DOES NOT INCLUDE
BLOCK WALL, POOL/•SPA OR DRIVEWAY
APPROACH
------------------------------------------------------- ---------------------
Other Fees" . . . . . . . . . ART IN PUBLIC PLACES -RES
20.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER •- RES
366.00
ENERGY REVIEW FEE
46.12
DIF FIRE PROTECTION -RES
97.00"
DIF LIBRARIES.- RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
11.91
DIF STREET MAINT.FAC-RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total - 1025.23 .00 .00
1025:23
Plan Check Total 536.36 250.00 .00
286.36
Other Fee Total 2483.03 .00
2483.03
.00
Grand Total 4044.62 250.00 .00
3794.62
LQPERINUT
Date 9/27/05
No. 27697
Owner Thomas Buffin
Address
City Zip
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road < BERMUDA DUNES
Cr RANCHO MIRAGE
La Quinta, CA 92253 INDIAN WELLS
PALM DESERT y
(760) 771-8515 . , LA OUINTA :b
O INDIO y7
APN # 773-264-002
Jurisdiction La Quinta
Permit #
Tract # Study Area
Type Single Family Residence No. of Units 1
Lot # No. Street
Unit 1 52280 Avenida Herrera
Unit 2
Unit 3
Unit 4
Unit 5
S.F. Lot # No.
1918 Unit 6
Unit 7
Unit 8
Unit 9
Unit 10
Comments CC#361344 in the amount of $4,296.00 plus 32 cents changes = total below.
Street S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, crooking, eating or sanitation) or replacement mobile ho
mes. 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/Rabobank - Amanda Valez
Name on the check
By Ar. Doris Wilson
Superintendent
Check No. 361344
Telephone
Funding Residential
Fee collected /exempted b Payment Recd
p y on McG�lvrey
$4,296.32 ~i?verlunder _
Signature
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 o
r 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 District(s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting
JUL-23-2006
s0 >k CERYL
Prniact Ti;
05:42 PM
TE OF
tej
Street Address: Zgtl'oliS ffeydl4-l"d CIYC l e'
P.01
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/7�i.c0�� �/✓lti�n Gtr lySSyLi��
Builder Name
Plan Number
Sample Group Number
Sample House Number
elder: C. HJf R S
City/State/Zip:L u 4'/P"4 j LAI 9d-?- �? - 3
Copies to: Builder, HERS Provider
HgRS RATES COME61ANCCSMEMEbIT
The house was:Tsated 13 Approved as part of sample testing, but was not tested
e
As the HERS rater providing diagnostic testing and field verification, I certify that the houses Identified on this form
eom with the diagnostic tested compliance requirements as checked on this form.
EDistribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu
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 CFML
If fan flow is calculated as 400cfm/ton x number of tons enter
calculated value here 17D .
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) = / • r�
Check Box for Pass or Fall (Pass=6% or less) ❑
ass Fall
j ICJ THERMOSTATIC EXPANSION VALVE(TXV) or Commission approved equivalent
Yes ❑ No Thermostatic Expansion Valve (or Commission approvcd
equivalent) Is installed and Access is provided for inspection 0
Yes Is a passass Fall
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1, ❑ Yes ❑ No ACCA Manual D Design requirements have been met
(rater has 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 Fall
s" 9 C Testing Engineers - U.S. Labs !_1 Tosting Engineers- Inland Empire Vesting Engineers - Palm Springs
N 7895 Convoy Court, Suite 18 41146 Elm Streel, $ulle A 820 Research Drive, Suite 2
San Diego, California 82111 Murrieta, California 92562 Palm Springs. California 92262
Phone: (858) 715.5800 Phone: (951) 677-0366 Phone: (760) 325.8378
Fax: (858) 715.5810 Fax: (951) 677.5161 Fax: (780) 325-7480
NUCLEAR FIELD DENSITY TEST SHEET
Project Name:-- zga A.v� ieQeaa ._.
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