06-0188 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
rr 06-00000188--''
L51365`EISEN140WER
Property Address:
DR
APN:
773-091-018- -
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
6208
Applicant:
T414
t44Q"
Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I jlm licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business d Professionals c9p, and my License is in full force and effect.
License Class- B Lig se No.: 736920
Date/ss
! fJ . —Co trite - ✓
�L J
OWNER -BUILDER DECLARATION
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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 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 ISec. 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 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 contractors) licensed
pursuant to the Contractors' State License Law.).
( 1 I am exempt under Seca , 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: Y
Lender's Address:
LQPERMIT
Owner:
POWER FINANCE
PO BOX 134
LA QUINTA, CA 92253
Contractor:
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
Date: 1/17/06
---------------------------------------=`�_I
. WORKER'S 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 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 beco a subject to the workers' compensation laws of California,
and agree that, if I should become ubject to the workers' co pensation provisions of Section
3700 of the Labor Code, I shall rthwith comply with tho /Provisions.
WARNING: FAILURE'TO SECURE WORKERS' COIOIPENSATION 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.
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 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 is correct. I agree to comply with all
city and county ordinances and state laws relating to building c nstruction, and hereby a orize representatives
of this county to enter upon the above-mentioned property f inspection purposes.
- .w_ �
Application Number . . . . . 06-00000188
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . . . 90.00
Plan Check
Fee
00
Issue Date . . . .
Valuation
. . .
. 6208
Expiration Date . . 7/16/06
Qty . Unit Charge Per
Extension
BASE
FEE
45.00
5.00 9.0000 THOU BLDG
2,001-25,000
45.00
----------------------------------------------------------------------------
Special Notes and Comments
250 LF 6- BLOCK WALL/50 LF 5' BLOCK
WALL. CITY STANDARD
Fee summary Charged
Paid
Credited
Due
-------------------------------------
Permit Fee Total 90.00
--=-------
.00
----------
.00
90.00
Plan Check Total .00
.00
.00
00
Grand Total 90.00
.00
.00
90.00
LQPERMIT
EP -20-2006
i
CERTIFI,
08:23 AM
TION AND DIAGNO
Firm: TC, O- Arae_ /u1
Street Address: sr4�1v.! (firL
Copies to: Builder, HERS Provider
P.01
TESTING ' CF -4R
er Name
Plan Number
Sample Group Number
Sample House Number
HERS Provider:
City/State/zip: Lu 4 ?)/Pi%q ,jC�%
RS BEERC LIANCE STATIEMM
The house was: XTested ❑ Approved as part of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field verification; 1 certify that the houses Identified on this form
co7DIst,ribution
with the diagnostic tested compliance requirements as checked on this form.
system Is fully ducted (i.e., 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
ith cloth backed, rubber adhesive duct tape to seal leeks at duct connections.
141`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 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)
Check Box for Pass or Fail (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
Pass Fail
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1. d 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 C1 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 =
D 0
Yes for both 1 and 2 is a Pass
Pass Fall