04-6455 (SFD):r
Taf 4 4. a"
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CAL"LE TAMPICO FAX (760) 777-7011
LA',QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . .
Property Address
APN:
Application description . . .
Property Zoning . . . . . . .
Application valuation . . . .
Owner
LENNAR HOMES OF CALIFORNIA
78401 HIGHWAY 111, STE C
LA QUINTA, CA
LA QUINTA CA 92253
r04-00006455` Date 9/27/04
78355 VIA DIJON
604-032-999-41 -305212-
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
185849
Contractor
LENNAR HOMES OF CALIFORNIA INC
78401 HIGHWAY 111, SUITE C
LA QUINTA CA 92253
WCC: OLD.REPUBLIC IN
WC: MWC10877600 11/01/04
CSLB: 728102 09/30/04
CCC: B
------ Structure Information SFD -----
Construction Type . . . . . TYPEV - NON RATED
Occupancy Type . . . . . . DWELLG/LODGING/CCNG <=10
Flood Zone . . . . . . . NON -AO FLOOD ZONE
Other struct info . . . . CODE EDITION 2001 CBC
FIRE SPRINKLERS NO
GARAGE SQ FTG 425.00
PATIO SQ FTG 273.00
NUMBER OF UNITS 1.00
FIRST FLOOR SQ FTG 3040.00
-----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 940.50 Plan Check Fee 611.33
Issue Date . . . . Valuation . . 185849
Qty Unit Charge Per Extension
BASE FEE 639.50
86.00 3.5000 THOU BLDG 100,001-500,000 301.00
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 59.00 Plan Check Fee 16.63
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
VN
P.O. Box 1504
78=495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: 1� (D 0455
Applicant:
Applicant's Mailing Address:
or
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: • /0. 22.0
-r9rchtt ct or Engineer'WAddress:
/oma 1;5� . /ton—
cS
0-4 1a -7o/
tic. No.: 3a3 q S
ovil-ulm" rr-11i I utL;LAKATION5
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 in full force and effect.
;� r+1`icense Class cense No. �a
Date 40 v)a • O L ontrector
OWNER• 9UILDER DECLARATION
I hereby 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 oicounty 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 Aas 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 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 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
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 Labar 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
er: O/is ue y Norl�e cPmpensation i�sarance carrier n policy number a
// GG/O iC ��olicyNumber M U/C�Oi3 7loC>C�
_ I certify tha , 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, 1 shall
forthwith comply with those provisions.
/Date O'a a (� pplirant�.��jLG�C
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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.
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
APPLICANT
ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Buildingand Safety 1:' Each Apermit subject to the conditions and restrictions set forth on this application.
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 o1 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
construction, and hereby authorize representatives of this county to enter upon the above-mentioned property, for inspection purposes.
ate � O ±a �'IPSignature (Applicant or Agent): A_aaW0.-,
Page
2
Application
Number .
. . .
. 04-00006455
Date
9/27/04
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
.00
16.5000
EA
MECH
B/C >3-15HP/>100K-500KBTU
.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
. . . .
129.90
Plan Check Fee
3.77
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
3040.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
106.40
425.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
8.50
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Permit .
. . . . . PLUMBING
Additional
desc . .
Permit Fee
. . . .
177.00
Plan Check Fee
44.25
Issue Date
. . . .
Valuation
0
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
18.00
6.0000
EA
PLB
FIXTURE
108.00
1.00
15.0000
EA
PLB
BUILDING SEWER
15.00
1.00
7.5000
EA
PLB
WATER HEATER/'LENT
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
. . . .
Valua-ion . . . .
0
Qty
Unit Charge
Per
Extension
----------------------------------------------------------------------------
BASE
FEE
15.00
Special Notes
and Comments
SFD - LOT
41. PLAN 4Y,
3040
SF.
PERMIT
r -
I-„
0
Page 3
Application Number
. . . . .
04-00006455 Date.
9/27/04
----------------------------------------I-------------------7----------------
Special Notes and
Comments
DOES NOT INCLUDE BLOCK
WALL,
POOL, SPA
OR DRIVEWAY APPROACH.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
ART IN PUBLIC ?LACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
61.13
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
18.58
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
-----------------
Permit Fee Total
----------
1321.40
------------------------------
.00 .00
1321.40
Plan Check Total
675.98
.00 .00
675.98
Other Fee Total
2484.71
.00 .00
2484.71
Grand Total
4482.09
.00 .00
4482.09
0
�I
Certificate o
' f Insulation ! ��
Ycur home has been insula!ed with John Mansville Fiberglas: insulation products, which are designed
for today's safety standards and tomorrow's energy requirements.
Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated
with fire -retardant chemicals that will likely lose their effectiveness overtime. It has not been treated
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
sett'e over time as may other insulation materials.
This also certifies that insulat*on have been profess`onally installed in this home to provide the
fol'owing thermal performance.
Lennar Homes
Job Name: La Qvinte Del Oro Tract. 30521 Piano 4Y Phase: 7
Lot No: 41 Job Address: SFR- 78-366 Via Dijon, La Quinta, CA
Ceiling Area: R-38 batt insulat-on
Exterior Wall sR-13 batt insulat.on
Between Floors:
Garage Ceiling:
With Living Above
Non -Access:_
S Sloping Areas
Overhangs: Access Attic:
With Living Above
Interfor Walls:
Subcontractor ... 0 J Insulation, Inc.
72-227 Adelaid St, Thousand Palms, CA 92276
1
Mike Dickerson, General Manager - Palm Springs Division
R -means resistance to heat flow. The higher the R -value, the greater the insulat=ng paver.
Ask your builder for the fact sheet on R -values. Keep this certificate with your other
valued papers. If you ever sell this home, this certificate should be passed on to the buyer.
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF4R
LA QUINTA DEL ORO PH- 7
Project Title
Builder Contact
William Henson
HERS Rater, /n
Signature
FirmBCI Testing
PO Box 50575
Street Address:
Copies to: Builder, HERS Provider
760-578-6968
05-05-05
Date
I ennar
Builder NTfan 4Y (pg. 1 of 1)
Telephone Plan Num:)er
760-250-7022 Group 4
Telephone Sample Group Number
05-05-05 41 (ph 7)
Date Sample ffiuse Number
HERS Provider:
City/State/Zip:
CALCERTS
Phoenix, AZ 85076
HERS RATER COMPLIANCESTATEMENT
The house was: ❑ Tested Approved as part of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the hotues identified on this form comply
with the diagnostic tested compliance requirements as checked on this form.
❑ The installer has provided a copy of CF -6R (Installation Certificate.
❑ Distribution system is fully ducted (i.e., does not use building cavities as plenums o- platform returns in lieu of 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
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=6% or less)
❑ THERMOSTATIC EXPANSION VALVE (TXV)
❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection
Yes is a pass
❑ 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 -1R 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 -1R.
Measured Fan Flow =
Yes for both 1 and 2 is a Pass
❑ ❑
Pass Fail
❑ ❑
Pass Fail
❑ ❑
Pass Fail
Compliance Forms August 2001 A-16
a
Southwest Inspecti®n and Testing, Inc.
10826 South Norwalk Blvd., Santa Fe Springs, CA 90670
(562) 941-2990 - (714),526-8441 • Fax (562) 946-0026
REGISTERED INSPECTORS'S DAILY REPORT
sw T ob N
Date s ',
TYPE OF . 21'1?einforced Concrete ❑ Strtictural Steel Assembly ❑ Quality Control
INSPECTION ❑ Post Tensioned Concrete ❑ Fire Proofing ❑ Other
REQUIRED ❑ Reinforced Masonry ❑ Asphalt
City �1 v} N .r.A
- 1//
Job Address 79-31-5— A 1 40iT O� O/Permit
Job Nome 6 & UI � ! /�t �c/ v�t�
Permiite'� . 'Sy
Issued BY
Type of Structure S Y ko
Architect
66V A)69e-
Materiol Description (type. grade. source) / j)oo /t
(/
Engineer
X jT ) / LJ 7 f_
Ir/ 7JIv%
Contractor n f V4 � � r
G/ I/`/
Inspector(s) Nome
Subcontractor p r
T� el
kI -e �v
TESTS PERFORMED
TYPE OF SAMPLE
SLUMP
QUANTITY IN SET
ADDITIONAL REMARKS ON SAMPLES
xI a
s �,
3
INSPECTION SUMMARY — LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETC.
INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED, NUMBER, TYPE & IDENT. NO'S OF
TEST SAMPLES TAKEN: STRUCT. CONNECTIONS (WELD MADE H.T. BOLTS TORQUED) CHECKED, ETC.
A c emevt of 3f V,4R4j e -f oue fnk- J lA,6 a.v
6 Ijf- comfl?e e- -(-),00// .Q ASS6 C141ec OLE .Sed &Z C II V�If)
&)el2e Cast Slump L cis S
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE OBSERVED TOTHE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED
WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS,
SPECIFICATIONS, AND WLICABLE SECTDONS Of THE GDVERNING BUILDING LAWS.
SIGNATURE OF REGISTERED INSPECTOR&OU
�7G �C C
SPECIALTY NO.
AGENCY
CONTINUED ON NEXT PAGE
TIME IN TIME OUT
':h 3
All inspections based on a
minimum. Idition, any
hour minimu
Approved by
PAGE OF -t
REG. HOURS I O.T. HOURS I CYLINDERS
m ofh urs and over 4 hours - 8 hour
)n ex nqlng past noon hour will bean 8
Project Superintendent
WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR'S COPY, GOLDENROD - !OB SITE COPY