04-5157 (SFD)7i
P.O. BOX 1504
�— - 78I492 6A1L�
LJAUIN
Q�T,�T,
TA, CAL
CITY OF LA Q1UINTA
Application Number
Property Address..
APN:
Application description
Property Zoning . . . .
Application valuation .
Tuf 4 40 Q"
BUILDING & SAFETY DEPARTMENT
(760) .777-7012
CO FAX (760) 777-7011
NIA 92253 INSPECTION REQUESTS (760) 777-7153
UILDING PERMIT
. 04-00005157 Date 6/25/04
. . . 50100 VIA PUENTE
772-370-004- - -
. . . DWELLING - SINGLE FAMILY DETACHED
. . . LOW DENSITY RESIDENTIAL
. . . 275236
Owner
------------------------
R J T HOMES
1425 E UNIVERSITY DR
PHOENIX AZ 85034
Contractor
------------------------
RJT HOMES LLC
1425 E. UNIVERSITY DRIVE
PHOENIX AZ 85034
WCC: STATE FUND
WC: 1583906
10/01/04
CSLB: 690645
06/3.0/04
CCC: A -B
--------------------------
Structure Information -------------------------
Construction Type
TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/LONG <=10
Flood Zone . . . . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2001 CBC
FIRE SPRINKLERS
NO
GARAGE SQ FTG
724.00
PATIO SQ FTG
859.00
NUMBER OF UNITS
1.00
FIRST FLOOR -SQ FTG
4364.00
----------------------------------------------------------------------------
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee
1255.50 Plan Check Fee
816.08
Issue Date . . . .
Valuation . .
. . 275236
Qty Unit Charge
Per
Extension
BASE FEE
639.50
176.00 3.5000
THOU BLDG 100,001-500,000
616.00
------------------=---------------------------------------------------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee . . . .
127.50 Plan Check Fee
31.88
Issue Date . . . .
Valuation . .
. . 0
Qty Unit Charge
Per
Extension
BASE FEE
'15.00
1
�P.O. Box 1504 � VOICE (760) 777-7012
78-495 CALLS TAMPICO � FAX (760) 777-7011
LA QuINTn, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04' 5/57
Date: `7 —oZ a3 'O It
Applicant:
Applicant's Mailing Address: OLJ
—Architect or Engineer:
Architect or Engineer's Address:
40 thr2322=6:X
Lic. No.: .a,3 (, C,*
BUILUINU 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.
/ 2
License Class ''f'g �icense Noll qQ (2
f%
OWNER -BUILDER 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 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
I hereby affirm under penalty of perjury one of the following declarations:
1 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
issue . My w ers' cpmpensation ins nce carrier and li y n m r a
warier. S-r� f-tJ,. Number j �Q,
_ I certify that, ,n the perf6fmance 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 shall
forthwith comply with those provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION.OGVERAGE 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
ENT
IMPORTANT Application is hereby made to the Director of Buildingand Safety aCKNOWLEDGEo the
1. Each tY permit subject to the conditions and restrictions set forth an 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, indemnity 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
construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Date Signature (Applicant or Agent): �/
1
Page
2
Application
Number .
. .
. . 04-00005157 Date
6/25/04
Qty
Unit Charge
Per
Extension
3.00
9.0000
EA
MECH FURNACE <=100K
27.00
3.00
9.0000
EA
MECH B/C <=3HP/100K BTU
27.00
8.00
6.5000
EA
MECH VENT FAN
52.00
1.00
----------------------------------------------------------------------------
6.5000
EA
MECH EXHAUST HOOD
6.50
Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee
. . . .
182.22
Plan Check Fee
45.56
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
4364.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
152.74
724.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
14.48
-----------------------------------------------------7----------------------
Permit .
. . . . .
PLUMBING
Additional
desc . .
Permit Fee
. . . .
291.00
Plan Check Fee
72.75
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
31.00
6.0000
EA
PLB FIXTURE
186.00
1.00
15.0000
EA
PLB BUILDING SEWER
15.00
4.00
6.0000
EA
PLB ROOF DRAIN
24.00
2.00
7.5000
EA
PLB WATER HEATER/VENT
15.00
1.00
3.0000
EA
PLB WATER INST/ALT/REP
3.00
1.00
9.0000
EA
PLB LAWN SPRINKLER SYSTEM
9.00
12.00
.7500
EA
PLB GAS PIPE >=5
9.00
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
SFA - LOT
14. PLAN SF2AC4,
4364 SF.
Page 3
Application Number
. . . . .
04-00005157 Date
6/25/04
----------------------------------------------------------------------------
Special Notes and
Comments
PERMIT DOES NOT INCLUDE BLOCK
WALLS,
POOL, SPA OR DRIVEWAY
APPROACH.
----------------------------------------------------------------------------
Other Fees . .
. . . . .
ART IN PUBLIC PLACES-RES
188.09
DIF COMMUNITY CENTERS-RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
81.61
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
27.52
DIF STREET MAINT FAC-RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
----------
Charged
Paid Credited
Due
- - - - - --
Permit Fee Total
---- - - - - --
1871.22
---- - - - - ------ -- - - ----
.00 .00
-- - - - - --
1871.22
Plan Check Total
966.27
.00 .00
966.27 .
Other Fee Total
2702.22
.00 .00
2702.22
Grand Total
5539.71
.00 .00
5539.71
De - -
ENERGY S1 - CADEC
Se'""ces
P0. Box 621
Rancho Mirage, CA 92270
Email: DESNRG (WAOL.COM
Ph/Fax (760) 564-2044
Cell: (760] 250-1852
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R
PALMILLA PH 9
Project Title
50-100 VIA PUENTE LA QUINTA CA. 92253
Project Address
CHAD MEYER 760-5646555
C
Builder Contact Telephone
RICHARD KROWN 760-250-2084
HERS Raters Telephone
#CCNRK613292
Certifying Signature Date
Firm: DESERT ENERGY SERVICES LLC
Street Address: P.O. BOX 621
Copies to: Builder, HERS Provider
DATE TESTED 7-07-05
Date
RJT HOMES
Builder Name
PALO VERDE SF2C2 3 UNITS
Plan Number
GROUP 7
Sample Group Number
LOT 14
Sample Lot Number
HERS Provider: CHEERS
City/State/Zip: RANCHO MIRAGE, CA. 92270
HERS RATER COMPLIANCE STATEMENT
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 houses 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 or 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)
Duct Pressurization Test Results (CFM @ 25 Pa)
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
❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection
Measured
values
❑ ❑
Pass Fail
' 11INSTALLATION CERTIFICATE CF -6R
50-100 Via Puente
Permit #
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is
required; however, use of this form to provide the information is optionl.) Atter completion of final inspection, a copy must be provided to the building
department (upon request) and the building owner at occupancy, per section 10-103(b).
HVAC SYSTEMS:
Heating Equipment
Equip. Type
(pkg. heat
CEC Certified Mfr, Make &
pump, etc.)
Model Number
FAU
CARRIER 58STXI 01 22
FAU
CARRIER 58STX045108
Cooling Equipment
Equip. Type
Systems
(pkg. heat
CEC Certified Compressor Unit
pump, etc.)
Mfr. Name and Model Number
A/C COND.
CARRIER 38BRC060000
A/C COND.
CARRIER 38BRCO24000
1 z reads greater than or equal to
# of
Efficiency
Duct
Duct or
Heating Heating
Identical
(AFUE,etc.)'
Location
Piping
Load Capacity
Systems
[>_CF -1R value]
(attic, etc.)
R -value
(Btu/hr) (BTU/Hr)
2
80.0%
ATTIC
R-4.2
110,000
1
80.0%
ATTIC
R-4.2
45,000
# of
Effeciency
Duct
Cooling Cooling
Identical
(SEER, etc)'
Location
Duct
Load Capacity
Systems
[>_CF -1R value]
(attic, etc.)
R -value
(Btu/hr) (BTU/Hr;
2
12
ATTIC
R-4.2
60,000
1
12
ATTIC
R-4.2
24,000
I, the undersigned, verify that the equipment listed above is: 1) is the actual equipment installed, (2) equivalent to or more efficient than that specified in the
certificate of compliance (Form CF -1R) submitted for compliance with the Energy Efficiency Standards for residential buildings, and (3) equipment that meets
or exceeds t propriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable.
AMPAM LDI Mechanical
Sh ene brey 2/4/2005 HVAC Subcontractor (Co. Name)
OR General Contractor OR Owner
WATER HEATING SYSTEMS:
Water CEC Certified Distribution If Recir- Rated Input Tank Efficiency Standby External
Heater Mfr Name & Type (Std, culation, # of Identical (kW or Volume (EF, RE) Loss (%) Insulation R -
Type/# Model Number Point -of -Use) Control Type Systems Btu/hr) (gallons) value
FAUCETS & SHOWER HEADS:
All faucets and showerheads installed are listed in the Commisions Directory of Certified Faucets and Showerheads,
pursuant to Title -24, Part 6, Subchapter 2, Section 111.
I, the undersigned, verify that the equipment listed in the category above my signature is the actual equipment installed and that the equipment meets or exceeds
the requirements of the Appliance Efficiency Standards. In addition, I have verified that the equipment is equivalent to or more efficient than the equipment
specified on the Certificate of Compliance submitted to demonstrate compliance with the Energy Efficiency Standards for residential buildings.
Signature, Date
COPY TO: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy
RCR COMPANIES
Plumbing Subcontractor (Co. Name)
OR General Contractor OR Owner
INSTALLATION CERTIFICA'T'E (Page 3 of 13) CF -6R
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
DUCT LEAKAGE REDUCTION
Pressurization Test Results (CFM @ 25 PA)
Test Leakage (CFM)
Fan Flow
If Fan Flow is Calculated as 400 cfmhon x number of tons, or as 21.7 x Heating Capacity
In Thousands'o( Btu/hr, enter calculated value here
If fan flow Is measured, enter measured value here fi
Leakage Fraction - Test Leakage/(Measured or Calculated Fan Flow)
Pass if leakage fraction <0.06 Pass Fall
O For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed:
Duct Fan Pressurization at rough -in measured leakage (CFM)
CHECK AFTER FINISHING WALL:
❑ Yes ❑ No ❑ Pressure pan test or House pressurization test
❑ Yes ❑ No ❑ Visual Inspection of Duct Connections
❑ THERMOSTATIC EXPANSION VALVE
o a
Pass Fall
❑ Yes O No Thermostatic Expansion Valve is installed and Access is - provided for inspection
Yes is a pass t7
❑ DUCT DESIGN Pass Fall
ACCA Manual D Design calculations have been
1. ❑ Yes ❑ No completed, Duct Design Is on the plans and duct Installation
matches plans.
2. O Yes ❑ No 7XV is installed or Fan Bow has been verified. If no TXV, 0 o
verified fan flow matches design from CF -1R Pass Fail
Measured Fan Flow=
Yes for both 1 and 2 is a Pass
❑ I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is in conformance
with the requirements for compliance credit. (The builder shall provide the HERS provider a copy of the CF -611 signed by the builder
employees or subcontractors certifying that diagnostic testing and installation meet the requirements for compliance credit. ]
} 6 --) q~0 S �-• .L I� P.c� h cin 1 t(
Tuts ignature, Date Installing Subcontractor (Co. Name) OR
Performed General Contractor (Co. Name)
COPY TO: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy
Compliance Forms • August 2001 A-25
1116 TAJLLATION CERTIFICATE (Page 3 of 13) CF -6R
Site Address vermis Numoer
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
DUCT LEAKAGE REDUCTION
Pressurization Test Results (CFM Q 25 PA) Test Leakage (CFM)
Fan Flow
If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity
In Thousands'o( Btu/hr, enter calculated value here
If fan flow Is measured, enter measured value here MQ
Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) 7
❑
Pass if leakage fraction < 0.06
Pass Fail
❑ For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed:
Duct Fan Pressurization at rough -in measured leakage (CFM)
CHECK AFTER FINISHING WALL:
❑ Yes ❑ No ❑ Pressure pan test or House pressurization test
❑ Yes ❑ No ❑ Visual Inspection of Duct Connections
❑ (3
Pass Fail
❑ THERMOSTATIC EXPANSION VALVE fTXV)
❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is - provided for inspection
Yes is a pass %W ❑
❑ DUCT DESIGN Pass Fail
ACCA Manual D Design calculations have been
1. ❑ Yes ❑ No completed, Duct Design Is on the plans and duct Installation
matches plans.
2. ❑ Yes ❑ No •TXV is installed or Fan flow has been verified. If no TXV, ❑ ❑
verified fan flow matches design from CF -1R Pass Fail
Measured Fan Flow
Yes for both 1 and 2 is a Pass
❑ I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is in conformance
with the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF -6R signed by the builder
employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit. J
} 5 --) qs0 S- 1, D -L Jm e cA cin 1 ""_ 1
Tats ignature, Date Installing Subcontractor (Co. Name) OR
Performed General Contractor (Co. Name)
COPY T0: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy
Compliance Fortes August2001 A-25
INSTALL-ATION CERTIFICATE
(Page 3 of 13)
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
DUCT LEAKAGE REDUCTION
CF -6R
Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM)-±S—
Fan
CFM)± 5Fan Flow
If Fan Flow is Calculated as 400 cfmRon x number of tons, or as 11.7 x Heating Capacity
In Thousands'o( Btu/hr, enter calculated value here
If fen flow Is measured, enter measured value here__Q
Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) = D 05(7 ❑
Pass if leakage fraction < 0.06 Pass Fail
❑ For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed:
Duct Fan Pressurization at rough -in measured leakage (CFM)
CHECK AFTER FINISHING WALL:
O Yes O No O Pressure pan test or House pressurization test
O Yes O No O Visual Inspection of Duct Connections ❑ ❑
Pass Fail
O THERMOSTATIC EXPANSION VALVE (TXV)
O Yes O No Thermostatic Expansion Valve is installed and Access is - provided for inspection
Yes is a pass t7
O DUCT DESIGN Pass Fall
ACCA Manual D Design calculations have been
1. O Yes O No completed, Duct Design Is on the plans and duct Installation
matches plans.
2. O Yes O No 'TXV is installed or Fan flow has been verified. If no TXV, t] o
verified fan flow matches design from CF -IR Pass Fail
Measured Fan Flow =
Yes for both 1 and 2 is a Pass
O I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is in conformance
with the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF -6R signed by the builder
employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit. j
11f2GhCA-nitcr-4- 1
Tests ignature, Date Installing Subcontractor (Co. Name) OR
Performed General Contractor (Co. Name)
COPY To: Building Department
HERS Provider (if applicable)
Building Owner at Occupancy
Compliance Forms
August 2001
A-25