04-7104 (SFD)0
T-Vf 4 4 a"
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760),777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number . . . .04=0_0_0_0_7_L04__� Date 11/16/04
Property Address . . . . . . 80758 VIA PUERTA AZUL
APN: 762-240-003-22 300962
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . ... . . MEDIUM DENSITY RES
Application valuation . . 98984
Owner
------------------------
PUERTA AZUL PARTNERS
17700 SW UPPER BOONES FERRY RD
SUITE 100
PORTLAND OR 97224
Contractor
DAVIS/REED CONSTRUCTION.INC
169 SAXONY ROAD, STE #105
ENCINITAS CA 92024
(760) 634-2350
Qty Unit Charge Per
1.00 9.0000 EA
1.00 9.0000 EA
BASE FEE
MECH FURNACE <=100K
MECH BIC <=3HP/100K BTU
Extension
15.00
9.00
9.00
WCC: STATE FUND
WC: WC298892003
06/12/05
CSLB: 81.3480
10/31/06
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 CRC
# BEDROOMS
2.00
FIRE SPRINKLERS NO
GARAGE SQ FTG
251.00
PATIO SQ FTG
316.00
NUMBER OF UNITS
1.00
----------------------------------------------------------------------------
FIRST FLOOR SQ FTG
1571.00
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee . . . .
635.00 Plan Check Fee
103.19
Issue Date . . . .
Valuation . . . .
98984
Qty Unit Charge
Per
Extension
BASE FEE
414.50
49.00 4.5000'THOU
----------------------------------------------------------------------------
BLDG 50,001-100,000
220.50
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee . . . .
78.50 Plan Check Fee
4.91
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge Per
1.00 9.0000 EA
1.00 9.0000 EA
BASE FEE
MECH FURNACE <=100K
MECH BIC <=3HP/100K BTU
Extension
15.00
9.00
9.00
P.O. Box 1504 ��G�G/
VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011.
LA QUINTA, CALIFORNIA 92253 4 4VINSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Del- 7 to4 Date: • 1
Applicant:
Applicant's Mailing Address:
—Architect or Engineer: &01
---Architect or Engineer' Address:
lk-Hc. No.: 7�
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penna�al�tt of perjury that I am licensed under provisions of Che 9 (commenc!,wit action 7000) of Division 3 of the Business and Professionals
Code, and my Li Esnse is force and effect.
cense Class--ti—cense No.
--Date ontractor
OWNER -BUILDER DECLARATION
I here affi 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
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury a following declarations:
_ I have a d will m Main f ate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of th work fo is permit is issued.
Ir—I have n n orkers' cc nsation insurance, as required by Section 3700 P Labor Code, for the performance of the work for c is permit is
is y o e n ' ce c�m�Yand-polic. number are:
arrier olicy Number
ce 1 rforna of the work for which this permit is issued, t employ any pers��ann so as to becomea! t to the workers'
mpe tion laws of lifomia, and agree th f I should be a subject t e workers' compensation provisions of Section 3700 of the Labor Code, I shall
ort ' comply nth hose provisions.
1 -bate /.
pplicant
WAR NG: AILUR OSE URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CI
VI FIN UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SE TIO 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
1 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 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 a r 'ndemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to o being performed under or follo iag issuance of this permit.
2. Any permit issued as a result of this application becomes n nd void if rk is not mmence ithin 180 day from date of issuance of such permit, or
cessation of work for 180 days will subject permit to can lation.
I certify that 1 h e rea this a plication and state that the above inf ation is cI. ee to ply wi I city and count, ordinances and state laws relating to building
construction, d her y a orize representatives of this county to e r n o -ment' ed pr rty for inspection pu oses.
Date , IN Signature (Applicant or Agent):
Page
2
Application Number
04-00007104 Date
11/16/04
Qty Unit Charge
Per
Extension
6.00 6.5000
EA MECH VENT FAN
39.00
1.00 6.5000
---------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
--------------
Permit . . . . . . ELEC-NEW RESIDENTIAL
Additional desc . .
Permit Fee . . . .
75.01 Plan Check Fee
4.69
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1571.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
54.99
251.00 .0200
---------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
5.02
------------------------------------
Permit . . . . . . PLUMBING
Additional desc . .
Permit Fee . . . .
145.50 Plan Check Fee
9.10
Issue Date . . . .
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
13.00 6.0000
EA PLB FIXTURE
78.00
1.00 15.0000
EA PLB BUILDING SEWER
15.00
1.00 7.50.00
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
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
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
SFD - LOT 22. PLAN 3B,
1571 SF. PERMIT
DOES NOT INCLUDE BLOCK WALLS, POOL, SPA
OR DRIVEWAY APPROACH.
75% PLAN CHECK FEE
REDUCTION APPLIED FOR
MULTIPLE ISSUANCE
OF SAME PLAN TYPE_
-------------------------.----------------------------------=-------------_--
Other Fees . . ... .
. . . . ART IN PUBLIC PLACES -RES
.00
Page
3
Application Number . . . . . 04-00007104 Date
11/16/04
-----------------------------------7----------------------------------------
Other Fees . . . . . . . . . DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
'366.00
ENERGY REVIEW FEE
10.32
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
9.89
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
949.01
.00
121.89
.00
2425.21
.00
3496.11
.00
Credited Due
.00
949.01
.00
121.89
.00
2425.21
.00
3496.11
•
•
0
TIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING
M
rroieci itie
�,)�-17Y!?�✓T 1 QUI LIQ L�J)�
Project
Builder Contact Telephone
Cgr djg �7(4) 2/e- 5-79 3
HER ater I Telephone
Date
Builder Name
Plan Number
Sample Group Number
CF -4R
9rtifyin-g�^Signature / Date Sample House Number
Firm:y, C. �%S�o/L/u��S HERS Provider: C J�y}Et R S
Street Address: "OV- C/YL�� City/State/Zip: Z z�t'yJ07%e, Z C!%
Copies to: Builder, HERS Provider
HERS RATER COMPLIANCE STATE ENT
The house was: ❑ Tested a 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.
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.
0-11&AINIMUM 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)
AiHERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent
❑
'Pass Fail
�es ❑ 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. ❑ 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,
/0/y
verified fan flow matches design from CF -1 R.
Measured Fan Flow =
❑ ❑
Yes for both 1 and 2 is a Pass
Pass Fail
^'A
INSULATION CERTIFICATE
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80'758 VIApUERTA AZUL, LOT 22,RELEASE 9,PHASE 2,LAQU\NTA'CA `
TYPE: BLOW KAAUNFACTUREROwens Corning THICKNESS: R,11
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THICKNESS: R,19
TYPE:BATT----- � S MANUFACTURER:Ce�ain�od �
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GENERAL CONTRACTOR: DAVIS—REED CONSTRUCTION LICENSE
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TITLE: ACCOUNT REPRESENTIVE DATE
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