04-6980 (SFD)J�
Tuf Ot 4 a"
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
„ BUILDING PERMIT
Application Number . . . . . X04-00'0.0-6-9-80 Date 10/27/04
Property Address . . . . . . 80872 VIA PUERTA AZUL �.
APN: 762 -240 -003 -3 -300962 -
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . MEDIUM DENSITY RES
Application valuation . . . . 99599
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
(7 60) 634-2350
WCC.: STATE FUND
WC: WC298892004
06/12/05
CSLB: 813480
10/31/04
CCC: 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 CRC
# BEDROOMS
2.00
FIRE SPRINKLERS NO
GARAGE SQ FTG
255.00
PATIO SQ FTG
451.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
1549.00
----------------------------------------------------------------------------
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee . . . .
639.50 Plan Check Fee
415.68
Issue Date . . . .
Valuation . . . .
99599
Qty. Unit Charge
Per
Extension
BASE FEE
414.50
50.00 4.5090
THOU BLDG 50,001-100,000
225.00
----------------------------------------------------------------------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee . . . .
85.00 Plan Check'Fee
21'.25
Issue Date . . . .
Valuation
0
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
u �
P.O. Box 1504 it�
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: _��— (�Q OLI/ Date: • 3.o y
Applicant: chitect or Erigineer: 1�t
Applicant's Mailing Address: rArchitect or l ngipeer'� ddre�
��_ r v
'c. No. C2L37 9
BUILDING 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,f orce and effect. -p
cense Class w dense No./� ri
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 1, 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:
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 o for whi this permit is issued.
I have nd m ' tai orkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the w for which this permit is
w rs' o ation in nce c r er and policy number are:
artier - umber
(% ` Q—
_ (certify tha , in he performan the work for which this perni issued, I shall not employ any person in any manner so as to b come subject to the workers'
compensation laws of ifomia, and agr at, if I sh a subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith COmDly-with ose nrovisinn.
ate
WARNING: FAILURE TO SECURE W*KERS' 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 Q A
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 Ouinta, 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 1 have read this application and state that the above informa10 rrect. ee to y w'th all city and county ordinances and state laws relating to building
construction, and hereby a t orize representatives of this county to ent the a -men ' ed p y for inspection purposes.
,,Val
gnature (Applicant or Agent), :
Application Number
. . 04-00006980
Page 2
Date 10/27/04
Qty
Unit Charge
Per
Extension
7.00
6.5000
EA
MECH VENT FAN
45.50
1.00
6.5000
EA
MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit .
. . . . .
ELEC-NEW
RESIDENTIAL
Additional
desc
Permit Fee
. . . .
74.32 Plan Check Fee
18.58
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
1549.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
54.22
255.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
5.10
-----------------------------------------------------------------------------
Permit .
. . . . .
PLUMBING
Additional
desc
Permit Fee
. . . .
151.50
Plan Check Fee
37.13
Issue Date
. . . .
Valuation
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
14.00
6.0000
EA
PLB FIXTURE
84.00
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
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
3. PLAN 2B.
PERMIT
DOES NOT
INCLUDE BLOCK
WALLS,
POOL,
SPA OR
DRIVEWAY APPROACH.
----------------------------------------------------------------------------
Other Fees
. . . . .
. .
... ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
Page 3
Application Number
. . . . .
04-00006980 Date
10/27/04
----------------------------------------------------------------------------
Other-Fees . . .
. . . . . .
ENERGY REVIEW FEE
41.57
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
9.95
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
----------
965.32
------------------------------
.00 .00
965.32
Plan Check Total
492.64
.00 .00
492.64
Other Fee Total
2456.52
.00 .00
2456.52
Grand Total
3914.48
.00 .00
3914.48
INSULATION CERTIFICATE
`. his is to certify that insulation has been installed in conformance with the current energy
T Y
regulation, California Administrative Code, Title 24, State of California, in the building at
80-872 VIA PUERTA AZUL, LOT 3,RELEASE 6, LA QUINTA, CA
CEILINGS:
' TYPE: BLOW MAUNFACTURER: Owens Corning THICKNESS: R-38
WALLS:
TYPE: BATTS MANUFACTURER: Certainteed THICKNESS: R-19
GENERAL CONTRACTOR: DAVIS —REED CONSTRUCTION LICENSE #
BY: TITLE:
Y
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517
BY. �I TITLE: ACCOUNT REPRESENTIVE DATE:
%..r:.!%/.•�.:'/•'/.::/•ir.'l.:///�./•%J./!.%/%1.l/!.�%•:J://f././:✓Y%I%l./.J/.NN/_%/1i//J'./+!l'.�%f./ii..!ll./�..<.!/'/„�;!/'%JVA./✓./�/if..•l/-�l.'l.:/+'./��-til !/.%r%//.�•/:/�li �:/./••�'/•"•:'•"-: �':: /•. '. ".:. .. ..
1�
OCT -03-2005 08:21 AM
7 ► G:ERTIFICATE OF FIl
ru 1y Az of
Po' titll Da
2 -OT2
Prole t Addr ss Bu.Oder me
�76�f.
Builder Contact Telephone Plan Number
�► G 74'0) f - �3
HERS ater // T lep one Sample Group Number
P.03
4' ;00
CF -4R
ifying Signature Da Sample House Number
Firm: STC, f- %ss'OC/u7� S HERS Provider: G lye /E'
Street Address: %��h✓�r��d1�� c.��rC �� City/State/ZIp; u �'ylh/,� ��r� 47,2
Copies to: Builder, HERS Provider
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
coryly 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
f 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 leeks 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 Fall (Pass=6% or less)
THERMOSTATIC EXPANSION VALVE
or Commission a
Yes ❑ No Thermostatic Expansion Valve (or Commission approved
equivalent) is installed and Access is provided for Inspection
Yes Is a pass
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1, la 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. D 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 =
Measured
values
valent
Yes for both 1 and 2 Is a Pass
'Pass Fail
as 13
Fail
12 ❑
Pass Fail