04-4092 (SFD)P.O. BOX 1504
T4hf 4 4 a"
B
Application Number PT .
Property Address . .
APN:
Application description
Property Zoning . . . . .
Application valuation . .
Owner
BUILDING & SAFETY DEPARTMENT
(760) .777-7012
FAX (760) 777-7011
92253 INSPECTION REQUESTS (760) 777-7153
NG PERMIT
�.� 04-00004092 Date 5/17/04
80883 VIA PUERTA AZUL
762 -240 -003 -16 -300961 -
DWELLING - SINGLE FAMILY.DETACHED
MEDIUM DENSITY RES
. 112634
PUERTA AZUL PARTNERS
17700 SW UPPER BOONES FERRY RD
SUITE 100
PORTLAND OR 9.7224
Contractor
DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, STE #105
ENCINITAS CA 92024
(760) 634-2350
Qty Unit Charge Per
Extension
WCC: STATE FUND
WC: WC298892003
06/12/04
CSLB: 813480
10/31/04
CCC: B
--------------------------
Structure Information ---------------7---------
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
1.00
FIRE SPRINKLERS NO
GARAGE SQ FTG
250.00
PATIO SQ FTG
617.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
1740.00
----------------------------------------------------------------------------
Permit . ... . . .
BUILDING PERMIT
Additional desc'.
Permit Fee . . . ..
685.00 Plan Check Fee
445.25
Issue Date .'. . .
Valuation . . . .
112634
Qty Unit Charge
Per
Extension
BASE FEE
639.50
13.00 3.5000
THOU BLDG 100,001-500,000
45.50
----------------------------------------------------------------------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee . . . .
78.50 Plan Check Fee
19.63
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge Per
Extension
P.O. Box 1504 • 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
Applicant:
Applicant's Mailing Address:
�/Y
Arch
Date: (10-
cess:
t - . 0 to
fi-C. No.: 2 2
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penal y 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 Licerl's� i full�fo pe and effect. / fa 0
?cense Class ( License No. 6
Dam
11 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 stile 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
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 thework 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
is ed. y work rs' compensa�t�io�n i� nce carrier and number arrl_.,r-1
i K�3�POlicy Number �C� �� �`��
_ I certify that, in t e 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, I shall
`
forthwith comply with those provisions.
Date b 7 picant %15 fY--� U1°G.�' ��L—•
WARN G: AILURE 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 ty apermit 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, eac ra shall, defend, indemnity and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission relate a work being perforne nder or following issuance of this permit.
2. Any permit issued as a result of this application becom ull and void jwork is no commenc%d within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit ancellation.
I certify that I have read this application and state that the ove informal is correct
construction, a h by authorize representatives of thi county to e r pon the g mply with all city and county ordinances and state laws relating to building
V�A�Signature
oned rty for inspection purposes.
Date (Applicant or Agent):
Application Number
. . 04-00004092
Page 2
Date 5/17/04
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
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
. . . .
80.90 Plan Check Fee
20.23
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
1740.00
0350
ELEC NEW RES - 1 OR 2 FAMILY
60.90
250.00
------------------------------------7---------------------------------------
.0200
ELEC GARAGE OR NON-RESIDENTIAL
5.00
Permit .
. . . . .
PLUMBING
Additional
desc
Permit Fee'
146.25
Plan Check Fee
36.56
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
7.5000
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
5.00
.7500
EA
PLB GAS PIPE >=5
3.75
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
16. PLAN 4BR. PERMIT DOES NOT
�.
Page 3
Application Number
. . . . .
04-00004092 Date
5/17/04
---------------------------------
Special Notes and
-------------------------------------------
Comments
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
ENERGY REVIEW FEE
44.53
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
11.26
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
----------
1005.65
-----I-------------------------
.00 .00
1005.65
Plan Check Total
521.67
.00 .00
521.67
Other Fee Total
2460.79
.00 .00
2460.79
Grand Total
3988.11
.00 .00
3988.11
JAN -28-2005 07:59 AM P.03
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R
r v 71A )
• Prole t TitleZi%� L �� Date -T' �'i'ZrJI �J✓�e✓
Proje Addres /' Builder Name
B
or Cont ct L Telephone Plan Number
HERS Eater „Telephgne Sample Group Number
C ifying Signature Pat Sample House Number
Firm:.77G, d',�SSOGi eS HERS Provider: Tc. at-/9S5oc/��S
Street Address: XI'.��OY CYGLt� City/State/Zip: z4W 2�/Nrg C0 9�z53
Copies to: Builder, HERS Provider
hF-U-IRATER COMPLIANCE S
The house was: ❑ Tested &Z Approved as part of sample testing, but was not tested
As the HE=RS rater providing diagnostic testing and field verification, I certify that the houses identified on this form
com 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
��IvWhere
f ducts)
cloth backed, rubber adhesive duct tape ie installed, mastic and drawbands are used in combination
with cloth backed, rubber adhesive duct tape to seal leaks at duct connections.
Z MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum B% Duct Leakage)
Measured
• Duct Pressurization fest 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=8% or less)
❑
Pass Fail
rTHERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent
as ❑ No Thermostatic Expansion Valve (or Commission approved
v equivalent) is Installed and Access is provided for inspection
❑
Yes Is a pass
ass Fail
❑ MINIMUM REQUIREMENTS FOR DUCT DEsiGN COMPLIANCE CREDIT
1. ❑ Yes O 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. 13 Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV,
104
verified fan flow matches design from CF -1 R,
Measured Fan Flow =
C) d
Yes for both 1 and 2 is a Pass Pass Fail
•
.01/20/2005 08:17 17603401819 PAGE 03/09
INSULATION CERTIFICATE
• This to certify that insulation has been installed in conformance with the current energy
reguh ition, California Administrative Code, Title 24, State of California, in the building at
80-883 VIA PUERTA AZUL LOT 16, PHASE 3, LA QUINTA CA
CEIL.'\IGS:
TYPI:.: BLOW MAUNFACTURER: Certainteed THICKNESS: R-38
WAL,.S:
Typi: .7BAT7S MANUFACTURER: Certainteed THICKNESS: R-19
GENERAL CONTRACTOR: DAVIS- REED CONSTRUCTION LICENSE #
BY:— TITLE:
PAR,, GON SCHMID BUILDING PRODUCTS AMASCO Company LICENSE # 221617
A' .�04ATLE. ACCOUNT REPRESENTIVE DATE:
INSULATION CERTIFICATE
'NT
his i,,: to certify that insulation has been installed in conformance with the current energy
re a! on, California Administrative Code, Title 24, State of California, in the building I d at
C_ EM'
TYPE: BLOW
ACTURER:
THICKNESS: R-38
WALL
TYPE:
BATTS MAU , NFA16TURER�sqainteed THICKNESS: R-19
GENE:ZAL CONTRAC! DAVIS-REED CCNS�T CTION LICENSE #
BY: TITLE.-
.7
PAZI,GON SCHMID BUILDING PRODUCTS AMASCO Company ENSE#221517
BY: TITLE: ACCOUNT REPRESENTIVE DATE: