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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: