04-3981 (SFD)�F�4�rw
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760) 77740.12>
78-495 CALLE TAMPICO FAX (760) 777=7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777--71,53
BUILDING. PERMIT .
Application. Number .
. . . ." 04-00,003-981_
Date 5/10/04.
Property, Address ,... .
. . . 79605"jVIA SIN CUIDADO
APN:
77.2.-370-024-34. -29858 -
Application description
. . . DWELLING -_SINGLE FAMILY
DETACHED
Property Zoning
LOW DENSITY RESIDENTIAL
Application valuation
27040
.-Owner
Contractor
:.
- --=-.--- - - - - - - - - - -
-
- - -
R . J T :HOMES
- --
c
N .
•-
: w
----------------------
RJT HOMES. LLC
1425 E UNIVERSITY DR
�:'
1425 E.- UNIVERSITY
DRIVE
PHOENIX
AZ 850
334
U.
PHOENIX
AZ 85034
o.
...
c'-
v
WCC : STATEr FUND .
WC: 1583906
10/of/04
n
CSLB:. 690645
06/30/04
CCC: B -A
Structure Tn'formation
SFD
Construction Type ..
TYPE V' -'NON RATED
Occupancy Type . .
. DWELLG'/LODGING/CONG <=10
Flood Zone . . . ..
NON -AO FLOOD ZONE
Other�struct info . .
. CODE EDITION
2001 CBC
FIRE -SPRINKLERS
'NO
GARAGE SQ FTG
816:00
PATIO SQ FTG
"
NUMBER OF UNITS.
1.00
FIRST.FLOOR SQ FTG
4364.00.
Permit
BUILDING PERMIT
Additional desc
Permit Fee
1262.50. Plan Check Fee
:. 820.63
Issue Date
Valuation:
277040
Qty Unit Charge
Per
Extension
BASE FEE
.639..50
178.00 3:5000
THOU BLDG 100,001-500,000
623.00
Permit . . . . . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee
162.24 Plan Check Fee
40.56
Issue Date
Valuation
0
Qty "Unit Charge
Per
Extension
BASE FEE.
-15.00
P.O. sox 1504 � VOICE (76o);-7.77- 1 z
78-495 CALLE TAMPICO FAX (760) 777A 1
LA QUINTA, CALIFORNIA 92253. 4 44."
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
P (7 _ 6 n )c ZIQ
Date:
Architect or Engineer:
Architect or Engineer's Address:
IyiA177-1
6oL)z_DEiP, cp ec> C
Lic. No.:
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 Ucen,�e i n full fore and ellecl.
License Class <riVf%C� L !� License No.--
Date
o. Date 5-,9-0'H Contractor `
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 self4nsure 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
issued . -My workers' com ensation insurance carrier and pgli u eF�re
Carrier5?� f= U�/� Poficy Number
I certify that, in the 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 Applicant �,l `k;
WARNING: FAILURE 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
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 �I
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 agrees to, and shall, defend, indemnity 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 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 here/by authorize representatives of this county to enter upon the above-mentioned prope for inspection purposes.
Date '��r}—fir/ Signature (Applicant or Agent):
"
Page
2
Application
-Number
04-00003981Date
5/10/04
Qty
Unit .Charge
Per
Extension
4364.•00.
..0300
ELEC NEW RES -MULTI FAMILY
130.92
816.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
16.32
-1� -------------------------------
-
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,
Permit
------------------------
MECHANICAL
"
Additional
desc
3
".
Permit Fee
150.00 Plan Check Fee
3,0:75
Issue Date
Valuation
0 ..
Qty. Unit Charge
Per
Extension
BASE FEE
15..00
.3.00
9.0000
EA MECH FURNACE <=100K
27.00
3.:00
16:5000
EA MECH B/C >3715HP/>100K-500KBTU
49.50
8.00
6.5000
EA MECH VENT FAN
52.00
1.00
6.5000
EA MECH-EXHAUST HOOD
6.50
Permit
-----.-----------------------
PLUMBING
Additional
desc'.
31
Permit Fee
267.00 Plan Check. Fee
20;25
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
i5:00
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
15.000.0,
EA PLB GAS -METER
15.00
---------------------
Special Notes .and Comments
-----------
SFD LOT 34•:PLAN
SG2C4B. PERMIT DOES NOT
Page
3
` Applidation Number
04-00003981 Date
5/10/04
Special Note's and' CommeAs
INCLUDE BLOCK WALL,
POOL,, SPA
OR
DRIVEWAY APPROACH.
-t------------.--------.---------------------
..Other.Fees . . . .
. . . . .
,------------------
.ART,IN PUBLIC PLACES -RES.
--------------
192..60
'
DIF''COMMUNITY'CENTERS-RES
97.00
_
DIF CIVIC CENTER - RES
366.00
'
ENERGY REVIEW FEE
82:06 -
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
27.70
DIF.STREET'MAINT'FAC-RES
15.00
DIF TRANSPORTATION -:-RES
1098.00
Fee summary
Charged
Paid Credited
Due.
Permit Fee Total
185.6.74
.00 .00
1856.74
Plan Check Total
912.19
.00 .00_'
912.19
Other Fee Total
2707.36
.00.00
2107.36
..Grand Total
5476.29
.00 , .00
5476.29
t
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Rancho Mirage, CA 9.2270. Cell: (760) 250-1852
=Small; DESNRG' aAOL.COM:
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Paget d 7) cF-4R
PALMILLA PH 8 DATE TESTED1-11-05•
Project Title Date
09-665 VIA SIN CULDADO LA QUINTA, CA. 92253. RJT HOMES
fProjectAddress
Builder Name
CHAD MEYER 760-564-6555 PALO VERDE SF2C4 3 UNITS
Builder Contact Telephone Plan Number
RICHARD KROWN 760-250-1852 GROUP 6
'HERS
Rater Telephone Sample Group Number.-
r " #CCNRK613292 0U9-04 LOT 34
Certifying Signature Date Sample Lot.Number
Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS "
Street Address: P.O..BOX 621, 'CitylState/Zip: RANCHO MIRAGE, CA. 92270
t
Copies to: Builder,: HERS Provider
HERS. RATER COMPLIANCE STATEMENT
'
The house was: d 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 installerhas 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'.
El MINIMUM REQUIREMENTS: FOR DUCT-LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6%,Duct' Leakage)
?'
Measured
Duct Pressurization Test Results (CFM @ 25 Pay values
Test Leakage Flow in CFM
.'
iffan flow is•calculated as 400cfm/ton' x number of tons'enter calculated
I
value here
If fan 6oxv is measured enter measured value.here
:Leakage Percentage (100 x Test Leakage/Fan Flow.) _.
Check Box for Pass or Fail (.Pass=6%'or less) ❑ ❑
3
Pass Fail
.
.. t;
❑ TF[ERMOSTATIC EXPANSION VALVE JXV)
❑ Yes ❑ No Thermostatic Expansion Valve is-installed and Access is
r° a
provided for inspection ❑. ❑
.1
e
C4 s,Y s1'
INSTALLATION CERTIFICATE (page 3 of 13) CF -6R
PA j,", 110. PA - 9 +
' Site Address Permit ,Number
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
DUCT' LAAK.AGE 1RQU010N
Prerrarlaation Tett Results (CFM ® 3S PA) Test Leakage (CFM) 3}
Fan Flow
ff Fan Row is Calculated as 400 cWon :i number of tons, or as 21.7 x Heating Capacity
In Thousands of Btufhr, enter calculated value here
If fan flow Is measured, enter measured value here =0r'
Leakage Fraction -Test Lcakagel(Masured or Calculawd Fan Flow) -" D 5,6
Pass if leakage tacdon < 0.06 Pass
s •, Fan
❑ For AEROSOL TYPE SEALANTS ONLY -The following dlagoostfc testing was completed:
Duct Fan Presaairation at rough -in measurW lealcage (CFIvf)
CHECK AFTER FQIIS WG WALL: .
O Ycs O No O Pressure pan test or House pressttrizadon test
O Yes O No ❑Visual Ikon of DuctCoanectiaos o 0
Pass Fail
_t9r9MWMT1C EXPANSION VALVE (TTCV1 `y
;Wees O No 'Thermostatic &pansion Valve is installed at:d Access is - pmvidei for inspection
Yes is a pass '.*c 0
❑ DU DFAW Pass Fall
1. El Yes G No ACCA Mesal D Design calculation hars
have b
completed, Duct Design Is on the plane and duct lrtstallatlan
mab;tm ptans
2. O Yes G No' . TXV is itudallod or Fan flow has bent verified. If no TXV,
verified fan flow matches design from CF -IR. Pass Fall
Measured For, Flow
Yes fdr both I and 2 is a Pass
❑ L do undersigned, verify that the above diapostic text roaults and the work i performed associated with the tart(s) is in cm1bmwxe
witb the requirancob for compliance eredlL ('the builder shall provide the FIM provider a copy of the CF -6R sighed by the builds
erVloye es or eertit'yfng that diagnostic testing and installation melt the re Wfretmb fDr compliance credit )
Tem gun", Date fosunhg Sukontraeter (Co. Name) OR
Rub, d General Contractor (Co. Nemo)
r COFYTO; Building Dqm meat
TRS Prmidc (if applicable)
Building Outer at Occupancy a
Complfaftce Forms Augnst 2001
i z ' d 2680- EbE l 09L ) 1d0I 1JbH03W I Q- WIJBS = L go 02 t,Z ` ueC
INSTALLATION CERTIFICATE (Page 3 of 13)
CF -6R
P. lam: l0.,h 3 �f-
x S1ts Address Permit Number
' DUCT LEAKAGE AND DESIGN DIAGNOSTICS
DUC'LEA "GE R DU4'1-LUN
Pressarimtlon Tat Revolts (CPM Q 23 PA) Teat soakage (CFM)_2t
Fin Flow
If F= Flow is Calcuiatedas 400 cfWm % number of tons, or as 21.7: Heating C"city,
r In Thousands of Buff, enter calculated value here
If ten flow 13 measured, enter measured value here -�
Leakage Fraction - Test Leakagel('Mommcd or Calculated Fen Flow)
Pass if leakage fraction <0.06 Pass
Fall "
O For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed:
Duct Fen Pressurization at rough-ir. measured l=kBge (CFM)
CHECK AFTER FINISHING WALL:
0 Yes 0 No 0 Prtssore pan test or House pressurizatiotn test
0 Yes 0 No D Visual Inspection of Duct Connections
Paas
Fail
- -b+7TRM0STATIC $XPANSION VALVE (TXV1
.
k::Yes 0 \ o nF=ostatic Expansion Valve is installed and Access is -'.provided for inspection
Yes is a page
Pass
8 DUCT DESIGN
Fall
:.ACCA Manual D Design calculadorn have beat
]. O Yes ❑ No
-4, • •
completed, Duct DeWgn Is on the plans and duct Installation
mabches plans,
2. 0 Yes 0 No TXV is installed or Fen flow has been verified. If no TXV, O
D
verified Can flow matches design from CF -1R. PLS3
Fall
Mess ored Fan Flow -
Yes for both 1 and 2 is a Pass
❑ I, the undersigaa>, verify float the above diagnostic test results and the world pe*mted associated with ttro testis) is tnCMf0r rertce
witb the rKuinemartte for omnp Umcc credit (Tbe builder eW provide the HERS provider a copy of the CF -6R signed by the builder a
employees or sob-ccntr wt= ce:eArg that dlapeade testing and installation meet the requhaneata for eorr omwe aMdiL I
4
jD
Tem gnetut% Date LtstsMag Sutrcoatractor (Co. Name) OR
,
firmed C=xnI Contractor (Co. Nsme)
i COPY TO: BuildingDepertment
HM Provide: (if applicable)
Building Owner it Ocenpaney
I It
Cornpliance Forms August 2001
a-25.
02 ' d 2680—Ei;E f 09L ] _1U3I WUH33W I01 WU89
=L SOOZ bZ Uer
INSTALLATION CERTIFICATE (Page 3 of 13) CF -6R
?Alm:lJas PA - g o+ !Jtt 34
Site Mdreae Permit Number
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
" 1111[.-1' t,Me�A[.K. 1iFaUS.1`lUn
Frmnnlsatioo Tal Results (CFM ® :5 PA) Test Lealcap (CFM)1_0 "
Fan Flow
LfFan Flow is Calculated as 900 eftfton x number of tons, or as :1.7 x Heating Capacity
In Thousands of StuAtr, enter calculated value hers
r If flan flow Is measured, enter measured value here
Leakage Fraction -Test Leakagal(Meentrd or Cakulazed Fan Flow) -Q^Osf r � o
4 Past if leakage frutim < 0.06 Pass
s F&H -
r' a For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed: „
Duct Fan Presstuizstion at roug6-in is oanvd leakage (CFM)
CHECK AFTERFINiSHING WALL;
0 Yes 13 No G Pressure pan test or House pressurization test
O Yes" O No 0 VinsalInspection of Duct Connections ° °
Pass Fall
# .h�'l�wmtMOSTATiG EXPA clON V LVE fTafV1
A94res 0 No TaFrrrwstatic Expansion Valve is installed and Access is -.Provided for inspection
Yes b 6L pm p °•
Pass Fail
a ]DUCT DISl(3N
" ACCA Manual D Design calculations have been
1. Q Yes .O 140 completed, Duct Design to on the plans and duct Installation
mabches pfars.
# ' .1 0 Yea O No TXV is installed or Fan flow has been verified. If no TXV, °
verified fu flow matches deign from CF -1R Pats Rau
Measured Fs: Flow-
Yes for both 1 and 2 is a Pass
0 1, tato undrmigr:ed, verity that the above diagnostic test adults sod teas wo* I performed assoeiaed with the test(j) is in confammtce
with dm requiseatrnts for compliance credit ('ibe budder &hell provide the HERS provider a copy of the CF -6R signed by the bufWa
wVioyea or sub•aonnesors cerdfyfng that diagnostic testing and fnwlladon meet the iequirementa for cornii1lance Me& I
Tan gtmerre, Date tutaRing Subcontractor (Co. Name) OR "
Pvtbrseed Gareral Cosireofar (CO. Name) i
COPY T0: Building Dept "
HERS Provider (if applicable)
Building Oa►nc at Occupatac3
cemoiance Fonn9 AugW2001 A -as t y
26B0-E1;PE109LI' 71:13IWUH33W Ia-1 WFJG"S:G; SOOZ ,bz,.u"C