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09-1297 (SATT)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09-00001297 Property Address: 80239 VIA TESORO APN: 772-250-019-48 -30357 - Application description: DWELLING - SINGLE FAMILY Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1959QO Applicant: cippl�,A, Architect or Engi 01P ------------------ LICENSED CONTRACTOR'S DECLARATION 4 W BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 full force and effect. License Class: B License No.: 777699 ate:y-'tractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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): (_) 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 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.). (_ 1 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.). ( 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: 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 fSec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: TOLL CA V C/O KEVIN D DUERMIT 8901 E MOUNTAIN VIEW 200 SCOTTSDALE, AZ 85258 Contractor: TOLL BROS, INC. 73121 FRED WARING DRIVE, #100 PALM DESERT, CA 92260 (760)674-9699 LiC. No.: 777699 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/22/09 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION 1 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 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' compensation insurance carrier and policy number are: Carrier ZURICH AMERICAN Policy Number WC3878213-03 I certify that, in the performance of the work for which this permit is iscucd, 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. te:y�'-4;> licant:`� 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. 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 Quinta, 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. 1 certify that 1 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 hereby authorize representatives of this county to enter upon the above-mentioned prop y o inspection gurposes. Hat�L 1 � 7 ^ 3D nature (Applicant or Agent): I Application Number . . . . . 09-00001297 Structure Information Construction Type . . . TYPE V - 1 HR Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . • NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2007 # BEDROOMS 3.00 FLOOD ZONE NO GARAGE SQ FTG 450.00 PATIO SQ FTG 140.00 TOT ELIGIBLE NO NUMBER OF UNITS t.uli ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 2233.00 Permit ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 104.96 Plan Check Fee 26.24 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 6/20/10 Qty Unit Charge Per Extension BASE FEE 15.00 2233.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 78.16 590.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 11.80 Permit BUILDING PERMIT Additional desc . . Permit Fee . . . . 975.50 Plan Check Fee 634.08 Issue Date . . . . Valuation . . . . 195908 Expiration Date . . 6/20/10 Qty Unit Charge Per Extension BASE FEE 639.50 96.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 336.00 Permit MECHANICAL Additional desc . Permit Fee . . . . 72.00 Plan Check Fee 16.38 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 6/20/10 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 LQPERMIT . - ". LQPERMIT Application Number . . . . . 09-00001297 Permit . . . . . . MECHANICAL Qty Unit Charge Per Extension 5.00 6.5000 EA MECH VENT FAN 32.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ----------------------------------------------------------------------------- Permit PLUMBING Additional desc . . Permit Fee . . . . 178.50 Plan Check Fee 44.63 .T.ssue Date . . . . Valuation . . . . 0 Expiration Date . . 6/20/10 Qty Unit Charge Per Extension BASE FEE 15.00 17.00 6.0000 EA PLB FIXTURE 102.00 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 7.5000 EA PLB OTHER BACKFLOW <=2 INCH 7.50 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 15.0000 EA PLB GAS METER 15.00 ----------------------------------------------------------------------------- Special Notes and Comments SFA - PLAN TYPE B1 - GROUND FLOOR UNIT, 2233 SF LIVING, R-3 OCCUPANCY, TYPE V-1HR CONSTRUCTION, 2007 CODES. **PERMIT DOES NOT INCLUDE TEMP POWER, TRASH ENCLOSURE, BLOCK WALLS AND SITE LIGHTING** BLDG. 10, LOT 48 THIS PERMIT REPLACES EXPIRED PERMIT # 05-3041,ISSUED ON 8/22/05 BUT NEVER BUILT. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 8.00 ENERGY REVIEW FEE 63.41 STRONG MOTION (SMI) - RES 19.59 Fee summary Charged Paid Credited ---------------------------------------- Due ----------------- Permit Fee Total 1330.96 .00 .00 1330.96 Plan Check Total 721.33 .00 .00 721.33 Other Fee Total 91.00 .00 .00 91.00 Grand Total 2143.29 .00 .00 2143.29 Telephone Pia, Nwnber . D 499-6354 Teli ne Sample Group Numbcrksnu no 70t Cc. -ti: ' S Date Sample House Ntbcr _ ''l..:.D H.: gP_ .�rtC1 Ta, fling g Diagnostics HERS provider: CHEERS +i Slrcct ti 1 b 3 L McPherson .Avenue City/Stato/Zip: Dake Elsinore CA -92530 COOKS l4: Huilder, RE" Pmvider avA Btu`iding 2eftat!meut BUILDING DEPAR :Ii:FiS W.TER Co t.t,-NCE STATEMENT ropy 'mac ;xaa was. VTested d © Approved as part of saatple testing. but was not tested A; the H rater Prov g diaoaosfic testing and field verification, f certify #hat the house ideatifiAd on Ibis form complies with ;roc .ia,►t nwtrc tested compliance requhmusts as checked .0' oh this fom The - the nc,V. 3isMoution systcns is fully ducted and cm=t tape is used before a CF -4R Tb:: '-I S ;.ice -4 - :,,ust :lot release the CF -4R utttil a properly completed and signed Cl+ - and l _,!y Lcstrd buis. a _ 4 'n)o gwalkr ,," provided it copy of CF -6R Owtall on Ccttificatc), New uar butiot: system is fully ducted (Le., does not use building cavities as plea UC vc; sysmiis wheel: cloth backed, :ubb a adhesive duct tape is installed, mastic and draw beads are used in cvrabmuLioti wiiL cloth banked, rubber adhesive duct tape to seal leaps at duct cot =tia s. V , AZIMUM XEXt UIRLMENTS FOR DUCT f LW..AGE REDUMON COMPLLANCE CREDIT PhA4;aure:.: forjwia wrificalion and &apws& lesfing of air a4rribution systeou are available in RAC&4 Appendix RC4.3. Duct Dir sdc ; 4ge Testing Results Duz, Prea-wrizwk ii Test Results (CFM @ 25 1%) lvleas�trod _ Values En:o: Marled L.cukage Flow in CFM - Can FL)v,: Calculszcd Nl aminal. 13 Heating) or V 0 Measured ' { Eazcr Total Faa in CFM: E o o X - Q ✓ ✓ ----r---- ---- 3 s,..4 if Lcu ,i be Yc.- entage 5 6% [ 10o x (Line # 1)1 (Line # 2)JJ - - i Puss 13 Fail . ..k:.T1t:itA "'"O^vS: buci Stinal and/or HVAC EattipmentChanee Out -nwr T rsiai :,eal::�ge Flow in CFM front CF -61L Pre -Test ofExisting'DucL System Prior to Duct System Aiieri6on andlor Equipment Clant. ai.� Test : i �-.il:sse Ftow is CFM FhW Tea of New Duct System or Altered Duct System ar y-i.i :t ysuxc: A,11cratirm and/or F.clw mart C ut z mcx 27.oductioii .n i.L%kago for Altered. Duct system L'__ r s,t �, 4) &nus _ _ (Lia # s71 - (Only if Applcablc) uCdiag,C Flow i-- CFM to Outside (Only if Applicable) ✓ 1i --c Nc.•,v t5ucc Sya= - Lass ,f Leakage Percentage S 6'%° Pass d' Fail 511 Line # 2)11 ;"FST OR V'"KIZIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out / -� Use ane wing four Test or Verification Stand2rd's for compliance: 13% [1 00 x r # 5} 1 (mune #')]J 0 PM 0 Pail --..--� Pa�,.s i;Ica za-'e :r C)"jd ; Percentage 510% [l04 x j (Line # 7) I - (Linc 0 Pass 0 Fail .:a"Sc Rrciucti:on Percentage a 6Wo (100 x L_(Line # 6)1,i (Line # 4)JJ - - ` ` { -•e '•'c;rby '''tet and Visual i!ian 0 Pass 0 Fail S�iir.c o: .l' A x;ssibie Leaks and Verification by Smoke Test am Visual n Cl VSs Cl Pail ---- Pass if One of Lines #9 through .# t 2 pass 13 Pass 0 Fail aesido7:u:i "" npiiairce Forms - Angust 20'09 wx DIAGNOSTIC TESTING (Page 3 of 8) CF -4R BuilderName Telephone Plan Number x�--OA Telephone Sam le Grou Number H Climate Zone Date Sample I louse Number DI BUIUhAi OIV statc zip: 0 rL---P A R T M E NT DAVE am AND - l IMI *?MM AR LW RAW CA 9M of SWITIC tcStIn". bill wa t"WALSPAMCMIDI IN verklication, I ccrili\, JIM the ii -Ise id 104 w \ RVI IM 19: ,;ti on this is form. Ldion Ccrtincaic). 57k) Oj "v"011. I he procedure shall consist of I,, installed on the system and ❑ Shall be VCHIIC(l. Yes is lass Pa"", Fail Space Coolitiu. S\stcn I" without I'llernioOtic Fwalislo I I \,;Ikcs (Illus/10c ciiccked inondily) iust be Oicckcd monthly) with the inamit'. 'CLsOl C. It' 0111dOOt- dil. dl \ -hUlh IS 11ckl\\ 55 `FrarerShall use the -\11C1 nulivr saindard ;Method are available in RACM, Appendix RD2. -iOil Certificate) has been provided with refrigcrant. charge AlIgust 2009 rt CEI- TI:FICATU OF FIELD w ZE'i:THCATION S DIAGNOSTIC TESTING (Page 5 of 8) CF -4R t P~•1/�:r�•�1;.'tc0ss _ Buildcr Namc T?;}i?a r Cc;rta'st Telephone Plan Number liERS Rn yT�-i/�I y/'/� /� / / Telephone 11 Sam .le Group Numbc d7F:V.kC Date Sample House Num cr CHE RS HERS Provider a � 1: ��Z ► tom! i I!,E.R.S :�1'1'�� � i;� �D # C��D�216344 `��' Citi'/$talc/Zi �: :4?�; l BUIX A0 i espies it): 13,,1;-D EF BULLING DEPARTMENT OeVAKTIMMT .•+`[. . f`. "i RF,. 'i::Il i.i�.F.:c!-. .Ri�'L.;�6 �aTA, ".';i MENT :.:: it ,,l i._ ,1'Lb. ✓ ml.>C a f _ ,1.pro\ cd ils part of sampic lesting, but 11'il not tC5[Cd tL'c ` IEP-, r„c;:r pr.iN 4 c'!a, :csl, ; 1 -sting mid ti:ld Verification. i certify' that the oust identified on this form compliics with iliC Ctlii 1'i bti: rested on this form. al U!l1GNO5fIC5 T.1; r,, mlic: 1-nS has }rcvwcd , c::, �y ol'CF-(:Z (mIlation Certificate).106 Z! *1111FURNS70MI DAVE®G®,ANDHVACTESTING 1-1 AW'01 ATE AIRF LOiFI VERIFICATION ����R ERSID#CCNDH2163;1 l0 field verific Ilion and d,c� no tic teslln.(zol-adcc ca e aii/loloreavailableIVIA.W11-�1 � C1P>ir' I FAX 9S1 W2422 PH R. (909)499.0 .( 2z -:3 No t .Just 'es'; xiS1” G plans r C: t "E-!.,.! �.�71ao,t'=at:F':o�� lisina Flog a tore Hood -i-� --�Y aE :.1.2 - -t D:a_=,n-fic Fan_Flc« ?�sir,� P num Pressure Matchin --: _--.__--- L. �-- _ i. E i . -;i;-mostic Fan F iuw Us'I.;lFlo„' Grid Measurement . _.--..._._...__ - i Measured Ah -f o-tv: Total CFIv1 Rated Tons: dill/ton � i \o �i«,�nrr,l :�:a!•: � ' is g:'::itCr thn11 the CCIICrIa 111 Table RE -2 ❑ ❑ L__. __._- 1 _—M__�_ ✓ —. Yes is a pass Pass Fail ,; :R CDC>LIN-G -AZ kC11-y PRIE,itlrim c-,,ohn, h,acl cgpnci1v are avoilahle in R40/ ppendir IZ(:i. 1—J Y .j No A1&qucaic i111-.1ow Verified (see adequatc airflows' edit) t ) t V ' __ i' CS I .I ::o RCfrll.cvant charC or T\V 1, C> L. AJC• t^JIcCi �:ilha€;e 1'cQilCt:0i1 credit \'ei"IfICd 1 i Conlin, _ apacitics of installed sy-stcros ie 5 to maNinuun cooling capacity _ _ c! Pcrt'oma;icc-s CF- and RF If 1LC c:;o:nig cn;iacitics of install systems arc > than maxinuun cooling ✓ ✓ i V ` z 1 C] ti'c c)pacity :n tlic -F-1 R. then the Cctrical input for the installed systems must -� 1 ---- - - J he = is cicct :cal inaut in the -IR and RF --t. ❑ ❑ Y, to -L 2. and 3: and Yes to either 4 or ; is a pass Pass Fail al F'FR AIh C(;N.i;'.'i liti R -- ar.._a,'.ri.'z,r:: r;: /l:'t(':b! r >pendixR1. ..0 C. No ' r :? rallies of installed systems match the CF -IR 1 ✓ (_� _Yes ; ',:o _�`Jr spin systcm_indoo: coil is matched to outdoor coil ✓ -w/ j ✓ G 'y ,-s No f Tinic Delay RCInV Verified (if Required) ❑ Ycs to 1 and 2: and 3 (If Required) is a. pass ass Fail 1?c,„lentis. C 7r Form•s - December 2005