09-1283 (SATT)s
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09-00001283
Property Address:
80243 VIA TESORO
APN:
772-250-019-46 -30357 -
Application description:
DWELLING - SINGLE FAMILY
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1DOG92 ,
T4ht 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/22/09
Owner:
TOLL CA V
C/O -KEVIN D DUERMIT
AT 8901 E MOUNTAIN VIEW 200
/- SCOTTSDALE, AZ 85258
Applicant: Architec or E neer:
----------------------------------- ------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm underpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: B LicenseNo.: 777699
Date: y�i✓� tractor: 70/ JRI)5 O,*_
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.).
(_ I 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. , BAP.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 (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Contractor:
TOLL BROS, INC.
73121 FRED WARING DRIVE, #100
PALM DESERT, CA 92260
(760)674-9699
Lic. No.: 777699
------------------
WORKER'S 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 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 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.
ate: / plicant: jal( j&A:yA'1�Q/AS
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.
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 hereby authorize representatives
of this county to enter upon the above-mentioned prop y for inspection
Si cure (Applicant or Agent):
Application Number . . . . . 09-00001283
Structure Information
Construction Type .
. . . . TYPE V - 1 HR
Occupancy Type . .
. . . . DWELLG/LODGING/LONG <=10
Flood Zone .
. . . . NON -AO FLOOD ZONE
Other struct info .
. . . . CODE EDITION
2007
# BEDROOMS
2.00
FLOOD ZONE
NO
GARAGE SQ FTG
901.00
PATIO SQ FTG
156.00
TOT ELICIBLE
NO
NUMBER OF UNITS
1.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
2110.00
Permit
ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee . . . .
110.07 Plan Check Fee
27.52
Issue Date . . . .
Valuation
0
Expiration Date . . 6/19/10
Qty Unit Charge Per Extension
BASE FEE 15.00
2110.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 73.85
1061.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 21.22
----------------------------------------------------------------------------
Permit
Additional desc .
Permit Fee . . . .
Issue Date
Expiration Date .
BUILDING PERMIT
975.50 Plan Check Fee 634.08
Valuation 195692
6/19/10
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 . . . . 91.50 Plan Check Fee .
Issue Date . . . . Valuation . . . .
Expiration Date . . 6/19/10
Qty Unit Charge Per
BASE FEE
1.00 9.0000 EA MECH FURNACE <=100K
1.00 9.0000 EA MECH B/C <=3HP/100K BTU
LQPERMIT
22.88
0
Extension
15.00
9.00
9.00
Application Number . . . . . 09-00001283
Permit . . . . . . MECHANICAL
Qty Unit Charge Per
Extension
8.00 6.5000 EA MECH VENT FAN
52.00
1.00 6.5000 EA MECH EXHAUST HOOD
------------7---------------------------------------------------------------
6.50
Permit PLUMBING
Additional desc . .
Permit Fee . . . . 173.25 Plan Check Fee
43.31
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 6/19/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
16.00 6.0000 EA PLB FIXTURE
96.00
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
7.00 .7500 EA PLB GAS PIPE >=5
5.25
1.00 15.0000 EA PLB GAS METER
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFA - LOT 46 PLAN TYPE Al - GRND FLOOR
UNIT
2,110 SF LIVING, R-3 OCCUPANCY, TYPE
V-1HR CONSTRUCTION, 2007 CODES. **PERMIT
DOES NOT INCLUDE TEMP POWER, TRASH
ENCLOSURE, BLOCK WALLS AND SITE
LIGHTING**
THIS PERMIT REPLACES EXPIRED PERMIT #
05-3044,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
14.05
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 1350.32 .00 .00
1350.32
Plan Check Total 727.79 .00 .00
727.79
Other Fee Total 85.46 .00 .00
85.46
Grand Total 2163.57 .00 .00
2163.57
LQPERMIT
6 '
V iry
FURLD D r l:�iLJ:.C' 1CATI N & D.l' G <OST I C TESTING �K� 0f O� CF -4R
Buildar Name
Telephone Plan Nw nber
0 ) 499-1354'
s e: Telephone Sample Group Number- E ERS
C ,-til; is . c Date Sample House Number
i,�.vG _. �r.i.�..J testing & Diagnostics�SProvider CHEERS
14cPharson Avenue City/State,2ip: Lake Elsinore CA 925
laic s i :. i "a' der., 'd.EItS Provider &M Bing Department , a r k weg
r:�kLTL? ClowLu,scisrATZmENT DEPARTMENT
ire "owx eras: ,J _'� Te.,wd ✓ 0 Approved as part of sample testing, but was not tested r np'y
4s the fi li5 :.czcr [,,Sviding diaaostie testing and field verification, I certify that the house idcntiorl on this form complies
wit tt;Z scstZd compliance requirements as checked ✓ on this form. The ITERS rater must cbeck and verify that
the rC vi Z ..T ^b1t1JL ;ysu= is fully ducted and caffea tape is, used before a CF -4R maybe released on every testes building.
".atcr miss: ark release the CF -4R until a properly completed and signed CF -6R has been received for the sample
and :ester:. xuldin
;:,c 4"alcc uw proved a copy of CIF -6R (Installation C«t ficate).
to :tiut 3istribuion Zystcm is fully ducted (ie., does not use building cavities as plenu��
04"PRMSOIN AVEUM'
? ~eco systems where cloth bactod, rubber adhesive duct tape is installed, d t
b;ni;ina'on wan cloth backed, rubber adhesive duct to to seal leaks at duet c?
3f ,4,1 liirl��m. iunn� .
/ s .iliNilK;ivt 1c£4tG"IItk�.MENTS FSR DUCT LEAK -AGE REDUCTION COMPLL4.1�1C1� G�R�i?XT
v�,-rificadan and diagnav& testing of air drs» ibwion systems are available in RAS Appendix RC4.3.
Duct ✓idlytx a,; Lc.ai AV •: evting R=Wts
INEN4' CG:d.SixCiY<.'1:;GIr': ,/ _;7-nLJ U °`" A C t✓
?:tc: i' uirtitit n': Results (CFM Q 25 Pa) Vaalluesues
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7 F x Kc;%&- ::,,aicu:.Za Nowinabding ✓ 0 Heating) or ✓ IJ Measured
Foto " �uU rdn l :i,w in CFM: i G c K % - b ✓ ✓
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Pass ❑ Fail
ALT:1 ..."7"IGitiS: Duci Sysrem and/or HVAC Equipment Chaa Lout
r
• E:,.sr i.:: ted az"ge h ow in Cr M fivrn CF -6R Pre -Test of Existing Duct System Prior to
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4; DL.ct ,/u..n r.itan.aou and/or Equipment Chango-Out.
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,
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s
S .;w.'.i tzrabon and/or Equipmoest e -Out
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4��t1�
4) :viinus(I,t]DC # 5)] — (Only if Applicable)
.'aic: " a: u; Lcs.i:a.gc . low is CFM to Outside (Only if Applicable)
✓ ✓
-_irc .view Duct S7a: m -'ass if i-eakage Pe tage S 6%O
5 __:il
Pass ❑ Fail
: v a ' _ ; # 5) / Line # 2
_
i i' 3T 3R 't' :i .,r'iL i IDN SMANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out
✓ ^ ✓
Use use of : ie ;uilowing four '.est or Verification Standards for compliance:
S 15°/. [I00 x [_(]Lim # 5)
❑F
P'ail
i , z. i1_g� w O .t ide :°erg estage 5 ] Q% [100 x / 2)J]
PasCi_❑ Fal(Line#7) ;
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[ L__(Line # 6) /-- (Line # 4)11
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❑ Pass ❑ Fail
ss r� �. a� .4�I.•eaks
c._sible and Verification by Smoke Test and Visual Ins on
❑ Pass ❑ Fail
--_ —r--- Pass if One of Lines # 9 through # 12 pass .:
❑ Pass ❑ Fail
c. ,.•.i:.','ir-. ;.r:m. iiiance j ornis
Arigust 2009
& DIAGNOSTIC TESTING (Page 3 of 8) CF -4R
e6 7t
Telephone PAIan Number
Telephone Sample Grou 2 Number
Climate Zone
Date Sample I louse Number
C RS
ested
oil this form.
IT
FAX: (951) 02422 PM: (909) 49M354
�v.,Siwl wives are, available in RACA4, Appeiidix RI.
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:N'i,
�%r~wmSpxcCCooin,, c|'«pxuxi"xValves
UM
(1111,15v�w Checked monthly)
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70irdance
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- --- '----
Appendixs.,v the Standard Method are available in RACM, RD2
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-------'--'-----------
AlIgust 2009
-C Sll-
i;_�'VNV is Installed ()it the systeni and
ct.�upncnL shall be verilied.
Yes is a 111iss
Pass
Fail
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UM
(1111,15v�w Checked monthly)
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- --- '----
Appendixs.,v the Standard Method are available in RACM, RD2
`--- --��-------��Certificate) has been provided with refrigerant charge
-------'--'-----------
AlIgust 2009
Clr,:'', i_fF.CATE OF DIAGNOSTIC TESTING (Page 5 of 8) CF -4R
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Sample Group Number
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11Idic'. oil telt: S�C< 0(:ii illCC S CF -d RF -i.
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Sample House Num 0
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Copies to I:1` ILDE". FPIO IDS 'iZ AND ff3UiLDtNG DEPARTMENT
C(y�.NiPI.,#ANCE STA 1 E LENT
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lie -i: i.s: ccs. ✓ '.J tea:.G V'0 Approved as part of sample testing. but «
A, •1 c '3EPS rater p -m toil;, .as`.1Jb;.c ;csting and field verification. 1 certify that the
the c. a ':k;SIIC is t::d coI i,,H.-mco reC:II(":;( l^iitS cC. Checked on this forin.
r t^_I ; 1 : 'w'.. blot ,m Dva`•I-_ ed n coon OIC -6R (--nstailation Certificate).
.,� � a �., ►41� T"• �.I14FL.'�'4Y y'En'-F'I€'4TION
i7
�t lcstcd �BUILLJ,14. j
identified oil tlif-RA1b 114fF;Vtii
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1vielhod i;o( .=,:rtlr+w is'ieasurmilea r CER u,E,RSRATERCMNUIRC IJU
i ✓ - E3—�—:�'o —, Duct ds-1✓^ dist on pla,ls' FAX:(951)609.2422 PHOHEc(90�49¢6354 ,
_—_—�Ah~-t. 1 . l -_• L�Ii:r,170$riC } all r'lo;y Using Flo
NVINpturc Hood
: R'..:4.1.2 h D,:I•�nostic Fan Flow using unl Pressure Matching
l:J t -- - (l •4 ` �- "I,i1rnO�hC t --an Flow Usiml,4low Grid Measurement
Measured Airflow:
% Rated Tons:
—� -� Y,�'+o i J
• _ � •f` G :•cs E :� N� I
ssured nufftew is grca(er Ihall (lie criteria lel Table RE -2
Yes is a miss
'A il IT 'y'
::ao/in,K /oad ca >ac•ily are available ill /Zd('1!
uate all- iaw verified ("sec adequate airnoxv edit)
Refri—rant Chai-oc or t ,XV
folal CFN1
cfnl/Ion
Pass Fail
REi.
)'cs
1 C .'0
--�
7uci'.cal:ace :,'duction credit verified
1 s u ti. CS O
1-'i,An` capacities of Installcd s�-sic/rc!� l0 llli(Xlllllllll CO011llg Capacil\'
z
11Idic'. oil telt: S�C< 0(:ii illCC S CF -d RF -i.
11 t1W coohin � C'-pacltles Ol inslal) systems are > than maximum Cooling
✓
No
capa: tv in the -.F-1R, Ihen the ectrical input for the installed systems must
❑
❑
'••c < to electrical in ut in the 9f--IRand RF -4.
-
1
Y s to 1, 2. and I. and Yes to either -4 or; is a pass
Pass
Fail
vi:zt ;':'.(1" H isoP.ArRCONT)ITFe' NEi2---=
'.ri lcalion aY.'' m,(w, ihlc ill .2Ai„11 penc/ixlll.
F, , i _7” ? as :_ El- `:o EF:', vahncs of mglalled systems match the CF IR
_' r ✓ C %,cs ! i No For S,,-,14 t stem: indoor coil is matched to outdoor coil
i
1 _, ✓ Yes �i No� Timm Delay Rclav Verified (If Required)
l — ires to } and 2. and 3 (If Require
is a pass ass I Fail
December 2005