09-1294 (SFD)P.O. BOX 1504
-
78-495 CALLE TAMPICO
.
LA QUINTA, CALIFORNIA 92253
Application Number:
09-00001294
Property Address:
80245 VIA TESORO
APN:
772-250-019-47 -30357 -
Application description:
DWELLING - SINGLE-FAMILY
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation;
244630
♦ •4
40"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
ATTACHED
Applicant: Architect or Engineer:
�I
------------------
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 License is in full force and effect.
License Class: B License No.: 777699
ate: t entractor: -1
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).:
(_ 1 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 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. , 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.1•
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
TOLL CA V
C/O KEVIN D DUERMIT
8901 E MOUNTAIN VIEW
SCOTTSDALE, AZ 85258
200
Contractor:
TOLL BROS, INC.
121 FRED WARING DRIVE,
LM DESERT, CA 92260
760)674-9699
Lic. No.: 777699
#100
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/22/09
-
=-------------------------------------------—
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 wnrk fnr 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
�n 3700 of the Labor Code, I shall forthwith comply with those provisions.
A ' ant:lt' �/a94eGS
WARNING: FAIL E 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 t county to enter up o the above-mentioned propert C for inspection cur oses.
ignature (Applicant or Agent).
Application Number . . . . . 09-00001294
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 3.00
FLOOD ZONE NO.
GARAGE SQ FTG 547.00
PATIO SQ FTG 418.00
TOT RT,Tr.TRT,R TTO
NUMBER OF UNITS 1.00
2ND FLOOR SQUARE FOOTAGE 2748.00
----------------------------------------------------------------------------
Permit . . . ELEC-NEW RESIDENTIAL
Additional desc . .
Permit Fee . . . . 130.48 Plan Check Fee 32.62
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 6/20/10
Qty Unit Charge Per Extension
BASE FEE 15.00
2748.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 96.18
965.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 19.30
----------------------------------------------------------------------------
Permit .
Additional desc
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT
1147.00 Plan Check Fee . . 745.55
Valuation . . . . 244630
6/20/10
Qty Unit Charge Per Extension
BASE FEE 639.50
145.00 3.5000 THOU BLDG 100,001-500,000 507.50
----------------------------------------------------------------------------
Permit . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 116.00 Plan Check Fee .
Issue Date . . . . Valuation . . . .
Expiration Date . . 6/20/10
Qty Unit Charge Per
BASE FEE
2.00 9.0000 EA MECH FURNACE <=100K
2.00 9.0000 EA MECH B/C <=3HP/100K BTU
LQPERMIT
29.00
0
Extension
15.00
18.00
18.00
Application Number . . . . . 09-00001294
Permit . . . . . . MECHANICAL
Qty Unit Charge Per Extension
9.00 6.5000 EA MECH VENT FAN 58.50
1.00 6.5000 EA MECH EXHAUST HOOD 6.50
----------------------------------------------------------------------------
Permit PLUMBING
Additional desc . .
Permit Fee . . . . 183.75
Issue Date . . . .
Expiration Date 6/20/10
Plan Check Fee 45.94
Val iiat-A on . . n
Qty Unit Charge Per Extension
BASE FEE 15.00
19.00 6.0000 EA PLB FIXTURE 114.00
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 7.5000 EA PLB OTHER BACKFLOW <=2 INCH 7.50
9.00 .7500 EA PLB GAS PIPE >=5 6.75
1.00 15.0000 EA PLB GAS METER 15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFA -BLDG. 10, LOT 47 PLAN TYPE A2 -
UPPER FLOOR
UNIT -2748 SF LIVING, R-3 OCCUPANCY,
TYPEV-1HR CONSTRUCTION, 2001 CODES.
**PERMIT DOES NOT INCLUDE TEMP. POWER,
TRASH ENCLOSURE, BLOCK WALLS AND SITE
LIGHTING**
THIS PERMIT REPLACES EXPIRED PEl2MiT #
05-3138,ISSUED ON 8/22/05 BUT NEVER
STARTED
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 10.00
ENERGY REVIEW FEE 74.56
STRONG MOTION (SMI) - RES 23.83
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 1577.23 .00 .00 1577.23
Plan Check Total 853.11 .00 .00 853.11
Other Fee Total 108.39 .00 .00 108.39
Grand Total 2538.73 .00 .00 2538.73
LQPERMIT
:. > °' ^ . ' "E r >✓ WjtMCAMN DUGNOSTIC TUM,G �Nge I of S CF -4
Bui,acr CanLkA Telephtme Playa la urnber /
D3 ,` 3
499-6354
1 'stir
ei one Sample Group Nuanb%'!`
/ # ERS
crti=yir� Date Sample House Numb1
D:_z e r'lgtl-aad rusting & Diagnostics ITERS Provider: CHEERS
McPherson Avenue City/Stateaip:Lake Elsinore C'.,,
C- ors to: IU-R.S Provider and Ba kftg D rag -meat �'� � ttltrtil .� 111 ItrAf ti It Cr a q
HERS RATER COMPLLANCE STATEMENT
T`tC ,%ousc r as-- ✓Tested ✓ Approved as part of sample testi,,& bu( �i�t tc"JE � �#
MNS"
As trc fiFRS rater pz6 :3g diagnostic testing and field verification, I certify firer the hotWS ideni,*Sod, nUPWM
will: the dixjpx�stic twtcd co fiance requArments as checked f oia this forte. The B ERS rater must chock and v drat
.he new d; xnhuaon system i�ducted and cmTect tape is used before a CF -4R array be released ora cv test building.
rater u�ust not rcltse a CF -4R until a properly completed and signed CF -6R has hoer reayfo� sample
,:a���� �:. ��EPIIJJART 111+M�VVVENT
-_ .a ;�>sWkr h" provided a copy of CF -6R (Mchtllation Celt ficale).
?S, New DisL ibmion cyst= is fully ducted (i.e„ floes not use building cavities as plenums orplatfortfrGAMin lieu of
tlucts).
New systeaor s wuexe cloth backed, ribber adhesive duct tape is m>lsbdlcd, mastic and draw bands are used in
ombinntion with cloth backed, rubber adhesive duct tape to seal leaks at duct conmmfions.
✓ ;5 XLStMUM RiEQUH"ENTS FOR DUCT LEAKAGE REDUCTION COMPL ANCE CREDIT
Prr edares forfie:d uer*ation and itagnoax lating of air dis*ribution systew are available in "CV4 Appendz r RC4.3.
Duct nos
D14gtic r eaicage Testing Rcsults
NEW C6YS"rRVC 0N: C. 3-r A 2,4-r
► Duce Prrssuriution Test Results (CFM @ 2S Pa) lvteasured
Values
l E -,,a , cgtcd L.ruagc riow ire C.FM: � b
i F:,L Flow Cslcaeiutai (Nonvnal. FxCoo0 Heating) or ✓ 17 Measured ✓ ✓
` Fater Tata) Fan Flow in CFM: I G tt h
Pasi s :,cal .urc Percentage S 6% [ 100 x (_(Line # 1)1 (Laine # 2)1) - a � � : XPass ❑ Fail
i*81Ci $ytitew 9rid/or ICAC !1i eYit baa C•i?Ut
-Eato. Tested .Lmikage-low in CFM from CF -6R Pry -Test ofExisting'Duct System Prior to
Duct Syst,:.n Aivaauon and/or Equipment CbangerUuL
nir:r ' c-,stcd L,:.tl:agc Flow in CFM: Final Test of New Duct System or Altm -ed Duct System
for Wit. t S st< a ,� iteration and/or meat c-Clx�t
_
ti; t
}.�
:?,,ter Roduction m Lca►agc for Altered Duct System
4Aa r C
.Minus (L iwe # 5)) – (Only if Applicable)
-- -
7 1�� F_.tc;r .`cs" :. .1c F .Lw 1z CFM to Outside (Only if Applicable)
✓ ✓
-
c x &pct --)ruc,L - i'ass if Leakage Percentage:5 6%
Pass ❑ Fail
F; x ,`� :;.,: # 5' I Line # 2
1.
... ..._._._ -
TEST OR tv' {., U i1CwTION STANDARDS: For Altwed Duct System and/or HVAC Equipment Change -Out
v .–✓
use ode of rhe fkl UowinE four Test or Verification StSUd2rlds for coin liance:
y:,ass :.Ja: "ge Pw c-=ge 5 l5% 'l 00 x j (LiDe # 5) / (Lime # 2)J)
❑Pass ❑Fal l
Dass :z c .lege to Outsde Percentage 510°ls [lt)t} x(L.ine # 7) / (Dine # 2)JJ
❑Pass ❑Fail
! ' uwcaai:ngo Rc .;uc6on Percentage Z 6WR (100 x # 6) / (Lice # 4)I1
_(Line
L
Scrjote Test and Visual jERSCdon
❑Pass ❑Fail
.Z s._ icy. ;a, ��..� Aix siaic Leaks and Verification by Smoke Testand Vi _
o�1
❑ Pass a Fain
--�----------- Paas if One of Lines # 9 through # 12 paw 1.--: -
❑ PM ❑ Fail
LurrPliance Forms
August 2009
�. _� „_�+. t _" (•,_ ,� z ►�)�t & DIAGNOSTIC TESTING (Pa e 3 of 8) CF -4R
Builder Name
-
- U Telephone Plan Number
Telephone Sample Group Number
Climate Zone
-- - -• 1 z ' �7�)y'{fit' t Date Sample House Number
VIW t,yn1
:I/Q✓V _
City/state/zip:
R111
z� \G DEPARTNIEhT nA
as part of sample testing- but was not tested
r,
-ci
,,,i verification, I certify that the�it�}y�ldri�i��
c.ke:t on this form. A1e,lrz &jpCANS
,! ,>. ;ltiatlon Certiticatl'l. tall WIMM dlal!!n#
-iXV)
""
*tFFes'
rulves are available in RACII 41,pendi.� Rl.
tivstem
Cooling Systems without
Btu/hr
(111U,$Kc checked monthly)
Zust be checked monthly)
is Expansion Valves
-:-L,I:) 55 and above):
n,iance with the manutaeturer's specifications and installer vcrilication
.ccdure. If outdoor air dry-bulb is below 55 'T rater shall use the Alternative
_
L!" ng the Standard Method are available in RACM, Appendix RD2.
r-,t..Iation Certificate) has been provided with refrigerant charge
AlIgust 2009
lr inspection. The procedure shall consist of
, L1141, the'lAV is installed on the system and
❑
;C,:{ i cc ui iment shall be verified.
— Yes is a mss
Pass
I ail
tivstem
Cooling Systems without
Btu/hr
(111U,$Kc checked monthly)
Zust be checked monthly)
is Expansion Valves
-:-L,I:) 55 and above):
n,iance with the manutaeturer's specifications and installer vcrilication
.ccdure. If outdoor air dry-bulb is below 55 'T rater shall use the Alternative
_
L!" ng the Standard Method are available in RACM, Appendix RD2.
r-,t..Iation Certificate) has been provided with refrigerant charge
AlIgust 2009
CEI\T !F1CATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 5 of 8) CF -4R
?'r c',1cd,; s Builder Name
Builder t:1C, Telephone Plan Number
F
112HLA
�H.Ek' ti t Telephone Sample Group Numb
Date Samplc Housc Nu ear C E
_ _ ir, ■ slimes-��,((t�,���� r� 7 i Irn 4?: 1'1t 7116 !�
l --- - -
HERS Provider ..A
t..:t °.( dr: 5: A
All ( j `1x%•. Ld '�T� (7V7) �`�9 �3 cit} /state/zip: °• . �' 5 01A6
�jop>ct, rt�t3t.:i1.,1}�R�lft�hSsi�I�tiVi!}%4? ANiZ BitiI lliNG DEPARTMENT
IIERS G.")NI.FLI'f"?,NCE STATENIENT DEPARTMENT
I IT •,o,:tic 1A , s ✓ #., i est -d r FJ ?' dprcwcd as part of sample testin/-watested tr" cI)pY
:,,: tERti nater provl�li ;;� di,linostic tcstin�g -m i field Verification. I certif}- thentifiedj�ojilrthis form complies with
i ;. 'la-„c'itic wsted c(,iii�l.aal�C rl la:: :: iltS n.` chcc.�ed on this form. �"�”TWX ��`r`L-, ! 1�: liu,a.lcrli't: a'1 .t�9t. . cop, o, CF -(:R (I::stallation Certificate).
4,Lr ( :jA-FE At -,%j l- -X VERIr iCAT`ON
f :., � (!r,•� pr, ; is 4J "•r1', �' ir�r*' tL .'t '�...^. `'rrGSJI. r['.�Iil1L' trf
t�;.:tu:�c: F-t•Airflny: ��e::wr.�r,�crt r. -
-°�
L_>;a<. roe'ic ':in F;a;; Lsint
12 Dia,,P.oslic tall Fl -,w Usim!
raiai�r�N��.IC�Y>�'•'t �_ )D11C�iD1�Z163;,4
—TAX -.(951) � 42 E rPHO :X999)499.63541
RmKapturc Hood
Psvnum Pressure Matching;
� low Grid Measurement
Measured Airflo-ty:
Rated Tons:
L Yc', t:_ No is gre:iter titan the criteria in Table RE -2 ❑
_ �-� I ---1 --� !%�• Yes is a pass Pass
n_:::;tllryrr.u,c:rrr;,,L�loa:(c"a:rc:it,':n�rriai/nh/cirr/Z.1(.:1/.lprerrrli.rlZl%;i.
Lli lcm, veritled (See adequate alrfloll dit)
:-i Y• �u l'csJ - 'I No E<<fr,,,c.,I!lt ch :2,- cr T\V
`—I-V -t-) Yes t 1.j r:ductiou credit verified
Tolal CFM
cfnl/Ion
❑
Fait
Yes 1 �, NO :.0•)tlli'� ,.�,p:iCat1CS Of 11i$1;)l1Cd S\"$tCi11S PC < t0 Illii\iilllilll CO01111L; capilClt\'
Pcrrcrnalice's CF -I and RF-
} t t't c Iing capa: incl of Xectrical
s}'stemsarc>thannlazimum coolingL- Yc- '�'. �`o _a5;aczt�' Iti t,le :F -IR. thea tilt input for the installed systenls must
r< �. .:frit 1 Mout
In the -IR and RF --t.
Y/s to 1. 2. and 3: and Yes to tinter -1 or 5 is a pas,
•gym :,,,}�i i't,R .EIR c :"i'�D,7 ".-'R /
-1 rhr l'CY•',' .'r lrpn ;t o ,?t lJirn, ' it R ;t'l,I ,4r, PC? i"dix RL
-V' 11 Yes l i =tic, i FE'.Z vanes of ,ngalicd sVstcros match the CF-iR
:\o ,v:;zen-. indoor coil is matched to outdoor coil
�✓ i `r w ^' �o —I �..:,.; D- - - ::y Verified (If Required)
_—Ycs to 1 and 2-, and 3 (If Required) is a
11
Pass
Q
December 2005