04-7098 (SFD)�i
P.O. Box 1504.
G�OF"Tk�9
(760),777-7012-
78'-495 CALLS TAMPICO -'FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS
(760) 777-7153
"BUILDING PERMIT
Application Number_
04 00007098
Date 1.1/16/04
Prbperty,Address
57377 VIA VISTA .
APN:
762-240-003-27 -300962-
Application description
DWELLING -.SINGLE FAMILY DETACHED
Property Zoning
MEDIUM DENSITY RES
Application valuation...
11263.4
Owner"
- Contractor
PUERTA AZUL PARTNERS-
DAVIS/REED CONSTRUCTION"INC
"-"17700 SW UPPER BOONES
FERRY RD 169 SAXONY, ROAD,
STE #105
SUITE .100,:.
' ENCINITAS
CA 92024
PORTLAND
OR -9722:4 (760) 6.34-2350
WCC:" STATE FUND
WC: WC298892003 06/12/05
CSLB: •813480•
10/31/06
CCC*:: B "
-=--------- =---------------.'Structure
Information_ --------------------------
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 0`0.
;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
1.11.31
.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 de'sc
Permit Fee
78.50 .Plan Check' Fee
. 4.91
Issue Date
'"Valuation
0
.Qty Unit Charge
Per.
Extension
_ BASE FEE
15.00
1.00 9.0000
EA MECH -FURNACE <=LOOK
9.00.
1.00 9.0000
EA MECH"B/C-1`<=3HP/100K BTU
9.00
r"_
P.O. Box 1504 �� VOICE (760) 777-7012
Tiff
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 44 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04-. 709, om— Date: f l • l h' 04
Applicant: it - -ePEngineer:
Applicant's Mailing Address: chitect or Engineer's Address:
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
C de, and my Licen}s in full force and effect. -� f'
License Class 1 > -� ens, No. �7 N M
,Oent ccfor k S �� Gly
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 fora permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U 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 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 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.
have and will maintain workers' compensation insurance, as require ea 370 a Labor Code, for the performance of the work for which this permit is
�ssu d. My rkers' compensation it suwce ca�pu�l
i mber am
arrier s tete .>I TL oI�P icy Nu 45`+S r70 L\
I certify that, in the performance of thew or whi�'rni issued, shall n mploy any person in an anner so as to become subject to the workers'
compensation laws of California agree tha be a sub' a workers' corn nsatioh row ions of Section 3700 of the Labor Code, 1 shall
forthwith comply with those visions.
WARNING: FAILURE TO SECURE W HERS' COMPENSATIOy9'PVE1iAGE IS UNLAWF}SH BJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDREDTHOUSAND DOLLARS ($f00,000), IN ADDITION TO E COST OF COMPESAi1At+1. MAGES 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 II 1411r,
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 reque nd foFw ose benefit wo ormed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each agree , and shall, defend, indemnify and hold ss the City of La Quinta, its
officers, agents and employees for any act or omission related to the eing pvtormed under or following issuance of this pe it.
2. Any permit issued as a result of this application becomes null an id if work i of commenced within 180 days from date of issu ince of such permit, or
cessation of work for 180 days will subject permit to cancel) n.
I certify that I have read this application and state that the above i ation is corn I agree to c y with all c' nd county ordin state laws relating to building
construction, land hereby authorize representatives of this cou to enter upon abo e- enti property sp S.
e"1 t)L ignat3 ure (Applicant or Agent):.
_ Page
2
Application Number
°04.700007098 Date
11/16/04
Qty Unit Charge
'Per
Extension
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
5.06
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 0200
ELEC GARAGE OR NON-RESIDENTIAL
-5.00
Permit .. . . . . .. PLUMBING . .
Additional desc
Permit -Fee
146.25 Plan Check Fee
9.14
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.
1.00 7.5000
'EA_' PLB WATER HEATER/VENT
.15'.00
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'
1.5.00
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'27. PLAN 4A,
1740 SF. PERMIT
DOES NOT INCLUDE BLOCK WALLS, POOL, -.SPA
OR DRIVEWAY APPROACH.
75%.PLAN CHECK FEE
REDUCTION'APPLIED'FOR
MULTIPLE,ISSUANCE
OF SAME PLAN TYPE.
Other .Fees
ART'IN PUBLIC PLACES -RES
.00
'
Page _ -3
Application
Number04-000070'98 Date 11/16/04
---- - ---
- _.___ ------ - ---- -----------------------------------
-----
'OtherFees. ,
--
. DIF COMMUNITY: CENTERS-RES
------------Other
97.00
DIF CIVIC,.CENTER - RES
.366.00. ,
ENERGY,' REVIEW-FEE
11.1,3
t: DIF 'FIRE PROTECTION-RES
97.00
f
GRADING PLAN CHECK FEE
00
.�1
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-MATNT.FAC-RES
15.00
DIF TRANSPORTATION -,RES
1098.00
Fee summary
Charged', ;Paid`. Credited
Due
--------------,=--
-------- ------------ ----------------------
",. Permit Fee
Total ;1005.65 '' 00' 00
1005.65 ;
Plan Check
Total: = 1130.42-.-, ."00
130.42
Other Fee.Total 2427,..39;:' ° :"0.0 . .00
2427.39
,
Grand Total 3563.46 00
.,
3563.46
w r
.•
'�� ,. * '1. .'�
ate, �
r
,7`i.
3•
`i
` ' ' ' ,
f + _ ate" ` t .
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1' of 1). CF -4R
Proje&Address 1 Puerta Azul J
Builder /Installer
57-377 Via Vista / La Quinta / CA / 92253
Puerta Azul -Partners, c/o Pacific Security Capital
Builder / Installer Contact
Telephone
Plan Number/ Permit Number,
Mike Kwaske
7607027215',1
�. `�. ,
HERS Rater
Telephone,
Sample Group Number J '
Dave Bricker.- CIHIEIEIRISO ID #CCN99380828
•7607743676
11 S s
Compliance Method(Prescriptiv
Climate Zone 15
Certifying Signat e .
Date- ,
Sample House Number y
27:'
Firm. •
HERS Provider
Energy Driven Solutions
CjHjEjEjRjS®' r
Address
!
City/State/Zip
48 155 Still Water Street,
-
Indio /CA /92261
Copies -to: BUILDER; HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT ' z
This house was: ✓ Tested
As the HERS rater providing diagnostic testing and field verification'7M cceertify�that the houses identified on this form comply with the diagnostio:•
tested compliance requirements as checked on this form. r , - -
✓.The installer has provided a copy of CF -6R (Installation Certificate).,'
�✓ Distribution system is fully ducted (.i.e. doe not use building cavities affo
s plenums o"i plarm returns" in lieu of ducts).
kv
✓;Where clotfi:backed,`rubber adhesive duct tape is installed, mastic.and drawbands are uwd'm combination with cloth backed; rubber adhesive
t
ducta a to seal leaks at duct connections
✓ MINIMUM REQUIREMENTS FOR DUCT4LEA _ GE -REDUCTION" COM PL'IANCE•CREDIT '
J Duet Diagnostic Leakage Testing Results (Maximum 6%�Ducf Leakage) _y
r r
System # 1 '_ �i A •.�,�" �:�,�,.' N�� .,� . "
Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values
t Test Leakage Flowin CFM '82
r
If fan flow is calculated as 400cfin/ton x number of tons ent�calculated value here U ��
4
If fan,flow is measured�enter men red value here
je
' Leakage Percentage: (100 x Tested Leakage /,F low) _ 4.0 • ! r.
t Check Box for Pass or Fail (Pass=6% or less) . ✓ Pass a Fail +
Residential Compliance Forms- Gen.erated'by CjHjEjEjRj$@ http;//www.CHEERS.org a , ;August 2001 - j
FEE-06-2006.04:37 PM
P.04
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING ' ''
CF-4R
Pro ec Title Date
Project Addr9as Buy qq�Name
Builder Contact Telephone Plan Number
nirti c�rM d� 170 �� -.
HERSRater T h ne Sample Group Number
v j
C tying Signature Dat6 Sample House Number
u?� HERS Provider: Hff/Q 5
Street.Address: 2go �3ras� ark /YL �� City/State/21p:
Copies to: Builder, HERS Provider
HE&JEATER COMPLIANCE ATM N
pproved as part of sample testing, but was not tested
The house was: Tested ric
As the HERS rater providing Ilagnoesting and field verification, 1, certify that the houses Identified on this form
com ith 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
ucts) i
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.
MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
w Measured
Duct Pressurization Test Results (CFM ® 25 Pa) - - values
Test Leakage Flow lri CFM. i ...
If fan flow is calculated as 400cfm/ton x number of tons enter j
I alculated value here i
If fan flow Is measured enter measured value here F
Leakage Percentage (100.x Test Leakage/Fan Flow)
Check Box for Pass or Fall (Pass=6% or less) I
❑
i
`Pass Fall
eTHERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent
Yes ❑ No . Thermostatic Expansion Valve (or Commission approved
equivalent) is installed-and Access Is provlded*for Inspection
❑
Yes is a pass r .
a"P ss Fall
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE'CREDIT
1. C] Yes ❑ No ACCA-Manual D Design requirements have been met l
(rater has verified that actual installation matches values in
CF-1 R and design on plan. '
2. ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV,
verified fan flow matches design from CF-1 R. F
Measured Fan Flow = o
❑ 0
,• Yes for both 1 and 2 is a Pass I
Pass _ Fall