04-7615 (SFD)/ BUILDING & SAFETY DEPARTMENT '
P.O. Box 1504 (760).777-7012
.-32 4.9- AMPICO FAX (760) 777-701.1
®A u IFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
JAN 06 2005 BUILDING PERMIT
�F_4AAultdip►
App icat'on Number
[04.-0000761" Date
12/07/04
Pro 'A'adres s
5T407`VTA VISTA
APN:
.762-240-003-32 -300962-
Application.description',`,.
DWELLING - SINGLE-FAMILY DETACHED
Property Zoning
MEDIUM DENSITY RES
Application .valuation.
99599
Owner
Contractor
------------ ---- --
--
-.----.
PUERTA AZUL PARTNERS
-- --- ----------.---
DAVIS/REEDCONSTRUCTION
---
INC
17700 SW UPPER BOONES
FERRY RD 169`SAXONY ROAD, STE
4105
SUITE. 100
ENCINITAS
CA 92024
PORTLAND
OR .97224 (760) 634-2350
WCC: STATE FUND
WC:' WC2988920,04
06/12/05
CSLB: 81348.0
10%31/06
CCC: B
-----=--------------'----'-
Structure Information ----__--------------------
Construction Type-. .
. TYPE V, -.NON RATED .
Occupancy Type
DWELLG/LODGING/CONE <=10
Flood Zone
NON -AO FLOOD ZONE
Other struct info...-:
CODE EDITION 2001 CRC
#.BEDROOMS
2.00
FIRE SPRINKLERS.. NO
. ".,.
- GARAGE SQ FTG
255.00
PATIO SQ. FTG
4'51.0 0
NUMBER OF UNITS
1.00
1ST -FLOOR SQUARE FOOTAGE
1549.00
--------------------------- =--
- -- -- - - ---
�' - - -
Permit . . .BUILDING
PERMIT
Additional desc -
Permit -Fee
639:50 Plan. Check,Fee'.-
415.68
Issue Date
;Valuation _
.99599,
Qty Unit Charge
Per
Extension
-BASE FEE"
414.50-
50.00 .4.5000
THOU BLDG 50,001-100,000
225.00
Permit . . . . .
MECHANICAL`
Additional desc
Permit Fee . .
85..00 Plan' Check Fee
21.25
Issue Date
Valuat'i'on
0
Qty Unit Charge
Per
Extension
BASE FEE
1'5.00
1.00 9.0000
EA-MECH:FURNACE <=.100K
' 9.00
1.00 9.0.000
EA - MECH B/C'.<=3HP/100K.BTU
9.00
P.O. BOX 1504•
w VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253TINSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Q % (o/ Date:
Applicant:
Applicant's Mailing Address:
/7" TAW V
chltect
Architect or Engineer's Address:
Lic. No.: 0' 232 % % T
or Engineer: Q ,, , illec
BUILDINU PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of C apter 9 (Co Section 7000) of Division 3 of the Business and Professionals
C908; and my License ig, �ull)ce and effect. ,�
icense Clas" ense No. `
IF
ateC� r C1,014J
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 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
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 wor0f6l�h this permit is issued.
ISI hav d wi n workers' compensatinsurance, as required by Section 3700 f e Labor Code, for the performance of the work for which this permit is
issue workers' compensation i ante c icy number are:
farrier olicy er Z 7v5
_ I cetlify that, in the performance of th rk for which this permit is issued, I shall t employ an
p y y person m any manner so as to become bject to the workers'
compensation laws of Califom' , and agree t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
rtwith with thos rovisions.
---'Datz_ pplicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT ANE YER 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
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
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 and shall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission rel a work being pe o der or following issuance of this permit.
2. Any permit issued as a result of this application bet rel
and void if work is not commen 'thin 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject per o cancX'is
I certify that I have read this application and state that t above inforrrect. I agree to y with city and county ordinances and state laws relating to building
construction, and hereby � l"nze representatives of
' county toe above -me a or ins action purposes.
Signature (Applicant or Agent)•
2
Page.
2
Application
Number
04-00007615: Date
12/07/04
Qty
Ui it, Charge- Per
Extension
7.00`
6.5000 EA
MECH VENT FAN
45.50
1.,00
6 .5 0 0 0: EA
' MECHEXHAUST HOOD
6.50
-Permit
ELEC-NEW
RESIDENTIAL`
Additional'desc
Permit'Fee
74:32.
Plan Check Fee
18.58
Issue'Date
Valuation
0
Qty-
Unit Charge Per,
Extension
- '
BASE FEE
15.00
1549.00
:0350- ,.
ELEC, NEW 'RES - 1 OR 2 FAMILY
54.22
255.00
..0200
•ELEC GARAGE OR NON-RESIDENTIAL
5.10
------------------------------------
Permit
PLUMBING
«. Additional
desc
Permit Fee
151.50
,h Plan Check Fee
37.13
Issue Date
Valuation
0
Qty
Unit Charge Per
Extension
-BASE FEE.,',
15.00
14:00
6.0000--'EA
PLB FIXTURE
84.00
1.00
15:0000-EA"`
PLB BUILDING:SEWER
15.,00 .
1.00_''
7-5.000; 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
3.-0000 '"
',PLB.',GAS PIPE 1-4 OUTLETS.
3.00
' ,1.00
,EA
15.0000-EA
PLB GAS METER;
15.0.0
-
Permit.
GRADING'PERMIT
Additional"desc
Permit.Fee
15.00
Plan Check Fee
00
Issue Date
Valuation
0
Qty:.
Unit Charge"Peri-b;
Extension
BASE'FEE
15.00
Spdcial,Notes
and, Comments',
SFD - LOT
32. PLAN 2B, 1549
SF. 'PERMIT,..,"
DOES NOT INCLUDE
. BLOCK.`WALLS,
' POOL,., $.,PA
OR DRIVEWAY
APPROACH:
-----------------
a----Other Fees
-------
------------------------------------------
.ART IN PUBLIC PLACES-RES
00
DIF COMMUNITY CENTERS-RES,'
97.00
DIF CIVIC, CENTER-_RES
366.00
Page 3
Application Number
04:00007615
Date 12/07/04
Other Fees
ENERGY
REVIEW FEE
41.57
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
9.95
DIF
STREET MAINT FAC
-RES
15.00
DIF
TRANSPORTATION
- RES
1098.00
Fee summary ',Charged
Paid Credited
Due
Permit Fee Total
,965.'32
00
.-00
965.32
Plan Check Total-.
�' 492.64
. 00
`00
492.64
Other Fee Total
2456:52600
-00
2456.52'
Grand Total,
3914.48-1
.00
.00•
-3914.48
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING.(Page,1 of 1) , CF. -4R
Project. Address] Puerta Azul } \
Builder /Installer
52-407 Via Vista / La Qginta / CA./ 92253
Azul Partners,'c/o Pacific Security Capital
.lPuerta
Builder / Installer Contact Telephone
Plan Number / Permit Number
Mike Kwaske 7607027215
1
HERS Rater. t' Telephone
Sample Group Number d :.
Dave Bricker - CJHJEJEJRJS® ID,#CCN99380828 7607743676
8 u ,`
Compliance Method rescripti e ia..
Climate Zone 15
Cert4ying Signat c Date
Sample House Number ..:. '
_
M06
3a 2 y
Firm
HERS Provider .
Energy Driven Solutions-
CJHJEJEJRJS® 1
Address.
City/State/Zip
48-755 Still Water Street '
Indio /CA /92201
t.
r iJ,
r.
V
Copies to': BUILDER; HERS PROVIDER AND BUILDINGDEPARTMENT" '
_ '.HERS RATER COMPLIANCE -STATEMENT'
+' This house was: ✓ •Tested ;
As the HERS rater providing diagnostic.testing and field verification -I cceerttiiif „that, the houses identified on this form comply with the diagnostic ,
tested compliance req en "as checked on this form.
c
t . ✓The installer has provided a copy of CF -6R (Installation Certificate). `
✓ Distribution' system is fully ducted (i.e.,.does notuse building cavities•as plenums IpOaton returns in lieu of ducts).`
✓ Where cloth.backed; rubber adheswe duct tape is mstailed,;*^mastic,and{drawbands:azeuseed,incombination with cloth backed rubber adhesive. .
duct tape to seal leaks at duct connections y
MINIMUM REQUIREMENTS FOR DUCT,LEAKAGE.ftDUCTION C,OMPLIANCE•C-REDIT
Duct Diagnostic Leakage Testing Results (Maxim m�6%Duct Leakage)
System #rY
Duct Pressurization Test Results (CFM .@ 25 Pa) Measured Values'
^ ^ Nest L ea'97
�kagen CFM' _
If fan.flow is calculated as 400cfm/ton x numbe'.of tons,enter calculated value ere,
' (�
,. max: ., �
f
red`eni
If fan flow is measu er measured v alue here- .
v Leakage Percentage (I.00 z Tested Leakage, /Tan Flow) ` 4.9
�_. -Check Box for Pass or Fail (Pass=6%o or less)'. i ✓Pass O Fail' '
, R�
Residenhal Compliance Forms Generated by CJHJEJEJRJS® http://wkvw.CHEERS.org ) t +August 2001 r
FEB -06-2006 04:39 PM- r
• 'CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING '
2- t-1 1
Project Title Date
.. _ -77
ProJect Addr ss
au l er me
Builder C t
.
P.09
CF -4R
ontacI Telephone Plan Number
HERS star, TI hone Sample Group Number
ifylnp signature to Sample House Number
irm:' L' r� 0//a?� S HERS Provider
Street Address: 2�G�d ,�ra��ayo(' t�/rete. City/state/Zip:
Copies to; Builder, HERS Provider
HERS RATER COJOPLIANC T
The house was; ❑ Tested Approved as part of sample testing, but was not tested
As the HERS rater providing dlagnostl testing and field verification, I certify that the houses Identified on this form
co with the diagnostic tested com liance requirements as checked on this form.
Distribution system Is fully ducte� (I.e.,.does not use
�;If ducts) building cavities as plenums or platform returns in lieu
AOWhere cloth backed, rubber adh i sive duct tape is installed, mastic and drawbands are used in combination
with cloth backed, rubber adhesive duct•tape to seal leaks at duct connections.
A—M—INIMUM, REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
Measured
Duct Pressurization Test Results (CFM ® 25 Pa) values
Test Leakage Flow In CFM
If fan flow is calculated as 400cfm%ton x number of tons enter
calculated.value here
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) _.
Check Box for Pass or Fail (Pass=6% or less) ❑
ass fail
THERMOSTATIC EXPANSION VALVE (TXV or Commission a rovcd a uivalent
Yes ❑ No Thermostatic Expansion Valve (or Commission approved
equivalent) is installed and.Accessls provided.for Inspection ❑
Yes Is a pass , ess Fall
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1. ❑ Yes ❑ No ACCA Manual D Design-requlrementshave been met
(rater has verified that actual installation matches values In
CF -1 R and design on plan.
2. ❑ Yes O No TXV is Installed or Fan flow has been verified. If no TXV,
verified fan flow matches design.from CF -1R,'
Measured Fan Flow13
=
Yes for both 1 and 2:ls a Pass .Pass 'Fail