05-4393 (BLCK)P.O.. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT - -
• BUILDING PERMIT -
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
.1
s.- Date:. 9/29/05
Application Number: 105-00004393 t_ Owner:
Property Address: 57420 VIA VISTA PUERTA AZUL PARTNERS _
APN: 7627240-003-71 -300962- 17700 SW UPPER BOONES FERRY RD
Application description: WALL/FENCE SUITE 100
y Property Zoning: MEDIUM "DENSITY. RES 4J PORTLAND, OR 97224
Application valuation: 1800 ® ,
.' Contractor. y,
Applicant:Architect or En nee DAVIS/REED CONSTRUCTION INC t .
/ y
d169.SAXONY.ROAD, SUITE 105 •
C/fD.?495 ENCINITAS, CA 92024.
'(760)634-2350
Lic. No.: 813480
_ _ —— — _ _ _ _ _— _ _ _ _ _ _ — — _ _ _ — _ _ _.— _ _ _ _ _ — _— _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _—
U N D ONT OR'S DECLARATIO WORKER'S COMPENSATION DECLARATION -
• I hereb ffirm and penalty of jury the a i sed u er provisions apter 9 (commencing with s - I hereby affirm under penalty of perjury one of the following declarations:
Sectio 000) of rvision 3 of t e Busines n r essio Is Cod my License is in full.force and effect. - _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Lice Cl se No.i 813480 r - - - - ' for by Section 3700. of the LabocCoda' _ e pe o nce of the work for which this permit is _
., issued.
Da fi ntra or: -I have and will maintain -workers' mpensation insurance, a required by Section 3700 of the Labor •�
/ . Code, for the performance�f he work for which this pe it is issued. My workers' compensation
WNER-BUILDER DECLARATION - _ - insurance carrier and p ivy nu er are: - J'•� -
here affir under penalty of perjury t am exempt from the Contractor's State License Law for the - Carrier STATE FUND P cy Number. W 98892005
_ followi g re on (Sec. 7031.5, Busines and Professions Code: Any city or county that requires a permitto_ I ertif that, in the orma f e work for w this permit is issued, I shall not employ any +-
constr ct, at er, improve, demolish, or r pair any structure,, prior to its issuance, also requires the applicant for the - non in an ner so come sub'e ensation laws of California, F
permit o file a signed statement that he or she is licensed pursuant to the "provisions of the Contractor's State a d a at, if.1 s o me su 'e , o the workers' compensation provisions of Section ^
_ License Law (Chapter 9 (commencing with Section 7000) of Division.3 of the Business and Professions Code) or. 70 of the Labor all fo th comply with those provisions. - -
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).: a licant: -
(_ f 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 AR IN FA4 RE TO S WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL N
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUB ECT AN EMPLOYER TO RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND '
and who does the work himself or herself through his or her own employees, provided that the - DO R ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SE TIO 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). - APPLICANT ACKNOWLEDGEMENT - -
(�� 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.: IMPORTANT Application is hereby made to the Director. of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for -
pursuant to the Contractors' State License Law.). - - - whose benefit work is performed under or pursuant to any per a result of this application, '
(_) I am exempt under Sec. ,.B.&P.C. for this reason -4. the owner, and the applicant, each agrees to, and shall de indemnify a d hold harmless the City
of La Quinta, its officers, agents and employees for �u act or omission rel ed to the work being s
• performed under or following issuance of this pe it -
Date: Owner: - 2. • Any permit issued as a result of this --- -_ b mes null and void if ork is not comme
- -
hin/180 days from date of issuance of uc ermit, or cessation work for swill subject
CONSTRUCTION LENDING AGENCY erm1t to cancel)
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the Jcertit h e rea application andst a that ab informati orrect. I agree to comply with allwork for which this permit is issued (Sec. 3097, Civ. C.). - Ord' nces and state laws re ting to ildi on i , and hereby authorize representatives
o e ter upon above -me coned pe mspe n purposes. .
Lender's Name:
D./
Lender's Address:
I! LQPERMIT • µ
\i
gnature (Applicant or � 0: , ~ _ •
Application Number . . . . 05-00004393
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 41.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
.1800
Expiration Date 3/28/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
13.00 2.0000 HIND BLDG 501-2,000
26.-00
-------- ------------------------------------
Special Notes Comments
---
------
- -
-
•and
72 L.F. 61.BLOCK WALL, ORCO.SYSTEM.
Fee summary Charged Paid
- Credited
Due
Permit Fee Total 41.00
.00
:00
41.00 -,
Plan Check Total .00,
00 ."
.00
.00`
Grand Total; -.' 41.00
.00:
.00
41.00:, 4
„
LQPERMIT
CERTIFICATE OF FIELD VERIFICATION.&"DIAGNOSTIC TESTING(Page 1•4f 1). . , CF -4R
I
Project Address 1 Puerta Azul-]
Builder / Installer 3"
57420 Via Vista,/ La Quinti CA / 92253
Puerta Azul Partners, c/o Pacific"Security Capital '\t'
Builder / Installer Contact' Telephone
Plan Number / Permit Number.
Mike Kwaske 7607027215:•
1
HERS.Rater. :°' -Telephone,
Sample Group Number .
R
Dave Bricker -'CIHIEIEIRISO ID #CCN99380828 • . 7607743676..
14
Compliance Method (Prescri
hve) ` t ;•''.. '
Climate -Zone 15 '.
Certifying Sign Date..
Sample House Number
`
71 ,.
Firm
HERS Provider -..
Energy. Driven Solutionsr
CjHjEjEj9jS®
Address <. '
City/State/Zip
148-755 Still Water Street;'
Indio 7CA'l92201 '
-'Copies to: BUILDER. HERS PROVIDER AND BUILDING DEPARTMENT r •. `
.HERS RATER:COMPLIANCE STATEMENT
This house was: ✓ Tested
As the HERS rater.providing diagnostic testing and field verificationI�ce�fy that the houses identified on this form comply with the diagnostic
tested compliance :re4uirements as checked on this form. + `"
` ('+ ✓ The installer has provided a copy of CF -6R (Installation Certificate);
✓ Distribution s stem is full t ' yi I ies '
y y duc e'd ( .e., does not se building-cav�t�es as plenums.or platform returns in heu of ducts).
✓Where cloth backed; rubber adhesive duct tape is:mstalledlmastic.and"drawbands are used m combination with' cloth backed; rubber• adhesive
. duct tape to seal leaks at duct connections..� - '� . • � • ,,
t`' ✓ MINIMUM REQUIREMENTS FOR DUCT2LEAKAGE REDUCTION'CUMPLIANCE-CkEDIT '
Duct Diagnostic
LeakageTestingResults (Maximum -6% Duct Leakage)
:System # 1
Duct Pressurization Test Results (CFM;@ 25'Pa) ` w. s+ fy� h Measured Values
Test Leakage Flow; in CFM : r 87
`:•.' w .
If fan•flow is calculated as 40 to" x number of tons int er,cal cuI' ed value here ,
ti r.
' Iffan flow is measured`enter measn�redvalue here r
Leakage:Percentage (i00 x Tested Leakage /°Fan, Flow) _ 4.4
t Check Box for Pass or Fail (Pass=6% ofless) - ✓Pass " 0 Fail
AAPH E tj XN.
Residential Compliance Forms "r 'Generated by CIHIEIEIRIS® http..//wyVw.CHEERS.org i•'August 2001 'Y "