04-7621 (SFD)F OZ, •
�� (I 'Ot. yoo
BUILDING".& SAFETY DEPARTMENT
c P.0. Box 1.504 r (760).777-7012
�MpF�9
78 CALLE TAMPICo R' AX (760) 777-7011
Q �A t)`INTA; CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
JAN
06 Z��S BUILDING PERMIT
q �r LACAUlt(iA
Apfii c anti on�N°umber 0 4- 00 0 0 7 62+1 Date. 12/08'/04
p'erty Address' _5725 VIA VISTA
APN: 762-240-003-35 300962-
Application description DWELLINGSINGLE FAMILY DETACHED
Property Zoning . . MEDIUM DENSITY RES
Application valuation" 85886
Owner Contractor
PUERTA AZUL PARTNERS DAVIS/REED CONSTRUCTION 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: WC298892004 06/12/05".
CSLB:• 813.480 10/3.1/06
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 CBC
*BEDROOMS 2.00
FIRE SPRINKLERS NO
GARAGE SQ FTG. 244.00
PATIO SQ FTG 163.00
NUMBER OF UNITS .1.00
1ST,-FLOOR SQUARE FOOTAGE 13.80.00
Permit BUILDING PERMIT l
Additional"desc
Permit Fee 576.50 Plan, Check, Fee:... 93.68
Issue Date Valuation 85886
Q"ty Unit Charge Per Extension
BASE FEE 414.50
36.004.5000 THOU BLDG 50,001-100,000 162:00
Permit MECHANICAL
Additional desc
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 <=100K
1.00 9.0000 EA MECH B/C <=3HP/100K.BTU 9.00•
P.O. BOX 1504 • 4 4 "
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:yq- �eigogw /
Applicant:
Applicant's Mailing Address:
I hereby affirm
Code, and my
cense Class
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: S'
Architect or Engineer:
Architect or Engineer's Address:
ic. No.:!
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
ry that I am licensed under provisions of ter 9 (common' p vvvfffaaath Section 7000) of Division 3 of the Business and Professionals
and effect. /�
„� �e No. x U
Bate — �� t60ii Tactor_
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
Kof the work for IcTMis permit is issued.
l have and I m "ntai rkers' compensation 'nsurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. ors' compensation i nce carcier and policy number are:
artier olicy Number o Lti V
I certiWThat, in the performance of the work for emit is issued, I sha t employ any person in any manner so as to become subject to the workers'
compensation laws of California, and a the ould beco f o the rkers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith compI with those provisio
Ufa / —Co
WARNING: FAILURE TO SECURE WOS' 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.
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 ran or whose enefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each a o, 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 being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and d 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 informatio 's co I agree to co w' a ' and cou y ordinances and state laws relating to building
,construction, and�ebyauthorize representatives of this county to enter upo above -menti Pr rt nspectio urposes.
Signature (Applicant or Agent):
,
_ Page
2
_ Application Number, 04-0000762.1 Date
12/08/04
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 F,ee, 68.18 P1an.Check,Fee
4.26
Issue Date _ Valuation
0
Qty Uni.t-Charge Pery
Extension
,. "BASE FEE• _
15.00
- 1380.00- :. x .,0350- NEW RES.. --"'1 OR 2 FAMILY _
48.30
244.00. 0.200", ELEC GARAGE OR NON-RESIDENTIAL
4.88
Permit PLUMBING
Additional dese
Per Fee,,"139.50 Plan'Che'ck Fee
8.72 .
..Issue Date Valuation
0
Qty Unit Charge Per.
Extension
.'BASE, FEE'
15-00
12:00 6':0000'EA PLB FIXTURE
72.00
1. 00' 15.0000.Ek PLB BUILDING.SEWER
15.00
1.00 7..;5000., EA' PLB WATER HEATER/VENT
7.50
1.-00 3':00.00.EA. ,PLB WATER INST/ALT/REP
•3.00
1.00 9.0000 EA, PLB LAWN_.SPRINKLER SYSTEM
9.00
_1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3:.00
1.00 ' _ :.15.. 0000 , EA. PLB GAS . METER.
15.00
----- - - -. -- ------.----- - -- ---------------
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 35. PLAN 1RB, 1380 SF.'`PERMIT:'
DOES.NOT INCLUDE BLOCK WALLS, POOL,.SPP; ,
OR DRIVEWAY APPROACH. 75%' PLAN CHECK FEE
REDUCTION ,APPLIED' FOR,.'MULTIPLE ISSUANCE
OF SAME PLAN TYPE..
---------------------------------.--------------------------=------
Other Fees ART IN -PUBLIC PLACES -RES.
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Application Number :` X04-00007621 }T; Date
12'/08/04
-=------------------------------ ----=f-.-.---:- ---- ----;--- --------------------
` Other.. Fees :�, :, DIF ,.COMMUNITY CENTERS -RES
97.00
-DIF CIVIC" CENTER - RES
366.00
w -ENERGY REVIEW FEE
9.37
DIF" FIRE PROTECTION -RES
97.00
GRADING'. PLAN CHECK FEE
'.00
Q,DIF LIBRARIES - RES'
,225'.00
DhF PARK.MAINT FAC -'RES,
5.00
y° i•6 3 "- `DIFF PARKS/REC RES' t
502.00
STRONG MOTION (SMI) -` RES
'8.58
. DIF STREET;MAINT FAC -RES:
15.00
DIF TRANSPORTATION = • RES
1098.00
Feesummary`` --Charged o Paid Credited }
- --------------------------
Due
-
Permit Fee Total r" 877:68 F' 00 :, 00`` ----877.6.8
Plan Check Total , . �•. 111. 57 ,' Y - °� 00 '' .0o,.
111.57
Other Fee Total-_: 2422.95 >: '.,` 00 _00
2422.95
Grand :Total y.'..;`3412`:20 �' :00-:, .00
341,2.20•
,'-'
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CERTIFICATE OF FIELDYERIFICATION 8i DIAGNOSTIC TESTING a e l of 1 .-CF-4R
Project Address I Puerta Azul.J. / ' ^, "'
Builder / Installer i,•
57-425 Via Vista / La Quints / CA 7 92253'
Puerta Azul Partners, c/o'-Pacifie Security Capital
Builder/Installer Contact'' t Telephone .
Plan Number /Permit Number„
Mike Kwaske y { 1 7607027215 '
1
• T
1
HERS Rater •Telephone
Sample Group Number, a `
Dave Bricker` - CjHjEjEjRjS® ID #CCN99380828 : 7607743676.
20
Compliance Method Ti scriptiv
Climate -lone 15 'F
Certifying Signator Date,,
Sample House Number, '
35. r r t
Firm `'
HERS Provider
Energy Driven'SolutlOnS, r,
C�H�E�E�R�S®M
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z
Address.f
City/State/Zip
48 755 Still Water Street< f
1
Indjo /CA /92201.
^k s
.Copses to; BUILDER'HERS PROVIDER AND BUILDING DEPARTMENT }
HERS RATER COMPLIANCE STATEMENT ? t
This house was°"✓ Approved as part of sample testing, but was not tested. F
As the HERS rater providing diagnostic testing and field venfication"�I,certtifytthatthe houses identified on'this form comply with the diagnostic.i a i
tested compliance requirements as checked on'this form.
e Cl The installer has provided a copy of CF -6R (InstallationCert) • _
❑ Distribution system is fully'ducted does*n use �bryuilding cavities'as plenums �or�pylaa form returns'in lieu of ducts_). 4r
0 Where cloth backed rubber adhesive duct tape is installed,, mastic. and drawbands are _used in con'bination with'cloth backed rubber: adhesive
}z .
ducttape to seal leaks'. at duct,connection
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Residential Compliance Forms :+ .Generated by CjHjEjEjRjS®.http://www.CHEERS.oFg August 2001 ,
FES -06-2006 04:41 PM P.12
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"CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING' CF -4R
-„,,r1- ✓ e� Z tJ p
/ • act Tltl // // �Dateoor
7 97
Pro ect Add ass Build r em
Bullder Contact Telephonei
Plan Number
HERAln2ISM-1;nature
far T lap one Sample Group Number
,4
D e Sample House Number
Firm:;' C• �'�S�OGiaT�S / HERS Provider;
Street Address: Clty/State/21p'..
Copies to: Builder, HERS Provider
RSR TER QOMPLIANCE STATEMENT
The house was: ❑ Tested ja–Approved as part of sample testing, but was not tested
As the HERS raterroviding diagnostic testing and field verlfloation, "I certify that the houses Identified on this form
co with the diagnostic t-ested 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
ducts)
IBJ 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)
t Measured
Duct Pressurization Test Results (CFM 25 Pe) values
Test Leakage Flow in CFM
If fen flow Is calculated as 400cfm/ton x number of tons enter
' calculated'velue here
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) _
Check Box for Pass or Fall (Pass=6% or less) ❑
Pass Fail
4THERMOSTATIC EXPANSION VALVE (TXV) or Commission -approve equivalent
Yes , ❑ 'No Thermostatic Expansion Valve (or Commission approved”
equivalent) Is Installed and Access is provided for inspection❑
Yes is a pass ass Fall
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
0 Yes ❑ No ACCA Manual D Design requirements have been met
(rater has verified that actual Installation matches values in:
CF -1 R and design on plan..
2. Cl Yes l7 No TXV is Installed or Fan flow has been verified. If no TXV,.
verified fan flow matches design from CF -1 R.
Measured Fan Flow =
. ❑ 4
Yes for both 1 and 2.1s a Pass Pass Fail
i