05-4154 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05_-00.4
0-015-4'
Property Address: 56821 VILLAGE DR
-- - : -
- --- -APN:___-
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3875
Applicant:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/19/05
Owner:
BIRDIE HOMES I.II,_ LLC_,_ -. - - -- —'
300 E. STATE'ST. STE. 100
REDLANDS, CA 92373
�1
Contractor:
Architect or Engineer: Sep O FIRST PACIFICA DEV CORP
00 EAST STATE ST, SUITE #100
Cyd 99
REDLANDS, CA 92373
/^ Qj��F �G ✓ D -3-688
Lic. No83
:760044
�J ids Oen- �i4✓,.
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 f License.No.: .760044
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, piior.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).:
(_) 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 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-withlicensed 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.). '
(_) I am exempt under Sec. , B.&P.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.)'. .
Lender's Name:
Lender's Address: fes►
LQPERMIT
WORKER'S COMPENSATION DECLARATION
1 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 performahce 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 STATE FUND Policy Number W-5734291
_ I certify that, in the performance of the work for 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
3.700 of the Labor Code, I shall forthwith pomply�with thotse provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (sl 00,000). 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,j
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 this county to enter upon the bove-mentioned property for inspection purposes.
�B te: ^- ature (Applicant or Age
Application Number 05-00004154
Permit. WALL/FENCE PERMIT
Additional desc .
Permit Fee .63.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
3875
Expiration Date,. 3/18/06
QtyJ- .Unit -_.Charge- Per---- .-- -- ._,_
.___
--Extension -----------•:- ---- - - - _—___ __ _ _
BASE FEE.
45.00
2.D0 9.0.000 THOU BLDG 21'001-25,000
18.00
------------------------------------------------------
Special Notes and Comments
155 L.F. 6- GARDEN WALL, CITY STANDARD
Fee summary Charged Paid
Credited
Due
Permit Fee Total 63.00
.00
.00
63:00
Plan Check.Total .00
.00
.00
.00..
Grand Total 63.00
.00
.00
63.00
LQPERMIT
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part l) CF -4R �
The Palms �� P
Project Title Date
X56-821 Village Dr. La Quinta, CA first Pacifica Dev. Corp.
Project Address Builder Name -
Herb Herman (909) 322-7140 4-0
Builder Contact Telephone Plan Number
Ti v%al-J&(951) 780-7265 • 6
HERS Rater, J Tele hone Sample Group Number ;
66 Sys.1 '
Ce ifying Signature Date Sample House Number
Firm: Energy Calc Services, Inc HERS Provider: CHEERS
Street Address: 16551 Mockingbird Cyn. Rd.' City/State/Zip Riverside, CA 92504-9638
'Copies to: '' Builder HERS Provider -
HERS RATER COM IANCE STATEMENT .
The house was: Tested ❑ Approved as part of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on. this form . .
coRply with the diagnostic tested, compliance requirements as checked on this form.
The installer has provided a copy of CF -6R ( Installation Certificate)
biJ Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform
returns in lieu of ducts)
❑ Where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands 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) `
Measured
Duct Pressurization Test Results (CFM @ 25 Pa) values
i Test Leakage Flow in CFM
If fan flow is calculated as 400cfm/ton x number of tons enter
calculated value here 2000 ;.
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) ❑
r Pass Fail
® THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent
Yes ❑ No Thermostatic Expansion Valve (or Commission approved '
equivalent) is installed and Access is provided for inspection-
Yes
nspectionYes is a pass Pass : • Fail
- January 5, 2001
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part l) CF -4R
The Palms
Project Title
Dat ,
56-821 Village Dr. La Ouinta,
CA First Pacifica Dev. Corp.
Project Address
Builder Name
Herb Herman
(909) 322-7140 4-0
Builder Contac(t� l
1 S '
Telephone Plan Number
Tink-off OJ �i Y11'% k�>✓�'
951 780-7265 6
ERS Ratef
Telephone Sample Group Number
« J
66 Sys. 2
Certifying Signature
Date Sample House Number
Firm: Energy Calc Services, Inc
HERS Provider: CHEERS
Street Address: 16551 Mockingbird Cyn. Rd.
City/State/Zip: Riverside, CA 92504-9638
Copies to: Builder, HERS Provider
'
- HERS RATER COMPLIANCE STATEMENT
The house was: Tested ❑ Approved as part of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form -
mply with the diagnostic tested compliance requirements as checked on this form. '
The installer has provided a copy of CF -6R ( Installation Certificate) -
`LJ Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform
returns in lieu of ducts)
❑ Where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands 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)
Measured
Duct Pressurization Test Results (CFM @ 25 Pa) values"
Test Leakage Flow in CFM ��--
If fan flow is calculated'as 400cfin/ton x number of tons enter r
calculated value here 2000
If fan flow is measured enter measured value here ;
Leakage Percentage (100. x Test Leakage/Fan Flow =
Check Box for Pass or Fail (Pass=60/o or less) - ❑
Pass Fail.
❑x THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent
�J Yes ❑ No Thermostatic Expansion Valve (or Commission approved
equivalent) is installed and Access is provided for inspection^ ❑ '
Yes is a pass Pass Fail
January 5, 2001
x .
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING 1) CF-4R
/(Part
The Palms 'G
Project Title Datfi
56-821 Village Dr. La Ouinta, CA First Pacifica Dev. Corp.
Project Address Builder Name
Herb Herman (909) 322-7140 4-0
Builder Contact
Telephone Plan Number
951 780-7265 6
HERS.Rater
Tel hon Sample Group Number
66 Sys.3
Certifying Signature Date Sample House Number
Firm: Energy Calc Services, Inc HERS Provider: CHEERS ' .
,
Street Address: 16551 Mockin-gbird Cyn. Rd. City/State/Zip: Riverside, CA 92504-9638 '
Copies to: Builder, HERS Provider
HERS RATER COMMIANCE STATEMENT z
The house was: Tested ❑ Approved as part of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form
comply with the diagnostic tested compliance requirements as checked on this form.
+ The installer has provided a copy of CF-6R ( Installation Certificate)
Distribution system is fully ducted (i.e., does not use building cavities as.plenums or platform
returns in lieu of ducts)
❑ Where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands 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) -
Measured
Duct Pressurization Test Results (CFM'@ 25 Pa) values
Test Leakage Flow in CFM
If fan flow.is calculated as 400cfin/ton x number of tons enter T
calculated value here 1000
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow =Y
Check Box for Pass or Fail (Pass=6% or less)
❑
Pass
Fail
® THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent
J
_ Yes ❑ No Thermostatic Expansion Valve (or Commission approved
equivalent) is installed and Access is provided for inspection
❑ ',
Yes is a pass Pass
-Fail - >-
•_, January 5,2001