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SFD (04-4779)
54900 Avenida Madero 04-4779 o`` aIrl(/ BUILDING & SAFETY DEPARTMENT ew P. ox 1504. (760),777-7012 l 78 CALLE TAMPICO FAX (760) 777-7011 JUN O $ 200 ,A NTA., CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 C%TY0fl-p'nu1NTR BUILDING -PERMIT fIN NCe DEPT ppl-ication Number I;04-0.0004779 Date 6/04/04 Property Address 54900 AVENIDA MADERO APN: 774-265-010-15 -000000- Application description DWELLING.- SINGLE FAMILY DETACHED Property Zoning . . . COVE RESIDENTIAL Application valuation .121779. Owner Contractor POWER FINANCE : ADDINGTON, DAVID P.O.-BOX 134 4176'0 HERMITAGE 'DRIVE LA. QUINTA CA 922.53 INDIO' CA 92201 is-.•. i , WCC: STATE FUND i.: WC;, , ;22940:197.87 01/01/05 CSLB.: 6829'01 12/31/05 CCC: B ---.- Structure. Info.rmation 1955 SQ. FT. SFD ----- Construction-Type TYPE V.- NON RATED O.c.cupancy T_ype'--.–_.._._.-_.—._._.—D.WELLG./_.LOD.G.ING./_GONG_ <=_1.0_ Flood Zone . . . . . . . NON=AO FLOOD ZONE Other struct info.. CODE EDITION 2001 CBC # BEDROOMS 3.00.. FIRE .S.PRINKLERS NO GARAGE SQ'FTG 427.00 PATIO SQ FTG 119.00. NUMBER. OF UNITS 1.00 FIRST FLOOR SQ'1FTG, 1955.00 Permit BUILDING PERMIT Additional:-de.sc Permit Fee 716.50 Plan Check Fee 215.73 Issue Date; Valuation 121779 Qty Unit Charge Per;; Extension. -BAS-S` FEE 639.50 22.00 3.5000 THOU BLDG 100,0017500,000 77.00 Permit. . . . . ELEC-NEW RESIDENTIAL. Additional desc .Permit Fee 106.97 Plan Check Fee . 26.74 Issue Date Valuation 0 Qty Unit Charge Per Extension P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760)'777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: 6-g 0 Architect65FEngineer: rf Archit ct r Engineer's Address: ' Lic. No.: 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 - Code, and myLice r in full force and ect. O / Licence E3"license No. (0 D Date — G - Contractor OWNER -BUILDER DECLARATION 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 contractors) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. B.& 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 self4nsure 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. 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. M w ers' compensation insurance carrier and pqr y er fe Carrier ? Policy Number _ I cry that, in the performance of the work for which this permit is issued, I shall not bm-"pToy rs any person In any manner so as to become subject to the worke' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r• rDate J - LApp licant r 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 ($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 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.pernit, or cessation of work for 180 days will subject permit to cancellation. 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 coun7to erpon the above-mentio ed property for inspection purposes. Date Signature (Applicant or Agent): - ' Page 2 Application Number . . . . 04-00004779 Date 6/04/04 Qty Unit Charge' ..Per Extension BASE FEE 15.00 1955.00 .0350 ELEC NEW RES -'1 OR 2.FAMILY 68.43 427.00 - .0200 ELEC.GARAGE OR NON-RESIDENTIAL 8.54 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 Permit GRADING PERMIT i.' Additional desc Permit Fee 15.00 Plan Check Fee .00 Issue Date . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 Permit MECHANICAL_ Additional desc Permit Fee 46.00 Plan Check Fee 11.50 ' Issue Date,.- Valuation 0 Qty Unit Charge Per Extension 'BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K .9.00 1.00 9..0000. EA MECH B/C.<=3HP/100K BTU 9.00 1.00 6.5000 EA MECH VENT FAN .6.50 j! - 1.0.0 6.5000 EA MECH EXHAUST HOOD 6.50 j------------------------------------------------------------------------ Permit PLUMBING Additional desc PermitFee 158.25. Plan Check Fee •39.56 Issue Date. Valuation 0 Qty Unit Charge. Per Extension BASE,FEE 15.00 15.00 6.00.00 EA PLB FIXTURE 90.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 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 EA PLB GAS PIPE 1-4 OUTLETS 3.00 1.00 .7500 EA PLB GAS PIPE >=5 75 1.00 15.0000 EA PLB GAS METER'- 15.00 ,I Al it Page 3 Application Number . . . . . 04-00004779 Date 6/04/04 '•Special Notes and Comments ' , NEW SFD 1955' SQ. FT. Other Fees . . . . . . ART IN PUBLIC PLACES=RES .00 t DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00, ENERGY REVIEW FEE 46.57 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE 00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC -'RES 5.00 D.IF PARKS/REC - RES -502.00 COVE PRECISE PLAN FEE 100.00 STRONG MOTION (SMI") -,,RES 12.17 -DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1042.72 ---------- .00 .00 1042.72' Plan Check Total 293.53 .00 .00 293.53 Other. Fee Total ,2563.74 00 .00 2563.74 Grand Total 3899.99 00 00 3899.99' t I CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950. Dune. Palms Road z Q' q BERMUDA DUNES . Date'; 3/11/04 La Quanta, CA 92253 V) RANCHO.MIRAGE . No. I:' 25635 (760).771-8515 IPALMDE ERT V PALM DESERT LA QUINTA Owner 4 Power Finance APN # 774-265-010 Address'' P. O. Box 134 Jurisdiction La Quinta City La Quinta Zip 92253Permit # r 0403-117 Tract # BLK275 Study Area Type j Single Family Residence No. of Units 1 Lot # No. Street S.F. ' Lot # No. Street S.F. Unit 1 15 54900 Avenida Madero 1,955 Unit 6 Unit 2 Unit? Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports; covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995'.Et Seq. in the amount of $2.14 X 1,955 S.F. or $4,183.70 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage.in this proposed project may now be issued. , Fees Paid By C/C, VIP Bank - Alissa Aiton Check. No: 305374 Name on the check Telephone 485-3039 Funding Residential By Dr. Doris Wilson Superintendent Fee collii;0e 1`lexemp d by PatrLEBarbuzza Payment Recd- $4,183.70, ecd $4,183.70, Over/Under. Signature i. NOTICE: Pursuant to Government Code Section 660 d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the byilding or installation permit for this project is issued, or from the date on which those amounts are paid to the. District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting is . LA QUINTA . :ETY DEPARTMENT 7-7012 REQUEST LINE.: T; 71153 OwnXk AD c r ot -IErr or 't N�*ber'*, 6jjS;jpLAC1E Permit JOB IN CONSPICU INSPECTOR MUST SIGN ALL APPLICABLEISPACES ADERO 54-900 AVENIDA M JOB ADDRESS 0' NOT 1955 SQ. FT- SFD PEFA Fs /SPA OR NVALI--, �- INCLUDE BLOCK IVIEWAY APPROACH. POO DR TYPE OF INSPECTION '6i:TE INSP. — --o ITEMPORARY 'vrn' SETBACKS 7 U/G PLUMBING I WASTE Our-, ELECTRICAL / GROUNDING FOOTINGS/ STEEL CONCRETE SLAB �'T POUR CONCRETE UNTIL ABOVE SIGNED DO U `ROOFNAIL / PRE -ROOF TO WRAP FRAMING COMBINATION UGH ELECTRIC ROUGH PLUMBING ROUGH MECHANICAL INSULATION SIGNE CUVF-" fERNOWORKUNTILABOVE -I, INTERIOR GYP vv BD. UhymL- L LATH EXTthl- m GAS TEST SEPTIC ABANDONMENT -F,PfpFt CONNECTION 4' OR - 1 SEPTIC GREASEuO" MASONRY INSPECTIONS FOOTINGS 1 STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE GUNI E / SETBACKS U G PLUMBING U/G GAS U/G ELECTRICAL PRE -P ASTER'ALARMS/FBARRIER INAL INSPECTION TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. - FINAL/jQBCOMPLETED TINCLUDE RIGHT TO .--.,1..oQnVALSDON0 I MAR -02-2005 107:32 AM P.03 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R Proj®ct T!tle / _ Dat WIA Prnj t A ress – -- Bullder Name ti r L.4 )X Builder ContBCt Telephone Plan Number HER Rat9r ^— Telephone Semple Group Number rtifying Si3nature ~' ate Sampl9 House Number Firr9: Z1, C- e ' fs_aa,• 'ir; . /__/ HERS Provider: 1/ 7 4C"Street Address: WL S 2ro +% Ire Ie, city/Sta'e!zip, 4 a m- r. i no 7:9;e Cupies tn; Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: Tested 13 Approved as part of sample testing, but was not tested I As the HERS rater providingdiagnostic testing and field verification, I certify the' the houses identified on t^is form co with the diagnostic ested compliar"ce requirements as checked on this form. Distribution system is fu!ly ducted (i.e., does not use buildin6 cavities as )ienums or platform' ratums in I;eu - of ducts) Where cloth backed, rubber adhesive duct tape is Installed, mastic and drawbands ere used in corntination with cloth backed, rubber adhesive duct tape to sea! leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 5% Duct Lea_ kaga) Measured Duct Pressurization Test Results (CFM 25 Pa) values Test Leakage Flow in CFM s If fan flow Is. calculated as 400cfm/ton x numtier of tons enter .-1 fi calculated value here If fen flow is measured enter measured va'ue here jLeakaga•Percentag© (100 x Test Leakage!Fan Flow) Check Box for Pass or Fail (Pass=6% or less) fess . Fail j THERMOSTATIC EXPANSION VALVE (TXV) or Commission appruv,d equivalent __ _ _ Yes No thermostaticExpansion Valve"(or Commission approved. equivalent) is installad and Access is provided for Inspection Yes Is a pass 'Pass Fall. ' ® MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1 " Q Yes ❑ No ACOA Manual D Design requirements rave been met (rater has varified that actual !rstallatior. matches values in GF -1 R and design on pian. I 2. C Yes No TXV is ins' ailed or Fan flow has been verifies. !f no TXV, A,114 verified `en flow matches design from GF -1 R. Measured Fan Flow = ri Yes for..both 1 ard.2 is a Pass Pass Fail