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SFD (04-4070)55460 Medallist Dr 04-4070 Application Number Property Address . . . . . . APN: Application description . . . Property Zoning . . . . . . . Application valuation . . Owner NORMAN ESTATES II C/O MEDALLIST GOLF DEVELOPMENT 501 NORTH AlA JUPITER FL 33477 fG ft CV BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 F4 =0-0004-07-0 Date 5/12/04 55460 MEDALLIST DR 767-510-019- - DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 298162 Contractor EHLINE COMPANY 55375 MEDALLIST DR LA QUINTA CA 92253 (760) 771-8130 WCC: STATE FUND WC: 2290006783 01/01/05 CSLB:, 482085- 11/30/05 CCC: B ------ - -------------------- Structure Information ------------------------- Construction Type . . . ... TYPE V - NON RATED Occupancy Type . . . . . DWELLG/LODGING/LONG.<=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CRC # BEDROOMS 3.00 FIRE SPRINKLERS NO ' GARAGE SQ FTG 806.00 PATIO SQ FTG. 514.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 3410.00 Permit . . . . . .. BUILDING PERMIT Additional desc Permit Fee 1336.00 Plan Check Fee 868.40 Issue Date Valuation . . . . 298162 Qty Unit Charge Per Extension BASE FEE 639.50 199.00 3.5000 ----------------------------------------------------------------------------- THOU BLDG 100,001-500,000 a.. 696.50 Permit . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . •150.47 Plan Check Fee 37.62 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT s—� Application Number: IQ q - L{Q 70 Date: Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: o. 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 Licep a is in full force and effect. p2 z�S� �Cicense Class J License No. �f 1__� Data � _I Contractor l (-t it � i•� cin 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. , B.& P.C. for this reason Date Owner WORKERS' 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 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 fissyfed. My workers' co ensation m�urertce came and olicy numbeF are: �rrier. L Ft- (? �—c .D oi�licy Number �� dQ,W ') _ I certify that, in the performance of the work for which this permit is issued, I shall not em loy any person in any manner so as to become subject to the workers' compensation laws of California, and _gree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisioprs./ _ I--- Date 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.). Lenders Name Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the condifions 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 permit, or cessation of work for 180 days will subject permit to cancel ation. I certify that I have read this application and state that the above info tion is rrect. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby aut=ignature ives of this county to nt r p he above-mentioned property for inspection purposes. to �— (0-04 ant or Agent), /� Page 2 Application Number 04-00004070, Date 5/12/04 - Qty Unit Charge Per Extension BASE FEE 15.00 3410.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 119.35 806.00 0200 ELEC GARAGE OR NON-RESIDENTIAL 16.12 ------------------------------------------------------------------------------- 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 Permit . . . . MECHANICAL Additional desc' Permit Fee 127.50 Plan Check Fee 31.88 Issue Date . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3:00 9.0000 EA MECH.FURNACE <=10OK 27.00 3.00. 9.0000 EA MECH B/C <=3HP/100K BTU. 27.00 .8.00 6.50.00 EA MECH VENT FAN 52.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . .. PLUMBING Additional desc Permit Fee . . . .. 172.50 Plan Check.Fee 43.13 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE `15.00 17.00. 6.0000 EA PLB FIXTURE 102.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.500,0 EA- PLB WATER HEATER/VENT -EA 7.50 1.00 3.0000 PLB WATER INST/ALT/REP .3.00 1.00 9.0000 EA-: PLB LAWN SPRINKLER SYSTEM 9.00 8..00 .7500 EA PLB GAS PIPE >=5 6.00 1.0.0 15.0000 EA PLB GAS METER 15.00 Special Notes and Comments' SFD - TR -29657, E LOT 56. PLAN,2CR. PERMIT Page 3 Application Number 04-00004070 Date 5/12/04 Special Notes and Comments DOES NOT INCLUDE.BLOCK WALLS, POOL,,SPA OR DRIVEWAY APPROACH. Other Fees ART IN PUBLIC -PLACES -RES 245.40 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 86.84 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 29.81 DIF STREET MAINT FAC-RES 15.00 DIF TRANSPORTATION - RES 1098:00 Fee summary Charged Paid Credited -Due ----------------- --- - ------ Permit Fee Total. 1801.47. ---------- --------.-- ---------- .0.0 .00 18.01.47 Plan Check. Total 981.03 ..00 .00 981.03 Other Fee Total 2767.05 .00 .00 2767:05 Grand.Total 5549.55 .00 .00 5549.55 o f Occupancy r oCertificate 4 OF Building & Safety Department A This Certificate is issued pursuant to the requirements of Section 109, of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code. and. the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 55-460 MEDALLIST DR. Use classification: SFD Building Permit No.: 04-4070 Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: RL OWner of Building: MEDALLIST DEVELOPMENT Address: 1070 E. INDIANTOWN RD. City, ST. ZIP: JUPITER, FL 33477 By: STEVE TRAXEL Date: 03-28-2005 Building Official POST IN A CONSPICUOUS PLACE Deft - - AOE ENERGY 06. Box 62' S"`os Rancho Mir-eyc, - a i v vcu. k w GJV- I UJG Email: DESNRG @AOL.COM CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R GREG NORMAN ESTATES PH -2 DATE TESTED 3-21-05 Project Title Date 55-460 MEDALLIST DRIVE LA QUNTA CA. 92253 EHLINE CO. •Project Address 760-578-4301 Builder Name GILBERT LEVZA PLAN 2 3 UNITS Builder Contact Telephone Plan Number RICHARD KROWN 760-250-1852 GROUP 3 HERS Rate l / Telephone Sample Group Number #CCNRK613292 03-21-05 LOT 56 1 OF 3 Certifying Signature Date Sample Lot Number Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS Street Address: P.O. BOX 621 City/State/Zip: RANCHO MIRAGE, CA. 92270 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 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 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) r Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM 44 If fan flow is calculated as 400cfm/ton x number of tons enter calculated value here 800 'If fan flow is measured enter measured value here. Leakage Percentage (100 x Test Leakage/Fan Flow) 5.5 Check Box for Pass or Fail (Pass=6% or less) ® ❑ Pass Fail ® THERMOSTATIC EXPANSION VALVE (TXV) } ® Yes ' ❑ No Thermostatic Expansion Valve is installed and Access is ` provided for inspection - ® ❑ Deseft- - ENERGY CADEC + Vices — PO. Box 62' `7 Rancho Miragw, -^ wa 1 u _. . k' _J LJV- 1 VJL Email: DESNRG 0,AOL.COM CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R GREG NORMAN ESTATES PH -2 Project Title 55-460 MEDALLIST DRIVE LA OUNTA CA. 92253 DATE TESTED 3-21-05 Date EHLINE CO. -Project Address 760-578-4301 Builder Name GILBERT LEVZA PLAN 2 3 UNITS Builder Contact Telephone. Plan Number RICHARD KROWN 760-250-1852 GROUP 3 HERS RatVRL Telephone Sample Group Number #CCNRK613292 03-21-05 LOT 56 2 OF 3 Certifying Signature Date Sample Lot Number Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS Street Address: P.O. BOX 621 Copies to: Builder, HERS Provider City/State/Zip: RANCHO MIRAGE, CA. 92270 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 comply with the diagnostic tested compliance requirements as checked on this form.- 0 orma® 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 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) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM 80 If fan flow is calculated as 400cfm/ton x number of tons enter calculated value here 1600 If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) = 5 Check Box for Pass or Fail (Pass=6% or less) " -4 Pass Fail ® THERMOSTATIC EXPANSION VALVE (TXV) ® Yes ❑ No Thermostatic Expansion Valve is installed and Access is ® ❑ provided for inspection Li Desewt ENER Semces FO. Box 62' Rancho Mir -nye , . m acc t u Email: DESNRG OAOL.COM r.i o...i inn wi wt.. awa .•.i --. kI WJ 4J...... CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R GREG NORMAN ESTATES PH -2 Project Title 55-460 MEDALLIST DRIVE LA QUNTA CA. 92253 -Project Address 760-578-4301 GILBERT LEVZA Plan Number )-1852 GROUP 3 HERS Rate tL Telephone Sample Group Number //'' / #CCNRK613292 03-21-05 LOT 56 3 OF 3 Certifying Signature Date Sample Lot Number Firm: DESERT ENERGY SERVICES LLC HERS Provider: CHEERS Street Address: P.O. BOX 621 City/State/Zip: RANCHO MIRAGE, CA. 92270 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 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 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) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM 66 If fan flow is calculated as 400cfm/ton x number of tons enter calculated i value here 1200 If fan flow is measured enter measured_value here Leakage Percentage (100 x Test Leakage/Fan Flow) = 5.5 Check Box for Pass or Fail (Pass=6% or less) 91 ❑ Pass Fail DATE TESTED 3-21-05 Date EHLINE CO. Builder Name PLAN 2 3 UNITS Builder Contact RICHARD KROWN Telephone ® THERMOSTATIC EXPANSION VALVE (TXV) ® Yes ❑ No Thermostatic Expansion Valve is installed and Access is ® ❑ provided for inspection Nov 08 04 l Os 5?a RF b s XU6 ! UKHU&Snn 1 MFlm Lm r -- ---- R F ---R.F STRUCTURAL CON6'ULTANTS, INC. 75-153 MERLE DRIVE, SIE. B, PALM -DESERT, CA 92211 PHONE (760) 936••1000 FAX (760) 836-.0856 B- MAM RAY.IAOND@RFSTRUCi'URA.L,COM NOVEMBER 81 2004 EHLINE COWANY 81-480 NATIONAL DRIVE LA QUINTA, CA. 92253 Atte.: MR. GILBERT LEYVA Re.: THE NORNLAON ESTATES AT PGA WEST, SST460 V1ED ,LIST RI`IE ' a LA QUINTA, CA, 92253 FOLLOW-UP TO WALK THROUGH JOB NO.: 4082 DEAR PHU, THIS LETTER, ADVISES THAT WE HAVE OBSERVED THE STRUCTURAL, REQUME.MENTS THAT ARE VISIBLE DURING CONSTRUCTION AT THE TIME OF OUR SITE VISIT. WE BELIEVE THAT TIME AS -BUILT CONSTRUCTION AT THE TINE OF OUR VISIT IS IN GENERAL CONFORMANCE WITH OUR STRUCTURAL PLANS AND RELEVANT CORRESPONDENCE ISSUED DY OUR OFFICE. WE OBSERVED THE BUILDING IN ITS FRAMED CONDITION PRIOR TO INSTALLATION OF DRYWALL AND STUCCO. WE OBSERVED THE VISUAL AND ACCESSIBLE STRUCTURAL, REQUIREMENTS. ( EXCLUSIONS ARE ITEMS SUCH AS: FOOTING SIZE AND REINFORCENIENT, TOP PLATE SPLICES, ROOF SHEATHING, AND ANY STRAPS iE ROOF SBEATIE NG.). aFEss o y RESPECT y s No, 57958 F cp.06-340` r sr r c I Yk\ fOFCA. '`i ZEYAD FAQIH, PE Y