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SFD (04-4076)55655 Medallist Dr 04-4076 BUILDING & SAFETY DEPARTMENT (760).777-7012 -'FAX (760) 777-7011 A 92253 INSPECTION REQUESTS (760) 777-7153 LDING PERMIT APN: Application description Property Zoning . . . . . . Application valuation. . . Owner NORMAN ESTATES II C/O MEDALLIST GOLF DEVELOPMENT 501 -NORTH AlA JUPITER FL 33477 ,0`--00-004076 Date ..5/12/04 55-65-5`MEDALLIST DR I ' 767-510-013- - DWELLING —SINGLE FAMILY DETACHED LOW DENSITY'RESIDENTIAL 323904 Contractor 0 EHLINE COMPANY 55375 MEDALLIST DR LA QUINTA CA 92253 (76,0) 771-8130 Qty Unit Charge Per Extension Y ., t WCC:. STATE FUND WC: 2290006783 01/01/05 CSLB: 482086 11/30/05 CCC: B -------------------------- Structure Information ------------------------- Construction Type TYPE V - NON RATED Occupancy Type, . . . . . . DWELLG/LODGING/LONG <=10. Flood Zone . . . I. . . NON -AO -FLOOD ZONE Other struct info . . . CODE EDITION 2001 CRC # BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 64,6.00 . PATIO'SQ FTG 729.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 3732.00 ---------------------,------------------------------------------------------ Permit .. . . . . BUILDING PERMIT• - Additional desc . Permit Fee . . . . 1423.50 Plan Check Fee 925.28 Issue Date Valuation 323904 Qty Unit Charge' Per Extension BASE FEE 639.50 224'.00 3.5000. THOU BLDG 100,001-500,000 ` 784.00 t t ------------------------------------------ .-----------;---------------------- Permit ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 158.54 Plan Check Fee 39.64 'Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension Y ., t P.O. BOX 1504 • " VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4 4 a INSPECTIONS (760) 777-7153 BUILDING &I: SAFETY DEPARTMENT Application Number: 04- Date:�— Applicant: chitect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: . 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 r -ode, and my Lice �sa is in full force and effect_--- — ' r 9 License Class r•� License No. `F ,,-[T,-te -A. —P4 nrectorr3 ! - C,-, 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 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 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 C is ed. M coo compensatio urance carrier and policy number re Carrier J 0 .'�1 Policy Number > � C�� V—) _ 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 a ee that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall C -forthwith comply with those provisio �Date�'ro'T��'r Applicant 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 U 1A 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 Ouinta, 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 in tion ' 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 t e er on the above-mentioned property for inspection purposes. ture (Applicant or Agent I Page 2 Application Number 04-00004076 Date 5/12/04 Qty Unit Charge Per r Extension BASE FEE 15.00 3732.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 130.62 646.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.92 ---------=-.----------------------------------------------------------------- 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 . . . . 109.50 Plan Check Fee 27.38 Issue Date . . . . Valuation 0 Qty. Unit Charge Per Extension BASE FEE 15.00; 2.00 9.0000 EA MECH FURNACE <=100K 18.00 .2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 8.0;0 6.5000 EA MECH VENT FAN 52.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . ------------------------------------------------------- . . . PLUMBING Additional desc Permit Fee . . . . 203.25 Plan Check Fee 50.81 Issue Date.. . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 22.00 6.0000 EA PLB FIXTURE 132.00 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 9.00 .7500 EA PLB GAS PIPE >=5 6.75 1.00 ------------------------ 15.0000 EA PLB GAS METER =------------------------------------------- 15.00 Special Notes -------- and Comments SFD - TR 29657, LOT 12. PLAN 3B. PERMIT Page 3 Application Number -04-00004076 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. 309.76 DIF COMMUNITY CENTERS -RES,, 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 92.53 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 32.39 DIF STREET MAINT FAC -RES 15.00 DIF'TRANSPORTATION - RES 1098.00 Fee.summary Charged Paid Credited Due Permit Fee Total 1909.79 :00 .00 1909.79 Plan Check.Total 1043.11 .00 ..00 1043.11 Other Fee Total 2839.68 ..00 .00 2839.68 Grand Total 5792:58 .00 00 5792.58 { DIS t ENERGY CAOEC PO. Box 62' Rancho Mirayo, -- vc r v Email: DESNRG OAOL.COM CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF-4R GREG NORMAN ESTATES PH-2 PARTIAL DATE TESTED 04-08-05 Project Title Date C55-655 MEDALLIST DR'LA QUINT C 92253.-, EHLINE• CO. Project Address Builder Name GILBERT LEVZA 760-578-4301. PLAN'3 3 UNITS .Builder Contact. Telephone Plan Number RICHARD KROWN 760-250-2084 GROUP 4 HERS Rater Telephone Sample Group Number : #CCNRK613292 04-08-09 LOT 12 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) ' Measured t Duct Pressurization Test Results (CFM @ 25 Pa) values r Test Leakage Flow in CFM 76 , If fan flow is calculated as 400cfm/ton x number of tons enter calculated value here 1400 If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow)= 5.428 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 In 0 03/07/2005 20:50 17603401819 PAGE .03/18 INSULATION CERTIFICATE This is to certify that Insulation has been installed in conformance with the current energy Califomia Administrative Code, Title 24. State of Calgomia, in the building at regulation, 55.655 MEDALLIST DRIVE, LOT 12, PHASE 2, LA QUINTA CA CEILINGS: THICKNESS, R-38 TYPE:BATTS MAUNFACTURER: Certainteed TYPE: BATTS MANUFACTURER:. Certainteed, THICKNESS: R-19 GENERAL CONTRACTOR: EMLINE CO BUILDERS LICENSE # BY. TITLE: PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517 • BY, TITLE: ACCOUNT REPRESENTIVE DATE INSULATION CERTIFICATE Is to certify that insulation has been installed In conformance with the current energy sition. California Administrative Code, Title 24, State of California, in the building locate" CEILINGS: HIC TYPE:BATTS UNFACTURER: rd-- THICKNESS: R-38 S'TS UNFACT T RERCo d THICKNESS: WALLS: TYPE:'BATTS AUNFACTURER: rtainteed "THICKNESS: R-19 GENERAL NTRACTOR: EHLINE CO BUILDER LICENSE # ITL BY: TTITLE: PARAGON N SCHMID BUILDING PRODUCTS A'MASCO Company Lt E # 221517 'BY' TITLE' ACCOUNT REPRESENTIVE DATE- .3