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SFD (04-3908)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760) 777-70.12 78-495 CALLE TAMPICo ' FAX (760) 777-7.011 LA QUINTA, CALIFORNIA 92253 - INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number 4-.00003908; Date 5/21/04 Property Address . . . . .53350'AVENIDA MENDOZA APN: 774-093-005- - - Application description . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . .. . . . COVE RESIDENTIAL Application valuation 119569 Owner Contractor POWER FINANCE BRAUCKMANN INC P 0 BOX 134 P O BOX -51.7 .LA QUINTA CA 92253 LA QUINTA CA 92253 (760) 485-9269 WCC: EXEMPT WC: EXEMPT 06/17/04 CSLB: 781834 07/31/04 CCC: B -------------------- - - Structure Information ------------------- - ----- Construction Type TYPE V - NON RATED . Occupancy Type DWELLG/LODGING/CONG <=10 Flood Zone O. NON -AO FLOOD ZONE Other st CODE EDITION 2001 CBC O Qg 101 BEDROOMS' SPRINKLERS NO 3.00 FIRE GARAGE SQ FTG 480.00 G`�oNc�pEQ�' PATIO SQ FTG 34.00 . NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 1918.'00 ----------------------------------------------------------------------------- Permit . . . . . BUILDING PERMIT Additional desc Permit Fee 709.50 Plan Check Fee 461.18 Issue Date . . . . .Valuation . . . 119569 Qty Unit Charge Per Extension BASE FEE 639.50 20.00 3.5000 THOU BLDG 100,001-500,000 70.00. Permit . . . . . . MECHANICAL Additional desc 1 Permit Fee . . . . 59.00 Plan Check Fee 14.75 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 Application Number: 01- 390 Applicant: --Architect Applicant's Mailing Address: Architect 14-1:11c— No.: Date: o/V or Engineer: or Engineer's Address: 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 my Licepaq is in full force and effect. (� Class ense No. d� ,----License Date �6 d or OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 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 sp ygpensation insurance carrier an pQlint(ru�ntsgr Cartier lam" Policy Number 7 /, S3 V's I certify that, in the performance of the work for which this p i '§-su ed, 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 u d become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall /orth 'th comply with those provisions. �te W T PPIiA cant WARNIN : F ILURE TO SECURE WORKERS'CeMFfENSATION 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 It 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 160 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 co I agree to c�mplywtt a city and county ordinances and state laws relating to building construction, nd h eby authorize representatives of this county to enter u e ab ioit ned property for inspection purposes. ate O Signature (Applicant or Agent): Page 2 Application Number 04-00003908 Date 5/21/04 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.000O,EA MECH B/C <=3HP/.100K BTU .9.00 3.00 6.5000 EA MECH VENT FAN 19.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50- ---------------------------------------------------------------------------- Permit ELEC-NEW RESIDENTIAL ' Additional desc Permit'Fee 106.73 Plan Check Fee 26.68 Issue Date Valuation . . . . 0 ... 'Qty Unit Charge Per Extension BASE FEE 15.00 1918.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 6.7.13- 480.00 0200 ELEC GARAGE OR NON-RESIDENTIAL 9.60 1.00 ------------------------------------------------------------------------------ 15.0000 EA ELEC TEMPORARY POWER POLE 15.0.0 Permit . . . . PLUMBING Additional desc Permit Fee 129.00 Plan Check Fee 32.25 Issue Date Valuation .0 Qty Unit Charge Per Extension BASE FEE x15.00 10.00 6.0000 EA PLB FIXTURE 60.00 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 6.00 .7500 EA PLB GAS PIPE >=5 4.50 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 1918 S.F. SFD PERMIT DOES NOT INCLUDE Page 3 Application -Number . . . . . 04-00003908 Date 5/21/04 --------------------------------------- Special Notes and Comments ------------------------------------- BLOCK WALL, POOL/SPA OR,DRIVEWAY APPROACH ------------------------------------------------------------------------------ Other Fees . . . . . ... ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE, 46.12 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 COVE PRECISE PLAN FEE 100.00 STRONG MOTION (SMI) - RES 11.95 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES- 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1019.23 .00 .00 1019.23. Plan_Check Total 534.86 .00 .00 '534.86 Other Fee Total 2563.07 .00 .00 2563.07 Grand Total, 4117.16 .00 .00 4117.16 Date 6/8/04 No. 26007 Owner Power Finance Address City Zip Tract # Type Single Family Residence CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 Lot # No. Street S.F. Unit 1 53350 Avenida Mendoza 1918 Unit 2 Unit 3 Unit 4 Unit 5 Comments Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 J��FJLUs� Q BERMUDA DUNES G7 RANCHO MIRAGE INDIAN WELLS PALM DESERT , - Y LA QUINTA O INDIO l� 0 APN # 774-093-005 Jurisdiction La Quinta Permit # Study Area No. of Units 1 Lot # No. Street S.F. 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 $2.24 X 1,918 S.F. or $4,296.32 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 CCNIB - Mike Brauckmann Check No. 305615- Name 05615Name on the check Telephone 485-9269 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted S�haro�n MCGilvrey Payment Recd $0.00 l // z /1., / / $4,296.32 over/Under Signature %! NOTICE: Pursuant to Government Code Sectio660 (d)(1), this wi rve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting FEB -01-2005' 0$ :37�$AM CERTIFICATE OF F v�- yJ P.,0 1 .i, VERIFICATION AND DIAGNOSTIC TESTING CF -4R �,rolect 1 it e J O _ l ��l2� „lyt Pro'ect Address Builder Name i Builder Cont ct Telephone Plan Number E HER Rater Telephone Sample Group Number O rtifying Signature ate s Sample House Number Firm: C.d'.�SSOG�e�. HERSProvider; Street AddreCitylStatelzip. 4 W Q(4 0 r Ge 47.�?-,� Copes to- z Builder, HERS Provider , HER§ RAS ft,E COMP I NCE ST61EMEN The house' was: Tested j Q Approved as part of sample testing, but was not tested r As the HERS rater providing dlag`nostic testing and field verification, I certify that the houses identified on this form co ly with the diagnostic tested compliance requirements as checked on this form. rZ Distribution system is tifully ducted„(Le., does not use building cavities as plenums or platform returns in lieu f ducts) w, PWhere cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination PHI cloth backed, rubber adhesive duct tape to seal leaks at duct connections, ArMINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic leakage Testing Results (Maximum 6% Duct'Leakage} Measured Duct Pressurization Test -Results (CFM @ 25 Pa) i values Test Leakage Flow in CFM �`T If fan flow is calculated as 400cfm/ton x number of tons enter calculated value here if fan now is measured enter measured value here f• Leakage Percentage (100 x Test Leakage/Fan Flow) -- CheckCheck Box for Pass or Fail (Pass=6% or less) ❑ ass Fait THERMOSTATIC EXPANSION ViALVE (TXV) or Cotnmission•approved equivalent IF 1 Yes ❑ No Thermostatic 6panslon Valve (or Commission approved ❑ v equivalent) is installed and Access Is provided for Inspection , Yes Is a pass Pass Fail ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1 Q Yes ❑ No ACCA Manual D Design requirements have been met (rater hai verified that actual Installation matches values in CF -1 R and design on plan. 2. , ❑ Yes ❑ No TXV is Installed or Fan flow has been verified, if no TXV, t 4 verified fan flow matches design from CF -1 R. Measured Fan Flow = ❑ ❑ Yes for both ;t and 2 is 0 Pass pass Fail