SFD (04-4074)i
P.O. Box 1504
78-495 CALLE TAMPICO
�A QUMA, CRLIFOR q, 92253
JUL 0 6 2004 E
App licati n NQ ib%rZLA(�U0P�. .
Property dd�-c�sI. ANCE
. n�Pt
APN:
Application description . . .
Property Zoning . . .
Application valuation . . . .
Owner
NORMAN ESTATES II
C/O MEDALLIST GOLF DEVELOPMENT
501 NORTH AlA
JUPITER FL 33477
4Q"
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
PERMIT
QQ 04 00040.7_4_- Date.: 5/12/04
81100.NATIONAL DR
767-600-002-- - I -
DWELLING:- SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
298162
Contractor
---------------
EHLINE COMPANY
55375 MEDALLIST DR
LA QUINTA CA 92253
(760) 771-8130
Qty Unit Charge - Per Extension
WCC: STATE FUND
WC: 229000. 3 678
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
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
217.10.
Issue Date . . . .
Valuation
298162
Qty Unit Charge
Per
Extension
BASE FEE
639.50
199.00 3.5000
---------------------------
THOU BLDG 100,001-500,000
696.50
Permit . . .
-------------------------------------------------
ELEC=NEW RESIDENTIAL
Additional desc .
Permit Fee . . . .
1.50.47 Plan Check.Fee
9.41
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 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Architect
Architect or Engineer's Address:
ic. No.:
or Engineer:
Date:
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 Liceaft is in full force and effect. n r('�i� _ Or
cense Class lS cense No. y x
Tactor Cj�LA t3SZi
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. , BA 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 self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
-10kof the work for which this permit is issued.
I have and will maintain workers' compensatio , surance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ued. M wo comp nsatio Tante carrier andQoli numbQr are:
Cartier Number 6:5cs (0
_ 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 3700 of the Labor Code, I shall
forthwith comply with those prov)stons. /
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
Lenders 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 permit, or
cessation of work for 180 days will subject permit to canc yation.
I certify that I have read this application and state that the above i ortnation i 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 o nter u n the above-mentioned property for inspection purposes.
/ to
Sure (Applicant or Agent):
Application Number 04-00004074
Page 2
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
7 -----------------------------------------------------------------------
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
7.97
Issue Date .
. . .
Valuation . . . .
0.
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
3.00
9.0000
EA
MECH
FURNACE <=100K
27.00
3.00
9.0000
EA
MECH
B/C <=3HP/100K BTU
27.00
8.00
6.5000
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 ..
10.78
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
7.5000
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
8.00
.7500
EA
PLB
GAS PIPE >=5
6.00
1.00
15.0000
EA
PLB
GAS METER
15.00
----------------------------------------------------------------------------
Special Notes
and Comments
SFD - TR 29800,
LOT 3.
PLAN
2A.
PERMIT
Page 3
Application Number
. . . .
04-00004074 Date
5/12/04
Special Notes and
Comments
.DOES NOT INCLUDE BLOCK
WALLS,
POOL, SPA
OR DRIVEWAY APPROACH.
75% PLAN
CHECK FEE
REDUCTION APPLIED
FOR MULTIPLE
ISSUANCE
OF SAME PLAN TYPE.
----------------------------------------------------------------------------
Other Fees . .
. . . .
ART IN PUBLIC PLACES -RES
245.40
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
21.71
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
180.1.47
.00 .00
1801.47
Plan Check Total
245.26
.00 .00
245.26
Other Fee Total
2701.92
.00 .00
270.1.92
Grand Total'
4748.65
.00 .00
4748.65
D"eIt- -
ENERGY CAOEC
PO. Box 62' S"Cos
Rancho Mir-aae, �v44— —n. ki w1 4......
Email: DESNRG @_AOL.COM
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -4R
GREG NORMAN ESTATES PH -2
Project Title
81-100 _ NATIONAL DRIVE LA QUINTA, CA. 92253
'Project
GILBERT LEVZA 760-578-4301
Builder Contact Telephone
RICHARD KROWN 760-250-1852 _
HERS Ratej/ tL Telephone
(� #CCNRK613292 03-21-05
Certifying Signature Date
DATE TESTED 3-21-05
Date
EHLINE CO.
Builder Name
PLAN 2 3 UNITS
Plan Number
GROUP 3
Sample Group Number
LOT 52 1 OF I
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 N 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
If fan flow is calculated as 400cfm/ton x number of tons enter calculated
value here
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) ❑ ❑
Pass Fail
❑ THERMOSTATIC EXPANSION VALVE (TXV)
❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is 1:1 El
for inspection
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j 03/07/2005 20:50 17603401819 PAGE 10/18
INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, California Administrative Code, Title 24, State of California, in the building at
CEILINGS:..
TYPE: BATTS MANUFACTURER: Certainteed THICKNESS: R-38
WALLS:
TYPE: BATTS MAUNFACTURER; Certainteed THICKNESS: R-19
GENERAL CONTRACTOR: EHLINE CO BUILDERS LICENSE 6
BY: TITLE:
PARAGON SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517
BY: TITLE: ACCOUNT REPRESENTIVE DATE:
...: - ... ... r. ... .... s.. , r . . •r..r •.•.v.•r.. i •rr. is i/� i/i..r.i.i.i.i�ri ;. r, iri+:.r. �.,.v,ior.....iiri: iir+.r..i•. r. i:.i........-r... ... . ........:.r .: .. - .
INSULATION CERTIFICATE
This is to rnfy that insulation has been installed in conformance with the current energy '
regulation, 'fomie Administrative Code, Title 24, State of Califomla, in the building located
CEILINGS:
TYPE: BLOW
WALLS:
THICKNESS: R-38
TYPE: BATTS MAU TURER: s Coming THICKNESS: R-13
GENERAL CONT OR: LICENSE #
BY: TITLE:
PA AGON SCHMID BUILDING PRODUCTS A MASCO Company LI E # 221517
BY: TITLE: ACCOUNT REPRESENTIVE DATE: