SFD (04-8157)P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760).777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number 04-00008157 Date
2/10/05
Property Address
. . 81275 -NATIONAL DR
APRT:
767-500-013- - -
Application description DWELLING..- SINGLE FAMILY DETACHED
Property Zoning .
. . . . . LOW DENSITY RESIDENTIAL
Application valuation 298162
Owner
Contractor
NORMAN.ESTATES II
EHLINE COMPANY "
C/O MEDALLIST GOLF DEVELOPMENT 55375 MEDALLIST DR
501 NORTH AlA
LA QUINTA
CA 92253
JUPITER
FL 33477 (760)• 771-8.130
WCC: STATE FUND_
WC: 2290006783
01./01/06
CSLB: .482086
11/30/05
CCC: B
--------------------------
Structure .Information -------------------------
Construction Type
. . . . . TYPE V - NON RATED
Occupancy Typ"CIIOF�A�UIN
DWELLG/LODGING/LONG <=10
Flood ZoneN
AO FLOOD ZONE
Other structEDITION.
2001
CRC
DROOMS
5
3.00
E SPRINKLERS NOA
A GE SQ FTG
806.00
PA I O SQ FTG
514.00
BER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
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 100,001-500,0010•-'
'696.50
Permit . . . . .
. MECHANICAL
Additional desc
Permit Fee .
. 127.50 Plan Check Fee
31.88
Issue Date
Valuation
0
Qty Unit Charge Per
3.00 .9.0000 EA
3.00 9.0000 EA
BASE FEE
MECH FURNACE <=100K
MECH B/C <=3HP/100K BTU
Extension
15.00.
27.00
27.010
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: Date: Z'�J
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
itect or Engineer's Address:
No.:
t3U1LDING 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
Cede, and my License is full force and effect. ��'�O o
5
/License Class_ i`) icense No.
Bate ontractor Il I Yl A O
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 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.
-6I have and will maintain workers' compens tion insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
sued y work rs' compensati urance carrier and policy number are:
amer >° via Policy Number oo Q r,7'7 3 .
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 provisions.
,-6ate �Al Q/Applicant E h 11 Y1 Eti CQ
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 conditions and restrictions set forth on this application.
1. Each person upon whose behalf thisapplication 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 employeesfor 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 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 county t n r upon the above-mentioned property for inspection purposes.
ate n �S ignature (Applicant or Agent):
l
Page
2
Application
Number .
. . . 04-00008157 Date
2/10/05
Qty
Unit Charge
Per
Extension
8.00
6.5000
EA MECH VENT FAN
52.00
1.00
6.5000
EA MECH EXHAUST HOOD
6.50
Permit .
. . . . . ELEC-NEW RESIDENTIAL
Additional.desc
Permit Fee
150.47 Plan Check Fee
37.62
Issue Date
. . .
Valuation
0
Qty
Unit Charge'
Per
Extension
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 .
. . . . . 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
7.5000
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
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
SFD - LOT
27. PLAN 2C,
3410 SF. PERMIT
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 7 RES
366.00
i
Page 3
Application Number
----------------------=-----------------------------------------------------
. . . . .
04-00008157 Date
2/10/05
Other Fees . . .
. . . . . .
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
------------------------------
.00 .00
1801.47
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
DEC 12,2005 13:16 BCI*TESTING,ril 000-000-00000
CERTIFICATE OF FIELD VERIFICATION AND BLAGNOSTIC: TEST] Nd (Page 1 of 7)
GREG NORMAN ESTATES
I►H-4
12-12-05
Doti:
f nR] Drive La Quinta, CA 92253
EHLINF. CO.
yet sat
lluit/ku Name
Rrian Brown _
760-427-7288
Plan 4 (pg. I of 1)
!Builder Contact
Telephone ,
. Plan Number
Kex Graham (CCN cCC2004077)
602-999-1350
Group 2
IIERtiRator
Tcicphonc
Sample Group Number
12-12-05
32 (ph 4)
Certifying Signature
Date
Sample I Inure Number
Fimt• n0 Teming
HERS Providct: CAL. IM'S
Page 3
CF -4R
Struul nddre~,: 41800 Washinbton Sl., li I OS_314 city/Statc0p: Bermtida Dunes, CA 92203
Coplec ua: Builder, HFRS Provider
I1 ERS RATER COMPLrCE STATEMENT
'11he house was: ❑ 'ftAcd Appnlvlxl ax purl of l:ungdc ti dirlg, heal was lull wstud
As the HL -KS rater providingdiaprhostic tcWng and field vuriliitmdain, I mytify (hill the himse% lalelltlflwl iM this (alnol comply
with the diagrutstic la-•skxl compliance ruyuirentents as ch eked on this form.
❑ Tow: incWllcr ham' pnwidcd a copy of (:1'-61t (Inslallatlon C:enifacatc.
❑ Distribution systan u fully ductal (f.c., docs not use building cavities as plenums (w plat6irm reprcnv in lice of(flicu)
❑ Wlurc ok,th hacked, rubber adhesive duct tape is installed, mastic and drawbands aro used in combination with cloth
hacked, rubber adhesive duct tape to seal leaks at duct connections.
❑ MINIMUM RF.QUIRrmrNT51 F4.)R DU(rr I.FAKAGE REDWI-ION C;UMPLIANCE C;ltir'Dl'f
Duct Diagmstie Leakage Tcrtiog Results (Maximum 6% Duct Leakage)
Duct Pm suriyAori Test Results ((:FM (.4 25 1'a)
Twat Leakage Flow in (:FM
If fen fhaw i+ uvlwluwJ us 400cfin/kon ). nunther at'imis atter calculated
value hero
Measured
values
If fan flow is inaal:ured enter meagutW value hero
Lcatkagc Pw4;vnW8i: (100 x Toa Leakage/ran Flnw)
Chisuk Dun liw Pwei or rail (Pax -GY9 or leu;) ❑ ❑
Pavy mil
❑'I'IIERM(WI'A'I'IC EXPANSION VALVE (TXV)
❑ Yes 13N, Thermostatic Expansion Valve is installed and Access is
provi&-il filr inspcw4ioo ❑ ❑
Yes is a pati
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
I- ❑ Yea ❑ No ACCA Manual D EX -sign requirements have been incl (raker hats
verified that actual installation owtches values in (:17-1 R and
tlusign on plan.
z• ❑ ye% u No TXV u installed or Pan flow haw been verift&l. if no TXV,
vuffed I•an Ilow nhatebesdecign front ('F -IR.
Mchswcd ran Flow =
Yes thr both 1 and 2 is a Pew.
Pass Fuil
13 ❑
Pass Fail
Compliance fo(ms August 2001 . A-16