SFD (04-8158)P.O: Box 1504
78-495CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760)..777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
J
Application Number 14 0.0-0-0-8-1-58 Date 2/10/05
Property Address . . . . 81295 NATIONAL.DR
APN: 767-500-014- - -
Applicat.ion.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) 771-8130
-- - - - - - - - - - - - - - - - - - - - - - - - -
Construction Type
Occupancy,Type
Flood Zone . . . . .
Other struct info
I
WCC: STATE FUND
WC: 2290006783 01/01/06
CSLB: 482086 11/30/05
CCC: B
Structure Information -------------------------
. . TYPE V - NON RATED .
DWELLG/LODGING/CONE <=1.0'
. . . NON -AO FLOOD ZONE;
. . . CODE EDITION 2001 CRC
#.BEDROOMS 3.00
FIRE SPRINKLERS NO
- GE SQ FTG. 806.00
10 SQ FTG 514.0 0 �'
BER OF UNITS 1.00
U FEB 2 5 ?vQ j FLOOR SQUARE FOOTAGE 3410.00
Permit CITY A - P RMIT
Additional de F.INANCEDEPT.
Permit Fee 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
-----------7--------------------7-------------------------------------------
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
P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-701 1
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: io4-8159 Date:
Applicant:
Applicant's Mailing Address:
Architect
--Architect
ic. No.:
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
e, and License i full force and effect. , , e 0� LP
License Classss G License No.
Date 9,"J o ntractor Ehtine, CO
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.).
L) 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
_Kof the work for which this permit is issued.
Lhave 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
Z- t is ued. ,My worke(s' compensation in rance carrier and olicy number are:
�r rmle 9A Yttl olicv Number �� �14 Orin o ,�
_ 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, 1 shall
forthwith comply with those provisions.
.Me 9 ) at'5pplicantlillli�LL 0-o
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 P 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 inf ation is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby auth�represetives of this countyt e tr upon the above-mentioned property for inspection purposes.
acant or Agent):
Page
2
Application Number
04-00008158 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
9.41
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
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
----------------------------------------------------------------------------
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 28. PLAN 2A,
3410 SF. PERMIT
DOES NOT INCLUDE BLOCK WALLS; POOL, SPA
OR DRIVEWAY APPROACH.
75% REDUCTION TO
PLAN CHECK FEE DUE TO
MULTIPLE ISSUANCE
OF SAME PLAN TYPE
--
---------------------------
Other Fees . . . . .
-----------------------------------
. ART IN PUBLIC PLACES -RES
------------
245.40
Page 3
Application Number
. . . . .
04-00008158 Date
2/10/05
-------------------------------------------------------------------------=--
Other Fees . . .
. . . . .
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
1801.47
.00 .00
1801.47
Plan Check Total
245.26
.00 .00
245.26
Other Fee Total
2701.92
.00 .00
2701.92
Grand Total
4748.65
.00 .00
4748.65
09/16/2005 15:26 FAX PARA60NPSCHIMID 009/014
V INSULATION CERTIFICATE
Tris -s to cr-rtify that insulation nos been insta:led it conformance with the current energy
p\ regulation, California Administrative Code, Title 24, Stato of California, in the ruildmg at
NORMAN ESTATES, LOT 28, PHASE 3, LA QUINTA CA
CEILINGS:
TYPE: BAITS MANUFACTURER: Certainteed THICKNESS: R-38
WALLS:
TYPE: BATTS MAUNFACTURER: Ceitainteed THICKNESS- R-'9
GENERAL CCNTRACTOR: EHLINE GO BUILDERS LICENSE #
BY: _^ _ TITLE:
PARAGO SCHMID SUI G PRODUCTS A kASCO Compuny LICENSE #' 21517
� c
BY: �lC�"�` ; me % TITLE: ACCOUNT REPRESENTIVE DATE:�� �✓ (I
'SEPI.27,2005 13:12 BCI*TESTING,ril
000-70.00-00000
i-
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7)
GREG NORMAN ESTATES PH -3 9-13-05
Date
.8.1295 National Drive La Quinta, CA 92253 171 11,1NE. CO.
Project Address. , ; Builtiv Name
760-238-2383 Plan 2A- (pg. I of 1)
Build— V tact Telephone :Plan Nurnticr
Wiliam Henson (CKW 4(,7C72004076) - 760-250-7022 Group I
HERS Ratcr�/ Telephone Sample Uroup Number
-9-13-05 28 (ph 3)
r t,Oatur(A(W Date Sample How -c Niunher
44g
L
, X
aturl
Firm: RC1 Testing HER'S' liro`v'i&CALCERTS.
CF -4R
%tructAddress", P01iox50575
. Phoenix, AZ 85076
Copies U); Bk1ildcr, UPS Provider. 0,1V 71
HERS RATER COMP CE STATEMENT,
The house was; 0 7 . exted Approved as p4apf sample testing, but was not tested.
As the TIERS ratcrprovidingdiagriostic testing and held verifica'tion. I certify thatthc houscs,idcritified tin this limn comply
with the diagno-46c U.-4tcd compliance rcqtiirrTncnLs wi chucked onAhi% Ibmi.
11 The installer has provided a copy orCF-6R (Installation(7crtificate. f.j; sass
0 Di%vibutionsystem is fully ducted (Lc:,docs -not use building eAviticsss p1ciurn:iorp'lal-l'orni returns inlieu uklueLs)
11 Where clolb backed, nobbcr adhesive duct tape is installed, mastic and drawbands arc'used in combination with cloth
backmi, nihb(,r udhe-,-ive duct tape to seal leaks at duct connections.
0 MINIMUM REOUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CRFDIT
Duct Diagnostic Leakage Te -ding Results (Maxinituni 60/6 Duct Leakage)
Me aSUTCAI
Duct Pressurization Test Requltq (CFM (a) 25 Pa)
stc�
Te,
,Lcakaph'Iow in CFM
%
Tffan llow is calculaied as 400c1`hVton-x` huniber f toni' ' enter calculated -
N
F fall flow is measured enter measured 61ue li!eie'
l.UHk-t,1gC Perizenuige (I6d,`,liest Ueakav/Fan Plow)
Chmit Boi for Puke ur Fail (Pass 6-/4'(')r less) 0 0
0 THERMOSTATIC EXPANSION VALVE (TXV)
0 Y,, 0 No Thermostatic Upansion. Valve is installed and Access is
provided R)r inspection
YPsisapass Pass Fail
E3 MINIMUM REQUIREMENTS FOR DUCI"DESIGN COMPLIANCE CREDIT
1. 0 Y,, 0 No ACOA Manual D Dcsi,(,rn rcquir.crn�cn'ts have been met (Tater has
mi lied that HL-Liml in's - W1111661I rnlkches vHl ties in CF- I R and
design on plan.
2.❑ Yes TXV is installed orFan':flowihas been Verified. If no TXV, No
veriliLd Tim flow matches , &Hign firooi.(T-1 R.
Measured Fan Flow
.t 13 13
Yes for both I and 2 is a Pass Pass Fail
Compliance Forms August,1001
A-16
Page 6
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