04-8161 (SFD)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CALLE TAMPICO tr FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS. (760) 777-7153
BUILDING PERMIT
Application Number . . . 04=OOb0.81.61_ Date 2/10/05
Property Address . . . . 81315 NATIONAL DR -
APN: 767-500-015- - -
Application description . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . ... . . LOW DENSITY RESIDENTIAL_
Application valuation . . . . 342299.
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
WCC: STATE FUND'
WC: 2290006783
01/01/06
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
ROOMS
4.00
SPRINKLERS NO
E SQ FTG
843.00SQ
EA
FTG
698.00
R OF UNITS
1.00
LOOR SQUARE'FOOTAGE
3917.00
-------------- ------ ------------.---
Permit '.IT
Additional desc
Permit"Fee
1490.00
Plan,Check Fee
968.50
Issue Date
Valuation
342299.
Qty Unit
Charge Per
Extension
,BASE
FEE. f
639.50
243.00
3.5000 THOU BLDG,100,001-500,,000
850.50
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
9.000O,EA MECH
FURNACE <=100K
18.00
2.00
9.0000 EA MECH
B/C <=3HP/100K BTU
18.00
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 8t: SAFETY DEPARTMENT
Application Number: L.) I % I Date: Z 7�
Applicant: Architect
Applicant's Mailing Address: itect
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
Cod nd my License ' in full force and effect. V�V �7 i
ense Clais_ �nse No. C> C 6
Date212115105_ontractor t�h I I yu . t�
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 1, 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
Aof the work for which this permit is issued.
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
i sued. A4y work rs' compensation in�*9nce card nd olic number are,
amer � _ -run (I �licy Number Wn�ZL —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.
Date o� D
Applicants ( {L, rp
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
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 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 ter upon the above-mentioned property for inspection purposes.
Dated �`5�IgnatureApplicant or Agent):
Page
2
Application
Number
04-00008161 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
. . . .
168.96 Plan Check Fee
42.24
Issue Date
. . . .
Valuation
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
3917.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
137.10
843.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
16.86
Permit
------------------------------------------------------
. . . .
PLUMBING
Additional
desc
Permit Fee
. . . .
187.50 Plan Check Fee
46.88
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge_
Per
Extension
BASE FEE
15.00
19.00
6.0000
EA PLB FIXTURE
114.00
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
9.0.0
12.00
.7500
EA PLB GAS PIPE >=5
9..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
29. PLAN 4B -OPEN, 3917 SF.
PERMIT DOES
NOT INCLUDE BLOCK WALLS,
POOL, SPA
OR DRIVEWAY
APPROACH.
----------------------------------------------------------------------------
Other Fees
. . . . .
. . . . ART IN PUBLIC PLACES -RES
355.74
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER- RES
366.00
Page 3
Application Number
--------------------------.--------------------------------------------------
04-00008161 Date
2/10/05
Other Fees .
. . . . . ..ENERGY
REVIEW FEE
96.85
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
34.22
DIF STREET MAINT FAC -RES
15.00
'
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1970.96
.00 .00
1970.96
Plan Check Total.
1085.00.
.00 .00
1085.00
Other Fee Total
2891.81
w .00 .00
2891.81,
Grand Total.-
5947.77
.00 00
5947.77
SiSf- 27,.2005 13:12 BCI*TESTING,ri1 000-000-00000 Page 7
CERTIFICATE OF FIELD VERIFICATION ANDDIAGNOSTIC TESTING (Page I of 7)
(3R176 NORMAN F. S- I ATI:S Pi 1-3 9-13-05
Project Title Date
(8,71 ational Dii— La Quinta, CA 9225.3. 11II,1NL' CO..
Project Address — 11uildcr Mime
Scott _ 760=238=2383 ' Plan NPS (pg. I of 1)
Builder Cu tact 1'elephone Plan Number
Wiliam I Icnson (CCN #C'C'2004076) 760-250-7022. Group 1
HERS Rater _.Telephone Sample Group Number
�J...... _.. ..... 9-13-05" 29 (ph -3)
Certifying 'ignature Date Sample Ilou?w Number
Firm: B0 Testing lihRS`Pricvider CALCERTS
Street Addrtss: PO Box 50575 C►ty�Statc/Lip. Phoenix, AZ 85076
Copies to: Builder, HERS 11rovidcr
CF -4R
HERS RATER COMPLIANCE STATEMENT
The house was- ❑ TC::tetl Approved as•ptcft ol-sample cstinb; but was noL W-Acd
As the HERS rater providing diab-nos .ic test g and field verification, l certify that the houaey identified on this fiorm comply
with the diagnostic tested compliance requirements as checked onahis form.':'.
❑ The installer has provided a copy of UF -6R (Installation Certificatc.
❑ Di,trihution system is fully ducted (i.e., docs not use btiildink cavities as plenums or platform returns in lieu of ducts)
❑ Where cloth backed, rubber adhesive dact tape is inntall.ed, mastic and drawharids are used in combination with cloth
backed, rubber adhesive duct tape to seal leaks at 63ct"conhectiim,;.
❑ MINIMUM REQ(AREMENTS FOR DUC-l' LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct Diagnostic Leakage Testing Resulls (Maximum 6% Duct Ix-4kage)
Mc:asitrcxl
Duct Pmsswiration Test Results (CFM (a? 25 I'a) values
Test Leakage; Flow in CFM
I1' fan flow is calculated as 4000TVton x• numher of tuns enter calculated'
vttliic: here
If fan flow is measuri d .enter "miasurud ,value fieri:
Leakage Percentage (I 0'U x`Ccst'Ccakagc%Fan Flow)
Check 130x fa(Pass or.tail (Pass=6%o or less) ❑ ❑
Pass rail
❑ 'ritERMOS"FATIC EXPANSION VALVE (TXV)--'
❑ Yes ❑ No TblRllnstatic Expansion Valve is inKtallul dTld'Access lK
prtcvidcd lir inspection ❑ ❑
Yes is ;+ pass. E'ass Fail
❑ MINIMUM RFQIIIRFMFNTS FOR D(1( -r DFSI(.N,COMPI,IAN(:F. ('RFDIT
❑ Ye c ❑ No ACCA Manual 1) Dcsigq ri gain imcnfs liavc liu:n mut (rdtcr lues
vcrilicd that actual installation matches values in(IF•I R and
design on plan.
2' ❑ Yes ❑ No TXV is installed or.17kn ijciw"has,hacn v'L fie;ci: If no TXV,
verified Ian Ilow'ntatclt�s.dcsign from .CF -1 R.
Measured Fan blow
❑
Yes for both i and Z is a Pass Pass Fall
Compliance Forms August 2001 A-16
09/1.6/2005 15:26 FAX PARABONPSCHIMID Ia 012/014
INSV
LATION C-.RTIFICATE
This is to certify thet nsulatio-i nas been instellec it cunfoimanee with the cur•ent energy
regulation, California Administrative Cade, Title 24, State of Califoinia, in the building at
NORMAN ESTATES, LOT 29, PHASE 3, LA QUINTA CA
CEILINGS:
TYPE: BATTS MANUFACTURER: Certeinteed THICKNESS R-38
WALLS:
TYPE: BA'rTS MAUNFACTURER: Certainteed THICKNESS R-19
GENERAL CONTRACTOR: EWLINE CO 31,11I1-DERS LICENSE 4
BY: TITLE:y
PARAGO . SCHA11p BUILDING PRODUCTS A tilA 3C0 Ccmpany LICENSE #'21517
1
BY Uur�� TITLE: ACCOUNT REPP.ESENTIVE JAPE:%� l''