05-3689 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 0 :_00003689__
Property Address: 81355 NATIONAL DR
APN: 767 -570 -002 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3860
Applicant: 6�:��Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
1. BUILDING PERMIT -
----------------------------------------- - - - - - - - - - - -
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty Of perl'u'ryAat I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Div is ion. 3 of the )K Code, and my License is in full force and effect.
,/Y and ProfessionA
License qass*., B . I /UcenseWo.: 482086
OWNE rUILDER D
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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
p rmit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's 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).:
1, 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 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.).
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.).
I—) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
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: 01A.
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760).777-7153
Date: : 8/19/05
Owner:
NORMAN ESTATES II
C/O MEDALLIST GOLF DEVELOPMENT
501 NORTH AlA
JUPITER, FL 33477
Contractor:
EHLINE COMPANY
55375 MEDALLIST DR
LA QUINTA, CA 92253
(760)771-8130 SEP 0 8 2005
Lic. No.: 482086
1k. CI;TY OF LAdoxilmyAj
- - - - - - - - 7-- - - - - - - - - 7 - - - - - --- --7 - - - - - - - - 7 - - - - - - - - - —
WORKER'S 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.
Y I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for 'he performance of the work for which this permit is'issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1814972
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 to become subject to the workers' compensation laws of California,
s
and agree that, if I sh d come subject rs' compensation provisions of Section
0 0 1 to?
#3700 1 the L rC d al forthwith c -1 ZitketVs6 provisions.
4
ate: 5 pplicant:.
W A. "LLI,
ARN111G.: AILURE 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.
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 cancellation.
I certify that I have read this application and st
ate that t�_ above information is correct. I agree to comply with all
ng to
city and county ordinances and state laws relati ng c.n.tru ction, a here authorize representatives
of this co *ntY to en�ter upDn the above-mentioned p p p as.
tu
e: ature (Applicant or Agent)
Application Number . . . . .05-00003689
Permit WALL/FENCE PERMIT
Additional desc
Permit Fee . . . . 63.00'
Plan Check
Fee
.00
Issue Date . . . . . .
Valuation
3860
Expiration Date.. .2/15/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
2.00 9.0000 THOU BLDG 2,001-25,000
18.00
----------------------------------------------------------------------------
Special Notes and Comments
148 L.F. 61 GARDEN WALL, & 10 L.F. 41
GARDEN WALL, CITY STANDARD
Fee summary Charged Paid
----------
Credited
Due
-- ---------- ---- ----------
Permit Fee Total 63.00
----------
.00-
----------
.00
63.00
Plan Check Total .00
.00'
.00
.00
Grand Total 63.00
.00
.00
63.00
LQPERMff
m m 17 -IM j - - . .. , -". "
,DEC 12,2005 13:15 BCI*TESTING1,ri1
. .-� "-.1- -?-- ----
000-000-00000
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC 7104TING (Page I of 7) CF4R
GREG NORMAN ESTATES PH -4 12-12-05
Project Date
j
I I I r, C. wilt; five, La QuW"A-9=1. -EHLINFIC-0.
3 �5
"J
P Lluildcr Name
Brian Brown .76Q-AZL-22U—. Plan 7 (pS 1 IS 1)
IluilderComact Telephone I'Lin Numbur
Rex Graham (Gff 11CC2004077) 602-999-1356 Group 3
tl%�. Itulff 'Felepholic Samplc Gromp Ntanhcr
0'f
12-12-05 31 (ph 4).Tqt�.4..
Date SampIcHouscNumbcr
rirm; BCJ Testing I�PRS Provider CALCERTS
4 1900 Washington St., B 105-314 'taw
Sticct Addros; City/s /ip: Bermuda Duncs, CA 92203
Cmpiexhs: Buitaler.11ERSProvider
HERS RATERCOMPLIANCE STATEMENT
no biume wus. Tested 0 Approved as pan of sampIc icstirig, but was not tested
As the HERS rater providing diapostic testing and field verification, I certify that the housL-j idunfified un this horm wmply
with tbL dimpostitt: 1"-d utimplimnee requiremenuias checked on this forns.
The in.qtmllcr hxq provitled a tuipy WITAR (IngWlatlan Cerillicate.
Diaribution system is fully duoud (i.e., dom mt tom huildint; vivities as planunis or platfimu retums in lieu of ducts)
Where cloth backed, rubber adbcsivc duct tape i -j in3WIcd. maAw Hnd drawbmnds krt; touml in cottvihination with cloth
hmAud, rubber atfita%ivu duct LW toacal leas at duct connec6ons.
MINIMUM REQUIREMOMS FOR DUCT LEAKAGE REDUC-r1ON COMPLIANCE CREDIT
Putt Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage)
mmurAl
Duct Pressurization Ttim Results (CFM (til 25 Pit) valuci
C.,I
Tust W- kxI:v Flim in Cr -M -Y—())z&
If fan flow is calculated as 40k-firt/fAin x nurnher of tonx enter culculatud t
va [tic hirc
I r ran A)w is measured enter masured value here
L4.-"kmj,-u Pumuntagu (100 a Test LoaLago/Fan Flow) -
Lhock box for Pass or Fail (Pass -60/a or 1m)
PIA Fail
V.—THERHOSTATIC EXPANSION VALVF (TXV)
�yel.4 (3 N,) Thcrtnustatio 12-apmasiun Volvo is installed and Acums is
provided for insWetion
Yes Is a Pus I R., flail
13 mimmum REQuiRFmMTs FOR DU(,"T DIESIGN COMPLIANCIE CREUT
13 Yc, 13 N, ACCA Manual D Demign mquimments have been mot (rateir 11H.4
vcri6cd that actual insulladon nutvhcs volues in CF. I It mnd
design on plan.
2. [3 yc, [3 N,, 7XV is installed or ran flow hAs been verille� Il-nuTXV.
vcrified fan flow nutelics design limn CF -I K.
Mtmxwu4l Fan 171tew
13 El
Yes for hvLh I ml 2 ie. a Pass Pass Fail
Complianoe Forms August 2001 A-16
Page 2
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