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SFD (05-0308)BUILDING & SAFETY DEPARTMENT �. Box 1504 1 . (760).777-7012 495 CALLE TAMPICO FAX (760) 777-7011 QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Ap ication Number 05_000003.0-8 Date 2/02/05 operty Address.',-., 81375 NATIONAL DR APN: 767-570-001- - - Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 363387 Owner Contractor r - - - - - - - - - - - - - - - - - - - - - r - - - .. - ' -_ '+ . _ !v, L I--------------- 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,CBC r #BEDROOMS 5.00 FIRE SPRINKLERS NO GARAGE, SQ_ FTG - 8'4 3'.; 0 0 { �PATI.O ' SQ' FTG .s r 461.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 4217.00 ----- - - - -- Permit . . . . ---- ELEC-NEW RESIDENTIAL'_f Additional desc . Permit Fee . . . . 179.46 Plan Check Fee 44.87 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 4217.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 147.60 843.00 .0200 ------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 16.86 Permit . . . . . . -------------------------------------- BUILDING PERMIT Additional desc Permit Fee . . . . 1563.50 Plan Check Fee 1016.28 Issue Date . . . . Valuation 363387 Qty Unit Charge Per , �.y .:`'y - Extension " ,BASE 'FEE a 4- (� '. '63 9. 50• 264.00 3.5000 THOU BLDG 100;001-500,000 924.00 P.O. Box 1504 TAf 444" 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: O4 • 0.308 Applicant: Applicant's Mailing Address: VOICE (760) 777-7012 F; X (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3 �4-cS- architect or Engineer: trW1 (�oas+ �Arelrirl ec�s,�"�ra�►k Mhz. Architect or Engineer's Add res .1i- Lic. No. C' Zk4o!a BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed un er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals de, and my License n full force and effect. ^ 0 icense Class License No. '2 ate .319.410c::Contractor CID 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 of the work for which this permit is issued. I 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 issued. �y workgrs compensation insurance carrier r i of}�y umbel are, Carrier Sktr'e FLLVY� Policy Number �e( y (j00 (a �j _ I certify that, in the performance of the work for which this permit is issued, I shall riot 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. /ate I Q 141645ApplicanYI 1 i7 f, CO 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 fora 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 countytoenter upon the above-mentioned property for inspection purposes. /Date-3124Signature (Applicant or Agent):✓ Page 2 Application Number . ---------------------------------------------------------------------------- . . . . 05-00000308 Date 2/02/05 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 . . . . 109.50 Plan Check Fee 27.38 Issue Date Valuation 0 Qty Unit Charge .Per Extension BASE FEE 15.00 2.00 9'.0000 EA MECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 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 . . . . 211.50 Plan Check Fee 52.88 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 23.00 6.0000 EA PLB FIXTURE. 138.00 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 12.00 .7500 EA PLB GAS PIPE >=5 9.00 1.00 15.0000 -----------------------------------------------'----------------------------- EA PLB GAS METER 15.00 Special Notes and Comments SFD - LOT 32, PLAN 4A-ENC. PERMIT DOES NOT INCLUDE POOL, SPA BLOCK WALLS,OR DRIVEWAY APPROACH ------------------------------------------------------------ Other Fees . . . ----------------- . . . ART IN PUBLIC PLACES-RES 408.46 DIF COMMUNITY CENTERS-RES 97.00 DIF CIVIC CENTER --RES 366.00 ENERGY REVIEW FEE 101.63 DIF FIRE PROTECTION-RES 97.00 Page 3 Application Number ---------------------------------------------------------------------------- . . . . . OS -00000308 Date 2/02/05 Other Fees . ... 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 .36.33 DIP STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 2078.96 .00 .00� 2078.96 Plan Check Total 1141.41 00 .00 1141.41 Other Fee Total 2951.42 .00 .00 2951.42 Grand Total 6171.79 .00 .00 6171.79 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 , NORMAN ESTATES, LOT 32, PHASE 4, LA QUINTA CA CEILINGS: TYPE: BATTS MANUFACTURER: Certainteed THICKNESS: R-38 WALLS: L . TYPE: BATTS - MAUNFACTURER: Certainteed THICKNESS: R-19 GENERAL CONTRACTOR: EHLINE CO BUILDERS- :A LICENSE l# ` J BY: TITLE:- PARAGON ITLE: PARAGON CHMID BUILDING PRODUCTS A MASCO Company• LICENSE ## 221517 BY. 4 ITLE: ACCOUNT REPRESENTIVE DATE: 000/l.0018 OIWIH3SdN09VaVd XV3 CV:LI SOOZ/LO/ZI i II;� is lit I I �'I, l III I i I JNSTALLATION CERTIFICATE I F' ' (Page 3 of 13) CF -6R I,Si(e Address �' I (. II. PerinlfNutulier. I. , DUCT L +I ADAGE AND I)ESIGN DIAGNOSTICS I, I�i� SII •`r L..' � "6 I' DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM) r Fan Flow i If Fan Flow is Calculated as 400 c&ii/ton x number of tons, or as 21.7 x Heating Capacity in Thousands of Btu/hr,' enter calculated value here If fan flow is measured, enter measured value here Leakage Fraction = Test Leakage/(Measured'or Calculated Fan Flow) _ Pass if leakage fraction:5 0.06 ❑ ❑ For AEROSOL TYPE SEALANTS ONLY - The follo`ving diagnostic testing was completed: Pass Fail Duct Fan Pressurization at rougli-in measured leakage (CFM) CHECK AFTER FINISHING WALL: Cl Yes. ❑ No ❑ Pressure pan test or House pressurization test ❑ Yes ❑ No ❑ Visual Inspection of Duct Connections i ❑ ❑ Pass Fail THERMOSTATIC EXPANSION VALVE (TXV) 91 Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection ❑ Pass Yes is a pass Fail ❑ DUCT DESIGN 1. ❑ Yes ❑ No ACCA Manual D Design calculations have been completed, Duct Design is on the plans and duct installation matches plans. 2. ❑ Yes . ❑ No TXV is installed or Fan flow has been verified. If no TXV, . verified fan flow matches design fi-om CF -1R. Measured Fan Flow = ci ❑ Yes for both 1 and 2 is a Pass Pass Fail W I, the undersigned, verify that the above diagnostic test results and the work 1 performed associated with the test(s) is in conformance with. the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF -611 signed by the builder employees or sub -contract is certifying that diagnostic testing and installation meet the requirements for compliance credit.) a\a 1an��QA Tests i uati�re, Da.' Installing Subco tractor (Co. Name O Performed General Contractor (Co. Name) COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy Compliance Forms August 2001 A-25 ('I I INSTALLATION CERTIFICATE (Page 3 of 13).1. Cr-(IZ E F+>_► �c - uo �rJ �z Arte 44- � ISite Address I y a DUCT I , , MaG&AND DESIGN DIAGNOSTICS DUCT LEAKAGE. REDUCTION Pressurization Test Results (CFIvI @ 25 PA) Fan Flow Test Leakage (CFM) If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity ! in Thousands of Btu/hr, enter calculated value here If fan flow is measured, enter measured value here Leakage Traction = Test Leakage/(Measured or Calculated Fan Flow) _ Pass if leakage &action 5 0.06 [� / Pass Fail ❑ For AEROSOL TYPE SEALANTS ONLY - The following diagnostic testing was completed: Duct Fan Pressurization at rough -in measured leakage (CFM) CHECK AFTER FINISHING WALL: ❑ Yes El 1110 ❑ Pressure pan test or House pressurization test ❑ Yes ❑ No ❑ Visual Inspection of Duct Connections [� ❑ Pass Fail THERMOSTATICEXPANSION VALVE (TXV) Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection ❑ Yes is a pass ZPass Fail ❑ DUCT DESIGN 1' ❑ Yes ❑ No ACCA Manual D Design calculations have been completed, Duct Design is on the plans and duct installation matches plans. 2. ❑ Yes . ❑ No TXV is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -1R. Measured Fan Flow = ❑ ❑ Yes for both I and 2 is a Pass Pass Fail I, the undersigned, verify that the above diagnostic test results and the work I,performed associated with the test(s) is in conformance with the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF -6R signed by the builder employees or sub-contractoertifying that diagnostic testing and installation meet the requirements ! for compliance credit.] - -'7(! 1 I 1 arg►tart►reytr� - Installing Subcontract o • (Co. Name) OR Performed General Contractor (Co. Name) COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy Compliance Forms August 2001 A-25 „- WISTALLATION CERTIFICATE i (Page 3 o 13), CF -6R l Site Address 1 Petmi fNiimber.� DUCT I-, TAICAGE ,AND DESIGN DIAGNOSTICS ISI DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM @ 25 PA) Test Leakage (CFM) Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity '” ' ° •"I in Thousands of Bh>/lir; enter calculated value here Y� If fan flow is measured, enter measured value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) _ Pass if leakage fraction 5 0.06 Q For AEROSOL TYPE SEALANTS ONLY - The following diagnostic testing was completed: 'Pass Fail Duct Fan Pressurization at rougli-in measured leakage (CFM) CHECK AFTER FINISHING WALL: El Yes ❑ No ❑ Pressure pan test or House pressurization test ❑ Yes , ❑ No ❑ Visual Inspection of Duct Connections11 ❑ Pass Fail THER1110STATIC EXPANSION VALVE (TXV) 91 Yes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection . . ElYes is a pass Pass Fail ❑ DUCT DESIGN 1 • ❑ Yes ❑ No ACCA Manual D Design calculations have been completed, Duct Design is on the plans and duct installation matches plans. 2 ❑ Yes . ❑ No TXV is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -1R. Measured Fan Flow= ❑ ❑ Yes for both 1 and 2 is a Pass Pass Fail I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is in conformance with the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF -6R signed by the builder employees or b -contract rs certifying that -diagnostic testing andinstallation meet the requirements for compliance credit.] Tests iati e, Installing Subcontractor (Co. Name) OR Performed General Contractor (Co. Name) COPY TO: Building Department IIERS Provider (if applicable) Building Owner at Occupancy Compliance Forms August 2001 A-25