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