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04-3881 (SFD)i P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . . 04-00003881 Date 5/20/04 Property Address . . . . . . 51825 AVENIDA BERMUDAS APN: - 773-184-016- - - Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . COVE RESIDENTIAL Application valuation . . . . 119569 Owner ------------------------ POWER FINANCE P.O. BOX 134 LA QUINTA GID (760) 564-8470 -------------------------- S Contractor ------------------------ ADDINGTON, DAVID •47-7760 HERMITAGE DRIVE I.,D! IO CA 92201 STATE FUND 2290019787 01/01/05 682901 12/31/05 B on------------------------- 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 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 480.00 PATIO SQ FTG 34.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 1918.00 ----------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 709.50 Plan Check Fee 461.18 Issue Date . . Valuation . . . . 119569 Qty Unit Charge Per Extension BASE FEE 639.50 20.00 3.5000 THOU BLDG 100,001-500,000 70.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 59.00 Plan Check Fee 14.75 Issue Date . . . ." Valuation . . . . 0 Qty Unit Charge Per Extension P.O. Box 1504I4 CE VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: oxo - 3918 ` Date: 5 '�.o • ©�/ Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.: 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 Code, and my License i 'n full force and effect. ,, License Class License No. gG� Date KV - Contractor__ 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 Owner 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 i�su dd. My wo ers' compensation insurance carrier and policy number are: Carrier ST®%L° /� Policy Number ��91Gj rJ� _ I certify that, in the performance of the work for which this permit is iss ed, 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 — Applicant 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 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 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 to the above-mentioned property for inspection purposes. DW -al Signature (Applicant or Agent): n N � Application Number . . . . . 04-00003881 Page 2 Date 5/20/04 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K' 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 3.00 6.5000 EA MECH VENT FAN 19.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 106.73 Plan Check Fee 26.68 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1918.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 67.13 480..00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.60 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 129.00 Plan Check.Fee 32.25 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 10.00 6.0000 EA PLB FIXTURE 60.00 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 6.00 .7500 EA PLB GAS PIPE >=5 4.50 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 1918 S.F. SFD PERMIT DOES NOT INCLUDE a Page 3 Application Number . . . . . 04-00003881 Date. 5/20/04 ---------------------------------------------------------------------------- Special Notes and Comments BLOCK WALL, POOL/SPA OR DRIVEWAY APPROACH ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 46.12 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 COVE PRECISE PLAN FEE 100.00 STRONG MOTION (SMI) - RES 11.95 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged ---------- Paid Credited ------------------------------ Due Permit Fee Total 1019.23 .00 .00 1019.23 Plan Check Total 534.86 .00 .00 534.86 Other Fee Total 2563.07 .00 .00 2563.07 Grand Total 4117.16 .00 .00 4117.16 CERTIFICATE OF COMPLIANCE v�tf�sc Desert Sands Unified School District z4����°o 47950 Dune Palms Road Q BERMUDA DUNES Date 6/23/04 La Quinta CA 92253 RANCHO MIRAGE d � INDIAN WELLS No. 26085 (760) 771-8515,� PLA DESS RT INDIO Q� O Owner Power Finance APN # 773-184-016 Address Jurisdiction La Quinta City Zip Permit # Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Unit 1 51825 Avenida Bermudas 1918 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments Lot # No. Street S.F. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: This certifies that school facility fees imposed pursuant to in the amount of $2.24 X 1,918 S.F. or $4,296.32 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By CCNIB-David Addington Check No. 305652 Name on the check Telephone Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by n McGilvrey Payment Recd $4,296.32 Over/Under Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - ApplicantlReceipt Copy - Accounting AN` -220- ;005 08:48 AM P.01 l U (� ERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTINC CF -4R (A o Project Title �z _. -� ^— J /p —. DatY��( Projvt Add(ess Builder Name der Con elephone Plan Number HERS ater/ Tele hone Sample Group Number -S hying Signature t� - -Sample Mouse Number rIrm:HERS Provider: -/J-G ,f - s cru/, G� CltIState2lp: � Street Address: 7�b�Ql�Y� OV� C�J'GC� Y Copes to: Builder. HERS Provider HERS RATER COMILIAN09 STAT EN The house was; JU Tested ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification. I certlfy that the houses Identified on this form Com y with the diagnostic tested compliance requirements as checked on this form. in Distribution system is fully ducted (I.e., does not use building cavities as plenums or platform,returns in lieu ducts) Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM ® 25 Pa) values Test Leakage Flow in CFM _._2_�-- If fan flow is calculated as 400cfm/ton x number of tons'enter �IG ,0 Z7- calculated value here t� If fan flow Is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) = 71 co Check Box for Pass or Fail (Pass=6% or less) ❑ Pass Fail HERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent Yes 0 No Thermostatic Expansion Valve (or Commission approved equivalent) is installed and Access Is provided for Inspection ❑ Yes is a pass ass Fail ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT t ❑ Yes D No ACCA Manual D Design requirements have been met (rater has verified that actual Installation matches values in CF -1R and design on plan, 2. ❑ Yes O No TXV is Installed or Fan flow has been verified. If no TXV, verified fan now matches design from CF -1 R. Measured Fan Flow D D Yes for both 1 and 2 is a Pass Pass Fail �a�0 �r� Certificate of Occupancy 0 0 g Ijl[gi70tA1FD ��"� . 19eQ G� OBuilding & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 51-825 AVENIDA BERMUDAS Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-3881 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC Owner of Building: POWER FINANCE Address: P.O. BOX 134 City, ST, ZIP: LA QUINTA, CA 92253 By: KIRK KIRKLAND Date: January 20, 2005 Building Official POST IN A CONSPICUOUS PLACE