04-7172 (SFD)1
i c
I
BUILDING & SAFETY DEPARTMENT
P.O. BOX 1504 (760).777-7012
s•
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760), 777-7153
BUILDING PERMIT
Application Number
Date
12/03/04
Property Address
153340 AVENIDA-VELASCO
APN:
774 -085 -005 -5 -000000 -
Application description
DWELLING ,= SINGLE FAMILY DETACHED
Property Zoning . . .
COVE RESIDENTIAL`•
Application.valuati
119569
D
Owner----
Contractor-'-------------
----�-----��
POWER FI OCp��
ADDINGTON, DAVID
P.O. BOX �p� ��qe��' 41760 HERMITAGE DRIVE
LA QUI NTA �9�92 2 4
7 I ND I O
CA 92201,
OF
WCC: STATE FUND
WC: .2290019787
01/01/05
CSLB: 682901
12/31/05
CCC: B
------ Structure Information SINGLE FAMILY DWELLING
-----
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
1ST FLOOR SQUARE FOOTAGE
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
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
` , f
P.O. BOX 1504 •
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: Date:
/- 4;,- o.5
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
C and my Licenseeas in full force and effect. ` Q
icensa Class L� icense No. 4 8 a., 4)
0
.,�Date I ontractor
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
of 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
iss pd. My w ve�rs' compge,QQsa�,nN�umber
carriera((��d poli number re:arrier .S+'l�f`�{/ l D O 9at, in the performance ohich 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
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 /T
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 enter upon the above-mentioned property for inspection purposes.
Z115atlf'l 0ignature (Applicant or Agent):
ti
Page
2
Application Number
:
. . . . 04-00007172 Date
12/03/04
Qty Unit
Charge
Per
Extension
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
1.100
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
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
Page
3
Application Number
04-00007.172 Date
12/03/04
Other Fees
. . . .
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
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 Check8
Total
534.6
250.00 .00
284.86
.Other Fee Total
2463.07
00 .00.
2463.07
Grand Total
4017.16
250.00 00
3767..16
t
Po. BOX 1504 APPLICATION ONLY
78-495 CALLE TAMPICO
Building �Ct�SG�c� LA QUINTA, CALIFORNIA 92253 O
Address
Owner
BUILDING: TYPE CONSTOCC. GRP. Number `-� /
Mai ing / % A.P. �� `� d �
Address
Cit ZpTel.
Legal Description LT
.57
�19,t 7 %�70
Co actor % Project Description
Ads
`
77Je 2 p
Ci - �/ Zip �z�3 Tel
State Lic. / City Sq. Ft. / �� No. No. Dw. f
& Classif. Lic. # Size / Stories Units
Arch., Engr., New Add 0 Alter ❑ Repair ❑ Demolition ❑
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and .
effect.
SIGNATURE DATE
OWNER-BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also PERMIT AMOUNT
requires the applicant for such permit to lila a signed statement that he �s licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that he rs exempt therefrom, and the basis Plan Chk. Dep.
for the alleged exemption. Any violation o/Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty o/ not more than five hundred dollars ($500). Plan Chk. 681.
O I, as owner of the property, or my employees with wages as their sole compensation, will do
fes-
Const.
the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Pro
sions Code: The Contractor's License law does not appry to an owner of property who builds Mech.
or improves thereon and who does such work himself or through his own employees, provided
that such improvements are not intended or oNere d for sale. If, however, the building or im. EIBCtrIC81
provement is sold within one year of completion, the owner-builder will have the burden of
proving that he did not build or improve for the purpose of sale). Plumbing
O I, as owner of the property, am exclusively contracting with licensed contractors to construct
the project. (Sec. 7044, Business and Professions Code: The Contractor's License Lawdoes S,M.I.
not apply to an owner of property who builds or improves thereon, and who contracts for such
projects with a contractor(s) licensed pursuant to the Contractor's License Law) Grading
O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Infrastructure
Date Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self-insure, or a certificate of Worker's
compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
D Copy is filed with the city. D Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM TOTAL
WORKERS' COMPENSATION INSURANCE
(This sdttion need not be completed if the permit is for one hundred dollars ($100) valuation REMARKS
or less).
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 Workers' Compensation Laws of
California.
Date Owner
NOTICE TO APPLICANT., If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith ZONE: BY:
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
CONSTRUCTION LENDING AGENCY Front Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the work Rear Setback from Rear Prop. Line
for which this permit is issued. (Sec. 3097, Civil Code.)
"" Side Street Setback from Center Line
Lenders Name
Lender's Address Side Setback from Property Line
This is a building permit wheh'properly tilled''out. Sigried'ahii'validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. FINAL DATE INSPECTOR
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the above-mentioned Issued b Date Permit
property for inspection purposes. y
Signature of applicant Date
Validated by:
Mailing Address
City, State, Zip Validation:
WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE
Date 1/6/05
No. 26767
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515 ,
0p5` ' IPN°
BERMUDA DUNES r
U= RANCHO MIRAGE
�. INDIAN WELLS
d� PALM DESERT y
LA QUINTA
11
IN1O0 O y�
O
r
Owner Power Finance. APN # 774-085-005
Address Jurisdiction La Quinta
City Zip Permit #
Tract•# "' Study Area
Type Single Family Residence No. of Units 1
'Lot # No. Street S.F. Lot # No. Street S.F.
Unit•1 5,3340 Avenida Velasco 1918 Unit 6
Unit 2. Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports,: covered patios/walkways, residential' additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho
mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 1.,91.8 S.F. or $4,296.32, have been paid for the propertylisted 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 CC/Valley Independent Bank -Amanda Velez Check No. 319829
Name on the check Telephone 5648470
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sh on McGilvrey Payment Rend.. o.fJO
. $4,296.32 Over/Under
Signature
ti
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 o
r 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 -Applicant/Receipt Copy - Accounting
y
1
RC DISTRICT - PLANNING REVIEW FORM
This form is 'to be used by CDD., staff for review of single family dwellings in the RC (Cove
Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine. 1)
that the proposed housing design does not duplicate the same architectlural style of any house
within 200 feet of the applicant, .and/or 2) if there is a need for the applicant to file .for Master
Design Guidelines. If the applicant does need to file a Master Design Guideline, please transmit
this information to'the Building and Safety Department as part of your correction list. Please
attach additional explanations as necessary.
APPLICANT: ADDINGTON, INC
SITE ADDRESS: 53-340 Velasco
APN 774 - : `-085 - 005CASE NO.: 1042
LEGAL: LOT 5. BLOCK UNIT 2 S.C.QV.L.Q. -
' CHECK AND APPROVED.BY: WALLY NESBIT DATE:
Inform the assigned Building plan checker upon. your assignment to this case. The CDD
Executive Secretary maintains 'a log book to track applications and assign case numbers.
REQUIRED ITEMY
N
COMMENT/CORRECTION
Verify legal and APN information.
Consistent with MDG on file.(as
applicable)
.MDG filing required (5 filings
since 9/3/98)
Architectural variety within 200
feet of the surrounding area:
Architectural design features
r --e d ft'. Meso #
City Council
-.ommunitv Dev. Dept.
nitials
"'----
. ase No. 12 C OV(_ ivc1 LPxhibil ,.
With Conditions,
Other Requirements:
AUG -23-2005 04:14 PM P.02
CERTII!ICATE OF FIELD VEWICATION ANDDIAO',OSTIC TESTINIG" : CF -4R
Plan Number
Sample Group Number
v
C"'ling Signature Dath Sample House Number
eoeL&TISrr— HERS Provider; � k 1Q s
Street Address; G-.lYL l� City/State/21p; �! U-
Copies to; Builder, HERS Provider
RS„BC PLIA T MENT
The house was!fi
Sated ® Approved as part of sample testing, but was not tested
As the HERS rater providin dlaggnostic testing and field verification, I certify that the houses Identified on this form
co with the diagnostic sated compliance requirements as checked on this form.
Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu
4f 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.
,CMINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Duct alagnostle Leakage Testing Results (Ma>tlmuM 6% Duct Leakage) Measured
Duct Pressurization fest Results (CFM Q 25 Pa) values
Test Leakage Flow In CFM �Z
If fen now Is calculated as 400cfm/ton x number of tons enter � �
calculated value here —G
If fan flow Is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow) 3 ( G'
Check 6ox.for Pass or Fall (Pess%,5 o or leas)
Pass Fell
TWZRMOSTATIC EXPANSION HALVE (TXV) or Commission approved equivalent _
Jdryes ®No Thermostatic Expansion Valve (or Commission approved
equivalent) Is installed and Access is provided for Inspection
Yes Is a pass ass Fail
® MINIMUM RE®UIREMENY3 FOR DUCT DESIGN COMPLIANCE CREDIT
1. ® Yes ❑ No ACCA Manual 0 Design requirements have been met
(rater has verified that actual Installation matches values in
CF -1 R and design on plan.
2.. 0 Yes ❑ No TXV is instalied or Fan flow has been verified. If no TXV,
verified fan flow matches design from CF -1 R.
Measured Fan Flow
❑ ❑
Yes for both 1 and 2 Is a Pass Pass Fall