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04-1124 (SFD)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 6 f BUILDING PERMIT Application Number d. . 0.4-=00-0.07124 Date,,, ` 4/07/04 Property Address7_8_7.0-0 AVENIDA TORRES ) APN: . 770 -171 -012f=153 -000000 - Application description-.. DWELLING'- 'SINGLE FAMILY DETACHED Application valuation 170227 Owner Contractor DAVID L. ADDINGTON ADDINGTON, DAVID P.O.,BOX 1573 41760 HERMITAGE DRIVE LA QUINTA ZCA 92P253 INDIO CA 92201 U APR 8 ?UO4 WCC: ..STATE FUND. WC: 229001.9787 01/01/05 OIC wLAUINTA CSLB: 682901 12/31/05 F'm y!CE DFPT. CCC: B -------=------------------w Structure Information .--------- _--- ------- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . . FLOOD ZONE AO .Other struct info . . . . CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 689.00 PATIO SQ FTG 446.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 2777:00: -------------------------------------------------------------------------=-- Permit . . BUILDING PERMhT Additional desc Permit Fee . . . . 888.00 Plan Check Fee 327.20 Issue Date . . Valuation . . . 17022" ,Qty Unit Charge Per 'Extension. BASE FEE 639.50 71.00 3.5000 THOU BLDG 100,001-500,000 248.50 ------------------------------------------------ Permit. . . . MECHANICAL Additional desc Permit Fee 98.50_ Plan Check Fee 14.13 Issue Date Valuation �) Qty Unit.Charge Per- Extension BASE FEE 15.0+) 2.00.; 9.0000 EA MECH FURNANCE <=100K 18.0) 2.00> 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 TP.O. BOX 1504•4 4 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: Applicant: Applicant's Mailing Address: 8 F—RI)aial,� ai,'.r,C'S Date: Architect or Engineer: Architect or Engineer's Address: - 14�L)All�; 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 ' in full force and effectNo.- / License Class License No. Date I' —G� L 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 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 f 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. My wo rs' compensation insurance carrier d oticY number are: Carrier y ,^//7 Policy Number �I / C� S7 certify that, in the performance of the work for which this permit is issued I shall not em loy 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 p ns. Date — —O 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 trhltierl on the -above-mentioned property for inspection purposes. Datez/1 Signature (Applicant or Agent): M Application Number 04-00001124. Page' 2 Date 4/07/04 Qty Unit Charge Per Extension on 4.00 6.5000 EA MECH VENT FAN 26.00 6.5000 EA MECH EXHAUST HOOD 6.50 ----------------------------------------------------------------------------- Permit . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 159.48 Plan Check Fee 39.87 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2777.00 .0350 ELEC NEW RES 1 OR 2 FAMILY 97.20 689.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 13.78 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 1.00 18.5000 EA ELEC SVC <=600V/<=200A 1'8.50 -------------------------------------------------------------------------- Permit . . .. . . . PLUMBING Additional desc Permit Fee . . . . 257.25 Plan Check Fee'. 55.31 Issue*Date . . . . Valuation . . . . 0 Qty Unit Charge- Per -Extension BASE FEE 15.00 25.00 6.0000 EA PLB FIXTURE i50.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 6.00 6.0000 EA PLB ROOF DRAIN 36.00 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 9.0c 9.00 .7500 EA PLB GAS PIPE >=5 6.75 1.100 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------- Permit . . . . . . 7 -------------- GRADING PERMIT Additional desc.. Permit Fee . . . . . 15.00 Plan Check Fee .0c Issue Date . . . . Valuation . . . . C Qty Unit -Charge. Per Extension. BASE FEE 15.00 ---------- * ------------------------------------------------------------------ Special Notes and Comments SFD - LOT 153, PERMIT DOES NOT INCLUDE s Page 3 Application Number . . . . 04-00001124 Date _4/07/04 Special Notes and Comments POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH '------------------------- ------------------------------------ Other Fees . . . . . . . -------------- DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER.- RES 366.00 ENERGY REVIEW FEE 57.72 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 17.02 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged ---------- Paid Credited Due Permit Fee Total 1418.23 ------------------------------ .00 .00 1418.23 Plan Check Total 436.51 .00 .00 436..51 Other Fee Total 2479.74 .00 .00 2479.74 Grand Total. 4334.48 .00 .00 4334.48 s vv P.O. BOX 1504 APPLICATION ONLY '-t!3 iId ing 78-495 CALLE TAMPICO Address 7 ��� ?'c�E QUINTA, CALIFORNIA 92253 Owner ing J –7 /' / ' CJ /.:/' , K/&A/Gg zie��Gf Address ' I Cj{y „ lZip „ _ ]Tel,, _ State Lic.City & Classif. /� �G Lic. # Arch., Engr., C� L Designer Address Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section Itof Division 3 of the Business and Professions Code, and my license is in full force and effec SIGNATURE DATE OWNER -BUILDER DECLARATION 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 requires the applicant for such permit to file a signed statement that he is 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 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 (8500). l.: 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such 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 did not build or improve for the purpose of sale.) 11 I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does 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.) I'! I am exempt under Sec. B. 8 P.C. for this reason Date Owner WORKERS' 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 C1 Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg work for which 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. Date Owner NOTICE TO APPLICANT., 8, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 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 city to enter the above- mentioned properly for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING: TYPE'CONST. OCC. GRP. A.P. Number- / /(.J — / / / !X Legal Description �17_ ISS 3 A Pi U J i Project Description `sr� • - r7 w 11 1V�� ,1111. _W1.7-11EFF, NO ll�■ � � � I l '1U_ 1 ■ ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE Sq' Ft. size 7 77 No. ` No. Dw. Stories ( Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading • - r7 w 11 1V�� ,1111. _W1.7-11EFF, NO ll�■ � � � I l '1U_ 1 ■ ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE CERTIFICATE OF COMPLIANCE ' Desert Sands Unified School District z4�cayo 47950 Dune Palms Road ¢ BERMUDA DUNES r La Quinta CA 92253 C/) RANCHO MIRAGE d Date 4/7/04 N INDIAN WELLS No. 25775 (760) 771-8515 ct-,�, PALM QUINT V t IN©O QS7 Owner David L. Addington APN # 770-171-012 Address 41780 Hermitage Dr Jurisdiction La Quinta City Bermuda Dnes Zip Permit # 0401-124 Tract # U-5 Study Area Typel Single Family Residence i No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 153 78700 Avenida Torres 2777• Unit 6 Unit 2 Unit 3 Unit 4 Unit 5 Comments Unit 7 Unit 8 Unit 9 Unit 10 fa , 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: 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 2,777 S.F. or $6,220.48 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 ' OCMells Fargo -David Addington Check No. 0737704160 Name on the check Telephone 760/408-7528 " Funding Residential' D� By Dr. Doris Wilson Superintendent Fee collected /exempte y aro MCGllvr y Payment Recd $6,220.48 Over/Under Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), AS, wi 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 - Applicant/Receipt Copy - Accounting G D off. 78-495 CALLE TAMPICO LA QUINTA, CA 92253 (760) 777-7075 APPLICATION ,,fix • �+- _ FILE: Upon Step 2 approval, original goes In -1-l000 Plain Development Permit" tile; copy goes to Applicant F096 REV -2 { 7/00 r. FLOODPLAIN DEVELOPMENT PERMIT BUILDING SITE LOCATION FLOOD ZONE "AO" - DEPTH 1 COMMUNITY- PANEL NUMBER nnQ060709 -7_7 V0 Avet ,CJ�cn T f_{'e s 0005 B Map Revised: 8/19/1991 t APPLICANT INFORMATION SECTION . APPLICANT NAME �'CQ r r: Sp S (, (_L �e HC1,1_16�6I APPLICANT r• l7 3 >< r. 5.7 3 ADDRESS V ��� l C (MAILING ADDRESS, NOT THE BUILDING SITE) - DAYTIME TELEPHONE NO. 76 0 - -7? "t-1 12,7 INSTRUCTIONS ^tr' i. MF 1. A Flood. Plain Development Permit is required by LOW Section 8.11.040(A). The, Applicant should complete the Applicant Information portion of this application and submit it to the' Engineering. Department along with the . required documentation noted hereon at .the same time the Precise Grading Plan is submitted to the Building and Safety Department for plan checking. 2. Documentation required for STEP 1 OF 2 APPROVAL prior to receiving clearance for Building Permit issuance .0 Copy of the proposed Precise Grading Plan for review and approval containing all information required by the checklist shown on the. back of this application. L ; 3. Documentation required for STEP 2 OF.2 APPROVAL prior to receiving Flood PlainDevelopmentPermit approval. Note, this approval occurs after forms for the lowest habitable floor are set and before the Building & Safety Department authorizes foundation construction. • Submit a completed FEMA "Elevation Certificate" form to the Engineering Department. • Submit 95% relative density soils compaction certification to the Engineering Department. STEP 1 OF 2 APPROVAL The Precise Grading Plan submitted for this application has been STEP 2 OF 2 APPROVAL All requirements have been satisfied. This Flood Plain reviewed and found to contain all data required to satisfy the Development Permit is approved. requirements of LQMC 8.11 The proposed dwelling is eligible to receive a building permit upon satisfying all other Building & Safety Department requirements. - C_3 -30 - AUTHORIZED SIGNATURE DATE AUTHORIZED SIGNATURE, DATE La Quinta Engineering' Department La Quinta Engineering Department FILE: Upon Step 2 approval, original goes In -1-l000 Plain Development Permit" tile; copy goes to Applicant F096 REV -2 { 7/00 r. FEB 12-2005 12:09 Pr -1 P.02 CERTIFICATE OF FIELD VERIFICATION AND'DIAGNOSTIC TESTING CF -4R Project Title .. / Date P,of tAddAdd®Sf S Build®r lamd B eider Contact _ Telephone P!an Number �7�0) g/g'- 572 3 HER§ Rater Isphone Sample Group Number rtlfying $Ign$tur® Da Sample 'r-,ouse Number Firm: Z 4� HERS Provider Street Address: 7;U6 _city/state/zip; Copies to: Builder, HERS Provider HERS RA' ER COMPLIANCE STATEMENT The house was; Tested ® Approved as pari of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form com with the diagnostic tasted compliance requirements as checked on this form, oistribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts) Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbar -As are used in combinat on with cloth backer, rubber adhesive duct tape to seal leaks at duct connections, ArMINIMUM 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,, If fan flow is calculated as 400cfmtton x number of tons enter r caicuiated value here ��- _ L'tr'o If far. flow is measured enter measured value here Leakage Percentage (100 x Test LeakagelFan Flow) Cineck Box for Pass or Fail (Pass -6% or less) Pass Fail li E THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved e�rivalent _ y aa7 Yes No Thermostatic Expansion Vaive (or Commission approved T equivalent) is installed and Access; is provided for. inspection J U. Yes is a pass Paas Fail ZI- MINIMUM REQUIREMENTS FOR DUCT DESIGN'COMPLIANCE CREDIT 1: ❑ Yes r-1 Ivo ACCA Manual C uesign requirements have been met (rater has verified that actual installation matches values in CF -1 R and design on plan. 2: O Yes G Nc TXV is installed or Fan flow has been verified. if no TXV, . verified fan.flow matches design from CF -IR. Measured Fan Flow ❑ ❑ Yes for both 1 and'2 is a Pass Pass Faii I � `��-a-�� �I o ,moo 4 Certificate of Occupancy Lwwou= IM OF Building & 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 N provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. T, BUILDING ADDRESS: 78700 "ENIDA TORRES Use classification: SFD Building Permit No.: 04-1124 V Occupancy Group: R3 - Type of Construction: VN Land Use Zone: RL V 44, IT, Owner of Building: DAVID ADDINGTON Address: P.O. BOX 1573 City, ST, ZIP: LA QUINTA CA 92247 ' By: KIRK KIRKLAND �4 Date: 2-23-05 Building Officral W POST IN A CONSPICUOUS PLACE