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05-1020 (AR)n� - >—. .)aFIT,jot 7 9 A 8 200 5 P.O.- BUILDING & SAFETY DEPARTMENT Bo 1 04 (7'60) 777-7012 CAL LE TAMPICo FAX (760) 777-7011 —'L-A YUINIA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . .. 05-00001020 Date 4/27/05 Property Address . . . . 79526 DANDELION DR APN: 604-453-013-12 -29623 - Application description.. ADDITION — RESIDENTIAL Property Zoning*. :.-LOW DENSITY_ RESIDENTIAL Application valuation . . . . 60000 Owner Contractor BRITTON CHRISTOPHER M FINAN. CONSTRUCTION 79526 DANDELION DR NO 12 78385 VIA CALIENTE LA QUINTA, CA 92253, LA QUINTA, CA 92253 (760) 285-9919 WCC: ..EXEMPT . WC: EXEMPT 10/31/05 CSLB: 853854 02/28/07 CCC: B P.O. BOX 1504 �� VOICE (760) 777-7012 78-495 CALLS TAMPICO TufFAX. (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)777-7153 BUILDING & SAFETY DEPARTMENT Application Number: O 10011 ` Date: 4,29 -os Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: p b4 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 is in full force and effect. License Class License No. Date Contractor. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for thelollowing 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 Vsold 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.). L 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 t 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 whi h this permit is issued. I have and will maintlin 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 work rs' compensation insurance carder and policy number are: Carrier Policy Number certify that, in th performance of the work for which this permit is issued, I shall moa employ any person in any manner so as to become subject to the workers' compensation aws 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 com ly with those provisions. WARNING: FAILURET "SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ON 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. 1 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 repres fives of this county to enter upon the above-mentioned property for inspection purposes. Date �� �� Signature (Applicant or Agent):q/30__ i =--------------------------------------------------------------------------- 1 Application Number . ---------------------------------------=-----------------------------=------ . . . . 05-00001020 ------ Structure Information 736 SQ. FT. ADDITION ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . : CODE EDITION 2001 CBC # BEDROOMS 2.00 FLOOD ZONE NO --------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE -------------- 736.00 Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 459.50 Plan Check Fee 298.68 •Issue Date . . . . Valuation . . . . 60000 Expiration Date 10/24/05 Qty Unit Charge Per Extension BASE FEE 414.50 10.00 4.5000 ---------------------------------------------------------------------------- THOU BLDG 50,001-100,000 45.00 Permit . . . . . . ELECT - ADD/ALT/REM Additional desc Permit Fee . . . . 40.76 Plan Check Fee 10.19 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/24/05 Qty Unit Charge Per Extension BASE FEE 15.00 736.00 .0350 -----------------------------------------'----------------------------------- ELEC NEW RES - 1 OR 2 FAMILY 25.76 Permit' . . . . . . MECHANICAL Additional desc Permit Fee . . . . 57.50 Plan Check Fee 14.38 Issue Date . . . . Valuation 0 Expiration Date 10/24/05 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 1.00 6.5000 ----------------------------------- EA MECH VENT FAN ----------------------------------------- 6.50 Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 91.50 Plan Check Fee 22.88 Issue Date Valuation . . . . 0 Expiration Date 10/24/05 Qty Unit Charge Per. Extension BASE FEE 15.00 10.00 6.0000 EA PLB FIXTURE 60.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 2.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 6.00 Special Notes and Comments 736 sq..ft. addition4/12/05 6:42:19. AM ---------------------------------------------------------------------------- « A lication Number 05-00001020 --------------------------------------------------------------------- ---- --------------------------------------------------7------------------------- Special Notes and Comments jjohnson ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 29.87 STRONG MOTION (SMI) - RES 6.00 Fee summary =---=------------ Charged Paid Credited Due Permit Fee Total ---------- 649.26 -------------------- .00 ---------- .00 649:26 Plan Check Total 346.13 .00 .00 346.13 Other Fee Total 35.87 .00 .00 35.87 Grand Total 1031.26 .00 .00 1031.26 CERTIFICATE OF FIELD VERIFICATI1ON AND DIAGNOSTIC TESTING (Page I of T) CIF' -4$ ��-►gTz� rl P—L--S .. hate �1 i� Project '271Title Project Address _ 9utiderwame Cartifyiing S � ---- >� Firm• � ►.� Pled Number SRmpie Group Number Semple House Ntnnber iaY (!s N � _ fs T"14Cao, E11M Pmv • leer: Sireet Aaaaew:1(Q82.1 i ��v.4 _ cls► terllp: � �s,nEor �,4_ Copies to: Builder. ITERS Provider HERS RATER COMPUA NCE STATEMENT The house was: % Tested ® AMoved as part of sample tastiittg, but was not tested wK so ERSgj dlaSttosdo and field vat cgion) I �1Y that tlra houat�s identified on rids � oomply oota>Fltattce as cheer ort tars fbM. 7lte installer hep provided a am of Cf =6R (iawkdm CrotiQoata, Distribution system Is fully dined (La,, dots riot we build* cavities as plemns or platform retains in lieu of duces) ❑ Wbin ckM backed, rubber a6esive duct tq* is w4biled, undo and drewbeads are used in combination with cloth backed, rubber affliesive duct tape to seal leaks at dung coanectiam MINIMUM UQU1atEIVMIVTlI BAtt DUCT LCAKAGE REDUCTION COMPLIANCE ►CP.EDtT Duct Diu6aostic Lnkage Teams R,esaft (Matmam 6% Dad Leake) Duct Pressuaization Test Results (CFM (§ 23 Pa) ,ahics M Teat Lockage Flow In CFM ,. / 21f,411 If (M flour is calculated as 400cWon at number of tons enter calculated vahrc here If tYtt flog is measumd enter meammW value heere Leakage Pa ew%ge (100 x Test LeakujWp n Flow) 7 a Clasen Baas Por Pass or Fath (Pas -69b or less) ❑ Pass Fail Q THERMOSTATIC EXI?ANSION VALVE OX)l E3 Yes © No Ibmnostaae Expansion Valve is installed dice Access is provided for hupeadon Yea >s a pees 13 MINMUM REQUMENMNTS FOR DUCT D=GN COMPLL P= ccRwrr t' ® Yes 0 No ALGA DBanttal D Design regairemerats have been used (rater bas va ifted thiel tactual itSlllllaflota malty vahm in CF -IR and design an phm. Z• jj Yes Q No TXV is ins WW or Pitt flaw fres beat verified, if rtoA V, verified fait flaw matclm daaipn Om Cp-1R melts ind Fiin flow x Yes for i?oth I and 2 Is o Paas ® ❑ Pass Fall E3 13 ire Fall DUCT L.EA]KAGL AND DESIGN DL4GNOS'i'ICS 1LlEAKAOE ;n Test Renu Pemit Number f� Fan Flow Test Leakage (CFM) -.' —c -s"41 If Pan Flow is Calculated as 4M cfin/tan A number oft=, or as 21.7 x Heating Capacity in 'Ihotaands of BW1r- enta calculated value here Iffen flow is measw%A W= Mmsumd vaiue hem, Leakage Fraction — Test W(M=Mffod or CalM:leted Fan Flv ar) -I !Pass if leakage f cation S 046 Ry � ❑ For AEROSOL. TypE SE Pass Fail Al[,AlVT3 01�11LY - The feeII thug tpg� w� co�tpleted: Duct Fan PMMdzW" at rough -M measured leakage; (CFM) CHECK AFTER ,FMISHING WALL: ❑ Yes ❑ No ❑ PMUure pan test or House pressttrizetion reit ❑ Yes ❑ No ❑ Visual inqwtion of Duct Connections ' ❑ ❑ Pass Fail VALVE ❑ Yes ❑ No Thea>Inostatic Expansion Valve is LuWled and A"=9 is provided for bspmfiou ED El Yes n pars Pass Fail ❑ DICT DESIGN 1' ❑ Yes ❑ No AC'.CA Manual D Design ealCuhd havebeer► --.. OMplM, Duct Design is an the pane and duct huWation mauhes pleas. 2. ❑ Yes ❑ No TXV is iwWled or Far flow hue been vart ied. if no i?tV, verified fan flow matches design from CF -3 R. Meaftred Fan Flow = Yes fur both l auld 2 is a Pass Ci ❑ Pass Fail I. the undersign 4 verify that the ebove` conformance with the diatetic test Ib anal tt►a work 1 pga�forraed a�ociated with the tests) is in signed by the builder �ulm'ema for cosnpliauee MWIL ITS bWlder shall provide the HERS provider a copy of the CF -6R for compliance credit, jibe" or sub-ommutors certifft that dkowstic t+ertbug and installation. meet the requirements .- /--& �� f TOM- signAriujG, DatePerfomed Installing SuIconmctor (Co. ; e-) 60 — COPY 7'O: Building Deparbnea! Gewral Contna&or (Co. ire) HERS Provider (if applicable) prrildino !}"gr at 4)C-o+ranoy