04-4785 (SFD)P.O. Box 1504..
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
Application Number.
Property Address
APN:
Application description
Property Zoning
Application valuation
BUILDING &' SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
0.4-x0004785 Date 6/23/04
. . . 52800 EISENHOWER DR
773-331=002-25 -000000-
. DWELLING - SINGLE FAMILY DETACHED
COVE RESIDENTIAL
119596
Owner
---------------
POWER FINANCE
P. O BOX 134
LA QUINTA CA 92253
Contractor
------------------------
CONTEMPORARY HOMES INCORP
P.O. BOX 1141
LA QUINTA CA 92253
Qty . Unit Charge Per
Extension
WCC: STATE FUND
... WC: ': .1:5764'98
07/01/04
CSLB:.. 736920
03/31/05
".,..... ... f ..' 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
# BEDROOMS
3.00
FIRES.PRINKLERS... .NO
GARAGE SQ FTG
480.00
PATIO SQ FTGc
36.00
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
119596
Qty Unit Charge
Per
Extension
BASE FEE
639.50
20.0.0 3.5000
THOU' BLDG 100,001-500,000
70.00
----------------------------------------
Permit . . . . . .
-------------------------------
MECHANICAL
-----
Additional desc. .
Permit Fee
77.00 Plan. Check Fee
19.25
Issue Date . . . .
Valuation
0
Qty . Unit Charge Per
Extension
or `•
P.O. Box 1504 • VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: O �% 'y��Jr Date: •.� 3 O�
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
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 is in full force and effect. - ? —3 9
License Class se No.
Date Z � Con
OWNER -BUILDER DECLARATION
I hereby affirm u der 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.).
(-.) 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
issued. My workers' compensation insurance ca`rier and pmber are:
Cartier Policy Number f _ S- G `-/ R �i
1 certify that, In the performance of the work for whichthis permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, a�agre that, if I should be ubject to the workers' compensation provi ' ns of Section 3700 of the Labor Code, I shall
forthylith comp with t visions.
WARNINV. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS U t�WFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FID&S UP ONE HUNDRED THOUSAND DOL RS ($100,000), IN ION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTI 3708 OF THE LABOR CODE, INTEREST, AND ORNEY' S.
/ 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 ' ork is not commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subjeapermit to ca n.
I certify that I haver this app ation and s3te'1 at the mformab s cored. I agree to comply with all city and county ordinances and state laws relating to build•
construction, and y auth ze repr tentative is county toe r upon the _9) ' ed property for inspection purposes. �n
Z
ZSlg ature (Applicant or Agent):
Page
2
Application Number .
. .
. . 04-00004785 Date
6/23/04
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
3.00
9.0000
EA
MECH FURNACE <=100K
27.00
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 .
. . .
1.06.73
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
w
1037.23
.00
289.36
Page
3
Application Number . . . .
. 04-00004785 Date
6/23/04
----------------------------------------------------------------------------
Special Notes and Comments
BLOCK WALL, POOL/SPA OR DRIVEWAY
APPROACH
----'------------------------7-----------------------------------------------
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
STRONG MOTION (SMI) - RES
11.95
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total.
Charged Paid
---------- ----------
1037.23 .00
539.36 250.00
2463.07 .00
4039.66 250.00
r
Credited Due
.00
1037.23
.00
289.36
00
2463.07
.00
3789.66
CERTIFICATE OF COMPLIANCE ��11;IEI) SC'
Desert Sands Unified School District �4eERMUDA s
47950 Dune Palms Road
Date 7/21/04 La Quints MIRAGE
f INDIAN WELLS CA 92253 RAN AN WELLS
N ti
No. 26203 (760) 771-8515 PALM DESERT
LAQUINTA �y
.QINDIO 1�
Owner Power Finance APN # 773-331-002
Address 52800 Eisenhower Dr Jurisdiction La Quinta
City La Quinta Zip 92253 Permit #
Tract # $tudy Area
Type Single Family Residence No. of Units 1
Lot # No. Street S.F.
Unit 1 52800 Eisenhower Dr 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 patiosJwalkways, 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 1,918 S.F. or $4,296.32 have been paid for the property listed above and that
Wilding 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 -Power Finance Check No. 319541
Name on the check Telephone 564-6470
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Beth Schieferstine
Signature
Funding Residential
Payment Recd $0.00
$4,296.32 Over/Under
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 DistrictCs) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
MAY -12-2005 07:48 AM
OF FIEI,D VERIFICATION AND DIAGNOSTIC
P.02
G .' ' CF -4R
Date( '
//A�,,� )4_ h4nLV �SS ra7eS
Builde
Plan Number
L q -
HERS_Rater Telephone Sample Group Number
/ v
Cjdffiing Signature V Dath Sample House Number
HERS Provider: C HJEE R S
Street Address: .28'd D �I�Q�?'o1��iC�YC�t✓ City/State/zip: �t' '7�a L_
Copies to: Builder, HERS Provider
HERS RATER OMPLI STATgMCNT
The house was: JOrTested ❑ Approved as part 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
comply with the diagnostic tested compliance requirements as checked on this form.
PIDistributlon system Is fully ducted (i.e., does not use building cavities as plenums or platform returns In Ileu
6:°f ducts)
I.ld 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.
iZl 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) 4 values
Test Leakage Flow In CFM /O
If fan flow is calculated as 400cfm/ton x number of tons enter)
calculated value here
If fan flow is measured enter measured value here
Leakage Percentage (100 x Test Leakage/Fan Flow)
Check Box for Pass or Fail (Pass=6% or less) ❑
Pass Fail
THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent
;!�Yes ❑ No Thermostatic Expansion Valve (or Commission approved
equivalent) is installed and Access is provided for Inspection ❑
Yes Is a pass . Pass Fail
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
1 • ❑ Yes ❑ No ACCA Manual D Design requirements have been met
(rater has verified that actual Installation matches values in �% ;/�
CF -1 R and design on plan. 1'`i
2. - D Yes 0 No TXV is installed or Fan flow has been verified. If no TXV,
verified fan flow matches design from CF -1 R.
Measured Fan Flow = --J
Yes for both 1 and 2 Is a Pass
❑ ❑
Pass Fail