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04-5396 (SFD)T4hf 4 4 QU4 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 t FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . .C04-00005396---- ' Date 8/03/04 Property Address . . . . . . 538-65 EISENHOWER DR APN: 774-165-019-8 -000000- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . COVE RESIDENTIAL Application valuation . . . . 119596 Owner ------------------------ POWER FINANCE PO BOX 134 LA QUINTA CA 92253 Contractor ------------------------ ADDINGTON, DAVID 41760 HERMITAGE DRIVE INDIO CA 92201 Qty Unit Charge Per 2 2m Extension CINCE Q&�MPq WCC: STATE FUND WC: 2290019787 01/01/05 CSLB: 682901 12/31/05 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 FIRE SPRINKLERS NO GARAGE SQ FTG 480.00 PATIO SQ FTG 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'.00 3.5000 THOU BLDG 100,001-500,000 70.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL `-- Additional desc . . Permit Fee . . . . 59.00 Plr�ri1 Check Fee 14.75 Issue Date . . . . V���uation 0 Qty Unit Charge Per 2 2m Extension CINCE Q&�MPq P.O. Box 1504�� VOICE (760) 777-7012 Tvf 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 0A1 03 Z I Date: ® • .3- o y 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 Lice ns is in full force and effect. License Class License No._J�L Date — + C —dt 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 civif 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 c6ntracting 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 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 sued. My worker� compensation insurance carrier and p icy number are: n Cartier Ci�/r� /_ 1'C// _Policy Number a 100 l Cf'26 _ I certify that, in the performance of the work for which this permit is issued, Ied, Ishanot 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 _1,2-GLApplicant 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 hereby authorize representatives of this county to r upo the above-mentioned property for inspection purposes. Date �d 'UL Signature (Applicant or Agent): Page 2 Application Number . . . . . 04-00005396 Date 8/03/04 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 . . . . 114.00 Plan Check Fee'. 28.50 Issue Date . . . . Valuation . . . . 0 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 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 --------------------------7------------------------------------------------- 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 Page 3 Application Number . . . . . 04-00005396 Date 8/03/04 ---------------------------------------------------------------------------- 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 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 1004.23 -------------------- .00 .00 1004.23 Plan Check Total 531.11 250.00 .00 281.11 Other Fee Total 2463.07 .00 .00 2463.07 Grand Total 3998.41 250.00 .00 3748.41 City La Quinta Zip 92253 Permit # Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street Unit 1 53865 Eisenhower Drive Unit 2 Unit 3 Unit 4 Unit 5 S.F. Lot # No. 1918 Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 Comments Check #319577 in the amount of $4,296.00 and 32 cents in cash. 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: 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 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. 319577 Name on the check Telephone By Dr. Doris Wilson Superintendent Fee collected /exempted by Juanita Green. Signature Funding Residential Payment Recd $4,296.32 Over/Under NOTICE; Pursuant to Ggrnment 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 identifie ove 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 pai 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 APi2-06-2005 04:06 PM AND Firm: J. C . -0' Street Address: 2 aQ &A6°� CIYC /2 Copies to: Bullder, HERS Provider -4R oaten ! Builder Name Plan Number ' 5pmplo Group Number Semole House Number HERS Provider: G / G yIER.i Clty/Stete!Zip: I a 4107 , r, 3 ddjRS RATgFt CQMPLIANCE STATEMENT The house was:Tested ED Approved as part of sampie testing, but was not tested As the HERS rater providing dlagnostic testing and field verification, I certify that the houses identified on this form comps ,ith the ciagncst;c tested 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 f ducts) rG! 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 Diagnosticleakag,e Testing Results (Maxlmurn 8% Duct Leakage) Measured Duct Pressurization Test Results.,(CFM a 25 Pa) values Test Leakage Flow in CFM if fan flow is calculated as 400cfrn/ton x number of tons enter calculated value here 10�:_`_ _ if'fan flow Is measured enter measured value here _ LeaRage Percentage (100 x Test Leakage/Ftin Flow) = �' i Check Box for Pass or Fali (Pass=e% or Iess) 0 r35 Fad ;THZRMOSTAT.IC EXPANSION VALVE (TXV) or Commission approved c -uivalert e5 (] No .Thermostatic Expansion Valve (or Com+nissier. -approved equivalent) is installed and Access is provided for inspection Yes Is a pass ® MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1. 0 Yes ❑ No ACCA Manual D Design requirements have been mat (rate, has verified that actual installation matches values in CF -1 R and eeslgn on plan. C Yes ❑ No TXV Is Installed or Fan flow has been verified, if no TXV, verified fan flow matches design from CF-IR- Measured F•1R.Measured Fan Flow = Yes for both 1 and 2 is a Pass Q. Pass Fail ❑ ❑ Pass Fail.