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.