BPLB2017-0045w�
s. 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application, Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
JORGE A ALVAREZ
PO BOX 984
THERMAL, CA 92274
. . 4 ,Qumr
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BPLB2017-0045
80555 OAK TREE Q
775082014
GROTH RESIDENCE/ 40 GALL N�/ T R H ER a
$850.00 MAR 21 2017
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT
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 Professions Code,
and my License is in full force and effect.
License Class: C36 License No.: 880103
OWNER -BUILDER DE RATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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
Contractor's 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).:
(1 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 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.).
( ) 1, 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. . B.&P.C. for this reason
Date
Owner:
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
Lender's Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/21/2017
Owner:
SALLY GROTH
80555 OAK TREE
LA QUINTA, CA 92253
Contractor:
JORGE A ALVAREZ
PO BOX 984
THERMAL, CA 92274
(760)698-8975
LIC. No.: 880103
WORKER'S 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 carrier and policy number are:
Carrier: EXEMPT Polity Number: _
I certify that in the performance of the 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, 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.
% ��nt:
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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 city to enter upon the
above-mentioned property for inspection purposes.
�7 ' Sign`natuceplicanL:or;A_gent):
k
10
Date: 3/21/2017
Application Number:
BPLB2017-0045
Owner:
Property Address: '
80555 OAK TREE
SALLY GROTH
APN:
775082014
80555 OAK TREE
Application Description:
GROTH RESIDENCE/ 49 GALLON WATER HEATER.
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: "
$850.00
Applicant:
Contractor:
JORGE A ALVAREZ
JORGE A ALVAREZ '
PO BOX 984
PO BOX 984
THERMAL, CA 92274
THERMAL,"CA 92274
r
(760)698-8975
---------------
-----------------------------------------------------------------------------
LIc. No.: 880103
Detail: 40 GALLON WATER
HEATER CHANGE OUT [GAS) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA
BUILDING CODES.
k
10
FINANCIAL
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT PC
101-0000-42600
0
$7.60
Total Paid for PLUMBING FEES: $20.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
I
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
F��
CEC-CFIR-ALT-01-E Revised 09116 CALIFORNIA ENERGY COMMISSION '01z `
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 6)
Project Name: r -o Date Prepared: —
A. General Information
Insulation Details — Framed (Section 150.2(b)1)
01
01
Project Name: \
02
Date Prepared: _
03
Project Location: e
04
Building Front Orientation (deg or card.inal).;
05
CA City: O~
06
Number of Altered Dwelling Units: - V
07
Zip Code: 2S
08
Fuel Ty e:14'
09
Climate Zone:
10
Total Conditioned Floor Area
11
Building Type:
12
Slab Area (ft):
13
Project Scope:
14
Exceptions to Minim, •. `AJ-fd)Solar Reflectance`
r&
and Minimum Ther ,;al i tance or 5
B. Building
Insulation Details — Framed (Section 150.2(b)1)
01
02
03
04
05
06, . W07 F 8, 009
10
11
. ,
Assembly
Materials
Thickness
(inches)
` Proposed
Required
Comments
'PPoO d
Required
U -factor
Appendix JA4
Reference
.3kontinuous
q�
Appendix JA4
U -factor
from
Package A
Frame
Frame
Depth
Frame
Spacing
Cavity
Insulation
Reference
Tag/ID
Assembly Type
Type
(inches)
(inches)
R va102
R -value Jfrtor
Table Cell
U -Factor
Comments
Note: k� a �r
0.3
• Where insulation is installed above the roofing membrane�!00a,ab the layer us�'ii;t the roof from at penetration, the insulation shall have a maximum water absorption of
percent by volume when tested according to ASTM4tan A d C272.
%L 1191AV
C. Building Insulation Details — Non -framed _
01
02
Q3
04 , '`
0 05 07 08 1 09
10
11
Tag/ID
Assembly Type
%R
. ,
Assembly
Materials
Thickness
(inches)
` Proposed
Required
Comments
Core
Inwulation
-value
Continuous
Insulation
R value
U -factor
Appendix JA4
Reference
Required
Table
Cell
U -factor
from
Package A
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2016 Resldential Compllance
HERS Provider:
September 2016
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT=01-E Revised 09116 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE MR -ALT -01-E
Prescriptive Residential Alterations (Page 5 of 6).
Project Name: `.` Cc r - Date Prepared:
I. Space Conditioning (SC) Systems - Heating/Cooling (Section 150.2(b))
01
02 03
Dwelling Unit Name
Dwelling Unit Total CFA (ft') Comments ;. L
04
05
1!!�'tv `•:rid
J. Water Heating Systems
(Section 150.2(b)1G)`
01
02
03
04
05
06
07
OS
09
10
v11
ele
13
14
15
Water
# of
Water
% M
'
Heating
System
Water
Heating-
Water
Water
Heaters
Heater
Storage
Rated
Rated
Heatin
beating
St dby, '
Exterior
Back -Up
Solar
Central DHW
System
Dwelling Unit
DHW System
Identification
System
Heater
in
Volume
Fuel
Input
Input
tffilie !y�
Efficiency
tow
%LLoss
Insul.
Savings
Distribution
Distribution
or Name
Type
Type
System
(gal)
Type
Type
Value
Vale, WK.4
(%
R -Value
Fraction
Type
Type
K. Space Conditioning. Systems and Water Heating Systems In Multifamil Dwelling Unit: u
01
02
03 '
04 O
05
06
Dwelling Unit Name
Dwelling Unit Total CFA
(ft')
,,-°
Til, nt"F�I�Water Heating
yFs m IdentificatIS'n o6
Narn_ ,
Dwelling-.%rl
Water Keatin System
-IdentitNtlon or Name
Dwelling Unit:
Alteration to Existing or
Installtion of Space
Conditioning System(s)?
Comments
%NNP
N" `
a
J Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2016 Residential Compliance September 2016
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
4 +.r
;;tG-G1`-1R-ALT-01-E Revised 09/16 CALIFORNIA ENERGY COMMISSION '
CERTIFICATE OF COMPLIANCE MR -ALT -01-E
Prescriptive Residential Alterations (Page 6 of 6)
Project Name: raj Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
7yor
N\\'�o-
Dotumentation.Author Signatur+'+i
Compan :Signature
R
Date: �
- I7�.,
Address
CEA/ HERS Certification IdentifltStlori(if.p11`t3ble)i
°»a
City/State/Zi
r CA-
Phone:
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:� y
1. The information provided on this Certificate of Compliance.is true and correct. r t
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility f6� : i21111ding desigt) o�s stt design identified on this Certificate of Compliance (responsible
designer),``
fhe
3. That the energy features and performance specifications, materials, components, an manufactured dev t ' building design or system design identified on this Certificate of
Compliance ••ode of
conform to the requirements of Title 24, Part 1 and Part 6 of the Cali0N Regulat ,.&
4. The building design features or system design features identified on this Certi a of Compliance e% istent with th, information provided on other applicable compliance documents,
J'
worksheets, specifications to the forapp6va�°With this buildup application.
calculations, plans and submitted enf�or..cemen agency emit
S. I will ensure that a registered copy of this Certificate of Compliance shil"I& made avail Ale With t e building pert, is iltsued for the building, and made available to the enforcement agency
.for all applicable inspections. I understand.that a registered eapyQA%kertificate oft nIiiibce is require d`t beiiicluded with the documentation the builder provides to the building
owner at occupancy.
Responsible Designer Name: esti ` Res�poneibe'siiiPer Sign to
Company: -' V°
Da 51(;ned: `1
Address. �`� .
o `fox -
License:
oro
City/State/Zip:Phone:
'�
C`
- 4 Fs - Fs�7S
r
f oassistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2016 Residential Compliance September 2016
Permit #
Project Address. 5( 0 5�
A. P. Number: —.—.�=
Legal Description
Contractor: CzrE
Address:dX C
City. ST, Zip:�P fp�I
Telephone: j(o A4 9-8 _Fci 7 S
State Lic. # : 98-0 103
Arch, Engr., Designw.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact person:
Telephone # of Coma Person.
City of La Quints
Widing 8r Safety Division
P.O. Box 1504, 78.495 CaOe Tampico
La Qalnta, CA .92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Mee
2 Owner's Name:
Address: s 2 E
City. ST, Zip:
g uw.�nq Telephone: � I - � S- &?S
Project Description:
7® r
wa
type (circl
Project e one): New AddIn Alter Reinar De
M
Submittal
RM*d
Recd
TRACIONG
PERMIT FEES
Plan Sets
Plan Cheek submitted
Item
Amount
Structural Glee.
Reviewed, ready for corrections
Rau Check Deposit
Truss Gies.
Called Contact Person
Pha Check Batauce
Title M Gies.
Rasa pleked ap
Constraedon
Flood plain pi
Rana resubmitted
Mechanical
Grading plan
2'! Review,, ready for correct7ons/issue
Electrical
Subcontactor Ust
Called Contact Persoe
Plumbing
Grant Deed
Pians picked up
S.M.L
H.O.A. Approval
Plana resubmitted
Grading
IN HOUSE:-
Review, rrady for eorreetionsiinue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fen
Total Permit Fees