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11-0321 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: (:�11=00000321 Property Address: 54295 AVENIDA OBREGON APN: 774-241-014-3 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 150 Applicant: Architect or Engineer: C A ------------------ LICENSED CONTRACTOR'S DECLARATION • t!t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 usiness and Professionals Code, and my License is in full force and effect. . License Class: C36 License No.: 731855 Da -Con raaor: -- — — — OWNER -BUILDER DECLARATION 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 70001 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 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 I -am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 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: LQPERMIT Owner: .PTERSON CONNIE 54295 AVENIDA OBREGON LA QUINTA, CA 92253 (760)564-3564 Contractor: STATE WIDE PLUMBIP 70244 CATANIA COM INDIO, CA 92203--( (760)393-6115 Lic. No.: 731855 VOICE`,(760) 777-7012 FAX (760).7-7011 INSPECTIONS (760) 777-7153 Date: 3/31/11 WORKER'S COMPENSATION DECLARAITO�I I hereby affirm under penalty of perjury one of the following declarations: .�\P I have and will maintain a certificate of consent to self -insure for workers' com /ation, 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 Policy Number EXEMPT I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any man er so as to become subject to the workers' compensation laws of California, and agree that, if hould become subject to the workers' compensation provisions of Section 3700 of the Lab e�, I�shallQfortQh�with comply with those provisions. Date: - Ij r _--Appli. 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 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 a above information is correct. I agree to comply with all city and county ordinances and state laws relating to ' ding construction, and hereby authorize representatives oLilais county to enter upon the above-mentioned pr pe y for inspBCtion purposes . Signature (Applicant -or an r LQPERMIT Application Number 11-00000321 Permit . . . PLUMBING Additional desc . Permit Fee. 22.50 Plan Check Fee 5.63 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/27/11 Qty Unit Charge Per Extension BASE FEE 15.00 1,.00 7.5000 EA PLB.WATER HEATER/VENT 7.50 ------------------------------------------------------------------------------ Special Notes and Comments REMOVE AND REPLACE 40 GALLON WATER ELECTRIC HEATER. ----------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN.(SB1473) - 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 22.50 .00 .00 22.50 Plari Check Total 5.63 .00 .00 .5.63 Other Fee Total 1.00 .00 .00 1.00 Grand Total .29.13 .00 .00 29.13 LQPERMIT Prescriptive Certificate of Compliance: Residential ResidenlW-Aileralions- --------------__-- CF-YR-ALT Climate Zorie•II kof Stories. General Information Site Address: Enforcement Agency: Date: Building Type , Single Family ❑ Multi Family Circle the FrontOrienta_tion: K. Ifs)W, or degrees Conditioned- Floor Area (CFA): Project Type: O ❑ Envelope O FenestO Roof O HVAC F Re lacement O Duct Replacement Water Heater o NOTE: This form Is not to be used jor Newly Constructed Buildings or Additions Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration. O Opening of framed cavity alone - Alterations that involve the opening of the framed cavity of a wall, ceiling, or floor must install the mandatory minimum insulation value per §l S0 for the altered assembly. Fill in Columns A -C and enter mandatory insulation value in Column H. O Replacement of eatire assembly- Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component Package- D insulation values in Table 151-C Fill in Column:.1 - _1 Opaque Surface Details For the furred portiosed of Mass Walls see Furring Strips Construction Table below. A B C D E F G H I J Pro Standard Values From JA4 Table Tap/ iD Assembly Name or T Framing Thidatess, Framed Continuous JA4Proposed Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembl and Size or Other' factor' Numbers R -value° R -Value Cell Valuer U-faaor E F G I H I 1 I J I K I L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference Note: For furred assemblies, accounting jor Contimrous insulation R-walue, see Page JA4-1 and Equation 4-1. For cakvlating furred walls —the Mats and Furring Construction table below. I. For Tag.11D indicate the identification name that matches the building plans. 2. Indicate the Assembly Name or type: R6of7Ceiling, Walls, Floors. Slabs, Crawl Space. Doors and etc... indicate the Frame type and Site: For Wood..Wetal. Metal Buildings. Mass, enter 2x4. 2x6. or etc... see JA4 for other possible frame type assemblies - J. Enter the thic*ness for incus in inches or Spacing between framing members enter; 16 "or 24 "OC: or Other for all other assembly description such as Concrete Sandwich Panel. Spandrel Panel. Logs. Straw Bale Panel and etc.... 4. Based on the Climate Zone: enter the Standard U factor from Table I S 1-B. C or D jor tach different assembly Name or type. S. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise. enter 7. Enter the Continuous Insulation R -value for the proposed assembly: otherwise. enter "0 ". 8. Enter the row and column of the U factor value based on Column F Table :Number and enter the Assembly U factor in Column J 9. Ilse Proposed Assembly U factor, Column J, must be equal to or less than the Standard U -factor in Column E to Co"WY- Furring Strips Construction Table for Mass Walls Onl A IB C D J. E F G I H I 1 I J I K I L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference Joint A ndix Table 4-3.5.4-3.6.4.3.7 Joint Appendix Table 4.3.1. • � `o a Assembl)- -S U. o c ' 2 _ - `o V - -., Final Mass Thickness Name or JA4 Table a = `v, 8 E a 6 b S ' Y, A ' Assembly 6 7 T Number' < > e % 2 < > L;J-' � U -factor Comment Registration Number • Registration Date Time: HERS Provider: 2008 Residential Compliance Forms August 2009 HVAC SYSTEMS - HEATING List water heaters and boilers for both domestic hot water (DHW) heaters and hvdronic space heating. individual dwelling DHfi° heaters must be Heating Equipment Type and Capacity'-:-' Minimum Efficiency (AFUE or HSPF) Distribution Type and Location Duct or Piping Configuration Insulation Thermostat (Central. Split_ R -Value Type Space. Package or H •dronic) Type' (Standard. Recirculating2 system Capacity (al) Thermal Efficiency R -Value' fir1 a I. Indicate Heating Tipe (Central Furnace. {fall Furnace. Heat pump, Boiler. Electric Resistance. etc.) 2. Electric resistance heating is allowed only in Component Package C. or except where electric heating is supplemental (i.e.. if total capacity 2 KlV or 7.000 Btu••hr electric heating is controlled by a (ime-limiting device not exceeding 30 minutes). See $151(b)3 exception_ 3. Refer to the HERS Verification section on Page a of the CF- IR -ALT Form for additional requirements and check applicable bates. 4. Indicate Type or Location (Ducts. Hydronic in Floor. Radiators, etc.) HVAC SYSTEMS - COOLING Cooling Equipment Type and Capacity" Minimum Efficiencv Duct or Piping Configuration (SEER/EER or- Distribution Insulation Thermostat (Central. Split COP) Type and Location' R -Value Type Spam Package or H •dronic not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water heating tank andpipes shall be insulated to meet the requirements of §150(j). 1. Indicate Cooling Type (A C. Heat pump. Evap. Cooling, etc) 2. Refer to the HERS Verification section on Page # of the CF -IR -ALT Form for additional requirements and check applicable bates. 3. Indicate Type or Location (Ducts. Hydronic in Floor. Radiators. etc.) WATER HEATING , List water heaters and boilers for both domestic hot water (DHW) heaters and hvdronic space heating. individual dwelling DHfi° heaters must be gas or propane fired. and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground hot water pipes is required in all omponent packages in all climate =ones. External Tank Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation Type' (Standard. Recirculating2 system Capacity (al) Thermal Efficiency R -Value' fir1 a 1. Indicate Type (Storage Gas. Heat Pump. Instantaneous. etc.) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of 0150(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water heating tank andpipes shall be insulated to meet the requirements of §150(j). SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These items ma • require written 'usti tcation and documentation and special verification- NEW era ication.NEW ROOF ASSEMBLY - Radiant Barrier The radiant barrier requirement of § 151 2 does not apply to roof alterations. Slab Edge (Perimeter) Insulation O YES O NO YES: In Climate Zone 16 in Component Packages D. R-7 insulation is required. Heated Slab Insulation O YES O NO YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table i 18-A of the standards. Raised Slab Insulation O YES O NO YES: In Climate Zones 1. 2. H. 13. 14 & 16. R-8 insulation is required: in Climate Zones 12 & 15. R4 is required under component Package I Thermal Mass To obtain Compliance Credit for the installation of thermal mass. use the Performance Approach. Registration Number: _ _ _ Registration Date Time. HERS Provider: 2008 Residential Compliance Forms August 2 HVAC SYSTEMS- HEATING Heating Equipment Type and C city =' Minimum Duct or Piping Configuration Efficiency Distribution Insulation Thermostat (Central. Split - (AFUE or HSPF) Type and Location' R -Value Type Space. Package or H -dronic Distribution Type (Standard. Recirculatin 2 Number In System Tank Capwity (gal)- External Tank, Energy Factor or Insulation Thermal Efficiency -Value' 1. Indicate Heating Ttpe (Central Furnace. Wall Furnace. Heat pump, Boiler. Electric Resistance. etc.) 2. Electric resistance heating is allowed only in Component Package C. or except where electric heating is supplemental (i.e.. if total capacity" 2 K 11"or 7.00 0 Btu"ltr electric heating is controlled by a time -limiting device nor exceeding 30 minutes). See 051(b)3 exception. 3. Refer to the HERS Verification section on Page 4 of the CF -1 R -ALT Form for additional requirements and check applicable boxes. 4. Indicate Type or Location (Ducts. Hydropic in Floor. Radiators. etc.) HVAC SYSTEMS - COOLING —R o Minimum Cooling Equipment Type and CapacitV1.2 Efficiency (SEER/EER or COP) Duct or Piping Configuration Distribution Insulation Thermostat (Central. Split - Type and Location] R -Value Type Space. Package or H •dronic' I. Indicate Cooling Type (A -C. Heat pump. Evap. Cooling. etc) 2. Refer to the HERS Verification section on Page 4 of the CF- IR -.4 LT Form for additional requirements and check applicable boxes. 3. Indicate TAy or Location (Ducts, H _ onic in Floor. Radiators, etc.) W-�►-ER.HEAMNG, List water heaters and boilers for both domestic hot water (DHW) heaters and hvdronic space heating. Individual dwelling DHII`heaters must t gas or propane fired and may not exceed 50 gallons. Hot water pipe insulation from the DHW" heater to the kitchens) and on all underground hot water pipes is required in all omponeni packages in all climate =ones. Water Heater Type/Fuel T ' i Distribution Type (Standard. Recirculatin 2 Number In System Tank Capwity (gal)- External Tank, Energy Factor or Insulation Thermal Efficiency -Value' � —R o 4/1 t. tnarcate type rWorage Uas. Heat Pump. Instantaneous. etc.) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements d. not allow the installation of o recirculating water heating system for single dwelling units. 3. The external water heating tank and pipes shall be insulated to meet the reauirements of 61506). SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These items ma • require written justi tcation and documentation and special verification NEW ROOF ASSEMBLY - Radiant Barrier The radiant barrier requirement of § 151 2 does not apply to roof alterations. Slab Edge (Perimeter) Insulation O YES O NO YES: In Climate Zone 16 in Component Packages D. R-7 insulation is required. Heated Slab Insulation O YES O NO YES: Slab edge insulation r' uired for all heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raised Slab Insulation O YES G NO YES: In Climate Zones 1.2. 11. 13. 14 & 16. R-8 insulation is required: in Climate Zones 12 & 15. R4 is required under component Package Thermal Mass To obtain Compliance Credit for the installation of thermal mass. use the Performance ADDroach. Registration Number:___ Registration Date Time. HERS Provider: 2008 Residential Compliance Furors Augu HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures'specified in this checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealing & Testing HERS verification is required for this measure. ❑ YES ❑ NO YES: In Climate Zones 2 and 9-16. if more than 40 linear feet of new or replacement ducts are installed in unconditioned space. the ducts are to be sealed per §1 52(b)l Dii and the newly installed ducts are to be insulated per § 15l (f)10. ❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced. the ducts are to be sealed per § 152(b)1Di. ❑ YES ❑ NO YES: In Climate Zones 2 and 9-16. if the existing HVAC equipment is replaced (including the replacement of the air handler. outdoor condensing unit of a split system. cooling or heating coil. or the furnace heat exchanger) the ducts are to be sealed per § 152(b) t E. , ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. 13 EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Refrigerant Charge - Split System HERS verification is required for this measure. ❑ YES 13 NO YES: In Climate Zones 2 and 8-15. when the existing HVAC equipment is replaced (including the replacement of the air handler. outdoor condensing unit of a split system A/C or heat pump. cooling or heating coil. or the furnace heat exchanger) a refrigerant charge measurement shall be verified per 152(b)I F. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of § I 50(o) do not 491y to existing residential homes. Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. YES 13 NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced. the airflow and fan watt draw shall be verified per § 152(b) I Ci to meet the requirements of §11S1(f)711. Documentation Author's Declaration Statement • 1 certify that this Certificate of Compliance documentation is accurate and fete. t Si a � L�-� tCofflqgiVde— r / / �� t date(C t '. Address:. D If Applicab a 0 CEA or 0 CEPE ' (Certification fl): City � =Ct (� Responsible BuildingDesigner's Declaration Statement • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certiA- that the energy features and performance specifications for the building design identified on this Certificate of Compliance conforr to the requirements of Title 24. Parts t and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms. worksheets. calculations. plans and specifications submitted to the enforcement agency for approval with this building permit application. Name: Signature: Company: Date: Address: License: City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300. Registration Number: Registration Date Time: _ _ HERS Provider: 2008 Residential Compliance Forms August Telephone:ix t:onsmicuon iype: vua,pau�y. State Lic. . �µ Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: �// (� (' Sq. FL: # Stories: # Units: Telephone # of Contact Person & 19og go Estimated Value of Projectff APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req-d Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called- Contact Person Plan Check Balance. Tide 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionvissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''a Review, ready for correcdons/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees