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06-1500 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 06-00001500 54325 AVENIDA OBREGON 774-241-015-4 -000000- PLUMBING COVE.RESIDENTIAL 500 O BUILDING & SAFETY DEPARTMENT BUILDING PERMIT SPR Architect or Engineu e�r��� Lt�Lgv� �1Pr -------------------------------------------------- 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. License Cie : C-16 icense No.: 828264 ate: ntractor: 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 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).: (_) 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.). (_) 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. , 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 Name: 1 Lender's Address: �J LQPERMIT Owner: JOHNSON LARRY N 54325 AVENIDA OBREGON LA QUINTA, CA.92253 Contractor: FOY, SCOTT A. 43579 MAIN STREET INDIO, CA 92201 (760-)775-9405 Lic. No.: 828264 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/12/06 ----------------------------------------------- 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 STATE FUND Policy Number 1576840 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith c ly with those provisions. e• plicant: . e,pe WARNING: FAILURE TO SECURE WORKERS' MPENSATION 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 the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and h eby authorize representatives of this coun toe ter upon the above-mentioned property for inspection pyu se O ature (Applicant or Agent): G Application Number . . . 06-00001500 Permit . . . PLUMBING Additional desc . Permit Fee 22.50 Plan Check Fee 5.63 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/09/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER m HEATER/VENT 7.50 ------------------------------------- Notes and Comments REMOVE & REPLACE jELE CTrL ix WATER HEATER.CF1-R APPROvhD Fee summary Charged Paid Credited Due Permit Fee Total 22.50 .00 00 22.50 Plan Check Total 5.63 .00 .00 5.63 Grand Total 28.13 .00 .00 28.13 LQPERMIT f t. 'CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 4 of 4) CF -1R' y Project Title t Date SPECIAL FEATURES NOT REOUIRING HERS VERIFICATION (add extra sheets if necessary) Indicate which special features are part of this project. The list below only represents special features relevant to the resur1 ✓ 11VC IIIGUALM. - Feature Required Forms if applicable) Description ❑ Metal Framed Walls CF -1R Refrigerant Charge ❑ Radiant Barriers CF -IR CF -6R art 6 of 12 ❑ Exterior Shades WS -4R N/A; Attach CRRC babel to s , ❑ Cool Roof ' Forms. t ` Hydronic Heating Performance Calculation 13 S stem System R uired• Attach Run to Forms." Performance Calculation f+l , ❑ Combined Hydropic System Required, • Attach Run to Forms.' . Performance Calculation • . e' ❑ Gas Cooling Required.' ,r ❑ Buried Ducts N/ • Indicate on building plans. See Section 5.6.2 Distribution ❑ Kitchen Pipe Insulation _ System in Residential Manual. ❑ Multiple Water Heaters Per M p See Table 5-13 or use Performance Calculation and • L + Dwelling Unit attach Run to Forms. , Central Water Heating System Performance Calculation and ❑ Serving Multiple Dwellings attach Run to Forms. ❑ Non-NAECA Large Water CF -1R s - • r Heater • { See Table 5-13 or use. ❑ Indirect Water Heater Performance. Calculaon and '. attach Run to Forms e See Table 5-13 or use ❑ Instantaneous Gas Water Heater Performance Calculation and attach Run to Forms ' See Table 5-13 or use , r' " ❑ Solar Water Heating System Performance Calculation and . s attach Run to Forms Performance Calculation and ❑ Wood Stove Boiler attach Run to Forms SPECIAL FEATURES REOUIRING HERS RATER VERIFICATION (add gko sheets if necessary) Indicate to the HERS Rater which credits are part of this project and need s ✓ Feature Required Forms if a Iicable Description ❑ Duct Sealing CF -611 part 4 of 12 ❑ Refrigerant Charge CF -6R part 5 of 12 ' ❑ Thermostatic Expansion Valve CF -6R art 6 of 12 . _ r Residential Compliance Forms CERTIFICATE OF COMPLIANCE: RESIDENTIAL age 3 of 4) • CF -1R ProjectTitle I rla Date _ SEALED DUCTS and TXVs (or Alternative Measures) A signed CF -4R Form must be provided to the building department for each home for which the foil owing. are ❑ Sealed Ducts all climate zones(Installer testing and certification and HERS rater field verificationrequired.) 0 TXVs, readily accessible (climate zones 2 and 845 only) (Installer testing and certification and HERS Rater field verification uired. ❑ Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field verification' red. . • OR 0 Alternative to Sealed Ducts and Refrigerant Charge fMs (See Package D Alternative Package Features for Pro•ect Climate Zone in the RM Appendix B Table 1'51-C Footnotes 7-14. OR For additions and alterations, duct systems that are not documented to have been previously 0 sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D. WATER HEATING SYSTEMS Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per ❑ dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation not allowed. Pa tY system is . ❑ Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential Manual. No water heating calculations arerequired, and the system complies automatically. Check box if system does not meet criteria of "Standard- system, and does not comply with the ❑ Alternative Water Heating -table. In this case, the Performance Method must be used and must beinincluded in the submittal. ❑ Check box to verify that a time control is required for a recirculating system pump for a'system serving multiple units Water Heater T e/Fuel T e System seMnk!pultiple di Water Heater in units Rated DistiibutionNumber Input) T--- :. (kwor-- Rated Distribution Number Input' T--- I • „ (kw or Tank Capacity En Factor Thermal • Efficiency Standby' Low /o Tank External Insulation R Value 1. For small gas storage water heaters( rated inputs of less than o pump water heaters, list Energy Factor. For 1 e9� W B ) electric resistance, and heat Btuthr), list Rated Input, Recovery Efficiency,, Thermal Efficiency and Standby Lossater heaters (rated e For iut Of nstantaneous than 75,000 heaters, list Rated Input and Thermal Efficiencies. water Pipe InsulatiOn (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are '/a inches or greater in diameter shall be thermally insulated as specified by Section 150 6) 2 •A or 150 0) 2'13. Residential Compliance Fors . - March 2005 Tank Capacity Ions En 'Factor' or Thermal Efficten Tank External Standby' Insulation Loss % R -Value r to 75 0 1. For small gas storage water heaters( rated inputs of less than o pump water heaters, list Energy Factor. For 1 e9� W B ) electric resistance, and heat Btuthr), list Rated Input, Recovery Efficiency,, Thermal Efficiency and Standby Lossater heaters (rated e For iut Of nstantaneous than 75,000 heaters, list Rated Input and Thermal Efficiencies. water Pipe InsulatiOn (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are '/a inches or greater in diameter shall be thermally insulated as specified by Section 150 6) 2 •A or 150 0) 2'13. Residential Compliance Fors . - March 2005 J� Y: CERTIFICATE OF COMPLIANCE: RESIDENTIAL; (Page 1 of 4) CF -1R Project Title Date Project Address Building Permit # Documentation_ Author Telephone per' (heck / Date Field mock / 11ft Compliance Method (Prescriptive) Climate Zone Fnfottxnzent mac, Use Only 0 Alternative Component Package Method: (check one) C D D (Alternative) Package C and Package D choices require HERS rater field `verification and/or diagnostic testing (see CF -111 page 3) For Package D Alternative see Appendix B Table 151-C Footnotes 7-14 t t GENERAL INFORMATION Total Conditioned Floor Area (CFA) —fe Average Ceiling Height: ft Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-0 — (5% X CFA) = f Maximum Allowed Total Fenestration Products Per Table 151-B or 151-0 ____ (206/6 X CFA) ft v" O Building Type: (check one or more) - Single Family. Multifamily Addition Alteration (if adding fenestration fill out WS -4R, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2 for Additions and 8.3.3 for Alterations.) t - Number of Stories: Number of Dwelling Units: Floor Construction Type: . Stab/Raised Floor (circle one or both) Front Orientation: North / South / East / West / All Orientations (input front orientation in degrees from True North and circle one). 0 RADIANT BARRIER (required in climate zones 2, 4, 8-151 • , c , t - - OPAQUE SURFACES INCLUDING OPAQUE DOORS Component Type (Wall, Roof, Floor, Slab Edge, Doors Frame Type (Wood or Metal) Cavity . Continuous Insulation Insulation R -Value R -Value Assembly U - factor (for wood, metal frame and mass assemblies)' Joint Appendix IV Reference Roof Radiant Barrier Location/Comments Installed (attic, garage,, Yes or No ical etc. 1) acx,u,nt rtPPenaix r v In aecnon ry-/, rv.s ana rv.4, wnrch is the basis for the U -tactor criterion. U -tactors can not exceed prescriptive value to show equivalence to R -values. , 1. r ' - t -- r Y.; *` � •t.. if 1, •, Residential Compliance Forms March 2005 i Bin,# 9l9 , Perntlt N , Address: SL A. P. Number. . 1xRaI Destxipdon: Contmcuu: .�. Address: X! 7 .. . t City, s' ; Zip. f Tdephoac-��j_ State Lie it Arch., Ergr., Designer: - Addrew City, Si: Zip: Tdrphonc State Lie: Name of Coulam Person: T • Cky of to QLdntaBmk ft ar Safky Dibi len P_O Box I504, 78-495 Cal* Tampion La Q00, CA 92233- (760) 77770I2 Bididing Permit Appgc adon and Tracfang Sheer a VP,n1Aa o►'rsN..�: I " � I k "h depheoe i! of Comttcl I'e9sort: EsrimLed Bain of APPUCAMT: DD turrr mmrrc Qv rwum -r— . 9 1 sdmdttai Pico Sets Sw"toral Cain. Tnm Cots. iitle24 ChIcs. Flood piaio Iden Grading plea Sahconmmr Lbt Grant peed ''IUML Approval IN HO:- Ptamdng Approve! Pub. W[m Appr Sebod Fees Reed TRACONG PP1ti urFm Pian Chale submitted Iaar Amoam N�R•T�•�• Cv� y' ms`s-+e`+ 'd. �� n+dp for txxrestioss Pian Check Deposit Caged Contaarem]) 1 Greek sulauce Puns picked ng Conmaacdon depheoe i! of Comttcl I'e9sort: EsrimLed Bain of APPUCAMT: DD turrr mmrrc Qv rwum -r— . 9 1 sdmdttai Pico Sets Sw"toral Cain. Tnm Cots. iitle24 ChIcs. Flood piaio Iden Grading plea Sahconmmr Lbt Grant peed ''IUML Approval IN HO:- Ptamdng Approve! Pub. W[m Appr Sebod Fees Reed TRACONG PP1ti urFm Pian Chale submitted Iaar Amoam n+dp for txxrestioss Pian Check Deposit Caged Contaarem]) 1 Greek sulauce Puns picked ng Conmaacdon Pious mubmimd tlfahaainl "d Rca�ee, rmdy for emrnyic metrical Called Contact Person Ptmabkg Plows picked op Plans reaabmitted Crate 1 sn° Revic v, resdf far eomedaaslusae evdoper b%met Fee Called C Ptrson _f A.tP.P Date ofpermit 'tssue LL Total Permit Ftrs.