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.