08-1893 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 08-00001893
Property Address: 54680 AVENIDA OBREGON•
APN: 774-274-009-9 -000000-
Application description: PLUMBING
Property Zoning: COVE RESIDENTIAL
Application valuation: 500
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
•4
�W
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 Business and Professionals Code, and my License is in full force and effect.
License Class: C36 License No.: 880103
ate: / /" Zontracto . li
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).:
(_ 1 1, 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 _) 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:
Lender's Address: to
LQPERMIT
Owner:
JOHN ALBRITTON
54680 AVENIDA OBREGON
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/25/08
Contractor:
ALVAREZ, JORGE A.
@F5
PO BOX 984THERMAL, CA 92274p(760)777-3613
Lic..No.: 880103 V �O`� 2oUv
,R O NSA
------------'�"
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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 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 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.theLa or C/ shall forthwith mply with those provisions.
ate: / �"ZS'V� plicar /
WARNING: FAIL RE 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 the above information is correct. 1 agree to comply with all
city and c my ordinances and st laws relating to building construction, a�����RRRnnd hereby authorize representatives
of this unty to eniter upon t above-mentioned prop r inspecti�ses.
Pete: /� Z G o S' ature (Applicant or Age 1: / rte__
LQPERAIIT
Application Number. .
. . . .
08-00001893
Permit
PLUMBING
Additional desc .
- Permit Fee
22.50
Plan Check
Fee
5.63
Issue Date •. . . .
Valuation
0
Expiration Date
5/24/09_'
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 7.5000
EA PLB
WATER HEATER/VENT
7.50
- ---------------------
Special Notes and Comments
-------------------------
INSTALL NEW 40 GALLON
GAS WATER
HEATER
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
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page I of 4) CF -1R
Project Title
-��0 Axte ��c-eQOo (r, &"--mc
Project Address .
Documentation Author
Compliance Method (Prescriptive)
✓ ❑ Alternative Component Package Method: (check one)
Telephone
Climate Zone
Date
Building Permit #
Plan Check / Date
Field Check / Date
Enforcement Agency Use Only
C D ' D(Alternative),v
Package C and Package D choices require HERS.rater_fie.ld ver_ificati.on-and/or diagnostic testing (see CF -I R page 3)
For Package D Alternative see Appendix B Table 151-C Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) ftz Average Ceiling. Height: ft
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C ---- (5% X CFA) ftZ
Maximurn Allowed Total Fenestration Products Per Table 151-B or 151-C ---- (20% X CFA) ft
✓ ❑Building Typ''e:3(aFieekton'e)or snore) Single Family Multifamily Addition Alteration
(If adding fenestratibn fill out WS -4R, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
:_Number of Stories: Number of Dwelling Units:
Floor Construction Type: la aised Floor (circle one or both)
Front Orientation: North /South / East / West / All Orientations (input front orientation in degrees from True
North and circle one).
✓ ❑ RADIANT BARRIER (required in climate zones 2,4,8-15)
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
or Metal)
Assembly U -
factor (for
Cavity Continuous wood, metal
Insulation Insulation frame and mass
R -Value R -Value assemblies
Joint
Appendix
IV
Reference
Roof Radiant
Barrier Location/Comments
Installed (attic, garage,
Yes or No typical, etc.
1) See Joint Appendix IV in Section IV.2, IV.3 and IVA, which is the basis for the U -factor criterion. U -factors can not
exceed prescriptive value to show equivalence to R -values.
Residential Compliance Fonns March 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -1R .
Project Title
Date
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -411 Form must be provided to the building department for each home for which the following. are
required.
OR
0 Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
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
Distribution
T e
17
Sealed Ducts all climate zones Installer testing and certification and HERS rater field verification required.)
01
TXVs, readily accessible (climate zones 2 and 8-15 only)
Installer testing and certification and HERS Rater field verification required.)
0
Refrigerant Charge (climate zones 2 and.8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
OR
0 Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
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
Systems serving single dwelling units
Water Heater
Type/Fuel Type
Distribution
T e
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
Tank
Capacity
(gallons)
dwelling unit. If the water heater is a storage I�Qe, 59 _gallQns_is_the maxmurn.cacity._and _recirculation system is
Standby'
%)
not allowed.
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the -system com lies automatically.
SIO
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
0
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
0
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Systems serving single dwelling units
Water Heater
Type/Fuel Type
Distribution
T e
Number
in System
Rated
Input'
(kW or
Btu/hr)
Tank
Capacity
(gallons)
Energy
Factor' orExternal
Thermal
Standby'
%)
Tank
Insulation
R -Value
roo
SIO
_Efficiency.Loss
.,-,92-
So'Jbl e
System serving multiple dwelling units
Water Heater
Type
Distribution
Type
Number
in S stem
Rated
Input
(kw or
Btu/hr)
Tank
Capacity
(gallons)
Energy
Factor or
Thermal
Efficiency
Standby
Loss %
Tank
External
Insulation
R -Value
I . For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas -storage water -heaters -(rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Pipe Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/4
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 (j) 2 B.
Residential Compliance Forms
March 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 4) CF -1R
Project Title
Date
FENESTRATION PRODUCTS — U -FACTOR AND SHGC
✓ ❑ FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS -4R —must be included for New Construction,
Additions and Alterations. .
Fenestration
P/Type/Pos.
(Front, Left, Orien-
Rear, Right, tation, Area U -factor
Skylight) N, S, E, W'(ft 2 U-factor2 Source
Exterior
Shading/Overhangs6.7
SHGC ✓ box if WS -3R is
SHGC°. Sources included
Distribution
Type and Location Duct or Piping Thermostat Configuration
(ducts, attic, etc.) R -Value Type (split or package)
d
1) Skylights are now included in West -facing fenestration area if the skylights are tilted to the west or tilted in any direction
when the pitch is less than 1:12. See § 151(f)3C and in Section 3.2.3 of the Residential Manual
2) Enter values in this column are either NFRC Rated value or from Standards default Table 116A.
3) Indicate source either from NFRC or Table I I6A,
4) Enter values in this column from NFRC or from Standards Default Table I I 6 or adjusted SHGC from WS -3 R.
5) Indicate source either from NFRC or Table 116B.
6) Shading Devices are defined in Table 3-3 in the Residential Manual and see WS -3R to calculate Exterior Shading devices.
7) See Section 3.2.4 in the Residential Manual.
HVAC SYSTEMS
Heating Equipment
Type and Capacity
(furnace, heat puinp, boiler, etc.)
Minimum
Efficiency
(AFUE or HSPF
Distribution
Type and Location Duct or Piping Thermostat Configuration
(ducts, attic, etc.) R -Value Type (split or package)
Cooling Equipment
Type and Capacity
(A/C, heat pump, eva . cooling)
Minimum
Efficiency Duct Location Duct Thermostat Configuration
(SEER or EER) (attic, etc.) R -Value Typ e (split or package)
Residential Compliance Forms March 2005
CERTIFICATE OF COMPLIANCE: RESYDENTiAL
(Page 4 of 4) CF -1R
Project Title
Date
SPECIAL FEATURES NOT REQUIRING IIERS 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
rescri tive method.
�! Feature
O Metal Framed Walls
Re uired Forms if a livable Descri tion
❑ .Radiant Barriers
CF -IR
CF -1R
❑ Exterior Shades
WS -4R
❑ Cool Roof
N/A; Attach CRRC Label to
❑ D edicated Hydronic Heating
Forms.
Performance Calculation
stem
R uired- Attach Run to Forms.
O Combined Hydronic System
Performance Calculation
RequiredAttach Run to Forms.
❑ Gas Cooling
Performance Calculation
❑ Buried Ducts
R uired.
N/A; Indicate on buildin Ions.
❑ Kitchen Pipe Insulation
See Section 5.6.2 Distribution
Systems in Residential Manual..
❑ Multiple Water Heaters Per
See Table 5-13 or use
Dwelling Unit
Performance Calculation and
:. ❑ . .Central.Water.Heating.System,
attach Run to Forms.
Performance Calculation and
)l Servin Multi le Dwellin
attach Run to Fors.
Non-NAECA Large Water
Neater... _ _....
-C-F.-IR-
F-1R❑
0Indirect Water Heater,
See Table 5-13 or-use-
ruse-
Performance
Performance Calculation and
attach Run to Forms
❑ Instantaneous Gas Water Heater
.See Table 5-13 or use
Performance Calculation and
attach Run to Forms
❑ Solar Water Heatin g System
See Table 5-13 or use
Performance Calculation and
attach Run to Forms •
❑ Wood Stove Boiler
Performance Calculation and
attach Run to Forms
SPECIAL FEATURES RE00113 G HERS RATER VERIFICATION
-Ladd extra sheets it necessary) Indicate to the HERS Rater which credits are part of this
verification.. project and need
Duct Sealin
uiredForms da livable
FE3FeatureR
Refri erant Char aThermostatic
CF -6R art4of'12
Ex anion Valve
CF bR part 6 of 12
Residential Compliance -forms
March 2005
Bin #
City of La Quinta
Building U Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # v\JP.O.
l�
l
!Pr'ojetddFe*s: �y �� ve �b�
Ownerrs-Name:�
A. P. Number.
�,-Add—ress: slE (0 90 Awe VLLfP—O
Legal Description:
City, ST, Zip:
Contractor:
�-
Telephone:
Address: �O �X (4
Project Description:
, vice
City, ST, Zip: ,-crcA C -a `n�'" 1 ZZ -7
Telephone: 1 00
State Lic. # : ((j3
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #: `__ ��
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
#Stories: #Units:
Telephone # of Contact Person:
Estimated. Value of Project: �O 0 o 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Plan Sets
Req'd
Rec'd
TRACKING . PERMU FEES
Plan Check submitted Item Amount
Structural Cafes.
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2w° Review, ready. for correctionslssue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
''' Review, ready for correctionslissue Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees