10-0116 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: X10-00000116
Property Address: 54490 RIVIERA
APN: 775 -031 -051 -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1676
T4ht I 4*4Qumrw
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
TALLAKSON ROGER R
54490 RIVIERA
LA QUINTA, CA 92253
Contractor:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
I
CIO
Date: 2/18/10
4
Applicant: Architect or Engineer:
CALIFORNIA DELTA MECHNI C
6052 E. BASELINE RD, #155§
MESA, AZ 85206-
5206(480)898-0007
(480)898-0007
pipLic.
No.: 811114
------------------------------------------------
" LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION '
I hereby,affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B -C10 -C36 License No.: 811114
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�r r�ajj A�i�Jrr f
ate: /d ontractor: C a�/�LT/9 / �'Gli'rf�J�i
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 1697823
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, shall forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemptiuii. Any violation of. Scction 7031.5 by
p Q�A�✓
�v �� yT� • 'C/'�(i'�
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate: A li :am:
(_ 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
WARNING: FAIP6RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES: -
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.).
(_ 1 I am exempt under Sec. , BAP.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:
LQPERMIT
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 hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
pia't'e: ignature (Applicant or Agent):
Application Number .
. . . .
10-00000116
Permit . . . PLUMBING
Additional desc .
Permit Fee
22.50
Plan Check
Fee
5.63
Issue Date . . . .
Valuation
. .
. 0
Expiration Date
8/17/10
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 48 GALLON
GAS WATER
HEATER.
2007 CODES.
-------------------------------------------------------
Other Fees . .
. . . .
-
BLDG STDS ADMIN (SBi473)
1.00
Fee summary Charged
Paid Credited
------------------------------
Due.
---------------------------
Permit Fee Total
22.50.
.00
.00
22.50
Plan 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
Prescri tive Certificate of Com fiance: Residential
Resadential Alteration r CF -IR ALT
Project Name: r, �J a e 1 of
7 ! q Vl �� Climate Zone # # of Stories
General Information
FCobditioned
��� �
�"1 iK4 �/j•y C�� EnforcemerrtAgency:
Single Family ❑MultiFamily Circle the Front Orientation: N. E, S, W, or degrees
oor Area (CFA): ProjectType; p Alations p Farvelape ❑Fenestration r1 Roof ❑HVAC
lacementorCb aout p Duct R lacement WHeater
-This form is motto be used forNealy Cons&ueiedBuildings orAddWons
Insulation Values For Opaque Surfaces (for Furring use the Mass
and FurtS
ConuiontaleAssemblyAteraton below)
❑ Opening of framed cavity alone -Alterations that involve the opening of theftamed cavity of a wall, ceiling, or floor must install the
mandatory minimum insulation value per. §150f,, the altered assembly. Fill in Cohanns A -C and enter mandatory insulation value in Column IZ
p Replacement of entire assem bly-)eplacement of an entire wall, ceiling; or floor assembly requires the installation of Component
Package- D insulationt'"
in Table 15/ C Fill in Columns -4 J.
a lie Surface Details For the furred
ortlored of Mans Walls see Burring
A C
g
Strips
Construction Table
Pro Deed °� °M
D
E g
Standard
G H I J
Framing
Thic)mess,
Values From JA4 Table
Ta/ Assembly Name
ID e
Spacing,
U- JA4 Table
Flamed Continuous JA4 Proposed
Cavity Insulatian
e) and Sim
m Crtbe�
factor° Numbers
Assemi Asseml
11 -value R Valuer Cell Values u fte
Note Farfimdassembfie,, — � 1 -1 1 r
anco"LftfOr Cmwuuw AndattonR-
Consbucttan table below. 1 QIsm �e Page JA�3 and Equation ¢1. For calculating fumd wa& use the Mass and
L F-Yag;M indicate the identification name that matches the buil Ungplans.
2. Indicate the Assembly Name or type; Raof/Ceili& 'JF`alls Racr s, Slabs, Crawl Space,Doors and etc...Indicate the Frame
39aod Metal; Metal Buildings, Mass, enter 29A 2x6, or etc... ise JA4 for other possible ame type and Size: Far
3. Enter the thickness for mass in inches or f' � assemblies
Spacing between fimsing members enter; 16"or 14 "OC,' or Other for all other assembly description
such as Concrete Sandwich Pane4 Spancb•el Panel, Logs, Straw Bale Panel and etc._
4. Based on the Climate Zone; enter the Standard U factor from Table 151-B, C or D for each different assembly Name or type.
5. 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 "0".
7. Enter the Contin uous.Insulation R -vola.: for the propos,-d assembly; 0ther1v&e, enier "0"
8. -An ter the sow and col i;mn of the J factor value based on Cciu)rn F Table Mumber and enter the Assembly Ufactor rn Colur.n J
9. The Proposed ;fssembly IJ -factor, Column.I, must be equal to or Iess the -the Sttrrdard l fader in Cnlrrmn b ;a r.:omp!v.
r ,r;
4Snd
77-
_
1)
r t reg • )c �d!)ed lnieri,zr Or sste.. ler• r - ..
'rY�lis .'ram : ererence i^sulaiion I
JointAppendia Table 4.3.5 4 3 6 4 J•� n .Furring Space from Reference
--r---- --- — _,.__ _, _ TointA.ppendix Tabfe 4.3.13
1 ;3f '
iAssembly
Mass Name cr i JA4 Tabie
)almesst Type) t Number' Q >
Final
"station Number: Regirtration Date1nme:
HERS Provider..
o it
mo
m
>
v �
Final
"station Number: Regirtration Date1nme:
HERS Provider..
CERTIFICATE OF COMPLIANCE: RESIDENTIAL
5-1tty9�
Project Title
Datb
3 of 4) CF -IR
SEALED DUCTS and TX -Vs (or Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the following. are
reauired.
❑ IAlternative 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 CVCTF.MC
Rated
Input'
Distribution Number (kW or
Tvve in System Btwhr)
❑
Sealed Ducts all climate zones nstaller testing and certification and HERS rater field verification required.)
❑
TXVs, readily accessible (climate zones 2 and 8-15 only)
taller testing and certification and HERS Rater field verification required.)
❑Refrigerant
Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
❑ IAlternative 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 CVCTF.MC
Svstems serving sinvle dwellino units
Water Heater
Type/Fuel Type
Rated
Input'
Distribution Number (kW or
Tvve in System Btwhr)
Tank
Capacity
(gallonsEfficieEg
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
Standby
Loss %
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
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 complies automatically.
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Svstems serving sinvle dwellino units
Water Heater
Type/Fuel Type
Rated
Input'
Distribution Number (kW or
Tvve in System Btwhr)
Tank
Capacity
(gallonsEfficieEg
Energy
Factor' orr
Thermal
Standby
Loss %
Tank
External
Insulation
R -Value
Svstem servine multinle dwellino units
Water Heater I Distribution Number
Type Type in system
Rated
In
Input'
I Ino'
I Btu/hr)
i Energy
l"ark Factor or
Capacity I Thermal
(gallons) Efficiency
Tank
External
Standby' Insulation
Loss '0io R -Value
1. 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 %
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005
Prescriptive Certificate of
.Ressdential ACteradons
Project Name:
_ 5i(9p
Residential
V 1 k f 'Cf.,
CF -IR -ALT
(Pagre4of
Climate Zone # # of Stories
WATER 1 EATIlYG
List water heaters and boilers for both domestic hot water (DHW) heaters and hytlrordc space heating Inafvicbtal dwellingDHW heaters must be
gut or propane is ea and may not exceed nt gallons. Plot water pipe MM19tion from the DHW heater to the wchen(s) and on aa underground
hot water pipes is required in all corrrpanent packa�s in all climate zones.
Water Heater Type/Fuel Distribution T
i Type
e Standard, Recirculatin z
OIAs d-
Number In
stem
16 S -oar
Tank
aci
4A
Energy Factor or
Thermal Efficien
I X
External Tank
Insulation
R Value'
—
1. Indicate Type (Storage Gas. Heat Pump, Instantaneous, etc.)
7. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Frescriptive requirements do
not allow the installation of a recirculating water heating s}ster l for ,Tingle dwelling urdts.
1. The external water heating tmtk and p es shall be insulated to ,met the reaub-p-mPnly n{ s 1 sni; r
TWT. -1T
'"'F.iii c:Q.iie;V SFC:L.7 r JPBCiQI e7itF. i7iion io Roc � eciai
l!ESB tt2117S ;RCT,+.=pZdir"c^ i �Z1S.'ania7fi'� .-ry• J �'�,'c_S ue:'l>ied ill ih1S c.i}e.
—.•-�� ,•. 40.: illi; ;,I?•.?ii : 'rili'.•iiiZ
IL �V ROOF SS s Eol'y - -- _r s svar..rl er;,--
:y l �' �:adant 1;arri-•r � ---.
he radiant baiTier re uiremeut o i5i(f)2 does not apply io ooT slterations
lab Edge (Perimeter) Insulation ❑ 1'ES 10 NO — —
TS: Ili Clinate Zone 16 is ComponeLt Packages D, R insulation is required.
eated Slab Insulation Cl YES ❑ NO — —
ES: Slab edge insulation required for ali healed slabs in all Climate Zones Seed tails in Table 114 A of the stanaalds
a1sed Slab Insulation ❑S ❑ NO
YE—
ES: In Climate Zones 1, 2, 1 i, 13, 14 & 16 R-8 insulation is required, in Climate Zones 12 & 15 R-4 is required under component Package
iermal Mass _-
r obtain Compliance Credit for the installation of thermal mass, use the Performance AAnnmacb
sd ation Number. Registration Date/15me:
Prescri five Certificate of Com fiance: Residential CF -IR -ALT
Residential Alterations
Project Name: (Page 5 of
Climate Zone # (# of Stories
HERS VERMCATION SUMMARY The enforcement agency should pay special attention to the HERS Me
checklist specified in this
ichecklist below. i1 completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before dust
ns coon
Duct Sealing & Testing HERS verification is required for thismeasure
O YES 13 NO YES: In Climate Zones 2 and 9-16, if more than 401ineer fleet of new or replacement ducts are installed in unconditioned
space, the ducts are to be sealed per § 152(b)2Dii and the newly installed ducts are to be fimIded per §151(f)10.
❑ EXCEPTION: E)dsting duct systems that are extended, which are constructed, insulated or sealed with asbestos.
❑ YFS ® 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)IDi.
13 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 §I52(b)1E.
❑ EXCEPTION: Duct systems that are documented to have been previously seated confirmed through HERS
verification in accordance with protedures in the Ileference Residential Appendix RA3.
❑ EXCEPTION: Duct systems with leas than 40 linear feet in unconditioned spaces
❑ EXCEPTTON: Existing duct systems constructed, insulated or sealed with asbestos.
Refrigerant Charge -Split System HERS verification is required for this measure.
❑ YFS ❑ 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
excbnn @' a refir Brant chame measrnemeat shall ha verified per 152(b)IF.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation requirements of §15 0(0) do not togg resdeatial homey
Ducted. Split Systems -Air Conditioners and Heat Pumps: Airflow HERS vert kdion is rgquired for thus measure,
❑ YES ❑ NO YES: In Climate Zones 10 through 15, when the existing space-conditioningi
system (HVAC equipment and ducting) is
ff-laced, the airflow and fan watt draw shall be verified per 152(b ICi to meet the requirements of 6151(f)713.
4ddress:
'rfSate/Zi.;yHO/t 4? X .moi �% 1 i a
e`�ponsible Building L?�.igner's i; er_Ia.t'aiior_ st,tr•.ntect -- - — - - _
-
15 !�Biiii�GatC 9i i.';i ._. .... _ _. ...._ ..... a '._Cup f:i: a: :.rtes i •��i;i"ts-iGlL[r :Oi t C 1'M I)GI12' d?.
a
• i .:Cl4ii:y ti]at ii_: energy Watur.s and J`i'ofn)ance g4,eid_']rai:Ct15 tri.' Thr ij)liiding des: . :Edwllled +jr', ibis Celil (Gate of Loinpiiance CGr;fO'r
to the ,equirements of Title 24, Fars.! and 6 of the Caiifcinia Code of Regulations. i I
The buiiding design features identified on this Certificate of Compllance are consistent with the information provided to document this
building design on the ocher aop:;cable compliance fonds. worksheets- ralcll(atinnc nuns —d
L / '
assistance or questlons regarding the Bi'tergy Standards, contact the Energy E'otHne (it. • 1-800-772-3300.
stratfon Number: Registration Date/time:
9 n, ._ .J_y _r .,__•_ *: —. - HERSProvider.
Bin #
City of La QUinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 511 ti V I .Low .
Owner's Name: 1�66,f— Ta 1 a S 0PL,-
A. P. Number:
Address: 5 -Lf
Legal Description:
Contractor: CCt,�4 M'y 0 ba
City, ST, Zip:Zkl U 'yL (� Cp¢
Telephone: k ra "
kt'
Address: 6056 . gtCp� , J j, j
Project Description:
City, ST, Zip: Z 6
/� 4
' 7 O r:CJI� o -P Q'
p X66-�qz-52°3`-xM-Ai>
Telephone:
,.
City Lic. #.: /0 00
1�
Qit-Y�1
State Lic. # : fill/
Arch., Engr., Designer:
Address:
City., ST, Zip:
Tel hone:
si L ,ia�Yti•"���xk .�.
State Lie. #: a«`r
Constroction Ty Occupancy:
Project type (circle one): New Add'n Alter ' 'repair Demo
Sq. FL: #Stories: #Units:
Name of Contact Person: ue'na-
Telephone # of Contact Person: 8 66-6 -( Z—•5-Z-:� 3
Estimated Value of Project: J 6 3
APPLICANT: 00 NOT WRITE BELOW THIS LINE
#
Submittal
Req'd Recd
TRACMG PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
Review, ready for corrections/Issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pluns picked up
S.M.l.
H.O.A. Approval
Plans resubmitted
Grading
IA' HOUSE:-)
'^ Review, ready for corrections/issue
Developer impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
t
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees