14509 (AR)4 4 Qum&
I
tiR
S
P.O. BOX 1504
Building 54-511 Riviera LA Q
Address UINTA, CALIFORNIA 92253
Owner Mr. & Mrs. Vreeland
Address StnB
CityZip
Tel.
La. Quintaa CA
92253
Contractor
cal Tech Builders
Address
52-711 Ave. Velasco
Ity.
Quinta, CA?
%2253
Tel
Tel
X44-'1309
State Lic.
City
& Classif. 8 590()90
Lic. # 402
Arch., Engr.,
Designer pain; Scott Anderson AIA
Address
Tel.
P.O.-Box 277
564-5038
�ity
C�
X2 Qui.nta, CA
Zip
92253
State
Lic. #
LICENSED CONTRACTOR'S.DECLARATION .
I hereby affirm that I am licensed under'provisions,of Chapter 9 (commencing with Section
7 ) of Division 3 of the Business:and Pr fesslon, Cod and ny license is in full force and
ffect. .
SIGNATURE ..n k DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Bustness and Professions Code: Any 'City .or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
Me provisions of the Contractor's License Law, • Chapter 9 (commencing with Section 7000) of
Division 3 of 'the Business and Professions Code, or that. he 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 penally 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, Buisness and
Professions Code: The Contractor's- License Law does not apply to an. owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such 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 did not build or improve for the purpose of sale.)
❑ 4, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044; Business and Professions Code: The Contractor's License Law
does not apply to an, owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason
Date Owner,
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker'ss,&mpensation Insurance, or a certified
T co€lV thereof .(Sec 380 Labor Code.) .)
Policy I�. Company Gip "9:l JU
. opy
is filed with the city, ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100) valuation
or less.)
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
Date Owner
NOTICE TO APPLICANT. H, after making this Certificate of. Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. _
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.
This 'is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 160 days.
-
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 city to -enter the above-.
mentioned property for inspection. purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 14509
LDING: TYPE CONST. OCC: GRP.
Number
Legal Description
Atrium
Project Description
Enclosure
Sq- Ft. No. No. Dw.
size p5 Stories Units
New ❑ Add ❑ . Alter ❑ Repair ❑ -Demolition ❑
I �
JAN 0 6 1995. U
Y _
Estimated Valuat' $6, 783,00
PERM1T AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. 58. 50
Const. 9U. Vu
Mech.
Electrical
.A—
S.M.I. . t)U
Grading
Driveway Enc.
Infrastructure
TOTAL 149.18
REMARKS
ZONE: BY:
Minimum Setback Distances:. '
Front Setback from Center Line
Rear Setback.from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by- Date Permit
Validated by: !
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
i
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 V. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ec
HOUSE SEWER
REMARKS:
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
i
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
.
AL INSP/� ?S
FRAMING _ / _(
r///���EEE777
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
G FINAL INSPECTION,2 [ ,
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
—
GARDEN WALL FINAL
Certificate of Compliance: Residential , (Page 1 of 2) CF -1 R
• 17-1
Project Title Date
'5,+ - f -v 6 I R-1 V I EPA . to av wl-A—, '12V53
Project Address Building Permit #
Plan Check/ Date
Docu nentatlon Author Telephone
Field Check / Date
Compliance Method (Package, Point System or Computer) Climate Zone Enforcement Agency Use Only
GENERAL INFORMATION
Total Conditioned Floor Area: 10 5 ft2
Building Type: Single Family _ Addition
(check one or more) Mufti-Famil Existing -Plus -Addition
Front Orientation: North . ast South / West / All Orientations
(Input orientation in degrees and circle one.)
Number of Dwelling Units: I
Floor Construction Type: CqLabJRaised Floor (circle one or both)
Revised January 1992
BUILDING SHELL INSULATION
Construction
Component Insulation Assembly,
Location/Comments'
Type R -Value LI -Value
(attic to garage typical, etc.) '
Wall ..............
Wall ..............
Roof ............. —�
•Roof
...:.........
Floor .............
Floor .............
Slab Edge....
FENESTRATION
Shading Devices
Fenestration Area Fenestration
Interior Exterior Overhang
Framing Type.
Orientation (sf) U -Value
(roller blind etc.) (shadescreen etc) (yes/no)
(metal/wood/vinyl)
Front..... ( )
Front.... ( )
Left ....... ( )
Left ....... ( )
Rear ..... ( )
Rear ..... ( )
Right..... ( )
Right.....
Skylight .......
Skylight
_ —
-
.......
THERMAL MASS
Type/Covering Area
Thickness
(slab/exposed, tile, etc.) (sf)
(inches) Location/Description (kitchen bath etc.)
sehi- VINYL to
N &&V cF- - C -F
Revised January 1992
Certificate of Compliance: Residential
Project Title
HVAC SYSTEMS
Note: Input hydronic or combined dronic data under Water Heati
Distribution
Heating Equipment Minimum Type and
Type (furnace, heat Efficiency Location
pump, etc.) (AFUE/HSPF) (ducts/attic, i
Cooling Equipment Minimum
Type (air conditioner,' Efficiency
heat Durno. evao_ molinnl_ mizizm
Duct
Location
(attic, etc.
(Page 2 of 2) CF -1 R
Systems, except Design Heating Load.
Duct or
Piping Thermostat.
R -Value Type
Duct Thermostat Configuration
R -Value. Tvoe (sniff or nackarial
WATER HEATING SYSTEMS Put-gr70:6—
Ene
r
Rated' Tank Factorr
Input (kW Capacity Recovery
or Btu/hr) (oallons) . Efficiencv
Water Heater Distribution
Number
in Systei
External
1 Tank
Insulation
1. For small gas storage (rated input:5 75,000 Btu/hr), electric resistance and heat pump water heaters, list Energy Factor.
For large gas storage water heaters (rated input 2 75,000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss.
For Instantaneous gas water heaters, list Rated Input and Recovery Efficiency.
SPECIAL FEATURES/REMARKS (Add extra sheets if necessary)
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts t and 6, of
the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the
individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple
orientations, any shading feature that is varied is indicated in the Special Features/Remarks section.
Designer or Owner (per Business a Professions code) Documentation Author
Name: p/ty� �. ! /V� Name: c
Title/Firm: 6�7k-r--T` . Title/Firm-
Address: �? C> . 277 Address:
Telephone:Telephone: -
Lic. r ��f
Agency
Name:
Title:
Agency:
Telephone:
(date) (signature) .
(signature/stamp) (date)
Rovisod January 1992
(date)