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13-1563 (AR)IIIIIII VIII III VIII (III 03 IE P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001563 Property Address: 54200 AFFIRMED CT APN: 767-320-999-300 -32879 - Application description: ADDITION - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 29572 Applicant: Architect or Engineer: l..rtul�cic,� � ------------------ LICENSED CONTRACTOR'S DECLARATION 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: B License No.: 954629 K.Date: ontractor: 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.). (_ 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 1 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: LQPERMIT Owner: CANNING, ELIZABETH & 27930 W RIVER TRL BARRINGTON, IL 609X6 Contractor: JAP CONSTRUCTION�� 35043 VICKEY WAY YUCAIPA, CA 92399 (909)206-9043 Lic. No.: 954629 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 WORKER'S COMPENSATION DECLARATION \k,\'\ v Date: 3/14/14 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 forby 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 9087557-14 _ 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 the Labor Code, I shall forthwith comply with those provisions. CDate:, Applicant: s� 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. 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. Date:!? -? !JJ Signature (Applicant or Agent): _ r Application Number . . . . . 13-00001563 Structure Information 517SF CASTIA/VB/RES-3/CLASS A -FR [ENG] Other struct info . . . . . CODE EDITION 2010 # BEDROOMS 1.00 FLOOD ZONE NO -----------------------------------------------7----------------------------- 1ST FLOOR SQUARE FOOTAGE 517.00 Permit . . . ROOM ADDITION 2013 Additional desc . . Permit Fee . . . . 181.61 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/10/14 Qty Unit Charge Per Extension 1.00 120.1200 LS MISC ROOM ADDN, 1ST 100 SF 120.12 1.00 61.4900 ---------------------------------------------------------------------------- EA MISC ROOM ADDN, ADDL 500 SF 61.49 Permit . . . ELECTRICAL 2013 Additional desc . . Permit Fee . . . . 143.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/10/14 Qty Unit Charge Per Extension 1.00 143.0000 ----------7---------------------------------7------------------------------- LS ELEC NEW RES, FIRST 1 KSF 143.00 Permit . . . MECHANICAL 2013 Additional desc . . Permit Fee . . . . 83.42 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/10/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH CONDENSER/COMP 35.75 1.00 35.7500 EA MECH AIR HANDLER 35.75 1.00 11.9200 ----------------------------------------------------------------------------- EA MECH VENT FAN 11.92 Permit . . . PLUMBING 2013 Additional desc . Permit Fee . . . . 71.52 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/10/14 Qty Unit Charge Per Extension LQPERMIT Application Number . . . . . 13-00001563 Permit . . . . . . PLUMBING 2013 Qty Unit Charge Per Extension 4.00 11.9200 EA PLBG FIXTURE/TRAP 47.68 1.00 11.9200 EA PLBG WATER HEATER/VENT 11.92 1.00 11.9200 EA PLBG WATER INST/ALT/REP 11.92 ---------------------------------------------------------------------------- Special Notes and Comments 517SF CASITA ADDITION/VB/RES-3/CLASS A -FR (ENGINEERED] THIS PERMIT DOES NOT INCLUDE BLOCK WALLS. SOIL MUST BE TESTED FOR LEVELS OF SULFATE IN ORDER TO DETERMINE MINIMUM STRENGTH CONCRETE PRIOR TO FOUNDATION INSPECTION. 2010 CALIFORNIA BUILDING CODES. March 13, 2014 2:27:55 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 2.00 PLAN CHECK, ELECTRICAL 47.19 PLAN CHECK, ROOM ADDITION 185.90 PLAN CHECK, MECHANICAL 40.52 PLAN CHECK, PLUMBING 66.75 STRONG MOTION (SMI) - RES 2.96 Fee summary Charged Permit Fee Total 479.55 Plan Check Total .00 Other Fee Total 345.32 Grand Total . 824.87 LQPERMIT Paid Credited Due .00 .00 479.55 .00 .00 .00 .00 .00 345.32 .00 .00 824.87 Bin #/�p �� - City of La Quinta cLC Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico NO La Quinta, CA 92253 - (760) 777-7012 V 212013 Building Permit Application and Trackin 8WIllyOF — Permit # Project Address: 5 -/-/—ZOO Owner's Name: A. P. Number: Address: 5V- 260 ✓4 FF11ZiX e;Tj Cl— l—Legal Legal Description: City, ST, Zip: QV IA(J?i Contractor: 0 W /VLA( -3 U /Lp E 12 telephone: W 7 _ 57/- S3 Tele Cl� ...,�':.. Address: 0-200 /9 F / R ME -0 Cr Project Description: City, ST, Zip: /fi Q U 11\(14 M 9225-3 Tele hone: 9 l_ SN State Lic. # : City Lic. #; Arch., Engr., Designer: Address: it .. I City., ST, Zip: Telephone: <:»:>;>?:::::>::>;::>::»::;.,; ::;;;;:•;>: ;.,:.:>:.;:;<:. Construction Type: Occupancy: Project a circle one): New Add'n Alter Repair Demo State Lic. #: ' : ,...:.......:..;;; ,::":..,:::":.:".:...=.."........ """' . .....". Name of Contact Person: R 16 144 P_ o Go N7qeeFS . Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: (p / — 77e— -7 oZ 3/Estimated Value of Project: X30 5 f. 55000 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted "6413 Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cala. Called Contact Person , Plan Check Balance Title 24 Cala. Plans picked up" 'r�� Construction Flood plain plan Plans resubmitted �f �e�jy— Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Pers �ia:L] Plumbing Grant Deed Plans picked up i S.M.I. H.O.A. Approval Ti��D Plans resubmitted 2a Grading IN HOUSE: -view, ready for corpCctior sfissue Developer Impact Fee Planning Approval ailedn2act Per n A.I.P.P. Pub. Wks. Appr Da_11'PC frrmit ssue School Fees —ALg W Lz it( Total Permit Fees Nwo xuw'�- 11sluo. me g 0 �D ✓r ? .. .......................:'S . ....... _... _. _. _... _. _. _. ITEM H$Wb&b Thiekma .. Fldrth Si$b Width tEactr side of Oponing) NO" 81$b larrgtft lFrom afopenh Haar son Reinfordrg Tll Ilm of WO of Firebox � Dirancs from Top of opaing FRA 6t Val to Throat v Smokes 0wrAar Ed& of Shah N gar WUi—Thielmas b" Front A Side wall—Tltkknas ? . 01`96na••110twWrl AdWwm C�dnvley all V#Aice1 Reinforcing tX liaad an Am of Fl*lmo Uj floiimnUl Rdnfareing J L Bond earns � Fnplao$1Jeld FRA 6t Val Wah with Ftnr Lining v . N 8" FirW&c$ opo.<6 sq.h. 12"finpiactopg.�6sq. it. b" � ..Welle•wfth tWIiN.fWa ? . 01`96na••110twWrl AdWwm •Plait .• • � Efkiilw Plue llree ittanfamd to um its "n liaad an Am of Fl*lmo Wahl Nm ale impend look GENERAL CODE REQUIUM-ENTS LawUniform Banding Cafe 1979 81982 Edition' FRA 6t Val A 4" 4" 8 8" FirW&c$ opo.<6 sq.h. 12"finpiactopg.�6sq. it. b" C 18�� fired. opg. <8 sq, it. 16" 2D Finpl. 01m.36 sq. h. D ittanfamd to um its "n Required if cantilevered in Wahl Nm ale impend look connrclion with ralad wood floorconouction, E • 10" common brick or 8" whom tl" inolading mirimam 2n flneack s fir*$ck Ilaing is u#ed. linir4--12" wh" no lining h Jls in liWwk K" max. prvAded. F a" 8"li" nt ommprd$d fi K" offset. �" 8"ioAsti ear$gieg eray M 4m1thd Vmall ellfeknat Is an 8" Or Mae at Solid maonry. Form damW h n0ulnd. "H Four r4 fell larrgltr biro for ChImMy Fourh bars lull Isgth. rro up l0 40" wide. Add two f4 bets for split# unim mmad aeth addlliw al 40" ae ftudon 0f width or e$ch additiand flue. J !i" ties at 18" and two ties at adv bond in wffcd #tad. Teo tp$cilhd nrolrem$nts. X"birsa124" Twe ii" but al bop bond beam 4" K L.A city ragairimana an good high. Two !1" bora •1 antharepa bond practices hum V high. L lncorneuseible rAat$riel 2w, a r x in r two with r end badrg m Brick V416 grout uqund lining, 4" aria from flue tante llrickwith WwtwWrrd lkd* 4" to ouwdr fab$ of ahirnw.. min. from Outside flu$ Iirdnk to ouaide (itHf chimaeY. 1) 4" Inelyding flue IIt4r ' 4" wy04 far brick • P ° Aourrd Ilnin�-lJi2 of li0 StIA&mih Vic -far thim"0* lir WO 1111 to Iloing il10 ar 81 pad over - tq. lftmea Slil•for thlmeoys tlss Own IV high or OF LA QUINTA VG & SAFETY DEPT. 'PROVED CONSTRUCTION BY CwAulmra klat"Id "ApPlietto ilAl{CLCMIMIdIY �rerewt ur 4 3i" fi" -M, in. lbwlKe operiiiy; . _. •"• ••'•�°' •••'"�••' W. to edge of Firw4ce iOIT lle Tt! Z"aa-a Above Root aneox. a-:tie- elOtY >ti 70 Brenn■a•pu4 n 12" from owing when mamd pio• �nlroorethan '1/9fords. l" ' 1Z" from aponlnf when profeetiiy marc iX" !'$" >r!sNAR uuxteR to iuvnsre Ort�aen r00 2'111" b6 to 7-18d r»Ib Amh°r*o 8 • W.W. W1id Halle f 1" bolt 3l16"x i" fawn trnrro art intosbfmnoy 14 6dnallt 12" hooked mound Data barw/6"ext 111" beaked around Doter ber .•3•Sdi"bolts Sola ToW''pIL Two K O TbieJ<� 3 ]x' min. 6" min. for 1 story chimoei C I i�dtlr 6" oath Sade of ilreplece wait 0" 9b skit ai�� cm weir " replee+vrall. BUI Oubids Air intake U OpdondRepaired 6 sq. im, minima oris ' �C1NfarNi Eneryli SommiWon Requiniiint) oleo 3cnon Door Optionai t but sot interfere I Roauired but shall na"tAT i env with ontvpy consarvrtion nj Interfere with energv. imprrWinp dwiws con"mation Improving Eel A slat Eovn and Los +• davJces Angeles City nouhemmb. -- — ••• nrsw"IT urccs may MW WrtjCil rorntalCinl gore epiiced to t""dowolk pmvued that Slee Tpiico is mvected prior to 1 �s grouting of 111af. gm._Reif ANCHOR TIE CONNECTION JIVXJI REMENTS FOR TALL CHIMNEYS rfE{QNT mk""V ilAl{CLCMIMIdIY �rerewt ur 4 3i" wne+ls"'oeM{I1CSOteNeY, 400i/i rii. iOIT lle Tt! Z"aa-a MAtI Y't �" Rt111rI1A ionuusttmondolil>s aneox. a-:tie- elOtY >ti 70 Brenn■a•pu4 n 4-0 1211001.13. !'$" >r!sNAR uuxteR to iuvnsre Ort�aen 9®' 2'111" b6 to 7-18d r»Ib �•S{•• bulb 12-16d nails' 9g' W.W. W1id Halle f 1" bolt cW. 14 6dnallt - - .•3•Sdi"bolts , .. .30 Y OF LA QUINTA DING & SAFETY DEPT. kPPPOVED )R CONSTRUCTION OAnehor tie1 different Iovele s�ltryid K IP Cetlnedni ofen treann niknq GABLE END OPEN BEAM ALTERNATE FOUNDATION SCHEDULE FOR A ONE STORE FREE STANDING 'FIREPLACE taint Smson g Ium PIT mix.1 FRU STANIMm i MOW—". SQ1lAAE MOOTMiO "Nr"tnln.i YOlTCM �tllNl. SAW WAY 10'aed ll' ;%yI 4-0 1211001.13. !'$" 444 IV Simi IW. 1.t1' erid lip .51-r . • •• w! -WT orm rwmrrry anrmars�q 1111 tai<i1ll MA11 p "itirHMIM1 tl�YltMflTiif" tlfiil�lneN a,reyt nle'enicha t�ll swnwaedcnttint•qutritlai roil aep>lpi�, b Fax sent by 999 823 8489 THOMSONS SALES 81-19-97 11:11 Pg: 3/8 40 .QCL tJl • ge'� �, .�i N o a x ID .� CITY OF LA QUANTA NBUILDING & SAFETY DEPT. Lu APPROVED — S WFOR CONSTRUCTION rc - •--+� ``fir ' --� r.. ` � �' -, .—• . • . � •� , y • •t C W Q •Bu►1001j }0 dol Wo1j eieldepg „ ., NINE it �� list, ttt� tit- 111111111111111 MINE VAP rZA 11'r 0 IM MENEM !��11111i SECTION 13 CHIMNEYS FOR .CONVENTIONAL-.... FIREPLACES A conventional fireploce is ane of Gf masonry construction ar one having a steel shell which is Intended for use wish a uviols open (ro o Whether or not glass doors are used, elle correct size of chimney depends moldy on dw mardmum frontal opening area and chimney height. Ideally, 0 a damper Is installed in such a fireplace, B should have a Wil aper area of twice chimney area or more. Otherwise, the reshidive effed or flow resistance of the damper may call for a larger or taller chimney, Steadies of firepkce operation hove shown that to provost smoke 16 average ah Inlet velocity into the full open area should at" 0.80' per second, or about 50' per minute. This IS comparable to 16 minimum capture velocity of conveMonal ventilation hoods over cooling appliances. The chimney sizing chart, Figure 38, For fireplaces is based on obtaining an average air veloclly� of at (east 0.80' per minute INo the fireplace opening. the chart was compiled from an equation which assumes a reasonable size of wood fire for gas low los taming in Lha hearth area. Actually, except fa very or smoldering fires, required chimney size amt he: ht does not.vary.muchwith the size -of fire,. . Also, the type of chimney selected has no effect on tis required size and height. Sdedian of the chimney �yp� depends mainly on Its surroundings In combwtlbb cons1rudion the only SeBA idetoibWos dale. Is do Selkirk Metalbwtos Model SSII, which Is specifically intended for use with any solid fuel application. In non�combustibb surrounding, Model DF, PS, or IPS can be used. For residential applications needing Chi mneys forger than 14" size, Models DF, PS and IPS can be= in a masonry or other noncombustible dose to provide the necessary protectioe to surrounding structure. fiber insulated Model IPS has been granted a Type'HP Ustias a Building Heating Appliance Chimney, better qudii ng 8 for use when a' to ger diameter chimney b required, a noncombustible chase is an option, mad lata) code requires an *I -M rating. - - BY H W ANCHOR PLATE SUPPORT UL #103 FOR MASONRY FIREPLACE ANCHOR PLATE The Anchor Plate prcwtdes a COMectlon from a masonry fireplace to' a Setklric Metatbestos Chimney. The following steps describe Instapatlon of this part. I. Using the anchor plate as a template, centered ever the outlet opening, drip and anchor four 1/4" diameter bolts 2" long securely into the top of the masonry fimphm See Figure & 2. Apply a bed of mortar approximately 3/4" in depth and 3" in width com- pletely around the Ireplace Opening. Maks sure the threaded ends of the bolts protrude a minimum of V above the bad of mortar. 3. While the mortar is adli damp: place and Ravel the Anchor Plate over the extended studs. Secure, using a washer and nut for each bolt. 4. Check ft plate far Level and allow mortar to set. `SELKIRK S. Place a section of chimney onto the Anchor Plate and secure to Anchor • 'METAMESTOS Plate with.a 1/3 clockwise turn. Up to 85' of chimney may be stacked on 14801 Quorum Drive - Dallas, Texas 75240 1-800-992-8368 the Anchor Plate. 0 n12 Anchor Plate Support for Masonry Fireniarp :• - - BY H W ANCHOR PLATE SUPPORT UL #103 FOR MASONRY FIREPLACE ANCHOR PLATE The Anchor Plate prcwtdes a COMectlon from a masonry fireplace to' a Setklric Metatbestos Chimney. The following steps describe Instapatlon of this part. I. Using the anchor plate as a template, centered ever the outlet opening, drip and anchor four 1/4" diameter bolts 2" long securely into the top of the masonry fimphm See Figure & 2. Apply a bed of mortar approximately 3/4" in depth and 3" in width com- pletely around the Ireplace Opening. Maks sure the threaded ends of the bolts protrude a minimum of V above the bad of mortar. 3. While the mortar is adli damp: place and Ravel the Anchor Plate over the extended studs. Secure, using a washer and nut for each bolt. 4. Check ft plate far Level and allow mortar to set. `SELKIRK S. Place a section of chimney onto the Anchor Plate and secure to Anchor • 'METAMESTOS Plate with.a 1/3 clockwise turn. Up to 85' of chimney may be stacked on 14801 Quorum Drive - Dallas, Texas 75240 1-800-992-8368 the Anchor Plate. 0 n12 Anchor Plate Support for Masonry Fireniarp Electronically Filed by Mark Gallant, CEPE and Authenticated at CalCERTS.com - 10/15/2013 Electronically Signed at CalCERTS.com by D Kirk McKinley (The McKinley Associates, Inc.) 10/15/2013 PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF-1 R Project Name Canning Casita Building Type 0 Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration 11011512013 Date Project Address La Quinta California Energy Climate Zone CA Climate Zone 15 Total Cond. Floor Area 517 Addition n/a # of Stories 1 FIELD INSPECTION ENERGY CHECKLIST El Yes ❑ No HERS Measures -- If Yes, A CF-4R must be provided per Part 2 of 5 of this form. ❑ Yes ❑ No Special Features -- If Yes, see Part 2 of 5 of this form for details. INSULATION Construction Type Area Special Cavity (ft) Features (see Part 2 of 5) Status Wall Wood Framed Door Opaque Door R-13 734 None 24 New New Roof Wood Framed Attic R-30 517 Radiant Barrier New Slab Unheated Slab -on -Grade None 517 Perim = 96' New FENESTRATION U- Orientation Area(ft2) Factor Exterior SHGC Overhang Sidefins Shades Status Front (S) 36.0 0.320 0.30 none none Bug Screen New Left (W) 36.0 0.320 0.30 none none Bug Screen New Rear (N) 20.0 0.320 0.30 none none Bug Screen New Right (E) 12.0 0.320 0.30 none none Scr en New �: -0R _ -- HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status 1 Central Furnace 80% AFUE Split Air Conditioner 13.0 SEER Setback New HVAC DISTRIBUTION Location Heating Duct Cooling Duct Location R-Value Status HVAC System Ducted Ducted Attic, Ceiling Ins, vented 6.0 New WATER HEATING Qty. Type Gallons Min. Eff Distribution Status 1 Instant Gas 0 0.82 No Pipe Insulation New EneryyPro5.1 by EnergySoft User Number. 2875 RunCode: 2013-10-15T08:32:09 ID: Pa e 1 of 5 Reg: 213-NO07813OA-000000000-0000 Registration Date/Time: 2013/10/15 11:38:01 HERS Provider: CalCERTS, Inc Electronically Filed by Mark Gallant, CEPE and Authenticated at CalCERTS.com - 10/15/2013 Electronically Signed at CalCERTS.com by D Kirk McKinley (The McKinley Associates, Inc.) 10/15/2013 PERFORMANCE CERTIFICATE: Residential (Part 2 of 5) CF-1 R Project Name Canning Casita Building Type ® Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 11011512013 SPECIAL FEATURES INSPECTION CHECKLIST The enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification to be used with the performance approach. The enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. The Roof R-30 Roof Attic includes credit for a Radiant Barrier that is Continuous meeting eligibility and installation criteria as specified in Residential .Appendix RA4.2.2. HERS REQUIRED VERIFICATION Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a completed CF-4R form for each of the measures listed below for final to be given. The Cooling System Rheem RGPN05NAUER/1.5T includes credit for a 11.0 EER Condenser. A certified HERS rater must field verify the installation of the correct Condenser. The HVAC System HVAC System incorporates HERS Verified Refrigerant Charge or a Charge Indicator Display. The HVAC System HVAC System incorporates HERS verified Duct Leakage. HERS field verification and diagnostic testing is required to verify that duct leakage meets the specified criteria. EnergyPro 5.1 by Ene Soft User Number- 2875 RunCode: 2013-10-15T08:32:09 ID: PaLce 2 of 5 Reg: 213-NO07813OA-000000000-0000 Registration Date/Time: 2013/10/15 11:38:01 HERS Provider: CalCERTS, Inc Electronically Filed by Mark Gallant, CEPE and Authenticated at CalCERTS.com - 10/15/2013 Electronically Signed at CalCERTS.com by D Kirk McKinley (The McKinley Associates, Inc.) 10/15/2013 PERFORMANCE CERTIFICATE: Residential (Part 3 of 5) CF-1 R Project Name Building Type 0 Single Family ❑ Addition Alone Date Canning Casita ❑ Multi Family ❑ Existing+ Addition/Alteration 11011512015 ANNUAL ENERGY USE SUMMARY Standard Proposed Margin TDV kBtu/ft2- r) _ Space Heating 4.05 4.82 -0.77 Space Cooling 81.64 91.24 -9.60 Fans 16.50 23.18 -6.68 Domestic Hot Water 43.39 23.19 20.19 Pumps 0.00 0.00 0.00 Totals 145.57 142.42 3.14 Percent Better Than Standard: 2.2 BUILDING COMPLIES - HERS VERIFICATION REQUIRED Fenestration Building Front Orientation: (S) 180 deg Ext. Walls/Roof Wall Area Area Number of Dwelling Units: 1.00 (S) 257 36 Fuel Available at Site: Natural Gas (W) 174 36 Raised Floor Area: 0 (N) 257 20 Slab on Grade Area: 517 (E) 174 12 Average Ceiling Height: 9.0 Roof 517 0 Fenestration Average U-Factor 0.32 TOTAL: 104 Average SHGC: 0.30 Fenestration/CFA Ratio: 20.1 % REMARKS THE INSTALLING CONTRACTORS ARE RESPONSIBLE FOR THE QUANTITYAND SIZING OF HEATING, COOLING AND DHW EQUIPMENT, DUCT SIZING AND EQUIPMENT SELECTION. (§150(h),CEC Blueprint #60) STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the Efficiency Standards of the California Code of Regulations. The documentation author hereby certifies that the documentation is accurate and complete. Documentation Author Gallant Energy Consulting Company 10/15/2013 Address 508 W Mission Ave Ste 201 Name Mark Gallant, CEPE City/State/Zip Escondido, CA 92025 Phone 760-743-5408 Signed Date The individual with overall design responsibility hereby certifies that the proposed building design represented in this set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit application, and recognizes that compliance using duct design, duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require installer testing and certification and field verification by an approved HERS rater. Designer or Owner (per Business & Professions Code) Company McKinley Assoc Inc ��u 1818 FirstAve., Ste. 200 / -� /yam't 10. -r*Frr Address Name O� f City/State/Zip San Diego, CA 92101 Phone 619 238 1134 Signed License # Date LEne Pro 5.1 by EnergySoft User Number: 2875 RunGode: 2013-10-15T08:32:09 ID: Pag e 3 of 5 Reg: 213-NO07813OA-000000000-0000 Registration Date/Time: 2013/10/15 11:38:01 HERS Provider: CalCERTS, Inc Electronically Filed by Mark Gallant, CEPE and Authenticated at CalCERTS.com - 10/15/2013 Electronically Signed at CalCERTS.com by D Kirk McKinley (The McKinley Associates, Inc.) 10/15/2013 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF-1 R Project Name Canning Casita Building Type m Single Family ❑ Addition Alone Date ❑ Multi Family ❑ Existing+Addition/Alteration I90/15/2013 OPAQUE SURFACE DETAILS Surface Type Area U- I Factor Insulation Azm Tilt Status Joint Appendix 4 Location/Comments Cavity Exterior Frame Interior Frame Wall 1971 0.102 R-13 180 90 New 4.3.1-A3 Casita Door 24 0.500 None 180 90 New 4.5.1-A4 Casita Wall 138 0.102 R-13 270 90 New 4.3.1-A3 Casita Wall 237 0.102 R-13 0 90 New 4.3.1-A3 Casita Wall 162 0.102 R-13 90 90 New 4.3.1-A3 Casita Roof 5171 0.031 R-30 1801 18 New 4.2.1-A20 Casita Slab 104 0.730 None 0 180 New 4.4.7-A1 Casita Slab 413 0.730 None 0 180 New 4.4.7-A1 Casita FENESTRATION SURFACE DETAILS ID Type Area U-Factor SHGC2 Azm Status Glazing Type Location/Comments 1 Window 36.0 0.320 NFRC 0.30 NFRC 180 New NonMetal LowE2 Casita 2 Window 36.0 0.320 NFRC 0.30 NFRC 270 New NonMetal LowE2 Casita 3 Window 20.0 0.320 NFRC 0.30 NFRC 0 New NonMetal LowE2 Casita 4 Window 12.0 0.320 NFRC 0.30 NFRC 90 New NonMetal LowE2 Casita (1) U•Factor Type: 116-A Default Table from Standards. NFRC = Labeled Value 2 SHGC T e 116-B = Default Table from Standards. NFRC = Labeled Value EXTERIOR SHADING DETAILS ID Exterior Shade Type SHGC Window Ove hang Left Fin Right Fin H t Wd Len FI t LExt RExt Dist Len H t Dist Len H t 1 Bug Screen 0.76 2 Bug Screed 0.76 3 Bug Screen 0.76 4 Buq Screen 0.76 EnergyPro 5.1 by EnergySoft User Number.- 2875 RunCode: 2013.10-15T06:32:09 1D: Page 4 of 5 Reg: 213-NO07813OA-000000000-0000 Registration Date/Time: 2013/10/15 11:38:01 HERS Provider: CalCERTS, Inc Electronically Filed by Mark Gallant, CEPE and Authenticated at CalCERTS.com - 10/15/2013 Electronically Signed at CalCERTS.com by D Kirk McKinley (The McKinley Associates, Inc.) 10/15/2013 CERTIFICATE OF COMPLIANCE: Residential (Part 5 of 5) CF-1 R Project Name Canning Casita Building Type m Single Family ❑ Addition Alone ❑Multi Family ❑Existing+ Addition/Alteration Date 10/1512013 BUILDING ZONE INFORMATION System Name Zone Name Floor Area Volume Year Built New Existing Altered Removed HVAC System Casita 517 4,653 Totals 5171 0 0 0 HVAC SYSTEMS System Name Qt . Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status HVAC System 1 Central Furnace 80% AFUE Split Air Conditioner 13.0 SEER Setback New HVAC DISTRIBUTION System Name Heating Coolin Duct Location Duct R-Value Ducts Tested? Status HVAC System Ducted Ducted Attic, Ceiling Ins, vented 6.0 0 New WATER HEATING SYSTEMS System Name Qty. Type Distribution Rated Input Btuh Tank Cap. al Energy Factor or RE I Ext. Standby Tank Loss or Insul. R- Pilot Value Status Rinnai R94LS 1 Instant Gas No Pipe Insulation 199,000 0 0.82 n/a n/a New MULTI -FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING Control Hot Water Piping Length ft _ o i� — Svstem Name Pipe Length Pipe Diameter Insul. Thick. Qty. HP Plenum Outside Buried rE—nergyPro 5.1 by Ene Soft User Number. 2875 RunCode: 2013-10-15T08:32:09 ID: Page 5 of 5 Reg: 213-NO07813OA-000000000-0000 Registration Date/Time: 2013/10/15 11:38:01 HERS Provider: CalCERTS, Inc MANDATORY MEASURES SUMMARY: Residential (Page 1 of 3 F-1 R ..Project Name Casita 7DTteCanning 512013 NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of the compliance approach used. More stringent energy measures listed on the Certificate of Compliance (CF-1 R, CF-1 R-ADD, or CF- 1 R-ALT Form) shall supersede the items marked with an asterisk (*) below. This Mandatory Measures Summary shall be incorporated into the permit documents, and the applicable features shall be considered by all parties as minimum component performance specifications whether they are shown elsewhere in the documents or in this summary. Submit all applicable sections of the MF-1 R Form with plans. Building Envelope Measures: 116 a 1: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leaka e. §116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U-Factor, certified Solar Heat Gain Coefficient SHGC and infiltration that meets the requirements of 10-111 (a). 117: Exterior doors and windows are weather-stripped: all hints and penetrations are caulked and sealed. 118 a : Insulationspecified or installed meets Standards for Insulating Material. Indicate type and include on CF-6R Form. §118(i): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of §118(i) when the installation of a Cool Roof is specified on the CF-1 R Form. * 150(a): Minimum R-19 insulation in wood -frame ceiling orequivalent U-factor. 150 b : Loose fill insulation shall conform with manufacturer's installed design labeled R-Value. * 150 c : Minimum R-13 insulation in wood -frame wall orequivalent U-factor. * 150 d : Minimum R-13 insulation in raised wood -frame floor orequivalent U-factor, 150 f : Air retarding wrap is tested, labeled, and installed according to ASTM E1677-95 2000 when specified on the CF-1 R Form. 150 : Mandatory Vapor barrier installed in Climate Zones 14 or 16. §150(I): Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3%; water vapor permeance rate is no areater than 2.0Perm/inch and shall be protected from physical damage and UV light deterioration. Fireplaces, Decorative Gas Appliances and Gas Log Measures: 150 e 1 A: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150(e)1 B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped with a with a readily accessible, operable, and tight-fittingtight-fifting damper and or a combustion -air control device. §150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the building, are prohibited. Space Conditioning, Water Heating and Plumbing System Measures: §110-§113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy Commission. §113(c)5: Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release valve, backflow prevention, pump isolation valve, and recirculation loop connection requirements of §113(c)5. §115: Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances (appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool and spa heaters. 150 h : Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA. 150 i : Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c). §1500)1 A: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with insulation having an installed thermal resistance of R-12 or greater. §1500)1 B: Unfired storage tanks, such as storage tanks or backup tanks for solar water -heating system, or other indirect hot water tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R-value is indicated on the exterior of the tank. §150@2: First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire length of recirculating sections of hot water pipes are insulated per Standards Table 150-B. §150@2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot water tank shall be insulated to Table 150-B and Equation 150-A. §1500)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table 123-A. 150 ' 3A: Insulation is protected from damage. including that due to sunlight, moisture, equipment maintenance, and wind. §1500)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in conditioned space. 150 ' 4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. EnergyPro 5.1 by EnergySoft User Number: 2875 RunCode: 2013-10-15T08:43:25 ID: Page 1 of 4 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3) MF-1 R ,Project Name Date Canning Casita 1011512013 §150(m)1: All air -distribution system ducts and plenums installed, are sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R- 4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181 A, or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings reater than 1/4 inch, the combination of mastic and either mesh or tape shall be used §150(m)1: Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross -sectional area of the ducts. §150(m)2D: Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such toe is used in combination with mastic and draw bands. 150 m 7: Exhaust fans stems have back draft or automatic dampers. §150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. §150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. 150(m)l 0: Flexible ducts cannot have porous inner cores. §150(o): All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air Quality in Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation required in Section 4 of that Standard. Pool and Spa Heating Systems and Equipment Measures: §114(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency Regulations; an on -off switch mounted outside of the heater; a permanent weatherproof plate or card with operating instructions; and shall not use electric resistance heating or a pilot light. §114(b)1: Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction and return lines, or built-up connections for future solar heating. 114(b)2: Outdoor pools ors as that have a heat pump or gas heater shall have a cover. §114(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or programmed to run only during off-peak electric demand periods. 150 : Residential pool systems orequipment meet the pump sizing, flow rate, piping, filters, and valve requirements of §150 Residential Lighting Measures: §150(k)1: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies contained in Table 150-C and is not a low efficacy luminaire asspecified by §150k)2. 150 k 3: The wattage of permanently installed luminaires shall be determined asspecified by §130 d . §150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. §I50(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line -voltage socket or line - voltage lamp holder; OR shall be rated to consume no more than five watts of power as determined by §130(d), and shall not contain a medium screw -base socket. 150 k 6: Lighting integral to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of 1 50k . 150 k 7: All switching devices and controls shall meet the requirements of §150(k)7. §150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 ftz or 100 watts for dwelling units larger than 2,500 ft2 may be exempt from the 50% high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a manual -on occuaant sensor. §150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated cabinet. EnergyPro 5.1 by Eriergysoft User Number: 2875 RunCode: 2013-10-15T08:43:25 ID: Page 2 of 4 MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF-1 R -Project Name Date Canning Casita 1011512013 §150(k)l0: Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms shall be high efficacy. EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual -on occupant sensor certified to comply with the applicable requirements of §119. EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a manual -on occupancy sensor. §150(k)11: Permanently installed luminaires located in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, closets, and utility rooms shall be high efficacy luimnaires. EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of §119, or by a manual - on occupant sensor that complies with the applicable requirements of §119. EXCEPTION 2: Lighting in detached storage building less than 1000 square feet located on a residential site is not required to comply_ with §150(k)11. _ §150(k)l2: 'Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; and be sealed with a gasket or caulk between the luminaire housing and ceiling, §150(k)l3: Luminaires providing outdoor lighting, including lighting for private patios in low-rise residential buildings with four or more dwelling units, entrances, balconies, and porches, which are permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy. EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that they are controlled by a manual on/off switch, a motion sensor not having an override or bypass switch that disables the motion sensor, and one of the following controls: a photocontrol not having an override or bypass switch that disables the photocontrol; OR an astronomical time clock not having an override or bypass switch that disables the astronomical time clock; OR an energy management control system (EMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2: Outdoor luminaires used to comply with Exceptions to §150(k)l3 may be controlled by a temporary override switch which bypasses the motion sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3: Permanently installed luminaires in or around swimming pool, water features, or other location subject to Article 680 of the California Electric Code need not be high efficacy luminaires. §150(k)l4: Internally illuminated address signs shall comply with Section 148; OR not contain a screw -base socket, and consume no more than five watts of power as determined according to §130(d). §150(k)15: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable requirements in Sections 130, 132, 134, and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable requirements of Sections 130, 131, 134, and 146. §150(k)l6: Permanently installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more dwelling units shall be high efficacy luminaires. EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided that they, are controlled by an occupant sensor(s) certified to comply with the applicable requirements of §119. EnergyPro 5.1 by EnergySoR User Number: 2875 RunCode: 2013-10-15T08:43:25 ID: Page 3 of 4 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Canning Casita Date 10/15/2013 System Name HVAC System Floor Area 517 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 1 COIL CFM Total Room Loads 446 Return Vented Lighting Return Air Ducts Return Fan Ventilation F-0 Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COOLING PEAK COIL HTG. PEAK Heating System Sensible I Latent CFM Sensible Output per System 41,000 9,033 853 256 9,846 Total Output Btuh 41,000 0 Output Btuh/s ft 79.3 616 568 Cooling System 0 0 Output per System 18,000 0 0 0 0 Total Output Btuh) 18,000 0 616 1 10,266 853 0 Total Output(Tons) 1.5 568 Total Output Btuh/s ft 34.8 Total Output s ft/Ton 344.7 10,982 Air System CFM per System 600 HVAC EQUIPMENT SELECTION Airflow cfm 600 Rheem RGPN05NAUER/1.5T 13.363 1,928 41,000 Airflow (cfm/s ft) 1.16 Airflow cfm/Ton 400.0 Outside Air °k) 0.0 % Total Adjusted System Output 13,363 1,928 (Adjusted for Peak Design conditions) TIME OF SYSTEM PEAK Aug 3 PM 41,000 Jan 1 AM Outside Air cfm/s ft 0.00 Note: values above siven at ARI conditions I HEATING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Heating Peak) 26 OF 67 OF 67 OF 105 OF 4 Outside Air 0 cfm Supply Fan Heating Coil 600 cfm 67 OF LL 1 ---f - 104 OF ROOM 68 OF COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak 112 / 78 OF 76 62 OF 76 / 62 OF 55 / 54 OF Outside Air 0 cfm Supply Fan Cooling Coil 600 cfm 47.7 % 76 / 62 OF TTi J4 56 / 54 OF ' 75 / 62 OF l EnergyPro 5.1 by EnergySoft User Number. • 2875 RunCode: 2013-10-15T08:43:25 ID: Page 4 of 4 CITY- OF LA QUINTA'SUB-CONTRACTOR LIST JOB ADDRESS PERMIT NUMBER OWNER BUILDER. This form shall be posted on the job with the Building laspeclion Card at all times in a cons(?ictious.place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by awlicant. "On File" is not an acceptable response. Trade Classificatio " - `c't.- Contractor ;, .:::: ;<r:::_>- .:..... State. Contractor s Lrcer�se - < -:; ;•:: Company Name Classification License Number Exp. Date (e.g. A, B, C-8) (xxxxxx) (xx/xx/xx) - `- > : - Workers .C.am ensation #risvrance: .: „` •City.. Bus op4s License`:':::- :,: Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) :r4/�CNJLt CAVipfuw <o +M � CONCRETE IC-81 �A11 t C Jr . - IN -' C S FRAMING :(C-5) roc ��, '� 8� 2 � �� ' ZJ7 �i `CIS 2 � 2-31' 13 R� -3I-I ( 31 �- gtsrA1 xNs- B5, ATr✓ C � 7& 60000 $1313 � 4,'Ib_1` -14 �- I-'20��1 �18 33 3-31- f q 31-1q STRUCT..-STEEL• (C-5a ) MASONRY (C-29) PLUMBING (C-36j LATH; PLASTER (C-35) n �, n ..��fia,.� 2U c DRYWALL (C-9) n Z fO iNNkto'4\ HYAG (G-2o) e n� �n��11 r2 - z� '5-y LT� (% �g L �� 0" l { 'J l I �7� r r' 6,�AVi r ^ ram. ^ <.' He� O'N �4Wf r fr Y� �, o �I fob 3 S- i3 f r, i U s _3 15 !Z- 1 M 32 1 -3 1 _) ELECTRICAL (C=10) CA Co g y� �' Tc �.i. J'l�iG i q { 1 _ f10QFING (C=39) ''... 13AZv4 C - 3a Q� qq V Z L.3 9'30' l5 ATr N O SHEEr METAL {C 43) = - Ck-L 0 - e00'r t ' - L{ 3 (1321� Z. 7-3 FLO04RING (C=15) GLAZING (C;77)-.- oA pite- t'r(o2 (A S INSULATION (C-2) .: .1 Gl e Ga3.+1S ifJvC, a✓1 q i5 SEWAGE DISP. (6-42) p, E tG GNc. 5191.2 9 PAINTING (C=33) CERAMIC TILE (C-54) CABINETS (C-6) FENDING (C-13) i LANDSCAPING (C=27.) ' . r1 Ei p0'OL (C-53) n I P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 7$-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 e BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner-Bullders Applying for Construction Permits - aRRANT! N011,CE.TO PROPE&TY_OWNF, Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at f y-a eO "flYti P 4 We are providing you with an Owner -Builder Acknowledgment and In€onnation Vertficatio n. Forth to make you aware of your responsibilities and possible risk you may incur by halving this permit issued i4 your name as the Owner -Builder. We will not issue a building permit until you -have read, initialed your understanding of eaeh'provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. U %S ACKNOWLEDGMNT AND VERMCMION OF DwoRNATWN DIR70NS: Read and Maki each statement below to sign6 you understand or verify this Warma Lion. L 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" wilding permit that erroneously implies that the property owner is providing his or her own labor and material penonally.1, as an Owner -Builder, rnay be held liable and subject to serious financial risk for any injuries sustained by an r r hcewed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property- . I understand building permits are not required to be signed by property owners unless they are responsible for the �2 construction and are not hiring a licensed Contractor to assume this responsibility. eysel3. I understand as an "Owner-Builder"I amthe responsible party of record on the permit. I understand that I may protect f from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. J4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on ermits and contracts. J'��5_ I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value f my construction is at least five hundred dollars ($500), including labor and materials, I may be. considered an "employer" under state and federal law. I understand if I am considered an "employee' under state and federal law, I must register with the state and federal ?6_ vernment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential tructures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be hOA liable, for any financial or personal. 44wies sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 9. I understand I may obtain more information regarding my obligations as an "employee" from the Interval ROW' ue Service, the United States Small Business Administration, the California. Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at I- 800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors. 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for prof o cd construction activity at the following address: -200 e-Re. ofiL//l L I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all /applicable laws and requirements that govern Owner -Builders as well as employers. 12.1 agree to notify the issuer of this form immediately of any additions, deletions, or chimes to any of the information I 'have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is iAfured while working on your property; you may be heldliable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsiMe for verifying whether or not those Contractors are properly licensed and the status of their wo&ers' coon insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuiug: fte permit. Note. A copy of Ake property owner's driver's l e# farm notadVre*1M or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of Property o f -i7r — Date: Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BE -HALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. /� Scope of Construction Project (or Description of Work): L� �!5- / rg Project Location or Address: 2-d U C! Name of Authorized Agent: TelNo Address of Authorized Agent: ed 7 cff fVljl C (11,5f g 1�? a6/ I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is requ ie presented whenFF�erred is issued to verify the property owner's signature. � Date: Property Owner's Signature�t � Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 Project Name: Owner's Name: Elizabeth & Terrence Canning Phone No. 847-922-8128 Project Address: 54-200 Affirmed Ct., LaQuinta This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMMAND. AMOUNT: DATE: RECEIPT: CHECK#: INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Griffin Ranch Project Description: Casita APN: 767-780-077 Tract #: Type of Development: Residential Xx Total Square Feet of Building Area: Commercial 517 Date: March 11, 2014 Lot #'s: Industrial Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on behalf of the owner/developer. Dated: March 11, 2014 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code 17620 Number of Sq.Ft. Amount per Sq.Ft. Amount Collected Gov. Code 65995 517 $3.20 $1654.40 Project Agreement Existing Not Subject to Fee Approval Prior to 1/1/87 Requirement Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of Facilities and Maintenance Note: Pursuant to AB 181 any room additions or enclosures of 500 sq. ft. or less are exempt from developer fees. Any mobile homes being relocated within the same school district's jurisdiction are exempt from developer fees. i Certificate issued by: Laurie Howard, Secretary Signature: ]GC,ILi, 11 NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90-day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90-day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. 1V1C/lu�of cowphallec faxnl "IlAoted 3-2007 11/2010 GRIFFIN RANCH HOMEOWNERS ASSOCIATION Pi•o_ fessionally managed by Personalized 68-950 Adelina Road Cathedral City, CA 92234 Propegy Phone: (760) 325.9500 Management Fax: (760) 325-9300 October 13, 2013 MR. TERRY CANNING 27930 W. RIVER TRAIL BARRINGTON, ILL. 60010 Re: Architectural application approval for addition of casita; 54-200 Affirmed Court, Grfn Ranch Homeowners Association. Dear Mr. Canning: The Architectural Committee has reviewed your request for the addition of a casita to be built on the property at your home, per the application and plans submitted. We appreciate your adhering to the Architectural Guidelines and procedures as part of this exciting project with your submission of all of the proper forms, application and such detailed plans. After review of the materials submitted, the Architectural Committee has approved your proposed installation as submitted. With receipt of this letter, you may move forward with your project in conjunction with the specifications set forth and approved. A reminder that any fees or City permits necessary would be the responsibility of the homeowner to obtain in advance of this undertaking. Again, we appreciate the time and proper course of action you have taken in the planning of this exciting project and look forward to sharing in this outcome and finished product with you, as your neighbors. We wish you the best in your endeavor! FOR THE GRIFFIN RANCH HOMEOWNERS ASSOCIA TION BOARD OF DIRECTORS Sincerely, Michael W. Livingston CCAM Community Manager cc: Board of Directors Tim Jachlewski, Consulting Architect File,