9911-213 (RER) LICENSED CONTRACTOR DECLARATION
BUILDING PERMIT PERM //
IT
j..hereby affirm under penalty of perjury that I am licensed under provisions of `�fl-X.4•i
I— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and DATE 1If1�1/1109VALUATION iS.IlJ0.4at LOT TRACT
WProfessionals Code,and my License is in full force and effect. -
O =) ch License#, Lic.Class Exp.Date.
ty'i� IY t t;'3011.9.- JOB SITE 41-710 i'k ILA 010111 iM APN f 1101-.L7�- MI-7
W �� ADDRESS
j
r !
~ Z � jDate i�'• � Signature of Contractor OWNER'— �- CONTRACTOR/DESIGNER/ENGINEER
J U OWNER-BUILDER DECLARATION 11)-;I0 ttvlLt1 DMV`c: 78-395 SIWING PAI AiS
LU H d I hereby affirm under penalty of perjury that I am exempt from the Contractor's LA� Lf1N`,t'A. i'.A. 921253 1,A i f 1N"t'�� C.A. !►74�:i
License Law for the following reason: f�C�{?t 64-6209 C:13f,? 7067
Z_ ( ) 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
(al)(Sec.7044,Business.property,Professionals
sionals Code). y USE OF PERMIT I III II VIII II VIII IIII ,Z
I, as owner of theam exclusive) contractingwith licensed ItVail)1z1�1I LAI,IiL•:1b1'C3(;AU,
contractors to construct the project (Sec. 7044, Business & Professionals IE
Code). x��vV11,tiol". L�vt° w;vi.t t,rrlc� �sllS�{SSY6:ittilil tiLJ t5Y .t{t.�1Y1 --
cr) () I am exempt under Section B&P.C.for this reason
LO
N Date Signature of Owner
ON
0)
dQ WORKER'S COMPENSATION DECLARATION
C) Q Z I hereby affirm under penalty of perjury one of the following declarations: tia�t�t � .� �,y't"IT USA 131;•
r O ( ) 1 have and will maintain a certificate of consent to self-insure for workers'
X W �= compensation, as provided for by Section 3700 of the Labor Code,,for the
O J Q performance of the work for which this permit is issued.
m Q CJ ( ) I have and will maintain workers'compensation insurance,as required by
O U Q Section 3700 of the Labor Code, for the performance of the work'for which this
dLOH permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier 7U�^sl''.1'IC127 CjN.cqL1 Policy No. IM 111
w 5
CY PERM IT FU SWAINIARV
J (This section need not be completed if the permit valuation is for$100.00 or less). i3l_,aki(atfFA,-k.irpts 1Ej1-i 3-4fi •�Iti 52,fS
(�r 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 ['0M. e z1,kry90N PFF 101-YM4 1. 41)l FSfi,tlt3
workers-'compensation laws of California, and,agree that if I should become (.f:D7TRtC'AL IM,, 101-000-420-WO MIA
Subject to the workers'compensation provisions of�Section 3700 of the Labor NT.ttONO,iv#O'1'I ti FE -RES31) 1.01-4007-2+11•00
Code,.I sh ll Orthwith comply witJ those ypfov S16ns.ti s, ,
date: I Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to$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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 MAI-11,7f rA I,C;C}MM`1dUCTION 1OND PLAN CTPE-(.,1< ylp
any permit issued as a result of this applicaton agrees to,&shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees. i LESS PRE-PAID FFEI""S $0•00
2.Any permit issued as a result of this application becomes null and void if Q
Work is not commenced within 180 days from date of issuance of such l;,('gTNt,PFRAUT FEES DU NOW $1.52.24
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 State laws relating to the building
const ruction, and hereby authorize representatives of this City to enter upon j,•_�.��• ,
the above-mentioned property for inspectio5,purposes.
t.� RECEIPT DATE BY DATE INA INSPECTOR
Signature (Owner/Agent) �- '"'�/'"-1�� Date`)"k /�/
_�s: f
INSPECTION RECORD
OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR
BUILDING APPROVALS MECHANICAL APPROVALS
Set Backs —Underground Ducts
Forms&Footings Ducts
Slab Grade Return Air
Steel Combustion Air
Roof Deck Exhaust Fans
O.K.to Wrap F.A.U.
Framing Compressor
Insulation `S�a– Vents
Fireplace P.L. Grills
Fireplace T.O. Fans&Controls
Party Wall Insulation Condensate Lines
Party Wall Firewall
Exterior Lath .—
Drywall-Int.Lath 2� }
_ Final
Final -- B� G
POOLS - SPAS
BLOCKWALL APPROVALS Steel
Set Backs Electric Bond
Footings Main Drain
Bond Beam Approval to Cover
Equipment Location
Underground Electric
Underground PIbg.Test
Final Gas Piping
PLUMBING APPROVALS Gas Test
Electric Final
Waste Lines Heater Final
Water Piping Plumbing Final
Plumbing Top Out Equipment Enclosure
Shower Pans O.K.for Finish Plaster
Sewer Lateral Pool Cover
Sewer Connection Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice(Gas)
ELECTRICAL APPROVALS
Temp.Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
-Temp.Use of Power
Final
Utility Notice(Perm) f
VILLA LA QUINTA HOMEOWNERS ASSOCIATION
Post Office Box 15
La Quinta CA 92253
November 19, 1999
City of La Quinta
BUILDING DEPARTMENT
P. 0. Box 1504
La Quinta CA 92253
RE: Remodel - Henning Residence
49-701 Avila Drive
t .
Ladies and Gentlemen:
The Board of Directors/Architectural Committee of Villa La Quinta has reviewed
the plans for subject remodel and find it meets all the criteria of our
governing documents.
If you have any questions, please contact the office at 564-2177.
Thank you,
Q�
PATRICK ROSS
President
PR/bk
Proposal for work on the Henning residence, 49.710 Avila. .11/10/99
This project that is presented for consideration would change the present golf cart garage area
into a hobby/storage area.
A single 2x4 stud wall would be added to the interior, and an 8 foot ceiling all 16" on center,
would enclose the area. On the inter the walls and ceiling would have 5/8 fire resistant drywall
with R-13 insulation in the walls and R-19 over the ceiling. The golf cart door will be closed off,
with.a matching stucco.on.the_outside;there would.also be a 40 window installed where the golf
cart door once was. A prehung 36"fire rated one hour entry self closing door would be built into
the interior wall. Electrical for inside use would also be installed.as noted on drawing according to
guidelines.
Attached are drawings that depict these plans which are being submitted for approval.
For any questions please contact Victor Brodt at 760.564.6208.
Thank you,
Victor Brodt
F
Henning 49710 Avila
Existing
Drawing by Victor Brodt Services
564-6208
Golf cart area of
proposed change
N House
part}
Garage
Gate/entry
7
CITY OF LA QUINTA REINSPECTION FEE OF $30
BUILDING & SAFETY DEPT. A
APPROVED nis ago bs°, `rte APPROVED
OT N
FOR CONSTR)4CTI N THE SITE FOR A SCHEDULED
(,W i � 11VSPECTIOM.
DATE BY .ND
i
Proposed -"Henning work
area"
Drawing by Victor Brodt Services
564-6208
Owner Henning at t
49710 Avila
.7
1
Golf cart area of
proposed change
A SO House
orywao in mr ft*by spat. (part)
Garage ma WW`eam
Gate/entry
o—
F— — — — — — — — — - — —�
i
CITY OF LA O U I N TA ARE-tNSPECTYON THE EEAPPROVED
BUILDING & SAFETY DEPT. WILL BE CHARGED IFNOT ON
. pLANSE ,FOR OB �SCHEDULED
ARE
APPROVED THE S
FOR CONSTRUCT ON INSPECTION-
XO EXCEPTION
DATE �l BY
� �N�N
W chl �C1 Coll
ale
ol
oll
ot
i \
CITY OF LA QUI NTA A RE-INSPECTION FEE OF $30
BUILDING & SAFETY DEPT. Will BE CHARGED IF THE APPROVED
APPROVED THE SITE'FO A SCHNOT LEo
THE S
FOR CONSTRUCTION IN$pECTIONNO MEPTIONSI
DATE G� BY
der �(o Qc'S�� I�erstltN� \,w6.1 c.1CICA..
y9 Ito Av�l�.
�eu.t`iN��Qy1
.Cows
a
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' c ac t
t I 6 P-r
c�\lir
ou'r c ark
T,XPa�1c�c
f
I
CITY OF LA QUIUTAA RE-INSPECTION FEE OF $30
BUILDING & SAFETY DEPT. WILL BE CHARGED IF THE APPROVED
►� -�(° ��-°�'e- E NOT ON
APPROVED THE SITE FOR EOCARD SCHEDULED
THE S
FOR CONSTR �TIO�c` INSPECTION.
49�
�" A EXCEPTIONSI
DATE BY
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 2) CF-1R
Project Title Date
Project Address J Building Permit#
q LLk-oz X2>,tlr,& Plan Check/Date .
Dococume�n/tattiion Author Telephone
l� Field Check/Date
Compliance Method(Package or Computer) Climate Zone Enforcement Agency Use Only
GENERAL INFORMATION
Total Conditioned Floor Area `� Z Average Ceiling Height:_ ft
Conditioned Slab Floor Area C6 ft2
Building Type: _jL_Single Family ✓ Addition_Z-a-S'6
(check one or more) Multi-Family Existing-Plus-Addition
Front Orientation: North/South/East/West/All Orientations
(input front orientation in degrees from True North and circle one)
Number of Stories
Number of Dwelling nits:
Floor Construction Type: Sla ised Floor(circle one or both)
BUILDING SHELL INSULATION
Component Frame Type Cavity Sheathing Total R- Assembly Location/Comments
Type wd=wood Insulation Insulation Value' U-Value' (attic,garage,typical,etc.)
stl=steel R-Value R-Value
Wall w o
Wall
t
Roof
Floor
Floor
Slab Edge
FENESTRATION Shading Devices
Fenestration Orien- Area Fenestration Fenestration Interior Exterior Overhangs `
#/Type/Pos. tation (ft2) U-Value SHGC Shading Shading Att. /Fins
Att.2
Front ; Standard
Front Standard
Left C) Standard
Left Q Standard
Rear C> 0 k& Standard
Rear Standard
Right Standard
Right Standard
Skylight Standard
Skylight Standard
C CITY OF LA QUI NTA A K-INSPECTION' FEE OF $30
1W NW4cWi1TcY,0&!K-V-,lue and Assembly U-Value are not require d4&, & 0J01fihff9"
cavity �f ment for the Prescriptive Package. {.ANS #Xp JOB CARD ARE HOT ON
2 For pr� rt tv il�r c� ere are n credits for any interior shading except the �u1 � +S rc d U
defa e ' aperi )need not be installed for compliance pure01
July 1, 1999 *NO EEP?=
DATE BY
CERTIFICATE Of COA1I'LIANCE: RESIDENTIAL'. (Page 2 of 2) CF-1R
Project Title Date
HVAC SYSTEAS
Note:Input h\dw-nic to cn:n!,in:•J IIydwnic.ri,!! ui:Jc! \V;:t:r II:a!inc S\st_;a .C,. vp!I'.,i_n Ilca;ing Load
0. Di-,ICihUIi0n
Heating Fquipment Minimum Type and Duct or Heat Pump
Type (furnace.hcat Efficiency LOc3+i0n Piping Thermostat Configuration
pump.etc.) (AFUL or IISIT) (ducts_attic.ctc.) R- slue Type (split or package)
�''� —�— •�r =mac`
Cooling Equipment h`lttlnl)UM Duct Heat Pump
Type(air conditioner. Liliciencv Location Duct Thermostat Configuration
heat pump,ecap.cooling) (SEF.It) (anis,ctc.) R-Value Type (split or.package)
WATER HEATING SYSTEMS
Energy' External
Rated' Tank Factor or Tank
Water Heater Distribution Number Input VAV Capacity Recovery Standby' Insulation
T ' c Type in Svstem nr BuChr) (gallons) Efficiencv Loss(°:o) R-Value
1. For small gas siorage cater beaters(recd inputs ofles;Ilmn m equal to 75.0t'0 Bur/hr).electric resistance,and heat pump water heaters,list Energy
Factor. For lane gas simaee watcr heatcis(rated input of greater than 75.01.10 fttulhr).list Rated Input.Recovery Efficiency and Standby Loss.
For instantaneous gas water heaters.list rated input and rccocn efficiencies.
SPECIAL FEATURES anti A10DELING ASSUMPTIONS (Add extra sheets if necessary)
Including Thermal Mass(thermal mass type,coering,thickness.and description)
COMPLIANCE STATUA11.;NT
This certificate of wrimliancc list the-building foultuez and pei forniancc specifications needed to comply with Title 24.Parts I and G of
the California Code of Rcgul,!tions.and the adrninisuatire rC2U11 ions to inlp!c•nicnl them. This certificate has been,signed by the
individual with oc c•rnll design responsibilit\. When this certificate of COMpliancC is Submitted for a single building plan to be built in
multiple oricntotioiis. any shading f,alurc that is caric•cl is indicated in the•SpeCial hcaturc'/Remirks section.
Designer or Owyner(her Busing«and Professions Code) Documentation Author
Name: �� � (�'� --_-- N:nnc:
Title'Firnl: l isle/Finn:
Address. itii Z �,� i �e, ParFR.�5 :%ddress:
Telephone:
Lic. !''tl Cl,phunr.
t�G». _ —�–�',,, –
(signature) (d:n:l (si^_nature) (date)
Enforcement Agency
Name:
Title:
Agency:
Telephone.
(signature l stamp) Ida!^)
11 1999 .