The URL can be used to link to this page

04-6999 (SFD)+k N P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&-" d A Oa&rfi, VOICE(760) 760 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 4=0 0.0 0 6-9-9-9 Property Address: 52360 AVENIDA MONTEZUMA APN: 773-241-034- - - Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: COVE RESIDENTIAL Application valuation: 136195 Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION 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 effem License Class: 13 License No.: 855557 Date: Y� — Pfl Conttactoc OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 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 1, 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. , 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: Ruben Valencia 68250 Verano Rd CATHEDRAL CITY, CA 92234 Contractor: ANGLES CONSRUCTION 45175 PANORAMA.DRIVE PALM DESERT, CA 92260 (760)568-6064 Lic. No.: 855557 Date: 8/31/05 ----------------------------------------------- . WORKER'S COMPENSATION DECLARATION 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 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number'are: Carrier STATE FUND Policy Number 0002290030801 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 T 3700 of the Labor Code, I shall forthwith comply with those provisions. Dale 3 / App1Z.nt:R-. 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 1$100,0001. 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 1 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. Application Number . . . . . 04-00006999 ------ Structure Information SINGLE FAMILY DWELLING ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info . . CODE EDITION 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 489.00 PATIO SQ FTG 144.00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 2180.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . .769.00 Plan Check Fee 499.85 Issue Date . . . 11/10/04 Valuation 136195 Expiration Date 10/24/05 Qty Unit Charge Per Extension BASE FEE 639.50 37.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 .129.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 116.08 Plan Check Fee 29.02 Issue Date . . . . 11/10/04 Valuation . . . . 0 Expiration Date 10/24/05 Qty. Unit Charge Per Extension BASE FEE 15.00 2180.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 76.30 489.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.78 1.00 15.0000 ---------------------------------------------------------------------------- EA ELEC TEMPORARY POWER POLE 15.00 Permit . . . GRADING PERMIT Additional desc . Permit Fee . . 15.00 Plan Check Fee 00 Issue Date 11/10/04 Valuation 0 Expiration Date 10/24/05 Qty Unit Charge Per Extension ----------------------------- BASE FEE ----------------------------------------------- 15.00 Permit . . . . . . MECHANICAL LQPERMIT C4 Application Number . . . . . 04-00006999 Permit . . . MECHANICAL F, Additional desc . Permit Fee . . . . 65.50 Plan Check Fee 16.38 Issue Date . . . . 11/10/04 Valuation 0 Expiration Date 10/24/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 4.00 6.5000 EA MECH VENT FAN 26.00 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 153.00 Plan Check Fee 38.25 Issue Date . . . . 11/10/04 Valuation . . . . 0 Expiration Date 10/24/05 Qty Unit.Charge Per Extension BASE FEE 15.00 14.00 6.0000 EA PLB FIXTURE 84.00 1.00. 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50• 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 2180 S.F. SFD PERMIT DOES NOT INCLUDE BLOCK WALL, POOL/SPA OR DRIVEWAY APPROACH 3/11/05 Change of Owner & Contractor. dpc. 8-31-05 change of contractor to Angels Const.er ---------------------------------------------------------------------------- Other Fees . . . . . . .. . . ART IN PUBLIC PLACES -RES .00 CHANGE OF CONTRACTOR 4.50 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 49.99 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 13.61 LQPERMIT Application Number . . . . . .04-00006999 ---------------------------------------------------------------------------- y Other Fees . . . . . . . . DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged ---------- Paid Credited ------------------------------ Due Permit Fee Total 1118.58 1118.58 .00 ..00 Plan Check Total 583.50 583.50 .00 .00 Other Fee Total 2473.10 2468.60 .00 4.50 Grand Total 4175.18 4170.68 .00 4.50 LQPERMIT Bin # Permit # Q Project Address: S2-36,0 A. P. Number: 77 3 _ 2 VI _ Legal Description: ^/ S Contractor: K Address: City, ST, Zip: Y_ Telephone: State Lic. # Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: _ Telephone # of Contact Person: # Submittal Plan Sets Structural Calcs. Truss Calcs. Title 24 Cales. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees 5 City of La Quinta Building 8r Safety Division . P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: 3y -,S Lic. #: /ffD 6 3 Address: K City, ST, Zip: X Telephone: X Project Description: X 0 Date.of permit issue Total Permit Fees Construction Type: P Occupancy: Project ect n Pe (circle rc l eone): New Add'n Alter Repair Demo rr n� /P Sq. Ft.: # Stories: #Units: 0& t( Estimated Value of Project: X APPLICANT: DO NOT WRITE BELOW THIS LINE TRACKING PERMIT FEES Plan Check submitted Item . Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2"d Review, ready for corrections/issue Electrical Called Contact Person Plumbing Plans picked up S.M.I. Plans resubmitted Grading Review, ready for corrections/issue Developer Impact Fee Called Contact Person A.I.P.P. Date.of permit issue Total Permit Fees e�i iJ Certificate of Occupancy 4 4 gum& LrwsronhnG�� OF'T9w� Buildin & Safet Department 9► y p This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 52-360 AVENIDA MONTEZUMA Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-6999 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RC Owner of Building: RUBEN VALENCIA Address: 68250 VERANO RD. City, ST, ZIP: CATHEDRAL CITY, CA 92234 By: STEVE TRAXEL Date: NOVEMBER 13, 2006 Building Official POST IN A CONSPICUOUS PLACE �i} i� C-4 71 I r .4 �" • i i eA i 4r / • Box 1504 )5 CALLE TAMPICO �INTA, CALIFORNIA 92253 BUILDING PERMIT ion Number rty Address APN: Application description Property Zoning . . . . . . Application valuation . . . BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-0.OV 6999 Date 3/14/05 52360 AVENIDA MONTEZUMA 773-241-034- - - DWELLING - SINGLE FAMILY DETACHED COVE RESIDENTIAL 136195. Owner Contractor ~ ------------------------ Ruben Valencia ------------------------ ALVAREZ CONSTRUCTION 68250 Verano Rd 133 DESERT FALLS CIRCLE CATHEDRAL CITY CA 92234 PALM DESERT CA 92211 (760) 567-1351 WCC: EXEMPT WC: EXEMPT 09/30/05 CSLB: 427733 09/30/06 CCC: B ------ Structure Information SINGLE FAMILY DWELLING. ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . CODE EDITION 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 4 8 iNO 0� ., PATIO SQ FTG 144.00`N".� NUMBER OF UNITS 1,.00 ----------------.------------------------------------ 1ST FLOOR SQUARE FOOTAGE 2180.00 Permit -_----------------------- BUILDING PERMIT - Additional desc Permit Fee . . . . 769.00 Plan Check Fee 499.85 Issue Date . . . 11/10/04 Valuation . . . . 1.36195 Expiration Date 5/10/05 Qty Unit Charge Per Extension BASE FEE 639.50 37.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 129.50 Permit . . . . . . .MECHANICAL Additional desc Permit Fee . . . . -65.50 Plan Check Fee 16.38 Issue Date . . . . 11/10/04 Valuation . . . . 0 Expiration Date 5/10/05 Qty Unit'Charge Per 'Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 P.O. BOC 1504 • �� VOICE (760) 777-70 2 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 04- &q lq q I Date: 3- 14.4.5 Applicant. I33 0 t Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: ars Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 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 Lice se is in full force and effect. �ense Class 2a `1 ?a ::�) f2_ I ,cense No. Date 3 O ontractor A L-x%Ai-Z_eZ Ca1v %rl(/Wc—nod% — OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 1, 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.). U I am exempt under Sec. , BA P.C. for this reason Date • Owner WORKERS' COMPENSATION DECLARATION 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 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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: .:arrier Policy Number 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. .ppli/F cant WARNING: FAILURE TO SECURE WORKERS' COMPE SATION 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. 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 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 uuppon the above-mentioned property for inspection purposes. ate 3 ,gnature (Applicant or Agent): Page 2 Application Number . . . . . 04-00006999 Date 3/14/05 Qty Unit Charge Per Extension. 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 4.00 6.5000 EA MECH VENT FAN 26.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 116.08 Plan Check Fee 29.02 Issue Date . . . . 11/10/04 Valuation . . . . 0 Expiration Date 5/10/05 Qty Unit Charge Per Extension BASE FEE 15.00 2180.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 76.30 489.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.78 1.00 ------------------------------------------------------- 15.0000 EA , ELEC.TEMPORARY POWER POLE 15.00 Permit --------------------- PLUMBING Additional desc . . Permit Fee . . 153.00 Plan Check Fee 38.25 Issue Date . . . . 11/10/04 Valuation 0 Expiration Date 5/10/05 Qty Unit Charge Per Extension BASE FEE 15.00 14.00 6.0000 EA PLB FIXTURE 84.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 6.00 .7500 EA PLB GAS PIPE ->=5 4.50 1.00 ---------------------------------------- 15.0000 EA PLB GAS METER 15.00 Permit ----------------------------------- GRADING PERMIT Additional desc Permit Fee . . . . 15.x00 Plan Check Fee .00 Issue Date . . . . 11/10/04 Valuation . . . . 0 Expiration Date 5/10/05 Qty Unit Charge Per Extension ---------------------------------- BASE FEE 15.00 ------------------------------------------ Special Notes and Comments 2180 S.F. SFD PERMIT DOES NOT INCLUDE BLOCK WALL, POOL/SPA OR DRIVEWAY Page 3 Application Number . . . . . 04=00006999 Date 3/14/05 ---------------------------------------------------------------------------- Special Notes and Comments APPROACH 3/11/05 Change of Owner & Contractor. dpc ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 CHANGE OF CONTRACTOR 4.50 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 49.99 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE 00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 13.61 DIF.STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ---------- 1118.58.;.. ------------------------------ 1118.58 .00 .00 Plan Check Total 583.50 583.50 .00 .00 Other Fee Total 2473.10 2468.60 .00 4.50 Grand Total 4175.18 4170.68 .00 4.50 Bin # r City La umta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: S Z 3(P (j L/,g Mcrt-&ZL444,i4- Owner's Name: g U A. P. Number: Address: (p g Z�� V CvAk •b Legal Description: City, ST, Zip: C-,t, Z2.3 4— Contractor:Tel 6Z. ►t.(sj�ZCJ �9ZG a hone P Address: I 3 E,SE""Pr &-zC5 , Na Project Description: City, ST, Zip: PjX4 f O�C7' C'B %7SL/� N 6� GG Qlk�l Tele P hone: 3 ..............................::::::::::::::::: State Lic. # : If-7-7-753 - CityLic. #: Arch., Engr., Designer: SCK-'ql4 Address: L°y C� 3 i100 S(e Z2%. City, ST, Zip: L4- ui na 72r1�,3 O State Lic. # ConstTelephone:S/o4 tion Type: anc Occupancy: Y• Project ct type (circle e one . Neww Add'n Alter Repair Demo o Name of Contact Person: F144-ey � — Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: `1(p0 Estimated Value of Project. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3"Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees )EFF.SHIVELY CONSTRUCTION, INC. uc. #440s10 Ph: 760-776-8290 41-625 Eclectic St; Ste. F-2 Fax: 760-776-8253 Palm Desert, CA 92260 March 10, 2005 Tom Hartung City of La Quinta Building Department 78-495 Calle Tampico La Quinta, CA 92253 RE: 53-360 Avenida Montezuma, La Quinta, CA 92253 Dear Tom: This letter is to inform you that I have sold my vacant lot (Lot 20 Block 40, APN 773-241-034) with the City assigned address shown to Ruben and Guadalupe Valencia. Please assign my current building permit # 04-0999 to the Valencias or their agent. Sincerely, JEFF SHIVELY CONSTRUCTION, INC. Jeff Shivel President BUILDING & SAFETY DEPARTMENT P O 15-0 4,N (760),777-7012 ti 7,�$�,CALLE TAMPICO FAX (760) 777-7011 1� QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . 04-00006999 Date 11/10/04 Property Address . . . . . . 52360 AVENIDA MONTEZUMA APN: 773-241-034- - - Application description . . DWELLING - SINGLE FAMILY DETACHED Property Zoning COVE RESIDENTIAL Application valuation . . . . 136195 Owner 'Contractor ------------------------ SHIVELY JEFFERY J ------------------------ SHIVEY CONSTRUCTION,INC., JEFF 52810 AVENIDA MONTEZUMA 41625 ECLECTRIC STREET, F-2 LA QUINTA, CA 92253 _PALM DESERT CA 92260 (760) 7.76-8290 WCC: CLARENDON INS WC: 07KR0016704 07/15/05 CSLB: 440810 07/31/06 CCC: B . ------ Structure Information' SINGLE FAMILY DWELLING ----- Construction Type . . . . . TYPE V - NON RATED. Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 489.00 PATIO SQ FTG 144.0'0' NUMBER OF UNITS_ 1.00 FIRST FLOOR SQ FTG` 218.0.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee 769.00 Plan Check Fee 499.85 Issue Date' Valuation . . . . 136195 Qty Unit Charge Per Extension BASE FEE 639.50 37.00 3•.5000 THOU ----------------------------------- BLDG 100,001-500,000 129.50 Permit . . . . . . .MECHANICAL ---------------- Additional desc Permit Fee . . . . 65.50 Plan Check Fee 16.38 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.'0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA' . MECH B/C <=3HP/100K BTU •9.00 4.00 6.5000 EA MECH VENT FAN 26.00 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number:_Q'y -.6 Applicant: I Architect or Engineer: Date: 11, 10-04 Applicant's Mailing Address: r IV Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS A LICENSED CONTRACTOR'S DECLARATION 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 ode, and my License is inf ---License force and effect. License Class se No. JF - OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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 penally of not more than five hundred dollars ($500).): U 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 or 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.). U 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.). U I am exempt under Sec. , B.& P.C. for this reason Date WORKERS' COMPENSATION DECLARATION 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 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. JV/.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 issue . M worker ' compensation i ce carrier and olic n tuber are` arrier �o� -Policy Number 9_ /2tv C O _ 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. WARNING: FAILURE TO SECURE WORKERS' COMPtNSATION 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. 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 f� 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. �ateZ4A2�Signaturepplicant or Agent): r Page 2 Application Number . . . . . 04-00006999 Date 11/10/04 Qty Unit Charge Per Extension 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . . . . 'ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 116.08 Plan Check Fee 29.02 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2180.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 76.30 489.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL• 9.78 1.00 ---------------------------------------------------------------------------- 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 153.00 Plan Check Fee 38.25 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 14.00 6.0000 EA PLB FIXTURE 84.00 1.00 15.0000. EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 ---------------------------------------------------------------------------- 15.0000 EA PLB GAS METER 15:00 Permit . . . . . . GRADING PERMIT Additional desc ,Permit Fee. 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Qty .Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Special Notes and Comments 2180 S.F. SFD PERMIT DOES NOT INCLUDE BLOCK WALL,-POOL/SPA OR DRIVEWAY APPROACH -----------------------------------------------------------------7---------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00. DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 Page 3 Application Number . . . . . 04-00006999 Date 11/10/04 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 49.99 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES -RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION .(SMI) - RES 13.61 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited ---------- Due Permit Fee Total ---------- 1118.58 ---------- .00 ---------- .00 1118.58 Plan Check Total 583.50' 250:00 .00 333.50 Other Fee Total 2468.60 00 .00 2468.60 Grand Total 4170.68 250.00 .00 3920.68 Building Address SZ f YA1 / l/CG' Address o -., _ TUT at 4 a" P.O. BOX 1504 78-495 CALLE TAMPICO -7.0,rAgA QUINTA, CALIFORNIA 92253 2z <' --:k 1,21<- - 6 7- Ir 21t- -6zIr e ,s7. F -Z 0 1 75Y.0-Rz-9,0 & Classif. J1 I Lic. #¢f08/0 Arch., Engr., Desi Desi ner Address Tel. Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divi )) 3� f t Bu gess ofessions Code, and my license is I full for and effect. G Ii C /_ W SIGNATURE ATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, 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 the 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 penalty of not more than five hundred dollars ($500). O 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 Profes- sions 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 im- provement 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). O I, as owner of the property, am exclusively contracting with licensed contractors to construct 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.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company tl�a/L/i/ra Oas✓ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it 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 Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT.' If, 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. Sec. 3097, Civil Code.) Lender's Name . `� Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 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 WHITE = BUILDING DEPARTMENT qct LO0 APPLICATION ONLY BUILDING: TYPE CONST. OCC. GRP A.P. Number �� ' �"� c)o4 Legal Description Project Description 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:— Validated by: Validation: YELLOW = APPLICANT Date PINK = FINANCE Sq. Ft. Size 2L 8O No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ O Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I.-- Grading Driveway Enc. Infrastructure T "T TOTAL 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:— Validated by: Validation: YELLOW = APPLICANT Date PINK = FINANCE Date 11/10/04 No. 26619 Owner Jeff Shively Address City Zip Tract # Type Single Family Residence CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Jurisdiction Permit # Study Area No. of Units N' , Q BERMUDA DUNES DO RANCHO MIRAGE d INDIAN WELLS 'ter �i. PALM DESERT LA QU I TA ~�y 773-241-034 La Quinta 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 52360 Avenida Montezuma 2180 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 ''.Unit 10 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.24 X 2,180 S.F. or $4,883.20 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By CC/Valley Independent Bank - Jeff Shively Check No. 319750 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempt7d b�Sh ron M¢ICpilurey Signature e Telephone 275-4333 Funding Residential Payment Recd $4,883.20 Over/Under NOTICE: Pursuant to Government Code Seclt*mt602O(d)(1), Ms will serve to notify you that the 90 -day approval period in which you may protest the fees o r other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to.collect'them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicaht Copy -Applicant/Receipt Copy -Accounting RECORDING REQUESTED BY AND WIN RECORDED MAIL TO: JEFF SHIVELY 52810 AVENIDA MONTEZUMA LA QUINTA, CA 92253 A.P.N.: 773241-034 Order No.: 1 DOC a 2004-0334403 05/05/2004 08:00A Fee:7.00 Page 1 of 1 ..Recorded in Official Records County of Riverside Gary L. Orso k.Asses%or, County,Clerk.& Recorder I IIIIII VIII) IIII IIIIIII IIII IIII IIIIIII III VIII IIII IIII M s U PAGE SIZE DA PCOR OCOR SMF MISC. I t A R L COPY LONG REFUND NCHG EXAM Qa0 GRANT DEED THE UNDERSIGNED GRANTOR(s) DECLARE(s) THAT DOCUMENTARY TRANSFER TAX IS: COUNTY ZERO Computed on full value of property. -conveyed, or RU computed on full value less value of liens or encumbrances remaining at time of sale, unincorporated area; [ ] City of LA QUINTA , and FOR A VALUABLE CONSIDERATION, Receipt of which is hereby acknowledged, JEFFREY J. SHIVELY AND JANET L. SHIVELY, HUSBAND AND WIFE AS JOINT TENANTS hereby GRANT(S) to JEFFREY J. SHIVELY AND JANET L. SHIVELY, HUSBAND AND WIFE AS JOINT TENANTS the following described property in the City of LA QUINTA, County of State of California; LOT 20 OF BLOCK 40 OF, SANTA CARMELITA AT VALE LA QUINTA, AS SHOWN ON A MAP RECORDED . IN BOOK 18, PAGE 59 OF MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF RIVERSIDE COUNTY, CALIFORNIA i Document Date: May 3, 2004 STATE OF CALIFORNIA )SS COUNTY OF RIVERSIDE ) On MAY 4, 2004 before me, ESTHER T LOPEZ a Notary Public, personally appeared JEFFREY J SHIVELY AND JANET L SHIVELY personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me t he/she/they executed the same in his/her/their authorized capacity(ies) and that by his/her/their signature(s) on the instrument the person(s) or the a ty pon behalf of which the pe on(s ted, executed the instrument. WITNESS my ha n official se Signature This area for official notarial seal. ! STHER T LOPEZ COMMISSION #1334075 = CA Notary public- California C _ RIVERSIDE COUNTY R My Commission Expires DECEIMBER 3, 2005 Mail Tax Statements to: SAME AS ABOVE or Address Noted Below A TITLE 24 REPORT Title 24 Report for: Shively Residence Lot 20 5360 Montezuma Ave Quinta, CA 92253 Project Designer: Stephen R. Nieto 78-120 Calle Estado Ste. 206 La Quinta, CA 92253 760-564-4707 Report Prepared By: Stephen R. Nieto South West Concepts 78120 Calle Estado, Suite 206 La Quinta, CA 92253 (760) 564-4707 LDAMI SIDE A AVE STRUCTION Job Number: � BY s� 00136 Date: 10/28/2004 The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2001 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC (415) 883-5900. EnergyPro 3.1 By EnergySoft Job Number: 00136 User Number: 5970 TABLE OF CONTENTS Cover Page 1 Table of Contents 2 Form CF -1 R Certificate of Compliance 3 Form MF -1 R Mandatory Measures Checklist 6 Form C -2R Computer Method Summary 8 HVAC System Heating and Cooling Loads Summary 12 Room Load Summary 13 EnergyPro 3.1 By EnergySoft Job Number: 00136 User Number: 5970 1 Certificate of Compliance: Residential (Part 1 of 2) CF -1 R Shively Residence Lot 20 10/28/2004 Project Title Date 53-360 Montezuma Ave La Quinta Project Address Building Permit # South West Concepts (760) 564-4707 Plan Check I Date Documentation Author Telephone Computer Performance 15 Field Check / Date Compliance Method (Package or Computer) Climate Zone Enforcement Agency Use Only GENERAL INFORMATION Total Conditioned Floor Area: 2,180 ft2 Average Ceiling Height: 10.0 ft Total Conditioned Slab Area: 2,180 ft2 Building Type: (check one or more) X❑ Single Family Detached ❑ Addition ❑ Single Family Attached ❑ Existing Building ❑ Multi -Family ❑ Existing Plus Addition Front Orientation: (West) 270 deg Floor Construction Type: ® Slab Floor Number of Dwelling Units: 1.00 Number of Stories: 1 ❑ Raised Floor Const. Component Frame Assembly Location/Comments Tvne Tvve U -Value (attic, garage, typical, etc. R-38 Roof (R.38.2xl4.16) Wood 0.028 Exterior Roof R-19 Wall (W.19.24.16) Wood 0.065 Exterior Wall Slab On Grade n/a 0.756 Covered Slab w/R-0.0 Perimeter Insulation FENESTRATION Shading Devices Type Orientation Area Fenestration Exterior Overhang Side Fins SF U -Factor SHGC Shading Yes / No Yes / No Front (West) 40.0 0.87 0.70 Bug Screen[g] ❑ ❑ X❑ Front (West) 21.0 0.85 0.70 Bug Screen X❑ ❑ ❑ X❑ Left (North) 51.0 0.87 0.70 Bug Screen X❑ ❑ ❑ X❑ Left (North) 40.0 0.85 0.70 Bug Screen X❑ ❑ ❑X❑ Rear (East) 40.0 0.55 0.65 Bug Screen X❑ ❑ ❑ X❑ Rear (East) 12.0 1.19 0.83 Bug Screen X❑ ❑ ❑ X❑ Right (South) 74.0 0.87 0.70 Bug Screen X❑ ❑ ❑X❑ Right(South) 40.0 0.85 0.70 Bug Screen a ❑ ❑ a El F1 ❑❑ El EJ El El El 1:1 F1 0 El El Run Initiation Time: 07/26104 16:39:29 Run Code: 1090885169 Ener Pro 3.1 By Ener Soft User Number: 5970 Job Number: 00136 Pa e:3 of 14 Certificate of Compliance: Residential (Part 2 of 2) CF -1 R Shively Residence Lot 20 10/28/2004 Project Title Date HVAC SYSTEMS Note: Input Hydronic or Combined Hydronic data under Water Heating Systems, except Design Heating Load. Distribution Heating Equipment Minimum Type and Duct or Type (furnace, heat Efficiency Location Piping Thermostat Location / pump, etc.) (AFUE/HSPF)(ducts, attic, etc.) R -Value Type Comments Cantral Furnas 92% AFUE Ducts in Attic 4.2 Setback Res HVAC 1 Cooling Equipment Minimum Duct Type (air conditioner, Efficiency Location Duct Thermostat Location / heat pump, evap. cooling) (SEER) (attic, etc.). R -Value Type Comments Split Air Conditioner 12.0 SEER Ducts in Attic 42 Sethark Res HVAC 1 WATER HEATING SYSTEMS Rated 1 Tank Energy Fact! 1 External Water Heater Water Heater Distribution # in Input Cap. or Recovery Standbyy Tank Insul. System Name Type Type Syst. Btu/hr (gal) Efficiency Loss (C ) R -Value Standard Gas 50 gal or Less Small Gas Standard 1 40,000 50 0.53 n/a 12 For small gas storage (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 and Standby Loss. For instantaneous gas water heaters, list Rated Input and Recovery Efficiency. REMARKS COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 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. The undersigned recognize that compliance using duct sealing and TXV's requires installer testing and certification and field verification by an approved HERS rater. Designer or Owner (per Business & Professions Code) Documentation Author Name: Title/Firm: Stephen R. Nieto Address: 78-120 Calle Estado Ste. 206 La Quinta, CA 92253 Telephone: 760-564-4707 Lic. #: (si ature) (da e) Enforcement Agency Name: Title/Firm: Address: Telephone: Name: Stephen R. Nieto Title/Firm: South West Concepts Address: 78120 Calle Estado, Suite 206 La Quinta, CA 92253 Telephone: (760) 564-4707 IfF�/0 2 0 ( gnature) (date) IEnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00136 Page:4 of 14 1 - Certificate of Compliance: Residential (Addendum) CF -1 R Shively Residence Lot 20 10/28/2004 Project Title Date Special Features and Modeling Assumptions The local 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 local enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies --- --- --- u— aucyua.r v1C OFOU 0 Juaaawauvn anu uocumrnLauvn suomiaea. Plan Field The DHW System "Standard Gas 50 gal or Less" Energy Factor = 0.530. An EF below 0.58 requires an R-12 External Blanket. The HVAC System "Res HVAC 2" must meet all CEC Criteria for a Zonally Controlled system serving only Living Areas. The HVAC System 'Res HVAC 1" includes credit for a Radiant Barrier installed per Section 8.13 of the Residential Manual. HERS Required Verification These features must be confirmed and/or tested by a certified HERS rater under the supervision of a CEC approved HERS provider. The HERS rater must document the field verification and diagnostic testing of these measures on a form CF -6R. Plan I Field The HVAC System 'Res HVAC 2" includes Refrigerant Charge and Airflow Credit (or a TXV). A certified HERS rater must provide verification of the TXV, or measure the Refrigerant Charge and Airflow. The HVAC System 'Res HVAC 2" is using reduced duct leakage to comply and must have diagnostic site testing of duct leakage performed by a certified HERS Rater. The results of the diagnostic testing must be reported on a CF -6R Form. The HVAC System 'Res HVAC 1" includes Refrigerant Charge and Airflow Credit (or a TXV). A certified HERS rater must provide verification of the TXV, or measure the Refrigerant Charge and Airflow. The HVAC System 'Res HVAC 1" is using reduced duct leakage to comply and must have diagnostic site testing of duct leakage performed by a certified HERS Rater. The results of the diagnostic testing must be reported on a CF -6R Form. Run Initiation Time: 07/26/04 16:39:29 Run Code: 1090885169 EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00136 Page:5 of 14 Mandatory Measures Checklist: Residential (Page 1 of 2) MF -1 R NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (") may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION Instructions: Check or initial applicable boxes or enter N/A if not applicable. DESIGNER ENFORCEMENT Building Envelope Measures E] 4150(a): Minimum R-19 ceiling insulation. E] § 150(b): Loose fill insulation manufacturers labeled R -Value. §150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -value in metal frame walls (does *not apply to exterior mass walls). "§ 150(d): Minimum R-13 raised floor insulation in framed floors or equivalent. ❑§150(1): Slab edge insulation -water absorption rate no greater than 0.3%, water vapor transmission rate no greater than 2.0 perm/inch. ❑X §118: Insulation specified or installed meets insulation quality standards. Indicate type and form. ® §116-17: Fenestration Products, Exterior Doors and Infiltration/Exfiltration Controls 1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. 2. Fenestration products (except field fabricated) have label with certified U -Factor, certified Solar Heat Gain Coefficient (SHGC), and infiltration certification. 3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. a§ 150(g): Vapor barriers mandatory in Climate Zones 14 and 16 only. § 150(0: Special infiltration barrier installed to comply with Section 151 meets Commission quality standards. § 150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs. 1. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. Space Conditioning, Water Heating and Plumbing System Measures ❑X § 110-13: HVAC equipment, water heaters, showerheads and faucets certified by the Commission. § 150(h): Heating and/or cooling loads calculated in accordance with ASH RAE, SMACNA or ACOA. a§150(i): Setback thermostat on all applicable heating and/or cooling systems. FX §1500): Pipe and Tank Insulation 1. Storage gas water heaters rated with an Energy Factor less than 0.58 must be externally wrapped with insulation having an installed thermal resistance of R-12 or greater. 2. First 5 feet of pipes closest to water heater tank, non -recirculating systems, insulated (R-4 or greater) 3. Back-up tanks for solar system, unfired storage tanks, or other indirect hot water tanks have R-12 external insulation or R-16 combined internal/external insulation. 4. All buried or exposed piping insulated in recirculating sections of hot water systems. 5. Cooling system piping below 55 degrees F. insulated. 6. Piping insulating between heating source and indirect hot water tank. EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00136 Page:6 of 14 Mandatory Measures Checklist: Residential (Page 2 of 2) MF -1 R NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (') may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether thev are shown elsewhere in the documents or on this checklist only. DESCRIPTION Instructions: Check or initial applicable boxes or enter N/A if not applicable. DESIGNER ENFORCEMENT Space Conditioning, Water Heating and Plumbing System Measures: (continued) X❑ '§ 150(m): Ducts and Fans 1. All ducts and plenums installed, sealed and insulated to meet the requirements of the 1998 CMC Sections 601, 603, 604 and Standard 6-3; ducts insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape, aerosol sealant, or other duct -closure system that meets the applicable requirements of UL181, UL181A, or UL181 B. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used. Building cavities shall not be used for conveying conditioned air. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and drawbands. 2. 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. 3. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such a tape is used in combination with mastic and drawbands. 4. Exhaust fan systems have back draft or automatic dampers. 5. Gravity ventilation systems serving conditioned space have eitherautomatic or readily accessible, manually operated dampers. 6. Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind but not limited to the following: Insulation exposed to weather shall be suitable for outdoor service e.g., protected by aluminum, sheet metal, painted canvas, or plastic cover. 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. ❑ § 114: Pool and Spa Heating Systems and Equipment 1. Certified with 78% thermal efficiency, on-off switch, weatherproof operating instructions, no electric resistance heating, and no pilot. 2. System is installed with at least 36" of pipe between filter and heater for future solar, cover for outdoor pools or spas. a. At least 36" of pipe between filter and heater for future solar heating. b. Cover for outdoor pools or outdoor spas. 3. Pool system has directional inlets and a circulation pump time switch. ❑ §115: Gas fired central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously burning pilot light. (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr) ❑ §118 (f): Cool Roof material meet specified criteria Lighting Measures ® § 150(k)1: Luminaires for general lighting in kitchens shall have lamps with an efficacy 40 lumens/watt or greater for general lighting in kitchens. This general lighting shall be controlled by a switch on a readily accessible lighting control panel at an entrance to the kitchen. rV §150(k)2: Rooms with a shower or bathtub must have either at least one luminaire with lamps with an efficacy of 40 lumens/watt or greater switched at the entrance to the room or one of the alternative to this requirement allowed in Section 150(k)2.; and recessed ceiling fixtures are IC (insulation cover) approved. 3.1 By EnergySoft User Number: 5970 Job Number: 00136 Page:? of 14 Computer Method Summary (Part 1 of 3) C -2R -ShivelyBesideace I at 20 Project Title 10/28/2004 Date 93-36n Montp71na Ave I a Qidnta Project Address Building Permit # ifh ran (760) 564-4707 Sint West pts Documentation Author Telephone Plan Check/Date SnmputBr PerformancnP 15 Field Check/Date Compliance Method (Package or Computer) Climate Zone Source Energy Use Standard Proposed Compliance (kBtulsf-yr) Design Design Margin Space Heating 0.93 0.47 0.46 Space Cooling 31.08 27.13 3.95 Domestic Hot water 12.36 12.24 0.11 Totals 44.36 39.84 4.52 Part -ant hatfar than Atanrlarrl- 10.2% Total Conditioned Floor Area: 2,180 ft2 Floor Construction Type: ❑ Raised Floor ❑X Slab Floor Building Type: Single Fam Detached Building Front Orientation: (West) 270 deg Total Fenestration Area: 14.6% Number of Dwelling Units: 1.00 Total Conditioned Volume: 21,800 ft 3 Number of Stories: 1 Total Conditioned Slab Area: 2,180 ft 2 BUILDING ZONE INFORMATION Zone Name # of Floor Area Volume Units Zone Type Thermostat Vent Type Hgt. Area RPthark n/a Solar OPAQUE SURFACES Act. Gains TvDe Area U -Fac. Azm. Tilt Y / N Form 3 Reference Location / Comments Computer Method Summary (Part 2 of 3) C -2R Shively Residence Lot 20 10/28/2004 Project Title Date FENESTRATION SURFACES U- Act. Glazing Type Location/ # Type Area Factor SHGC Azm. Tilt Comments IN INTERIOR AND EXTERIOR SHADING # Fvfcrinr CinnAn Tvnc cNrr 1 2 3 4 5 T- 7 8 9 10 11 12 13 14 15 16 17 18 19 Bug Window Front esti 40 0 0 870 070 2 Window Front (West) 21.0 0.850 0.70 3 Window Left (North) 3.0 0.870 0.70 4 Window Left (North) 12.0 0.870 0.70 5 Window Left (North) 12.0 0.870 0.70 6 Window Left (North) 12.0 0.870 0.70 Z Window Left (North) 40.0 0.850 0.70 8 Window Left (North) 12.0 0.870 0.70 6 Window Rear (East) 40.0 0.550 0.65 -M Window Rear(East) 0.1 12.0 1.190 0.83 11 Window Right (South) 8.0 0.870 0.70 12 Window Right (South) 40.0 0.850 0.70 Aa Window Right (South) 8.0 0.870 0.70 14 Window Right (South) 18.0 0.870 0.70 15 Window Right (South) 8.0 0.870 0.70 16 Window Right (South) 8.0 0.870 0.70 17 Window Right (South) 8.0 0.870 0.70 18 Window Riqht (South) 8.0 0.870 0.70 IN INTERIOR AND EXTERIOR SHADING # Fvfcrinr CinnAn Tvnc cNrr 1 2 3 4 5 T- 7 8 9 10 11 12 13 14 15 16 17 18 19 Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 0.76 Window Hgt. Wd. 6.6 6.0 6.6 3.0 1.0 3.0 4.0 3.0 4.0 3.0 4.0 3.0 6.6 6.0 4.0 3.0 6.6 6.0 5.0 4.5 4.0 2.0 6.6 6.0 4.0 2.0 4.0 4.5 4.0 2.0 4.0 2.0 4.0 2.0 4.0 2.0 4.0 2.0 _27.0 _90 Double Metal Clear Default 270 90 Double Metal Clear Default 0 90 Double Metal Clear Default 0 90 Double Metal Clear Default 0 90 Double Metal Clear Default 0 90 Double Metal Clear Default 0 90 Double Metal Clear Default 180 90 Double Metal Clear Default 180 90 Double Metal Clear Default 180 90 Double Metal Clear Default 180 90 Double Metal Clear Default 180 90 Double Metal Clear Default 180 90 Double Metal Clear Default 180 90 Double Metal Clear Default 90 Double Metal Clear Default 1$(L Overhang Len. Hqt. LExt. RExt. 8.0 0.1 8.0 8.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0J 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 Left Fin Dist. Len. Ist Floor Zone 1st Floor Zone 1st Floor Zone 1 st Floor Zone 1 st Floor Zone 1 st Floor Zone 1 st Floor Zone 1st Floor Zone 1 st Floor Zone 1st Floor Zone 1 st Floor Zone 1 st Floor Zone 1 st Floor Zone 1 st Floor Zone 1st Floor Zone 1st Floor Zone 1 st Floor Zone 1 st Floor Zone 1 st Floor Zone Dist EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00136 Page:9 of 14 1 Computer Method Summary (Part 3 of 3) C -2R Shively Residence Lot 20 10/28/2004 Project Title Date THERMAL MASS FOR HIGH MASS DESIGN Area Thick. Heat Inside Location Type (sf) (in.) Cap. Cond. Form 3 Reference R -Val. Comments Frame Wall, Stucco 256 4_00 21 0.47 R-19 Wall (W.19.2x6.16) 2 1st Floor Zone / Exterior Mass PERIMETER LOSSES F2 Insulation Type Length Factor R -Val. Depth Location / Comments HVAC SYSTEMS Heating Equipment Minimum Distribution Type Type (furnace, heat Efficiency and Location Duct Thermostat Location / pump, etc.) (AFUE/HSPF)(ducts/attic, etc.) R -Value Type Comments Central Furnace 92%AFUE Ducts in Attic 4.2 Setback Res HVAC 1 Pipe Hydronic Piping Pipe Insul. System Name Length Diameter Thick. Cooling Equipment Minimum Duct Type (air conditioner, Efficiency Location Duct Thermostat Location / heat pump, evap. cooling) (SEER) (attic, etc,) R -Value Type Comments Split Air Conditioner 12.0 SFFR Ducts in Attic 4.2 Setback Res HVAC 1 WATER HEATING SYSTEMS Ratedl Tank Energy Fact! 1 Tank Insul. Water Heater Water Heater Distribution # in Input Cap. or Recovery Standby R -Value System Name Type Type Syst. (Btu/hr) (gal) Efficiency Loss (%) Ext. Standard Gas 50 gal or Less Small Gas Standard 1 40,000 50 0.53 n/a 12 1 For small gas storage (rated input — 75000 Btu/hr), electric resistance and heat pump water heaters, list energy factor. For large gas storage water heaters (rated input > 75000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input, and Recovery Efficiency. REMARKS Run Initiation Time: 07/26104 16:39:29 Run Code: 1090885169 EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00136 Page: 10 of 14 Computer Method Summary (Addendum) C -2R Shively Residence Lot 20 10/28/2004 Project Title Date Special Features and Modeling Assumptions The local 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 local enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies )asea on the aaequacy or the special Justiricauon ana aocumentation suamrttea. Plan I Field The DHW System "Standard Gas 50 gal or Less" Energy Factor = 0.530. An EF below 0.58 requires an R-12 External Blanket. The HVAC System 'Res HVAC 2" must meet all CEC Criteria for a Zonally Controlled system serving only Living Areas. The HVAC System 'Res HVAC 1" includes credit for a Radiant Barrier installed per Section 8.13 of the Residential Manual. HERS Required Verification These features must be confirmed and/or tested by a certified HERS rater under the supervision of a CEC approved HERS provider. The HERS rater must document the field verification and diagnostic testing of these measures on a form CF -6R. Plan I Field The HVAC System 'Res HVAC 2" includes Refrigerant Charge and Airflow Credit (or a TXV). A certified HERS rater must provide verification of the TXV, or measure the Refrigerant Charge and Airflow. The HVAC System "Res HVAC 2" is using reduced duct leakage to comply and must have diagnostic site testing of duct leakage performed by a certified HERS Rater. The results of the diagnostic testing must be reported on a CF -6R Form. The HVAC System 'Res HVAC 1" includes Refrigerant Charge and Airflow Credit (or a TXV). A certified HERS rater must provide verification of the TXV, or measure the Refrigerant Charge and Airflow. The HVAC System 'Res HVAC 1" is using reduced duct leakage to comply and must have diagnostic site testing of duct leakage performed by a certified HERS Rater. The results of the diagnostic testing must be reported on a CF -6R Form. EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00136 Page:11 of 14 1 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME Shively Residence Lot 20 DATE 10/28/2004 SYSTEM NAME Res HVAC 1 FLOOR AREA 2,180 Number of Systems 1 Heating System Output per System 112,000 Total Output (Btuh) 112,000 Output (Btuh/sgft) 51.4 Cooling System Output per System 58,000 Total Output (Btuh) 58,000 Total Output (Tons) 4.8 Total Output (Btuhlsgft) 26.6 Total Output (sgft/Ton) 451.0 Air System CFM per System 2,055 Airflow (cfm) 2,055 Airflow (cfm/sgft) 0.94 Airflow (cfmlTon) 425.2 Outside Air (%) 0.0 Outside Air (cfm/sgft) 0.00 Note: values above given at ARI conditions EATING SYSTEM PSYCHROME' 26.0 of 69.4 of Outside Air 0 cfm Supply Fan 2055 cfm 69.4 of Total Room Loads Return Vented Lighting Return Air Ducts Return Fan Ventilation Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COIL COOLING PEAK COIL HTG. PEAK CFM Sensible Latent CFM I Sensible 115.0/73.5OF 78.9/62.3OF 78.9/62.3OF 55.0/53.5OF 1,630 39,886 -647 723 26,915 0 Outside Air 1,994 1,346 0 0 0 0 0 0 0 ROOMS 0 0 1,994 1,346 43,875 -647 29 606 BDP CO. 563AN060-A 45,293 3,289 112,000 Total Adjusted System Output 45,293 3,289 112,000 (Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK Aug 2 pm I Jan 12 am ream Temoeratures at Time of Heatina Peak) 69.4 OF . 105.0 of Heating Coil 1% Return Air Ducts `i Supply Air Ducts 104.4 of ROOMS 70.0 of COOLING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Cooling Peak 115.0/73.5OF 78.9/62.3OF 78.9/62.3OF 55.0/53.5OF Supply Air Ducts JJwO Outside Air 0 cfm Supply Fan Cooling Coil 55.9 / 53.9 of 2055 cfm ROOMS 40.4% R.H. 78.0 ! 62.0 of 78.9/62.3 of Return Air Ducts I EneravPro 3.1 By EneravSoft User Number: 5970 Job Number: 00136 Page: 12 of 14 ROOM LOAD SUMMARY PROJECT NAME Shively Residence Lot 20 DATE 10/28/2004 SYSTEM NAME Res HVAC 2 FLOOR AREA 0 ROOM LOAD SUMMARY ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK ZONE NAME ROOM NAME Mult. CFM SENSIBLE LATENT CFM SENSIBLE LATENT CFM SENSIBLE PAGE TOTAL l o o 0 oll 0 0 TOTAL I o l _o1 ol 0 0 EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00136 Page:13 of 14 ROOM LOAD SUMMARY I PROJECT NAME Shively Residence Lot 20 DATE 10/28/2004 SYSTEM NAME Res HVAC 1 FLOOR AREA 2,180 ROOM LOAD SUMMARY ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK ZONE NAME ROOM NAME Mult. CFM SENSIBLE LATENT CFM SENSIBLE LATENT CFM SENSIBLE 1stFloor Zone 1 st Floor 1 1,630 39,886 -647 1,630 39,886 -647 723 26,915 PAGE TOTAL 1 1,630 39,886 -647 723 26,915 TOTAL 1 1,630 39,886 647 723 r 26,915 EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00136 Page:14 of 14