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SFD (001185)PERMIT APPLICATION City of La Ouinta Department of Building and Safety This permit becomes void if work not commenced within 180 days from date of issuance, OR, if work has been suspended or abandoned for a period of 180 days. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and effect. License Class Lic. Number Contractor 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) orthat 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.): ❑ 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 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 improvemnt 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.). ❑ I, as owner of the property, am exculsively 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.). O 1 am exempt under Sec. _ , _ �r�8. f .C/Wtgched Certificate). Date Owner WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800. Lab. C.). Policy No. Company O Certified copy is hereby furnished. ❑ Certified copy is filed with the City Building Inspection Department or City Date Applicant Department. APPLICANT NAME (L, F. MI) Br"n Monroe ADDRESS P.O. BC 1040 CITY/COMMUNITY/STATE/ZIP14 Quin ..a, CA 92253 JOB SITE ADDRESS/SPACE 53-725 Avenida Menldow CITY/COMMUNITY/STATE2IPT .a Quinta, CA 92253 xM+y "+`• BOn4 PA232 �LOT U22 C TWN RNG SE S TRACT 11 .. Elect.Fee 43.13 MOD I SB Plt dAN Flee TRACT NAME l` mie OWNER NAME (L. F. MI) 2Lm /yam CONTRACTOR -FIRM NAME P �u131 C7onst• ADDRESS P.O. B='2288 CITY/COMMUNITY/STATE/ZIPJrJ i0, C 92202 PHONE • 357 -?171 250.00 Pd 127E4- L' J" 71169 ARC/ENG FIRM NAME - ADDRESS CITY/COMMUNITY/STATE/ZIP PHONE • LICNC M USE OF PERMIT single ng a L...n 1 y d e- '- { mt BL I ZON FSB SS8 SS8 RSB I OFC ZONE ORD • 1 LOT SZ END SIDE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed it the permit is for one hundred ($100) o, less. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Applicant 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. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 0 I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec 341, Title 8, C.A.C.) ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from that division. ❑ Division of Industrial Safety Permit No. Applicant 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, Civ. C.). Lender's Name Lender's Address 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. Signature of Applicant or Agent Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and state that the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling construction, and authorize a representative of the City of La Ouinta Department of Building and Safety to enter upon the property for.which I hwe`applied for IN&permitdor the purpose of making inspections. /', i I- 17/ ,Signature of Applicant or Agent . r ` JKr Date Print Applicant/Agent Name APPUPRMTfl-(1 S{ l ,,. OAT -8", S• • • Permit to construct 1592 sq. rt. 91 • tt• aiM430sq. r • or garage as per app=Ned plans. Mach. Free 22.0U Plan Chwk Fee Const. Free -418-1 `3 r3 8. l O .. Elect.Fee 43.13 SI Free 6.65 Plt dAN Flee 50.58 Prop. Devel• Free 450.00 250.00 Pd 127E4- NSW TOTAL FEE BLDG. DEPT. VALUATION o*6U NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms / 34 Plenums & Ducts 2A Slab Grade 35 Furnace Compart. 3 Steel 36 1 Inlets & Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck �`j 39 Appl. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10, Fireplace P.L. ❑ 43 Final 10A f=ireplace T.O. ❑ NO _ _ OADDITIONAL INFORMATION -77 /lally� SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall ' 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) i 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final PLUMBING APPROVALS 15 Ground Plumb S7-1 6t 16 Water Piping 17 Rough Plumb !� 9.0 18 Vents 19 Sewage Disposal zz5 20 Sewer 21 Water Heater 22 Water Softener 23 Water Service 24 Gas Test 25 Final Tank Pit L. Line - ELECTRIC APPROVALS REAR OF PROPERTY LINE p/L P/I STREET NAME 26 Power Pole / 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire* 296 Bonding 30 Fixtures 31 Service 32 Final 1Eo Coll = G Desert Sands Unified School District y BERMUDA DUNES r RANCHO MIRAGE 82-879 HIGHWA`(J21}jLfa"101 VALIFI)5@5 92201-6678 • (619) 347-8631 INDIAN WELLS ti PALM DESERT January 17, 1985 %1 LA OUINTA ',p INDIO y� 1 City of La Quinta Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 Re: 53-7?5 Avenida Mendoza Gentlemen: The developer of .the above referenced home has mitigated its impacts on our overcrowded schools by payment of the amount of $628 per unit to be applied to the cost of district educational facilities made necessary by such.new. development. Sincerely .eo�. M. John D..Brooks Assistant Superintendent Business Services JDB/crm op RES—ID—F-0-11-Al— - T I T L_E� 2.4_ �Cay�Lj.I.atir�.b- .eth;odj -p MIN MUM N 1,6•-r1 soL, IIPF p . a U M G �I r � �il� � of o� �. ► � �LL N�� �--� � �J l6�TIoN M os -DMECHANICAL SYSTEMS DESIGN 134 SOUTH GLASSELL STREET ORANGE, CALIFORNIA 92666 (714) S43-6571 r -... � ...-- P3r:VPr-6t:::'H HOME ----- 058:10 R2 _,28/84 VH/dr Attachment D Fo rm 2 (Revised 3/84) Climate Zones 2. 4, 6, and 8-15 COMPLIANCE CHECKLIST For Low -Rise Residential Buildings (except hotels and motels) Step 1: Enter on the form the values for each measure from your building plan and specifications sheet. Step 2: Enter points on this page while working through the point system Building Shell Measure Points 'Total Floor Area. 11��ft2 1. Slab -on -Ground; Perimeter ft.,�Depth � in. R- 2. Raised Floor R -Value.. . . . . . . . . . . R- 3. Ceiling Insulation or Construction Assembiy . . . . . . R-= Attic, Percent of Roof Over Conditioned Space �O % . . . . l'02n7 ft2 4. Wall Insulation or Construction Assembly. . . . . . . . Glazing; Total % Floor Area Single Double Triple S. North -Facing. S ft2 ft2 ft 2 6. East -Facing ft2 ft ft 2 7. South -Facing.•. 8. West -Facing . . EF-W-PE3 --ft2 —19*ft2 ft 9. Skylight. . . . % ft ft ft 10. Shading Coefficient (excluding overhang) a. East �/�-s Q%>(O,SC . . . . . . . . . . . . D. South. SC ... . c. West . . . . . . . . . . . . . . SC . . . . . . . . . . . . . d. North. . . . . . . . . . . . . . SC . . .. . . . . . . . e. Skylight .. . SC . . . . . . . . . . 11. Horizontal South Overhang Length. . . . ft . . . . . . . . . . . . 12. Movable Insulation, % Floor Area. . U ,. % . . . . . . . . . . . . . SdL1j 13. Infiltration (indicate Standard, M or ig t) 14. Thermal Mass Exterior Wall Thermal Mass Area, Heat Capacity, R -Value . . . . . . . ft2, HC; R - Interior Thermal Mass 2 Area, Heat Capacity, R -Value . . . . . .ft.HC, R - e. HVAC System *• 15. Gas Furnace without Refrigeration -Cooling *Checklist items; not a point system measure. "Attach documentation for efficiencies and NSF. (Seasonal Efficiency) ... . . . . . . . . . . . . . SE 16. Heat Pump (Energy Efficiency Ratio) . . . . . . . . . . . SEER 17. Gas Furnace with Refrigeration Cooling Seasonal Efficiency and Seasonal Energy Efficiency RatioSE SEER 18. Active Solar (Net Solar Fraction, %)� %NSF 19. Zonally Controlled Electric Resistance Space Heating . . . . . . . . . . (Yes/No) Domestic Water Heating* 20. Solar With•Gas Backup (Net Solar Fraction, %) . . . . . %NSF 21. Other Water Heating (Describe type) - Point System Compliance Total . . . . . . . . . . . . . . . *Checklist items; not a point system measure. "Attach documentation for efficiencies and NSF. HEAT TRANSFER COEFFICIENT PROPOSED CONSTRUCTION ASSEMBLY h FSI :'o In h s o t\ .�R� r vin I--�: o►rr►c �° � owns Oroloci title prci.ct location • e': --ter coeumentatlon autnor date Form 3R (8/81) Sketch of Consti ction Assembly List of Construction Components R (for section between framing member) (from Table 11) 2. 3. 4. 5. Framing Size 2 ' : 6. Framing Spacin �' " O.C. 7. Check one: '< 8. Inside Surface Air Film (from Table 3.18) ............. Ceiling/Roof Floor 9. Outside Surface Air Film (from Table 3.18)........... Wall Total Thermal Resistance (RT) — II Well. check the tum of ins soovs aporoor"ate weight: less than 25 Ib/h2 25 to 40lb/112 AVERAGE U VALUE OF ASSEMBLY ;rester :^an 40 ;bif12 rl I.C> :. Af = V.e.Q Stu/(hr.tt2.°FI Framing RT from soove Factor from Table 3.8 Use this U value for host toad calculation or Code comparison HEAT TRANSFER COEFFICIENT PROPOSED CONSTRUCTION ASSEMBLY C Owner project title Project location documentation author date Sketch of Construction Assembly Check one: Ceiling/Roof Floor Wall e+ If Wall, check the appropriate weight: less than 25 Ib/112 25 to 40 Ib/ft2 greater than 40 Ib/h2 Form 3R (8/81) enForcemeni Agency use Only List of Construction Components R (for section between framing members) (from Table 3.11 t. -y 2. 3. 4. 5. 6. 7. 8. Inside Surface Air Film (from Table 3.18) ............. 9. Outside Surface Air Film (from Table 3.18)........... n I Total Thermal Resistance (RT) 1;1 sum of the above AVERAGE U VALUE OF ASSEMBLY — _ _SCS_ Btu/(hr •ft2 -OF) Framing RT from Above Factor from Table 3.4 Use this U value for heat load calculation or Code comparison ENGINEER: SHEET: DATE: OF _ MEN am d i -m U-1- MEE m-®19-��� PROJECT: r -�tJT,�• �r�-a'1 ��-rT�- � SHEET: ENGINEER: IZ fir=4- DATE: OF Zone: rloor: Ft's I Volume: 7t 31 Time: SUMMARY L O A D S COOLING; BTU/i IR I EAT NG: MT.� SENSIBLE T -d I ,3111/IIR GLAZINq 1-715S WALLS '� S5 I � l � �✓ rMr/CCILINr, S� I� 2 O C�, FI=Tt TCYrAL — PDOPLE �� Z : C'II.U1NDCx 1S p 7MAL �P IMAL Cr?t . Se08ix]e1.T RS) IR Sensible Sens. t Lat. VT:2, 'ITATION 000 I2lFILTMTI0"I TGTAL TnTAL- � TSI IR • � TIG .