PLBG (10-1017)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: ,10-00001017
Property Address: 78865 MERIDIAN WY
APN: 609-480-062-16 -23773 -
Application description: • PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 600'
Applicant:
Tit!t 4 4 Q"
Architect or Engineer:
A4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 effect.
License v,Mass: C36 se No.: 880103
�Date:2�—�� Contract
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 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.). .
I—) 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:
BOOTH JAMES C
78865 MERIDIAN WAY
LA QUINTA, CA 92253
(760)360-4957
Contractor:
ALVAREZ, JORGE A.
PO BOX 984
THERMAL, CA 92274
(760)777-3613
Lic- No -:880103
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/29/10
Dr� /A
Qaul
t r_
J¢
Ci S'{H2010
FLA..::?it;ldiA f
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ 1 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:
Carrier EXEMPT Policy Number- EXEMPT
I certify that, in the performance of the work for which this permit is issued, 1 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 C e all fonhwi y with those provisions.
Date Applica -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS J$1 00,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned pr or inspection purposes.
Date:p-- /O Signature (Applicant or A t): —
Application Number . . . . . 10-00001017
Permit
PLUMBING
Additional desc .
Permit Fee . . .
. 22.50
Plan Check
Fee
5.63
Issue Date . . .
.
Valuation
. . .
. 0
Expiration Date
3/28/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB WATER
HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and
Comments
REPLACE 40 GALLON
GAS WATER HEATER.
----------------------------------------------------------
Other Fees . . .
. . . . BLDG STDS ADMIN (SB1473)
-----------------
1.00
Fee summary
-----------------
Charged Paid
--------------------
Credited
----------
----------
Due
Permit Fee Total
22.50
.00
.00
22.50
Plan Check Total
5.63
.00
.00
5.63
Other Fee Total
1.00
.00
.00
1.00
Grand Total
29.13
.00
.00
29.13
LQPERMIT
Prescriptive Certificate of
Residential Alterations
Project NamcL—T--
CF -IR -ALT
Pae 1 of 5
Climate Zone it no Stories
General information ,
Enforcement Agency: Date:—�b
Site Address: e
Building Type)! , Single Family ❑ Multi Family Circle the Front Orientation: N, E, S, W, or degrees
Project Type: O Alterations ❑ Envelope O Fenestratioj+' ❑ Roof ❑ HVAC
Conditioned Floor Area (CFA): Replacement or Change Out Duct Replacement Atater Heater
NOTE: This form is not to be used for Newly Constructed Buildings or Additions
Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
0 Opening of framed cavity alone— Alterations that involve the opening of the framed cavity ofa wall, ceiling, or floor must install the
mandatory minimum insulation value per § 130 for the altered assembly. Fill in Columns A —C and enter mandatory insulation value in Column H.
13 Replacement of entire assembly— Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component
Package- D insulation values in Table 151-C. Fill in Columns A —J.
Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below.
A B C D E F G I H I I J
ProposedRaft Standard Values From JA4 Table
L
M
Framing Thickness,
Framed
Continuous JA4
Proposed
Tap!
ID
Assembly Name
or Type'
Material Spacing, U- JA4 Table
and Size' or Othe? factor° Numbers
Cavity
R-value6
Insulation Assembly
R -Value Cell Values
Assembl
U -factor
Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-.1. For calculating furred w Its use the Mass and
Furrinx Construction table below.
1. For TaglID indicate the Identification name that matches the building plans.
2. indicate the Assembly Name or type: Rooj7Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc ... Indicate the Frame type and Size: For
Wood, Metal, Metal Buildings, Mass, enter 1x4, 20, or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter; 16 "or 24 "OC; or Other for all other assembly description
such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc....
4. Based on the Climate Zone; enter the Standard U faclor from Table 151-B, C or D for each different assembly Name or type.
J. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0 ".
7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter "0 ".
8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J
9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor in Column E to comply.
Furring Strips Construction Table for Mass Walls Onl
A I B IC D E
F I G I H I J I K
L
M
Proposed Properties of Masonry and Concrete
Wails From Reference
Joint A ppendix Table 43. 4.3.6 4.3.7
Added Interior or Exterior Insulation
in Furring Space from Reference
Joint Appendix Table 4.3.13
Final .
Assemblyy
U-factordr
Comment
Mass
Thickness'
Assembly
Name or
Type?
JA4 Table
Numbed
W
e,
v
Q>
wp
� �L a
o .° . ° g •
t3
1 t. d>
w ak
Registration Number: Registration DatelTime:
2008 Residential Compliance Forms
HERS Provider:
Aqua ZO09
Certificate of
Residential Alterations (Page 4 ofl) I
Project Name:—__t-_-_ rn , � I Climate Zone # I # of Stories
HVAC SYSTEMS - HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane fired, and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kttchen(s) and on all underground
Minimum Duct or Piping
Configuration
Heating Equipment
Type and Capacity' .2.3
Efficiency Distribution Insulation
AFUE or HSPF Type and Location° R -Value
Thermostat
Type
(Central, Split,
Space, Package or H dronic
Water Heater Type/Fuel
Distribution Type
Number In
Tank
Energy Factor or
Insulation
T
Standard, Recirculating)Z
1. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance, etc.)
2. Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental (<.e., if total capacity
< 2 KW or 7,000 Btulhr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(b)3 exception.
3. Refer to the HERS Verification section on Page 4 of the CF -IR -ALT Form for additional requirements and check applicable boxes.
4. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc)
HVAC SYSTEMS - COOLING
Minimum
Ce 2
Efficiency
Duct or Piping
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
Configuration
Cooling Equipment
Type and Capacity' .2
(SEERIEER or
COP)
Distribution
Type and Location
Insulation
R -Value
Thermostat
Type
(Central, Split,
Space, Package or H dronic
1. Indicate Cooling Type (AIC, Heat pump, Evap. Cooling, etc)
2. Refer to the HERS Verification section on Page 4 of the CF -IR -AL T Form for additional requirements and check applicable boxes.
3. Indicate Type or Location(Ducts, H dronic in Floor, Radiators, etc.
WATER HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane fired, and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kttchen(s) and on all underground
hot water pipes is required in all component packages in all climate zones.
External Tank
Water Heater Type/Fuel
Distribution Type
Number In
Tank
Energy Factor or
Insulation
T
Standard, Recirculating)Z
System
Capacity(al
Thermal Efficiency
R-Value3
Ce 2
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling :snits shall meet the recirculation requirements of §150(n). The Prescriptive requirements do
not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank and i es shall be insulated to meet the requirements o 150 ' .
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
These items may require written 'usti kation and documentation and special verification.
NEW ROOF ASSEMBLY - Radiant Barrier
The radiant barrier requirement of § 151 2 does not apply to roof alterations.
Slab Edge (Perimeter) insulation 0 YES 0 NO
YES: in Climate Zone 16 in Component Packages D, R-7 insulation is required
Heated Slab insulation O YES 0 NO
YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation 0 YES 0 NO
YES: in Climate Zones 1, 2 11, 13, 14 & 16, R-8 insulation isrequired; in Climate Zones 12 & 15, R-4 is required under component Package D.
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass use the Performance Approach.
Registration Number.-
2008
umber:2008 Residential Compliance Forms
Registration DatelTime: HERS Provider:
August 2009
Prescriptive Certificate of Compliance: Residential CF -111 -ALT
Residential Alterations Pa e 5 of 5
Project Name: Climate Zone # # of Stories
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this
checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final
inspection.
Duct Sealing & Testing HERS verification is required for this measure.
❑ YES O NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned
space, the ducts are to be sealed per §I52(b)IDii and the newly installed ducts are to be insulated per §15l(f)10.
❑ EXCEPTION: Existing duct systems that are extended, which are constructed, Insulated or sealed with asbestos.
❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the
ducts are to be sealed per § 152(b)1 Di.
❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler,
outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be
sealed per § 152(b)1 E.
❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS
verification in accordance with procedures in the Reference Residential Appendix RA3.
❑ EXCEPTION: Duct systems with less than 40 linear feet In unconditioned space.
❑ EXCEPTION: Existing ducts stems constructed, Insulated or sealed with asbestos.
Refrigerant Charge- Split System HERS verification is required for this measure.
❑ YES ❑ NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air
handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat
exchanger) a refrigerant charge measurement shall be verified per §152(b) IF.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation requirements of § 150(o) do not apply to existing residential homes.
Ducted Split Systems -Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure.
❑ YES ❑ NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is
replaced, the airflow and fan watt draw shall be verified per 152(b)1Ci to meet the requirements of §151(07B.
Documentation Author's Declaration Statement
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
Name*
� O_Xr eZ
Signature:
1 2, �
Comp
Date:
Ad
If Applicable ❑ CEA or ❑ CEPE
(Certification #):
City/Sta Zi
er
Phone:
7&0 -777-,3&
Responsible Building Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• I'certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
o� The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
.building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building snit application.
Name:
Signatu
Com an
P y�-�� l..
Date:
Address:
License��O I/jV
r1ty"'t-y-,
Phone -
e
;7 (�O 7
%
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300.
Registration Number: Registration Date/time: HERS Provider:
2008 Residential Compliance Forms August 2009
Bin #
City of La Quinta
Building u, Safety Division
Permit #
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 922S3 - (760) 777-7012
BLI11ding Permit Application and Tracking Sheet
Project.Address:
..-.: . . Owner's Name,
A. 11. Number:
i Addre
• Legal Descript ion:
i— — f,
Conti"actor: \
VKI=zwu -760-
�u M
cily, S -F, Zip., is, --------
Zi
Telephone: 0 WcAer LUW2�1
IZ( -22
I Stat, LIC. fi. Zip IQ3 City. Lic. ft:
Arch., Engr., Designer:
Address -
City, ST, Zip:
Telephoneg : C
.011struCtion"rype: occupwicy:
F-9-
�,
State Lie, It:
Project type (circle one): N%:-Xv Ad'dn Alter Repair Demo
p 11 1 enl-
Name Of Contact Person: -11 Stories: It Units:
-lic ff of Contact Person: Estimated Value of'Project:
'boo
APPLICANT: DO NOT WRITE BELOW THIS LINE
r4
Y,
Submittal ReWo TIUCKING. rE"Irr FEES
flan ."etsYl
Plan Checksubmitted
i -J Itclu Amount
IF
d
Structural CaIcs. j
Reviewed, ready for correc(ions
1! Plan Check Deposit
TV USS 4C-Alc
Coulact
Plan Check Balance
Energy CaIcs.
l ;"Taus ifirked tip
j Cous(ructiou
Flood plain plaiii
Pians resubmitted
Grading plan
j 2" Review, ready foi- correctionsrissuc
Flectrical
subcolitactor List
Called Con(act Person
I'lulalling
Grant Deed
Plans piclied up
S.M.F.
II.O.A. Approval
Plans resubmitted
Grading
1E
IN HOUSE:-
c
It View, ready For corrcc(iolWisstle
i Developer Impact Fee
Planning Approval
Called Contact Person
ii
Pub. Wks. Appr
Date of permit issue
School Fees
17
IVotal Perntic Fees