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SFD (14-726)"r a rw VOICE (760) 777-7125 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/10/2014 Application Number: SFD-14-726 Property Address: 51575 AVENIDA NAVARRO APN: 773144028 Application Description: NEW SINGLE FAMILY DWELLING Property Zoning: Application Valuation: $148,010.90 Applicant: MEDIA -FOUNDRY, INC. 50660 EISENHOWER DR. #511 LA QUINTA, CA 92253 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 Professions Code, and my License is in full force and effect. License Class: _ License No.::AZA:1407030442411823 Date: Contractor: 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 1* basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for ay permit subjects the applicant to a civil penalty of not more than five hundred dollars 0)j ( Pz s owner of the property, or my employees with wages as their sole mpensation, 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 o the did not build or improve for the purpose of sale.). as owner of the property, am exclusively contracting with licensed contractors 0 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 ractors' State License Law.). am exempt nder Sec. B.&P.C. for this reason Date: ID 2 ` Owner y '�l ��r% V IFnleo id,l'®`oto r•l 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 N Lender's Address: Owner: MEDIA -FOUNDRY, INC. 50660 EISENHOWER DR. #511 LA QUINTA, CA 92253 Contractor: MEDIA -FOUNDRY, INC. 50660 EISENHOWER DR. #511 LA QUINTA, CA 92253 Llc. No.::AZA:1407030442411823 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: rip Policy Number: I certify that in the performance of the work for which this permit is issued, I shfa Tot—,em`Lp1_.y 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 Sectior 00 of the Labor Code, I shall forthwith complyth th se prow ions. Date: �� Anolicant: / '.1� �,�j WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official 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. 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 thiWto er upon the above- mentione p perty for inspection purposes. Date: '� �l Signature (Applicant or Agent) DESCRIPTION FINANCIAL INFORMATION ACCOUNT },;,: QTY AMOUNT PAID PAID DATE BLDG PC 25001-200K 10160003428200 $1,000.00 $1,000.001 6/2/14 PAID BY ti, A_ ZIMETHOD }� •Ta=• RECEIPT # CHECK # CLTD BY Total Paid for BLDG PC 25001-20OK: $1,000.00 $1,000.00 .` DESCRIPTION ...ACCOUNT- -QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $6.00 $6.00 9/10/14 PAID BY METHOD RECEIPT # CHECK #. CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $6.00 $6.00 DESCRIPTION ;-s ACCOUNTQTY AMOUNT PAID PAID DATE .DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $942.00 9/10/14 PAID BY o METHOD RECEIPT # CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH y', DESCRIPTION ' ' ACCOUNT- QTY -AMOUNT - PAID PAID DATE DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 $129.00 9/10/14 (-:PAID BY . `. -METHOD RECEIPT # CHECK #- CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH }-DESCRIPTION ' ;¢ , = - .a ACCOUNTQTY, AMOUNT PAID ..PAID DATE, DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $433.00 9/10/14 PAIDBY METHOD RECEIPT # CHECK #,,, CLTD BY ; JM RENOVATIONS CHECK R1073 3263 SKH ;DESCRIPTION - ACCOUNT .-= QTY.+• AMOUNT �.,• 'PAID * ; PAID DATE' DIF - LIBRARIES 253-0000-43200 0 $344.00 $344.00 9/10/14 r ; PAID BY;; ;; METHOD RECEIPT # CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH a DESCRIPTIONACCOUNT QTY' AMOUNT PAID PAID DATE DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 $40.00 9/10/14 ' '.PAID BY METHOD, RECEIPT # CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH h 'DESCRIPTION 'ACCOUNT QTY _ AMOUNT PAID PAID DATE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 .$2,048.00 9/10/14 Y',' PAID BY L _ METHOD RECEIPT # -CHECK # CLTD BY V JM RENOVATIONS CHECK R1073 3263 SKH DESCRIPTION.. ' "ACCOUNT QTY 'AMOUNT PAID PAID DATE DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 $116.00 9/10/14 PAID BY r '. METHOD : t r= RECEIPT # ' ; CHECK # _ CLTD BY ' JM RENOVATIONS CHECK R1073 3263 SKH , c r DESCRIPTION; ' :ACCOUNT V -QTY,, AMOUNT. PAID PAID DATE DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 $2,842.00 9/10/14 4. PAID BY ' R , METHOD `•#.RECEIPT # . "CHECK # .CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH Total Paid forDIF - SINGLE FAMILY DWELLING: $6,894.00 $6,894.00 DESCRIPTIONa ;ACCOUNT s QTY. AMOUNT, PAID PAID DATE RESIDENTIAL FINISH GRADING PC 101-0000-42600 0 $143.00 $143.00 9/10/14 PAID BY f•, s5 'METHOD ' RECEIPT # CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH Total Paid forGRADING: $143.00 $143.00 " DESCRIPTION ACCOUNT QTY, AMOUNT PAID PAID DATE MULTI -SPECIES RESIDENTIAL 0-8 UNITS 101-0000-20310 0 $1,292.00 $1,292.00 .9/10/14 PAID BY...METHOD RECEIPT # CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH Total Paid forMULTI-SPECIES RESIDENTIAL- $1,292.00 $1,292.00 DESCRIPTION ACCOUNT.QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PERMIT 101-0000-42400 0 $532.30 $532.30 9/10/14 ';,PAID BY "...` ; METHOD ; ` RECEIPT # CHECK # = CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH Total Paid for NEW CONSTRUCTION PERMIT: $532.30 $532.30 DESCRIPTION �- ACCOUNT QTY' -• AMOUNT PAID PAID DATE NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $80.59 $80.59 9/10/14 z. PAID BY '' METHOD , r <. RECEIPT # CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH Total Paid forNEW CONSTRUCTION PLAN CHECK: $80.59 $80.59 DESCRIPTION ACCOUNTQTY AMOUNT ; PAID PAID DATE BACKFLOW DEVICE 101-0000-42401 0 $11.92 $11.92 9/10/14 PAID'BY _ METHOD'' RECEIPT # CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH DESCRIPTION - ACCOUNT- QTY AMOUNT- PAID PAID DATE BACKFLOW DEVICE PC 101-0000-42600 0 $4.77 $4.77 9/10/14 } PAID' BY' METHOD RECEIPT # CHECK # ' CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH , 'DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER 101-0000-42401 0 $11.92 $11.92 9/10/14 t. PAID BY' _ METHOD -RECEIPT # ;' . CHECK # CLTD BY AM RENOVATIONS CHECK R1073 3263 SKH ..DESCRIPTION . .' ACCOUNT QTY AMOUNT PAID' PAID DATE BUILDING SEWER PC 101-0000-42600 0 $11.92 $11.92 9/10/14 PAID BY METHOD ;, 5 RECEIPT # CHECK #, ,M1 CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH F .t DESCRIPTION .' `r."ACCOUNT QTY AI PAID PAID DATE FIXTURE/TRAP 101-0000-42401 0 $143.04 $143.04 9/10/14 PAID.BYY. "' • METHOD'. ;. RECEIPT #. � CHECK #; CLTD BY JM RENOVATIONS CHECK.— r R1073 3263. SKH DESCRIPTION.. _ �., � ', : ""'A' .• ,• -; ACCOUNT "' ,,QTYJ AMOUNT PAID PAID DATE FIXTURE/TRAP PC 101-0000-42600 0 $143.04 $143.04 9/10/14 AID BY . - --METHOD T t ' RECEIPT # '= CHECK #. CLTD BY ' JM RENOVATIONS CHECK R1073 3263 SKH DESCRIPTION; `ACCOUNT "- CITY. AMOUNT PAID PAID DATE GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $35.75 $35.75 9/10/14 • PAID.BY METHOD RECEIPT # CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH `DESCRIPTION - . ; ACCOUNT QTY AMOUNT PAID., PAID DATE GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $23.83 $23.83 9/10/14 PAID BY:. "`'�- a METHOD -• ..; RECEIPT # CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ROOF DRAIN 101-0000-42401 0 $59.60 $59.60 9/10/14 sw PAID -BY a y'= METHOD at ^ . RECEIPT # CHECK #, CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH _'•. DESCRIPTION.' - ACCOUNT n QTY; AMOUNT: PAID • PAID DATE ROOF DRAIN PC 101-0000-42600 0 $59.60 $59.60 9/10/14 ",PAID BY". METHOD, "- RECEIPT # CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH DESCRIPTION :' '• ' a ACCOUNT QTY AMOUNT., PAID PAID DATE WATER HEATER/VENT 101-0000-42401 0. $11.92 $11.92 9/10/14 PAID BY," '? x `METHOD, .%'.. RECEIPT # '<�� CHECK # CLTD BY' JM RENOVATIONS CHECK R1073 3263 SKH DESCRIPTION :ACCOUNT' QTY AMOUNT PAID PAID DATE WATER HEATER/VENT PC 101-0000-42600 0 $7.15 $7.15 9/10/14 ' .PAID BY RECEIPT # CHECK # CLTD BY.1 JM RENOVATIONS CHECK R1073 3263 SKH ,n 'DESCRIPTION. _ ACCOUNT QTY "AMOUNT '' ,:PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $11.92 $11.92 9/10/14 PAID,BY c - K ? _», METHOD RECEIPT # CHECK # ' CLTD BY JM RENOVATIONS CHECK' R1073 3263 SKH t' -DESCRIPTION ° : ;' ', ACCOUNT .'. QTY ;AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $11.92 $11.92 9/10/14 -�' PAID BY ; i m METHOD:)- _ RECEIPT # - CHECK # CLTD BY JM RENOVATIONS CHECK R1073 3263 SKH Total Paid for PLUMBING FEES: $548.30 $548.30 •t ,,c' DESCRIPTION + xn"ACCOUNT QTY:. '• AMOUNT. PAID- PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $19.24 $19.24 9/10/14 t� PAID BY -., "' ' _ , f METHOD , , w: RECEIPT # CHECK # CLTD BY .'orf •+• "- � a's Sti ," � , ,_ Y . — � 1 ail.. � . w�`� i � • • . ; 1 _ a � JM RENOVATIONS CHEW R1073 `, ,�. -3263";;' -;� 9KH Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $19.24 $19.24 DESCRIPTION ;` r{z ' �ACCOUNTv,s r tQTY' AMOUNT PAID` PAID DATE` Y. Z '.'e, 4. t.k i? k.. .. Y4 . SINGLE FAMILY DETACHED 224-00_00-20320 j 0 $1,837.44 $1,837.44 9/10/14 czPAIU_BY i t # x "' METHOD z s `' } i'TaRECEIPT # CHECK # CLTD BY_; _ ,'' JM RENOVATIONS CHECK R1073 3263 tiSKH Total Paid forTUMF - RESIDENTIAL: $1,837.44 $1,837.44 , /'1 �i n `b'. x" 'a4 F� `f'TNi y-{ .� - K - .;3.x w:} --F 3Y. - :=u{- _•-. y F ',+.d ..;e .�.- :4 '. ..��„ * �., ..5 .�.�._it, t�v�— a � � a siG:• ,y stele'} r.4 „1. - i y, �... _� ._ "�. J-.- - - �F.i, CX+`S � /�': v ,� �t�'' ��24-•. �ir�+j�! t` i• .f ~n ..�r�,. t N. �j �,q � - j R, s1. t t.. !/ .t ��;+ M T}r.:y f j� .J C @� ^^'s '+W^'�T'i'• �.'� '�`:v^t _ " o F s o • ` `r' . S,` _,%��a i7iX xt SrS '. Fd 'Lti L Y v k Ala jt '�'�+.� .. r_ { � �. , - ��`' i� f �� T� Yd � •W�.. Cf W' - , �� , a�-'�. ' ..... .iatC.� ?,�`c � ,�yj� } SF w7:� w+�'T._�! i "�'�3 .,' i, cS?"'�.• ;�� 3` � i .1-' •' / le �,Nx�.7�� * .r- �, :i�"'u� �'T�� _ +'K +�`. �y �^ �Y � O .�`9`, 4- .W'��... u ,i+t,ti^.w.-.+z•A,,."4+;'�.ay.'r�+".."K,P'•"i Description: NEW SINGLE FAMILY DWELLING Type: BUILDING, RESIDENTIAL Subtype: DWELLING - SINGLE Status: ISSUED Applied: 5/30/2014 FAMILY DETACHED Approved: 9/10/2014 JJO Parcel No: 773144028 Site Address: 51575 AVENIDA NAVARRO,CA Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: Lot: 4 Issued: 9/10/2014 SKH NO 12 Lot Scl Ft: Building Scl Ft: Zoning: Finaled: Valuation: $148,010.90 Occupancy Type: Construction Type: Expired: 3/9/2015 SKH No. Buildings: No. Stories: No. Unites: COMPLETION DATE NOTES Details:. NEW SFD THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCKWALLS, DRIVEWAY APPROACH, FIRE -PIT, BBQ OR WATER FEATURES. HOME IS FIRE SPRINKLED PER 2013 CRC CODES. 103 0 Applied to Approved' Approved to Issued g Printed: Wednesday, September 10, 2014 5:57:23 PM 1 of 5 CR5 YS TEMS ADDITIONAL CHRONOLOGY ' CHRONOLOGYTYPE - ;•STAFF%NAME ACTION DATE. ' COMPLETION DATE NOTES PENDING DOCUMENTS STEPHANIE KHATAMI 7/30/2014 7/30/2014 PLAN CHECK SUBMITTAL JIM JOHNSON 9/2/2014 TELEPHONE CALL JIM JOHNSON 9/10/2014 9/10/2014 CALLED APPLICANT TO INFORM HIM THAT PERMIT WAS READY TO ISSUE AND ITEMS PENDING CONDITIONS CONTACTS NAME TYPE NAME = 'ADDRESSI CITY ' STATE ZIP PHONE FAX EMAIL APPLICANT MEDIA -FOUNDRY, INC. 50660 EISENHOWER DR. #511 LA QUINTA CA 92253 CONTRACTOR MEDIA -FOUNDRY, INC. 50660 EISENHOWER DR. #511 LA QUINTA CA 92253 Printed: Wednesday, September 10, 2014 5:57:23 PM 1 of 5 CR5 YS TEMS ff ,._�-..,�� `.. "1:k'I: '7k� � �.*''�� l�".� ->>r. ;�.`• ,r "'�Y .�� -e-�-+G' ,�::'A' t ,;a�.. .v r', - / �. �z ta. :! �d - a" 4. ►.p lH�,:�n. -t,_,�"�y..- Y � �� r ,r��.�l{: t �s ..r 3u.»�,.: `` � L:;' - ��-'7 g'`�• �. � � " '"'` " - ,�:..�i�r'^'- �� P � Win., atf +3'.is r.'i�-_3w1� �"a c. y ,�,� .:1 . a -� t �^w� •`.. '''� or• nuc ��,i'� • __- ,._�=''°i�� . =., , . " �iS.,a. s�s*t-�',.�',a�. '�+,.a.. t '",g"_'`? .�rt,.-,�.;«- �' ,.r:.«..,.."su-, ;,lc,� ,:�-�^` �r < ` FINANCIAL • •' - DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE [ , . : RECEIPT # CHECK # METHOD PAID.BY;_, CLTD BY BLDG PC 25001-200K 10160003428200 $1,000.00 $1,000.00 6/2/14 Total Paid for BLDG PC 25001-20OK: $1,000.00 $1,000.00 BSAS SB1473 FEE 101-0000-20306 0 $6.00 $6.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH Total Paid forBUILDING STANDARDS ADMINISTRATION $6.00 $6.00 BSA: DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $942.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 $129.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH DIF - FIRE PROTECTION 257-000043200 0 $433.00 $433.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH DIF - LIBRARIES 253-0000-43200 0 $344.00 $344.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 $40.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH DIF - PARKS/REC 251-000043200 0 $2,048.00 $2,048.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 $116.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH DIF - TRANSPORTATION 250-0000=43200 0 $2,842.00. $2,842.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $6,894.00 RESIDENTIAL FINISH GRADING PC 101-0000-42600 0 $143.00 $143.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH Total Paid forGRADING: $143.00 $143.00 Printed: Wednesday, September 10, 2014 5:57:23 PM 2 of 5N?SYSTEMS 7.7-7-7 w:;77777-• .-,,•�.. ...-rr -t, r ,3 Y�. _•-> rte, i/ ::= � _ � ; ® ,�;,;�, .„l..'} r.=.rte• ,.y`�.'» ,r,� •, � . • �;, r Lai e '�..�:r�r*�tsa-3^r�.. Printed: Wednesday, September 10, 2014 5:57:23 PM 3 of 5 CSrsTEMS y - ._. - CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY MULTI -SPECIES 101-0000-20310 0 $1,292.00 $1,292.00 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH RESIDENTIAL 0-8 UNITS Total Paid forMULTI-SPECIES RESIDENTIAL- $1,292.00 $1,292.00 NEW CONSTRUCTION 101-0000-424000 $532.30 $532.30 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH PERMIT Total Paid forNEW CONSTRUCTION PERMIT: $532.30 $532.30 NEW CONSTRUCTION 101-0000-42600 0 $80.59 $80.59 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH PLAN CHECK Total Paid forNEW CONSTRUCTION PLAN CHECK: $80.59 $80.59 BACKFLOW DEVICE 101-0000-42401 0 $11.92 $11.92 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH BACKFLOW DEVICE PC 101-0000-42600 0 $4.77 $4.77 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH BUILDING SEWER 101-0000-42401 0 $11.92 $11.92 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH BUILDING SEWER PC 101-0000-42600 0 $11.92 $11.92 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH FIXTURE/TRAP 101-0000-42401 0 $143.04 $143.04 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH FIXTURE/TRAP PC 101-0000-42600 0 $143.04 $143.04 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH GAS SYSTEM, 5+ 101-0000-42401 0 $35.75 $35.75 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH OUTLETS GAS SYSTEM, 5+ 101-0000-42600 0 $23.83 $23.83 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH OUTLETS PC ROOF DRAIN 10170000-42401 0 $59.60 $59.60 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH ROOF DRAIN PC 101-0000-42600 0 $59.60 $59.60 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH WATER HEATER/VENT 101-0000-42401 0 $11.92 $11.92 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH WATER HEATER/VENT 101-0000-42600 0 $7.15 $7.15 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH PC WATER SYSTEM 101-0000-42401 0 $11.92 $11.92 9/10/14 R1073 3263 CHECK JM RENOVATIONS - SKH INST/ALT/REP Printed: Wednesday, September 10, 2014 5:57:23 PM 3 of 5 CSrsTEMS t,. ter, -. -;�.- -... �, �.- H1. g-:.:,::!- ... "T :`:f „ ,�"',ia., ;.,-.,,;,.-y, -.y,•c .. �f,r„�- \{ ,.q ai .s '- e a � r.,.{"' �'' �`< � .z•.. yh R� :� .r. �„�� ,.r „!J ./�,."�--.� -. �►.• �k°��' til #�` Y_., � T.K�, _L• 0 �'► i � ^� v- w'RT•.-.,� v 'fig s'•.» • • • • `�=�: .:'" -'- ®� _ c _ •• ..ter �i s 4{p. v ,tz. T�,K .- X ria~ ��.� +�i .cosi _ _ � _ ■,�::s '\..=.may.. �..� i �� . � � r • �' ... � �..4w.'f's '^ s , ��. � .. +c r r f . .. �,. d`:s�i�.� x'�CL,� i. �'. L.�i t "'�"�" `, ;' L -'. +A` :\ �.-s+j. �.:?�� " a.`� �Kv..�t �L* tL.-.�1�•x',-`' �y„ Al° w,i. A _ u}�,1,, w'i y7� , r.? yaa'. y,r•v • - r�,� . Printed: Wednesday, September 10, 2014 5:57:23 PM 4 of 5 C92" � SYS7EM5 PARENT PROJECTS RRECEIPT INSPECTIONS REVIEWS CLTD DESCRIPTION ACCOUNT QTY~ AMOUNT PAID PAID DATE # CHECK # METHOD*. PAID BY DATE BY WATER SYSTEM 101-0000-42600 0 $11.92 $11.92 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH INST/ALT/REP PC shall be landscaped to property line; Total Paid for PLUMBING FEES: $548.30 $548.30 SMI - RESIDENTIAL 101-0000 20308 0 $19.24 $19.24 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH Total Paid for STRONG MOTION INSTRUMENTATION SMI: $19.24 $19.24 SINGLE FAMILY 224-0000-20320 0 $1,837.44$1,837.44 9/10/14 R1073 3263 CHECK JM RENOVATIONS SKH DETACHED 7/8/2014 APPROVED appearance. Landscaping shall be in substantial Total Paid forTUMF - RESIDENTIAL: $1,837.44 $1,837.44 t TOTALS: $12,352.87 $12,352.87 Printed: Wednesday, September 10, 2014 5:57:23 PM 4 of 5 C92" � SYS7EM5 PARENT PROJECTS INSPECTIONS REVIEWS Printed: Wednesday, September 10, 2014 5:57:23 PM 4 of 5 C92" � SYS7EM5 PARENT PROJECTS REVIEWS REVIEW TYPE ' REVIEW ER SENT DATE DUE DATE ' RETURNED STATUS REMARKS NOTES DATE PLEASE BE REMINDED OF LQMC SECTION 9.50.090 9. Landscaping. All front and exterior side yards shall be landscaped to property line; 10. The landscaping shall include trees, shrubs and ground cover of sufficient size, spacing and variety to create an attractive and unifying PLANNING JAY WUU 7/3/2014 7/13/2014 7/8/2014 APPROVED appearance. Landscaping shall be in substantial compliance with the standards set forth in the manual on architectural standards and the manual on landscape standards as adopted by the planning commission; 11. An irrigation system shall be provided for all areas required to be landscaped; 12. The landscaping shall be continuously maintained in a healthy and viable condition; Printed: Wednesday, September 10, 2014 5:57:23 PM 4 of 5 C92" � SYS7EM5 gi"77 'ris T`�3 �f��1 1 :.t r`�:' rrwr'r r' y"lt,.y.'.� / 5� "`'"'"�+.T F,�r'^,� ,�. ;+ ` ;1:1 -rt_ r °I ' ° r:•a if' . GR .,t. 3��.� r ST ;t �jTt,_ •, ✓+".;• s.:4 .✓�.. .. �Z t xc .fid t- sy;Fro- 01 ,, CJi'I��t'v +.'err u ;ks'�_��a�'"�mw-$>r..t%`. ti: rs'�. �k^'.' .t..,yF. w ' • ,e,.* ,,,+ ,..._,,,y>'.i,}A'.Y'41sd' e�� # 'V,,� i,'4kT. �'F� L..,a: -.r. t•.S�' *s�ZRV*.'•4`F} y7 sz re ,-t� -.''S, '�' ;,. , r" k F i:.1 F.�d . .?,eG rF: �. L ...f•:. nw"v." b4Gyr:d�.:._ 4 t tn. �, .� a. -i C. FIRE JACQUELINE 7/14/2014 7/28/2014 APPROVED CVWD Letter needed GARCIA W/CONDITIONS HEALTH NS REVIEWER 7/14/2014 8/4/2014 N/S APPROVABLE 9/2/2014 BY T.H. NON-STRUCTURAL TOM HARTUNG 7/14/2014 9/2/2014 7/14/2014 APPROVED STRUC PLANS APPROVED BY YOUNG ENGINEERING. 9/8/14 STRUCTURAL APPROVABLE. KH STRUCTURAL JIM JOHNSON 8/13/2014 8/27/2014 9/9/2014 APPROVED STRUC PLANS APPROVED BY YOUNG ENGINEERING 9/8/14 Printed: Wednesday, September 10, 2014 5:57:23 PM 5of5 cp SYSTEMS Building 1 Address 1 Owner Mailing Address CIt� L La0�tw Contactor _ N P.O. BOX 1504 5-ka i 74 AIA , ��7�ALLCALIFORNIATAMPIO V�/f�j(l�l IORNIA 92253 APPLICATION ONLY ✓uLy,rKC, TokK6"0.Kr.o1'_ ► (BUILDING: TYPE CONST. OCC. GRP. l Sa-K Vl owP� e, -/ A.P. Number rY r?_03 — + 4-- dZ j6 1 Tel.Legal Description y Project Description 06�Ew S & Classif, I Lic. # Arch., Engr., Designer �v� 5�� st L ��0go �y City Tt� Zip State �,v Y rD 01?2o Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) r of Division 3 of the Business and Professions Code, and my license is in full force and effect. + 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 Pro/essions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or re,airany 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 Contrac- tor'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 /or the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty o/ not more than five hundred dollars (S500). ❑ 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. I/, however, the building or improvement 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 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.) ❑ I 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 0 Copy is Tiled with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if 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 Sq. Ft. No. No. Dw. Size 2 Z 2— Stories Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ ANO P1 AEstimated-Valuatio�"'-. --PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL r CONTACT INFORMATION NAME: PHONE: e ZONE: Minimum Setback Distan s: le I �n11 Fro t S back fro ter * e# Re r Se a . Line Si treet S a 9P Line Side Setback from r Tree FINAL DATE INSPECTOR Issued by: — Validated by: Validation: YELLOW = APPLICANT Date Permit PINK = FINANCE Date 7/29/14 No. 32212 Owner John O'Connor Address City Zip Tract # Type Single Family Residence CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 ,x3(760) 771'-8515 Lot # No. Street S.F. Unit 1 51575 Avenida Navarro 2212 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit.10 Comments Q BERMUDA DUNES =� RANCHO MIRAGE r�J INDIAN WELLS G' PALM DESERT t}� LA QUINTA, QINDIO y� . 0 APN # 773-144-028 Jurisdiction La Quinta Permit # No. of Units 1 Lot # No. Street S.F. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. 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 $3.36 X 2,212 S.F. or $7,432.32 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/Chase Bank - John O'Connor Check No. 1038919043 Bank Name/Recipient of Certificate Telephone 858-205-5356 Funding Residential By Dr. Gary Rutherford Superintendent 1 J Fee collected /exempt b S ron Ilvr Payment Recd N $0.00 Y $7,432.32 ver/1det, Signature ti NOTICE: Pursu t to Government Code Section 66022L1), this will se e o notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which a 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 without embossed, seal Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy -.Accounting O :0 RECORDING REQUESTED BY: Western Resources Title Company Order No. 67609 _ ^1 AND WHEN RECORDED MAIL TO: Lois Liviccori Ceanopulos 1653 E. Jefferson Way, Ste 110 Simi Valley, Ca 93065 Escrow No. 22 -1904 -RB Parcel No. 773-144-028 l K R OaO-va 1 DOC # 2013-0479187 10/04/2013 08:00 AM Fees: $31.00 Page 1 of 3 Doc T Tax Paid Recorded in Official Records County of Riverside Larry W. Ward Assessor, County Clerk 8 Recorder "This docurrient.was electronically submitted to the County of Riverside for recording" Receipted by: ARIBAC HIS LINE FOR R npp -znFR e i ice GRANT DEED THE UNDERSIGNED HEREBY DECLARE THAT DOCUMENTARY TRANSFER TAX IS 596.25 and CITY 5 ® computed on full value of property conveyed, or ❑ computed on full value less liens or encumbrances remaining at the time of sale. ❑ unincorporated area: ® City of La Quinta, and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Luisa Esquer, an unrnarrieu woman(who acquired title as Luisa Esquer Whitfield, a married woman) hereby Grant(s) to Lois Liviccori Ceanopulos, Trustee of the LQ -51575 Land Trust dated September 1.81'', 2013 the following described real property in the County of Riverside, State of California: Date August 23, 2013 Luisa Esquer AUG 112014 l it CITY OF LA QUINTA STATE OF CALIFORNIA } COMMUNITY DEVELOPMENT } S.S. COUNTY OF jVE1Z5 f 77� } On�_I' ��_ before _e, t/�► [ .Rr/'� — a Notary Public, personally ppeared �--`" who proved to me on the basis of satisfactory evide to be the person(s) whose names) is/ c subscribed to the within instrume� and acknowledged to me that fn'/she/the executed the same in by b�fier/their signature(s) on the instrument the person(s), or the entity upon b half/ofwhchlthe person(s)iact d) executedtthe instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraphs is true and correct. WITNESS my hand and official seal. Signature - NAYAN P GHM I&Ml Mail Tax Statement to: SAME AS ABOVE N ` COMM. 02000011 Notary Pubk_Calgomla M''r E, 2p16 :.r.:. EXHIBIT LEGAL DESCRIPTION Real property in the City of La Quinta, County of Riverside, State of California, described as follows: , LOT 4 AND THE SOUTH 25 FEET OF LOT 3 (MERGED WITH.LOT 2 PURSUANT TO PM 99-361), BLOCK "111", UNIT 12, SANTA CARMELITA AT VALE LA QUINTA, AS PER MAP RECORDED IN BOOK 18, PAGES 79 AND 80, OF MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY, PURSUANT TO LOT LINE ADJUSTMENT 99- 321, AS APPROVED BY THE CITY OF LA QUINTA. APN: 773-144028-0 ' \%. r e-'q1QW` 77-682 Country Club Dr. Ste. B, Palm Desert, CA 92211 ph. (760) 772,5107 fax (760) 345-7620 please call.. R Letter of Transmittal To: City of La Quinta Today's Date: 9-8-14 This Material Sent 78-495 Calle Tampico City Due Date: ASAP 9 214 ❑ La Quinta, CA 92253 Project Address: 51-575 Avenida Navarro, Attn: Angelica Plan Check #: 14-726 Your Review ❑ Approval!A QUIN'% CITY OE Submittal: ❑ 1St ❑ 4 t ElAt the request of: VELOPMENT ❑ 2nd ❑ 5 t ® 3`d ❑ Other: r We are forwarding: ® By Messenger ❑ By Mail (Fed Ex or UPS) ,❑ Your Pickup Includes: # Of Descriptions:' Includes: # Of Descriptions: Copies: Copies:' 4 ❑ Structural Plans ® 1 Revised Structural Plans ❑ Structural Calculations ® 1 Revised Struct. Calcs ® 1 Truss Calculations Floor ® 1 Revised Truss and Roof ❑ Soils Report ❑ Revised Soils Report ® 1 Structural Comment List/ Responses ❑ Approved Structural Plans ® 3 Redlined Structural Plans ❑ Approved Structural Calcs ❑ Redlined Structural Calcs ❑ Approved Truss Calcs . ❑ Redlined Truss Calcs ❑ Approved Soils Report ❑ Redlined Soils Reports ® 1 Other: ICC -ES Evaluation_ Report Comments: Structural content is approvable. " If you have any questions, please call.. Time = 4 HR This Material Sent for: 9 214 ❑ Your Files ® Per Your Request SEP ❑ Your Review ❑ Approval!A QUIN'% CITY OE ElChecking ElAt the request of: VELOPMENT Other: ❑ By: Kathryn Samuels Palm Desert Office: ® (760) 772-5107 Other: ❑ F Building Permit Number. Project Description: SFR Exempt: ❑ (Materials may contain hazardous wastes and are not subject to recycling provisions) Construction Debris Management Plan Pian Submittal Datel 9/10/2014 Job Sile Addressl 51575 Avendia Navarro Owner's Name Number, Stmt, or PO Box City, State, Postel Code Owners Phone Number Owners E -Mail Address Project Managers Name Project Managers Phone Number Project Managers E-mail Address Builder/Contractor Number, Street or PO Box City, State, Postal Code Projed Square Footage Media Foundry, Inc. 2825 Townsgate Road, #330 Westlake, CA 91381 John O'Connor John.oconnorghmodle-coundrv-in com 50880 Eisenhower Blvd., #511 La Quints, Ca 92253 2,200 City Approval By Date of City Approval Materials To Be Discarded: Product Tons Trash 4.18 Not recyclable Product Tons Asphalt 0.00 Recyclable Masonry (broken) 0.00 Recyclable Bdck/Block 0.00 Recyclable Plaster 0.44 Recyclable Cardboard 0.73 Recyclable Scrap Metal 0.00 Recyclable Commingled 0.00 Recyclable Tile (floor) 0.37 Recyclable Concrete 0.18 Recyclable The (roof) 0.00 Recyclable Drywall 0.13 Recyclable Wood 5.50 Recyclable Donated / Reuss* 0.00 Recyclable Landscape Debris 0.00 Recyclable 'Describe Items ls: Recycle Trash Projected Diversion: 7.3 r 4.21 1 63.79/0 I understand it is the property owner's responsibility to submit copies of weight tickets or receipts to the District Enviromnerrtal Coordinator as these hauls occur. I hereby certify that completion, implementation and adherence of the Debris Management Plan (DMP) for the above named project shall guarantee that at least 50% of the Jobstte waste is diverted from landfilling. The remaining material will be recycled or reused. l will divert, for recycling or re -use, remaining materials generated from the first day of the project through the completion of the project in accordance with this plan. This DMP is Issued In the name of the property owner(s) and shall remain their property throughout the construction and/or demolition project. A contractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP Is still Issued In the name of the property owner(s) and the owner retains legal responsibility for ensuring that the provisions of the DMP sdhs to. The property owner(s) and general contractor shall be kept Informed of the diversion progress through b' nth . I fliaullng, all se material from this project site must be taken to an app re der or transfer o �6 Owner / toper / Project Manager / Superintendent Date P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760)777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been subrrtitted in olu e,jis g y self s builder of the property improvements specified at I 57 AyEN114!`r /"flVq Iii% , We are providing you with an Owner -Builder Acknowledgment and Infonn-atioh Verification Form to make.you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision,. signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. V1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" ing permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 1 2 I understand building permits are not required to be signed by property owners unless they are responsible for the `'construction and are not hiring a licensed Contractor to assume this responsibility. �3. I understand as an"Owner-Builder" I am the responsible party of record `on the permit. I understand that I may protect myself from potential financial risk by hiringa licensed Contractor and having the permit filed in his or her nam g p e instead of my W4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value �of my construction is at least five hundred dollars $500 including labor and material I " ( )> g s, may be considered an employer and state and federal law. I understand if I am considered an "employer" under state and federal law, I must register with the g state and federal government, withhold payroll taxes; provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. v7 I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential tructures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. t �I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. !9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue —Seice, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 80 -321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. 10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and ,}�ciall re ponsible fQr oposed constru tion activity ar,.) the following address: 5 15 7�_ �✓Er't,,4 /TgtuG�l^a o , �c� iEKtn7t7(. y l 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all QQQ. c y'ap�� ppllliicable laws and requirements that govem Owner -Builders as well as employers. 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to thecy is required to be presented when the permit is issued to verify the property owner's signature. n �� i / f I Signature of property owner V Vx_�-`� 791_ Date: l �l Mato- -pum ✓'l yjkc- . Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which'I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for,'sign, and file the documents necessary to obtain an Owner -Builder. Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: ICC -ES Evaluation Report" :ESR -1 988'° Reissued December 1, 2010 This report is subject to renewal in two years. wwvv.icc-es.orq(800) 423-6587 (562) 699-0543 A Subsidiary of the International Code Council® DIVISION: 06 00 00 -WOOD, PLASTICS AND COMPOSITES Section: 06 17 53--Shop-Fabricated Wood Trusses REPORT HOLDER: MITEK INDUSTRIES, INC. 14515 NORTH OUTER FORTY, SUITE 300 CHESTERFIELD, MISSOURI 63017 (314) 434-1.200 www.mii.com EVALUATION SUBJECT: MiTek® TRUSS CONNECTOR PLATES: TL19, MT18, MT18HSTm, M18SHST"', TL20 and MT20 1.0 EVALUATION SCOPE Compliance with the following codes: a 2009 Intemational Building Code® (2009 IBC) ■ 2009 International Residential Code (2009 IRC) ■ 2006 International Building Code (2006 IBC) * 2006 International Residential Code (2006 IRC) ■ 1997 Uniform Building CodeT11 (UBC) Property evaluated: Structural 2.0 USES MTeko metal truss connector plates are used as joint connector components of light wood -frame trusses. . 3.0 DESCRIPTION 3.1 MiTek®TL18 and MT18: Models TL1B and MT18 metal'truss connector plates are manufactured from minimum No. 18 gage [0.0466 inch total thickness (1.18 mm)], ASTM A 653 SS, Grade -40 steel, with a G60 galvanization coating [0.0005 inch thickness on each side (0.013 mm)] and having a base -metal thickness of 0.0456 inch (1.16 mm). The plates have teeth 'IB inch (9.5 mm) -long ' m) long; punched in pairs formed at right angles to the face of the parent metal so that two teeth.per hole occur along the length. The spacing along the longitudinal direction of each punched slot is 1 inch (25.4mm) on center. The transverse centerlines of adjacent slots are staggered 0.10 inch (2.54 mm). The distance between longitudinal centerlines of the slots is 0.25 inch (6.35 mm). There are eight teeth per square inch (645 mm) of surface area. Plates are available in 1/2 -inch (12.7 mm) width increments, up to 12 inches (304.8 mm), and lengthwise in 1 -inch (25.4 mm) multiples. See Figure 1 for details. 3.2 MiTek® MT1'SHST": Model MTI8HST" metal truss connector plates are manufactured from minimum No. 18 gage 10.0466 inch total thickness (1.18 mm)], ASTM A 653, Grade 60, high-strength, low -alloy steel (HSLAS) with a G60 galvanization coating 10.0005 inch thickness on each side (0.013 mm)) and having a base -metal thickness of 0.0456 inch (1.16 mm). The plate has teeth ale inch (9.5 mm) long, punched in pairs formed at right angles to the face of the parent metal so that two teeth per hole occur along the length. The spacing along the longitudinal direction of each punched slot is 1 inch.(25.4 mm) on center. The transverse centerlines of adjacent slots .are staggered 0.10 inch (2.54 mm). The distance'between longitudinal centerlines of the slots is 0.25: inch (6.35 mm). There are eight teeth per square inch (645 mm2) of surface area. Plates are available in %1 inch '(12.7 mm) width increments, up to 12 inches (304.8 mm), and lengthwise in 1 -inch (25.4 mm) multiples. See Figure 1 for details. 3.3 MiTek® M1.8SHS'" :.. Model M18SHST1" metal "truss connector plates are manufactured from minimum No. 18 gage [0.0466 -inch (1.18 mm) total thickness], hotAipped galvanized steel that meets the requirements of ASTM A 653 SS, Grade 80 steel; with a G60 galvanization. coating 10.0005 inch thicknesson each side (0.013..mm)] and having a base metal thickness of 0.0456 inch (1.16 mm). The plates have 31B -inch -long (9.5 mm) teeth,, .punched in pairs formed at right angles to the face of the parent metal so that two teeth per hole occur along the length. The spacing along the longitudinal direction of each punched slot is 1 inch (25.4 mm) on center. The "'transverse centerlines of adjacent slots are staggered 0:10 inch (2.54 mm). The distance between longitudinal centerlines of slots is 0.25 inch (6.35 mm). There are eight teeth per square inch (645 mm2).of surface area. Plates are available in '/z -inch -width (12.7 mm) increments, up to 12 inches (304.8 mm), and lengthwise in 1 -inch (25.4 mm) multiples. See Figure 1 for details. 3.4 MiTek® TL20 and MT201: Models TL20 and MT20Tm metal truss connector plates are manufactured from minimum No. 20 gage [0.0356 inch total thickness (0.9 mm)], ASTM A 653 SS, Grade 40 steel, with a G60 galvanization coating [0.0005 inch thickness on each side (0.013 mm)] and having. a base -metal thickness of 0:0346 inch (0.88 mm). The plates have teeth 3/B inch (9.5 mm) long,rn ched-iia-pairs gd at right angles to the face of tharent metal(s� than two pRer 4 occur along th e tti. The spac ni g alon j t'I ongl 1i 91 rl� n sty. fn L' I �Cf I. direction of a ch pwn bed`]slotzis4&1ci Ah:.25- "Revised April 2011 APPROVED vtVTtt) ICC -ES Evaluation Reports are not m be construed as repr6ewting aesthetics or any other attributer nm specificol addressed, nor are Ye V to he oast ed l as an endorsement o/lhe subject of Iris report trr a recommendation jor its use. There ix nu warranty by ICC Evoiu tion Service. LLC, express or implied, as .+ap m any finding or other matter in this report, or as to any product covered by the report. DATE Copyriohf 0 2011 BY Pace 1 of 3 MiTek USA, Inc. / CompuTrus Software Warnings & General Notes WARNINGS: 1. Builder and erection contractor should be advised of all General Notes and Warnings before construction commences. 2. 2x4 compression web bracing must be installed where shown +. 3. Additional temporary bracing to insure stability during construction is the responsibility of the erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. 4. No load should be applied to any component until after all bracing and fasteners are complete and at no time should any loads greater than design loads be applied to any component. 5. CompuTrus has no control over and assumes no responsibility for the fabrication, handling, shipment and installation of components. 6. This design is furnished subject to the limitations set forth by TPI/WTCA in BCSI., copies of which will be furnished upon request. GENERAL NOTES, unless otherwise noted: 1. This design is based only upon the parameters shown and is for an individual building component. Applicability of design parameters and proper incorporation of component is the responsibility of the building designer. 2. Design assumes the top and bottom chords to be laterally braced at 2' o.c. and at 10' o.c. respectively unless braced throughout their length by continuous sheathing such as plywood sheathing (TC) and/or drywall (BC). 3. 2x Impact bridging or lateral bracing required where shown + +. 4. Installation of truss is the responsibility of the respective contractor. 5. Design assumes trusses are to be used in a non -corrosive environment, and are for "dry condition" of use. 6. Design assumes full bearing at all supports shown. Shim or wedge if necessary. 7. Design assumes adequate drainage is provided. 8. Plates shall be located on both faces of truss, and placed so their center lines coincide with joint center lines. 9. Digits indicate size of plate in inches. 10. For basic connector plate design values see ESR -1311, ESR-1988(MiTek). Q kOFESS/0\ �� ql ' N0.(�FUtiUti EXA131!95 0� L2 ENG �P t �rFOF CAUFO�� J Bin # Qty. of, La Quinta Building &r Safety Division P.O. Box 1504,"78-495 Calle Tampico LR.Quinta, CA 92253 -:(7-60) 777-7012 Building Permit Application and Tracking Sheet Perinit # - ProjectAddress. 4 IS Owner's Nae:. %/O Y A. P. Nurnber. Address: Legal Description: City, ST, Zip: LqCci. cf tx' Contractor. Telephone: M - VZ Rig Address: Project Description: City, ST, Zip:• CN ell, Telephone:1 69J —r -IT -1—F. L4 LA ehmf-- State Lic.#: &AJa 6(4L6f_2 City Lic,.#,. Arch, Engr., Designer: 0 6;/ qo rpr, Address: CRY, SL Zip: Telephone: 1,- Construction Type: c: Pfo Occupancy - State Lic. M Project Project type (circle one): New Add7n. Alter Repair Demo Name of Contact Person: 41u 6 Co Sq. Ft: #units: Telephone* of Contact Person: Estimated Value of Project: APPLICANT: DO NOT. WRITE BELOW THIS UNE Submittal ..Reqld 'Reed TRACMG PERMIT FEES Plan Sets Plan Check.submitted ft. Amount' Structural Cala. Reviewed,* ready for corrections Plan Check Deposit. Truss C21cs. Called Contact Person Plan Check Balance. Title 24 Cald. Plans picked up Construction Flood plain plan Plans resubmitted.*. MCC1121iiC111 Ghding plan 2" Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.NLL H.O.A. Approval Plans resubmitted Gradin' 9 'IN HOUSE.- Review, ready for corrections/issue Developer Impact Fee Planning Approval. Called :Contact Person Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees BUILDING ENERGY ANAL-YSIS REPORT C6 -r PROJECT: New Residence For Media -Foundry Inc. 51-575 Avenida Navarro La Quinta, CA 92253-1 Project Designer: Sergio K Garcia Design Consultants 49-960 Jefferson St., Ste.#130-219 Indio, CA 92201 760-880-6796 Report Prepared by: Sergio H. Garcia Consulting EIV , AUG 13 2014 COMA'UrV C'TY OF LA (?UIIVTA ITY Dcvp 'MENT 'Job ..6'r-AretoF 5 13UILDING LAQLJ1NTA,'7 T ' T- -2014 & SAF ETY X-7) �01 FOR ONS dote: C)tJCTION 8T20'14-= , 2 -4 01 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 Ndnresidential 2008, Building Energy Efficiency Standards. This program developed by EnergySoft, LLC — www.energysoft.COM. PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF -1 R Project Name New Residence For Media -Foundry Inc. Building Type ® Single Family ❑ Addition Alone ❑ Mufti Family ❑ Existing+ Addition/Afteration 18/12(2014 Date Project Address 51-575 Avenida Navarro La Quinta California Energy Climate Zone CA Climate Zone 15 Total Cond. Floor Area 2,212 Addition n/a # of Stories 1 FIELD INSPECTION ENERGY CHECKLIST El Yes ❑ No HERS Measures -- If Yes, A CF -411 must be provided per Part 2 of 5 of this form. ❑ Yes ❑ No Special Features — If Yes, see Part 2 of 5 of this form for details. INSULATION Construction T e Area Special Cavi Features see Part 2 of 5 Status Roof Wood Framed Attic R-38 2,212 Radiant Barrier New Wall Wood Framed R-19 1,940 New Door Opaque Door None 50 New Slab Unheated Slab -on -Grade None 212 Penm = 234' New FENESTRATION U- Orientation Area Factor Exterior SHGC Overhang Sidefins Shades Status Front (E) 30.0 0.330 0.31 8.0 none Bug Screen New Front (E) 30.0 0.330 0.31 4.0 none Bug Screen New Left (S) 36.0 0.330 0.31 none none Bug Screen New Rear (lM 158.0 0.330 0.31 none none Bug Screen New Right (N) 94.0 0.330 0.31 none none Bug Speen New HVAC SYSTEMS Ot . Heating Min. Eff Cooling Min. Eff Thermostat Status 1 Central Furnace 69% AFUE Split Air Conditioner 14.1 SEER Setback New HVAC DISTRIBUTION Location Heating Duct Cooling Duct Location R -Value Status Whole Residence Ducted Ducted Attic, Ceiling Ins, vented 8.0 New WATER HEATING Ot . Type Gallons Min. Eff Distribution Status 1 Small Gas 50 0.93 NJ Pipe<bisulation(-) I AA ,P.New 13U1LD1ry-',4 v y DEP En Pro 5.1 by EnergySoft User Number. 6079 RunCode: 2014-08-12701:30:08 ID: T-05$2b1¢�j a e 3 of 12 SATE ~—� BY PERFORMANCE CERTIFICATE: Residential Part 2 of 5) CF -1 R Project Name New Residence For Media -Foundry Inc. Building Type ® Single Family 0 Addition Alone o Multi. Family ❑ Existing+ Addition/Afteration Date 1811WO14- SPECIALFEATURES INSPECTION CHECKLIST The enforcement ager1q� should pay special attention to the items speed in this checklist. These items requirespecial written justification and documentation, and special verification to be used with the performance approach. The enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. The Roof R-38 Roof Attic includes credit for a Radiant Barrier that is Continuous meeting eligibility and installation criteria as specified in Residential Appendix RA4.2.2. HERS REQUIRED VERIFICATION Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a completed CF -414 form for each of the measures listed below for final to be given. The Cooling System York YC IF60S41 S2 includes credit for a 12.1 EER Condenser. A certified HERS rater must field verify the installation of the correct Condenser. The HVAC System Whole Residence includes credit for Verified Fan Energy. Measured Fan Energy may not exceed 0.58 w/cfm. The HVAC System Whole Residence inowporates HERS Verified Refrigerant Charge or a Charge Indicator Display. The HVAC System Whole Residence includes credit for verified adequate airflow. A certified HERS rater must diagnostically measure airflow of the HVAC System. ' Whole Residence includes a factory sealed air handler unit tested by the manufacturer and certified to the Commission to have achieved a 2 percent or less leakage rate. HERS field verification of the AHU model number is required. Duct Leakage cannot exceed 6%. ka. I Y 0 r 171r-1� DEPT Ene Pro 5.16 En Soft- User Number. 6079 RunCode: 2014-08-12TOt.30:08 Citrh ID'- T-0&20.1.4' V #— a e —4,f 12 - vulva rRUCTION DATE �-- BY PERFORMANCE CERTIFICATE: Residential Part 3 of 5 CF -IR Project Name Building Type la Single Family ❑ Addition Alone Date New Residence For Media -Foundry Inc. ❑ Multi Family ❑ Existing+ Addition/Afteration 1811212014 ANNUAL ENERGY'USE SUMMARY Standard Proposed Margin TDV kBtu/ftz- r Space Heating 4.34 5.66 -1.32 Space Cooling 57.77 47.26 10.51 Fans 11.55 11.78 -0.23 Domestic Hot Water ' 15.50 .9.70 5.80 Pumps 0.00 0.00 0.00 Totals 89.17 74.41 14.76 Percent Better Than Standard: 16.6% BUILDING COMPLIES - HERS VERIFICATION REQUIRED Fenestration Building Front Orient 01 on: (E) 90 deg Ext. Walls/Roof Wall Area Area Number of Dwelling Pnits: 1.00 (E) 383 60 Fuel Available at Site: Natural Gas (S) 289 36 Raised Floor Area: 0 (►M 638 158 Slab on Grade Area: 212 (N) 1,028 94 Average Ceiling Height: 10.0 Roof 2,212 0 Fenestration Average U -Factor: 0.33 TOTAL: 348 Aver�22 SHGC: 0.31 Fenestfation/CFA Ratio: 15.7% REMARKS Copyright 2014 Sergio H. Garcia STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 21, Parts I the Administrative Regulations and Part 6 the Efficiency Standards of the California Code of Regulations. The documentation author hereby certifies that the documentation is accurate.and complete. Documentation Author Com Sergio H. Garcia Consulting Company v'�,�� 8i1220f4 O AddressName "I,� �" City/State/ZipCity/State/Zip PhoneRAO Signed"' Date The individual with overall design responsibility hereby certifies that the proposed building design represented in this set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit application, and recognizes that compliance using duct design, duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require installer testing and certification and field verification by an -approved HERS rater. Designer or Owner (per Business & Professions Code) CITY OF LA QUINTA Company Sergio H. Garda Design Consultants BUILDING &SAFE DEPT. Address 49-950 Jefferson St., Ste.#130-219 Name Sergio H. Garda •` r"" ` q Z City/State/Tp Indio, CA 92201 Phone 760-880-6796 FQj=Sigti& S v cc_�c Date lEnemvPro5.lbyEnemYSoft User Number. 6079 Runcode: 2014-08-12TVI r=----1Q.—T-05-20-110Y e 5 of 12 14 CERTIFICATE OF COMPLIANCE: Residential., Part 4 of 5 CF -1 R Project Name New Residence For Media -Foundry Inc.... Building Type .® Single.Family ❑ Addition Alone , , ,. ❑ Muni Family O Existing+ Addition/Alteration Date 8/12/2014 OPAQUE SURFACE'DETAILS Surface Type Area U-;! Insulation Joint Appendix Factor Cavity Exterior Frame Interior Frame Azm Tin Status 4 Location/Comments Roof 2,212 0.025 R-38 90 22 New 4.2.1 A21 New Resdence Wall 115 0.074 R-19 90 90 New 4.3.1 A5 New Resdence Wall 8 0.074 R-19 180 90 New 4.3.1-A5 New Resdenoe Wall 18 0.074.R-19 90 90 New - 4.3.1-A5_ -- _ .. _ . _ New Resdenoe Door 32 0.500 None 90 90 New 4.5.1A4 New Resdence Wall 45 0A74 R-19 0 90 New 4.3.1-A5 New Resdenoe Wall 158 0.074 R-19 90 90 New 4.3.1-A5 New Resdence Wall 478 0.07.4 R-19 0 90 New 4.3.1-A5 New Resdence Door 18 0.500 None 0 90 New 4.5.1-A4 New Resdence Wall 245 0.074.R-19 180 90 New _ 4.3.1-A5 New Resdence Wall 248 0.074 R-19 270 90 New 4.3.1-A5 New Resdence Wall 71 0.074 R49 0 ..90. New 4.3.1A5 NewResdence Wall 960.074 R-19 270 90 New 4.3.1-A5 New Resdence Wall 33 0.074 R-19 0 90 New 4.3.1-A5 New Resdence Wall 136 0.07:4 R-19 270 90 New 4.3.1-A5 New Resdence Wall 289 0.074,R-19 0 90 1 New 4.3.1 A5 New Resdence FENESTRATION SURFACE DETAILS - ID Type Area 1.1 -Factor' SHGCz Azm Status Glazing Type Location/Comments 1 Window 15.0 0.330 NFRC 0.31 NFRC 90 New Mllgard LowE2 Vinyl StlyeLine New Resdence 2 Window 15.6 -0.330 NFRC 0.31 NFRC - 90 New M11gard'LowE2 Vinyl StlyeLine New Resdence 3 Window 15.0 0.330 NFRC -0.31 NFRC .90 New Mtlgard LowE2 Vinyt Stlyeline New Resdence 4 Window 15.0 0.330 NFRC 0.31 NFRC 90 New Mllgard LowE2 Vinyl StloLine New Resdence 5 Window 6.0. 0.330 NFRC . 0.31 NFRC 180 New Mllgard LowE2 Vinyl St"Line New Resdence 6 Window 15.0 0.330 NFRC 0.31 NFRC 180 New Mllgard LowE2 Vinyl StlyeLine New Resdence 7 Wrndow 15.0 0.330 NFRC 0.31 NFRC 180 New Mligard LowE2 Vinyl SttyeLine New Resdence 8 Window 15.0 0.330 NFRC 0.31 NFRC 270 New Mllgard LowE2 Vinyl SttyeLine New Resdence 9 Window 15.0. -0.330 NFRC _. .-0-31 NFRC-- .._.._-27.0. New- Mllgard-LowE2 Vinyl.StlyeLine._ AlewResdence 10 Window 24.0 0.330 NFRC 0.31 NFRC 0 New Mllgard LowE2 Vinyl StlyeLine New Resdence 11 Vlhndow 24.Q 0.330 NFRC 0.31 NFRC .270 New Mllgard LowE2 Vinlo4 StlyeLine New Resdence 12 Window 24.0 0.330 NFRC 0.31 NFRC 0 New Mllgard LowE2 Vinyl StlyeLine New Resdence 13 Window 20.0 0.330 NFRC 0.31 NFRC 270 New MlI rd LowE2 Vinyl StlyeLine New Resdenoe 14 Window 64.0 0.330 NFRC 0.31 NFRC 270 New Mllgard LowE2 Vinyl SttyeLine New Resdence 15 Window 20.0 0.330 NFRC 1 0.31 NFRC 270 New Mllgard LowE2 Vinyl StlyeLine New Resdence 16 Window 12.5 0.330 NFRC 1 0.31 NFRC 0 New Mllgard LowE2 Vinyl StlyeLine New Resdence (1) Ll -Factor Type: - 116A A =-Default Table1rom:Slandatds, NFRC =-Labeled Value 2 SHGC T 116-B = Default Table from Standards, NFRC = Labeled Value EXTERIOR SHADING DETAILS ID i Exterior Shade Type SHGC Window Hat Wd Ove ang Left Fin Len Hqt LExt RExt Dist I Len Hqt Right Fin Dist Len Hat 1 Bug Screen 0.76 5.0 3.0 8.0 0.1 , 80 . 8.0 2 Bug Screen 0.76 5.0 3.0 8.0 0.1 8.0 8.0 3 Bug Screen 0.76 5.0 3.0 4.0 0.1 4.0 4.0 4 Bug Screen 0.76 5.0 3.0 4.0 0.1 4.0 4.0 5 Bug Screen -0J6 6 Bug Screen 0.76 7 Bug Screen 0.76 8 Bug Screen 0.76 9 Buq Screen 0.76 10 Bug Screen 0.76 11 Bug Screen :0.76 +'- 12 Bug Screen 0.76 13 Bug Screen 0.76 14 Bug Screen 0.76 15 IBug Screen 0.76 1 Y t= A 16 JBug Screen 0.76 dt 6AFETY DEPT. Ene 5.1 b Ene Soft= User Number. 6079 RunCode: 2014-08.12T01: 0:08 ;' Q:�T+-05.2014-,� Pa e 6 of 12 " •r' _DATE BY t„ + yr• CERTIFICATE OF COMPLIANCE: Residential Part 4 of 5 CF -1R Project Name New Residence For Media -Foundry Inc. Building Type ® Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 8/12/2014 OPAQUE SURFACE•DETAILS Surface U-'' Insulation Joint Appendix Type Area Factor Cavity Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments Slab 212 0.730 None 0 180 New 4.4.7-A1 New Resdence FENESTRATION SURFACE DETAILS ID Type Area U -Factor SHG Azm Status Glazing Type Location/Comments 17 Window 12.5 0.330 NFRC 0.31 NFRC 0 New Mllgard LowE2 Vinyl StlyeLine New Residence 18 Window 21.0 0.330 NFRC 0.31 NFRC 0 New Mllgard LowE2 Vinyl StlyeLine New Residence (1) 1.1 -Factor Type:: 116-A— Default Table from Standards, NFRC = Labeled Value 2 SHGC Type: 116-8 = Default Table from Standards, NFRC = Labeled Value EXTERIOR SHADING DETAILS Window Ove ang Left Fin Right Fin ID Exterior Shade Type SHGC Hqt Wd Len Hgt LExt RExt Dist I Len Hgt Dist Len I Hat 17 Bug Screen 0.76 18 Bug Screen 0.76 :9 rNp INA,A #.% I vy I BUIL DIING & SAFETY DEPT. EneTyPro 5.1 by EnergySpft User Number. 6079 RunCode. 2014-08-12TD1.30.08 0 0...�lD:sT-05-261,4\ age 7 o 12 FOR CONSTRUCTION DATE By__ CERTIFICATE OF COMPLIANCE: Residential (Part 5 of 5) CF -IR Project Name New Residence For Media -Foundry Inc. Building Type ® Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 8/12/2014 BUILDING ZONE INFORMATION Floor Area System Name Zone Name New Existin Altered Removed Volume Year Built Whole Residence New Residence 2212 22,120 Totals 2,212 ol 01 01 1 HVAC SYSTEMS System Name Oty. Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status Whole Residence 1 Central Furnace 69% AFUE Split Air Conditioner 14.1 SEER Setback New HVAC DISTRIBUTION System Name Heating Duct Cooling Duct Location R -Value Ducts Tested? Status Whole Residence Ducted Ducted AttrF Ceiling Ins, vented 8.0 ® New WATER HEATING SYSTEMS S stem Name Cly. Type Distribution Rated Input Btuh Tank Cap. al Energy Standby Factor Loss or or RE Pilot Ext. Tank Insul. R- Value Status Rheem PE50T09' 1 Small Gas No Pipe Insulation 15,359 50 0.93 n/a n/a New MULTI -FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING ControlFQtyTHP Hot Water Piping Length (ft) C _ O (d a a — System Name Pipe Lenqth Pipe I Diameter Insul. Thick. Plenum Outside Buried ❑ I"V ("�C I 11 KMA ❑ ')tt ❑ UUY_Lflivta k4 0l SFETY - I. ❑ P MIN /r-: EnergyPro 5.1 by En ft User Number. •6079 RunCode: 2014-08-12TD :30:08 ID: 2 e 8 of 12 DATE By MANDATORY MEASURES SUMMARY: Residential (Page 1 of 3) MF -1 R New Residence For Media -Foundry Inc. I 8112/2014 NOTE: Low-rise residgptial buildings subject to the Standards must comply with -all applicable mandatory measures listed, regardless of the compliance appro4ch used. More stringent energy measures listed on the Certificate of Compliance (CF -1 R, CF -1 R -ADD, or CF - 1 R -ALT Form) shallsyPersede the items marked with an asterisk (•) below. This Mandatory Measures Summary shall be incorporated into the permit documents; and the applicable features shall be considered by all parties -as minimum component performance specifications whether they are shown elsewhere in the documents or in this summary. Submit all applicable sections of the MF -1 R Form with olans. 116(a)l: Doors and windows.between conditioned and unconditioned spaces are manufactured to'limit air leakage. §116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient (SHGC). and infiltration that meets the requirements of 610-111(a). 117: Exterior doors and windows are weather-stripped; all hints and penetrations are caulked and sealed. 6118(a): Insulation specified or installed meets Standards for Insulating Material. Indicate tvpe and include on CF -6R Form. §11 8(i): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of §118(1) when the installation of a Cool Roof is specified on the CF -1 R Form. *§1 50 a : Minimum R-19 insulation in wood -frame ceiling or equivalent U -factor. 150(b): Loose fill ins lation shall conform with manufacturer's installed design labeled R -Value. *§150(c): Minimum RA3 insulation in wood4rame wall or equivalent U -factor. *§150(d): Minimum R-13 insulation in raised wood -frame floor or equivalent 1.1 -factor. §150(f): Air retardinq wrap is tested, labeled, and installed according to ASTM E1677-95(2000) when specified on the CF -1 R Form. §150(g): Mandatory Vapor barrier installed in Climate Zones 14 or 16. §150(l): Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3%; water vapor permeance rate is no greater than 2.0perm/inch and shall be protected from physical damage and UV light deterioration. Fireplaces, Decorative Gas Appliances and Gas Log Measures: 150 e 1 A: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150(e)1 B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped with a with a readily accessible operable, and tight -fitting damper and or a combustion -air control device. §150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the building,are prohibited. Space Conditionhi , Water Heating and Plumbing stem Measures: §110-§113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy Commission. §113(c)5: Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release valve backflow prevention, pumpisolation valve and recirculation loop connection requirements of §113 c 5. §115: Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances (appliances with an electrical supply voltage connection with pilot'lights that consume less than 150 Btu/hr are exempt), and pool and 150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA. §150(i): Heatin systems are equipped with thermostats that meet the setback requirements of Section 112(c). §1500)1A: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with insulation having an installed thermal resistance of R-12 or greater. §1500)113: Unfired storage tanks, such as storage tanks or backup tanks for solar water -heating system, or other indirect hot water tanks have R-12 extemal insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the tank. §1500)2: First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire length of recirculating sections of hot water pipes are insulated per Standards Table 150-8. §1500)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot water tank shall be insulated to Table 150-B and Equation 150-A- §1506)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table 123-A. 150(j)3A: Insu 1500)3A:Insu onditioned sp; 1506)4: Solar :ne►gyRv 5.16 d from damage, including that due to sunlight, moisture, equipment maintenance, and water piping and refrigerant suction lines includes a vapor retardant or is enclosed en1 and/or collectors User Number. 6079 RunCode: 201448-1: olartRatin and•Certrfication Go • oration. BUILDING & SAFETY DEPT. 4 P P P lam\ �J01:30.8 9.x ! X14 i DATE By 9of12 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R Project Name Date New Residence For Media -Foundry Inc. 1811212014 §150(m)1: All air -distribution system ducts and plenums installed, are sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and retum-air ducts and plenums are insulated to a minimum installed level of R- 4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings reater than 1/4 inch the combination of mastic and either mesh or tape shall be used §150(m)1: Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities -and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. §150(m)2D: Joints and.seams of duct -systems and theircomponents shall not be sealed with cloth back rubber adhesive.duct tapes unless such tape is used in combination with mastic and draw bands. 150(m)7: Exhaust fans stems have back draft or automatic dampers. §150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. §150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. §150(m)10: Flexible ducts cannot have porous inner cores. §150(o): All dwelling units shall meet the requirements of ANSUASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air Quality in Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation required in Section 4 of that Standard. Pool and Spa Heating Systems and Equipment Measures: §114(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency Regulations; an on-off switch mounted outside of the heater; a permanent weatherproof plate or card with operating instructions; and shall not use electric resistance heating ora pilot light §114(b)1: Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction and return lines, or built-up connections for future solar heating. 114(b)2: Outdoor pools ors as .that have a heat pump or gas heater shall have a cover. §114(b)3: Pools shall have directional. inlets that adequately.mix the pool water, and a time switch that will allow all pumps to be set or programmed to run only during off-peak electric demand periods. 150 : Residential pool systems or equipment meet the pump sizing, flow rate, piping, filters, and valve requirements of §150 . Residential Li htin Measures: §150(k)1: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies contained in Table 150-0 and is not a low efficacy luminaire as specified by §150(k)2. 150(k)3: The wattage -of permanently -installed luminaires shall be determined as specified by -§1 30 d . §150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. §150(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line -voltage socket or line - voltage lamp holder; OR shall be rated to consume no more than five watts of power as determined by §130(d), and shall not contain a medium screw -base socket. 150(k)6: Lighting integral to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of §150 . 150(k)7: All switchino devices and controls shall meet the requirements of §150(k)7. §150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 ft2 or 100 watts for dwelling units larger than 2,500 ft2 may be exempt from the 50% high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a manual -on occupant sensor. §150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of -power per linear foot of illuminated cabinet. . CITY f'VItVTA IBUtLDiti SAFETY DF PT EnergyPro 5.1 by EnergySoft User Number. 6079 RunCode: 2014-08-127130.08 1-11D: T-05-20'14'_) _ r-% Page 0 of 12 FOR Cot"4STRUCTION DATE BY MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF -IR Project Name Date New Residence ForMedia=Foundry Inc. '8 IW014 §150(k)10: Permanently installed luminaires in bathrooms, attached and detached_garages, laundry rooms, closets and utility rooms shall be high efficacy. _ EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual -on occupant sensor certified to comply with the applicable requirements of §119. EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a manual -on occu anc sensor. §150(k)l1: Permanently installed iuminaires-located in rooms or -areas other than in -kitchens, bathrooms,"garages, laundry rooms, closets, and utility rooms shall be high -efficacy Umnaires. EXCEPTION 1: -Permanently installed -low -efficacy -luminaires -shall be _ allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of §119, or by,a manual - on occupant sensor that complies with the applicable requirements of §119. EXCEPTION 2: Lighting in detachea.storage building less than 1000 square feet located on a residential site is not required to comply with §150 11. §150(k)l2: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air R leakage less then 2.0 CFM at 75 Pascals -when tested in accordance with ASTM E283; and be sealed with a.gasket or caulk between the luminaire housing and ceiling. §150(k)l3: Luminairesiprovid'mg-outdoor lighting, including -fighting for private patios in low-rise residential -buildings with -four or -more dwelling units, entrances, balconies, and porches, which are permanently mounted to a residential building or_to_other buildings on the same lot shall be high efficacy. EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that they are controlled by a, manual on/off switch, a motion sensor not having an override or bypass switch that disables the motion sensor, and one of the following controls: a photocontrol not having an override or bypass switch that disables the photocontrol; OR an astronomical time clock. not having an override or bypass switch that disables the astronomical time clock; OR an energy management control system (EMCS)-not having.an override or bypass.switch2hat.allows the luminaire_to.be.always.on EXCEPTION.2:.0utdoor luminaires used to comply with Exception) to §150(k)13 may be controlled by a temporary override switch which bypasses the motion sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3:'Permanently installed luminaires in or around swimming pool, water features, mother location subject to Article 680 of the California Electric Code need not 4be hi h efficacy luminaires. §150(k)14: Internally illuminated address signs shall comply with Section 148; OR not contain a screw -base socket, and consume no more than five watts of power as determined according to §130(d). §150(k)l5: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable requirements in Sections.130, 132, 134, and 147. Lighting forpaddng-garages for -:8 or more vehicles shall comply -with -the applicable requirements of Sections 130 131, 134, and 146. §150(k)l6: Permanently installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more dwelling units shall be high efficacy luminaires. EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided - that they are controlled'by an occupant sensors certified to comply with the applicable requirements of 119. C I C 0 OF LJ Y Q. U I 1 V T - BUILDING & SAFETY DEPT. AF�OVED C r7 i�I'\P If'� 11 1/�TI EneigyRo 5.1 by Energysoft User Number. 6079 RunCode: 2014-08-12T01:30:08 ID: T-05-2014 " :Page 1 I of 12 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name New Residence For Media-Foundry Inc. Date 8/12/2014 System Name Whole Residence Floor Area 2,212 ENGINEERING CHOCKS SYSTEM LOAD Number of Systems 1 COIL COOLING PEAK COIL HTG. CFM Sensible Latent CFM Total Room 1-nark, 1240 .23;955 2,738 840 Return Mented-Lighting 0 Return Air Ducts 1,383 Return Fan 0 Ventilation 0 0 0 0 Supply Fan 2.557 Supply Air Ducts 1,383 TOTAL SYSTEM LOAD 29,2771 2,738 PEAK Heating System Sensible Output per System 22,810 264450 Total Output Btuh 22,810 Output Btuh/ ft 10.3 1,300 Cooling System 0 Output per System 56.500 0 Total Output Btuh . 56,500 -2,557 Total Output ons - 4.7 1,30U Total Output(Btu h/ 25.5 Total O ut on 469.8 1 26,493 Air Svstern CFM per System 2,000 HVAC EQUIPMENT SELECTION Airflow ctm 2= York YCJF6OS41S2 38,494 =9,422 22,610 Airflow cfm/ 0.90 Total Adjusted System Output 1 38,4941 9,422 1 22,810 (Adjusted for Peak Design conditions) TIME OF SYSTEM PEAK Aug 3 PM Jan 1 AM Airflow cf nITon 424.8 Outside Air'/, 0.0% Outside Air Cfln/ 0.00 Note: values above given at ARI conditions HEATING SYSTEM YCHROMETRICS Airstream Temperatures at Time of Heating Peak 26 OF Outside Air 0 cfrn 67 OF 67 OF 97 OF 98 OF D Heating Coil Supply Fan 98 OF 2,000 cfm ROOM 68 OF COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak 112/78°F Outside Air 0 cfm 76/62°F 76/62°F 55/54°F 56/54°F ME0' Cooling Coil Supply Fan 57 / 55 OF 47.7% ROOM CI 1 i OF LAQ7�f7��i�A BUIL iii JU 6Al-E:TY DEPT. APPRQVFn Energ^ 5.1 byEn&gy,%ft UserNumber.-W79 RunCode: 2014.0&12T01:30:08 I Di T-0532 ' -)NS e 120 12 DATE gX