10-1003 (PLBG)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/27/10
Application Number: 10-00001003 Owner:
Property Address: 52370 AVENIDA CARRANZA RODRIGUEZ AURELIANO
APN: 773-261-007-16 -000000- 52370 AVENIDA CARRANZ
Application description: PLUMBING LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL (
Application valuation: 500 n n
F1
�'
Contractor: E, (-�
Applicant: Architect or Engineer: CAMPESINOS UNIDOS, INC. OCT�.�. ��
P.O. BOX 39 i �t'' �'�(�
BRAWLEY, CA 92227 �-
(760)344-4500
Lic. No.. 618140 m�
-------------------------------------------------------------------------------------------------
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 Class: C36, license No.: 618140
/ OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury chat 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).:
(_ I 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.).
(_ I 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) 1 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:
LQPERM[T
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
V issued.
Y� I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
"//-- Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 569-0000490
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
andagreethat, if I should become subject to the workers' compensation provisions of Section
Pate:-,(2Lobo rthwith comply with those provisions.
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 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 thi count t enter up n the above-mentio property for inspec purposes.
.��,�
at gnature (Applicant or ant : --
Application Number . . . . . 10-00001003
Permit . . . .
. PLUMBING
Additional desc .
.
Permit Fee . . .
. 22.50 Plan Check
Fee
5.63
Issue Date . . .
. Valuation
. . .
. 0
Expiration Date .
. 4/25/11
Qty Unit Charge Per
Extension.
BASE FEE
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and
Comments
CHANGE OUT GAS WATER HEATER 40 GALLONS.
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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
General Information
Site Address:
Enforcement Agency:
Date:
Building Type. Singte Family O Multi Family
Circle the Front Orientation: N, E, S, W, or degrees
Conditioned Floor Area (CFA):
Project Type: O Alterations O Envelope O Festration O Roof O HVAC
E
cementor 'Qui 13'IJuct cennen aterHeater
: This form is not to be used or Newly Constructed
Balldings or Addidons
Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
O Opening of framed cavity alone —Alterations that involve the opening of the framed cavity ofa wall, ceiling, orJloor mutt install the
mandatory minimum insulation value per §150 for the altered ossembly. Fill in Columns A -C and enter mandatory insulation Value in Column H.
O Replacement of entire assembly — Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component
Package- D insulation valua in Table 151-C. Fill in Columns A —J
Opaque Surface DdSlls For the furred portioned of Maas Walla we Furring Strip Construction Table below.
A. S I C D 1 E I F G I H I J
Prnaosed 5W 148ft 1 Standard I Values From JA4 Table
Framing Thiclmess, Ftamcd Cotrtinuous JA4 Proposed
Tai/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assanbly Assembl
ID or Type t and Size' or Otbe? factor, Numbers R -value° R -Values _Cell Values U -factor
Note: For f —d asutnUW4 --WWf- Com Vous 1Mu1ation R -vol ire, see Page JA4-3 and Equatlon 4-1. For catcuixu g flared walls tue die Mau and
Furring Comm union table below.
1. For Tag/ID indicate the ident fieation name that matches the building plans.
2. Indicate the Assembly Name or type: RooffCeiling, Walls, Floors, Slabs. Crawl Space. Doors and etc ... Indicate the Frame type and Siff: For
Wood Metal. Metal Buildings, Mass, enter 2x4, 20, or etc... see JA4 for other possibleframe type assemblies.
3. Eater the thic iness for mass in incites or Spacing between framing members enter, 16 "or 24 VC. or Other for all other assembly description
such as Concrete Sandwich Panel. Spandrel Panel, Logs, Straw Bate Panel and etc....
4. Based on the Climate Zone; enter the Standard U factor from Table 15 I -B, C or D for each different assembly Name or type.
S. Einer 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 V
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 UJactor in Column E to comply.
Furring Strips
Construction Table for Mass Walls Onl
A
13I C IDI
E
F
G I H I i I J
K
L M
Proposed Properties
of Masonry and Concrete
Added Interior or Exterior Insulation
Walla From Reference
in Furring Space from Reference
Joint Appendix
Table 43.5 43.6 4.3.7
Joint Appendix Table 43.13
Mass
Assembly-
Name or JA4 Table �'
c c .�
S yt y3
E
>
Final
Assembly
' >
8
< >
�Ck
Comment
Thickness'
T Number'
U -facto
Registration Number: Registration Date, -Time:
2008 Residential Compliance Forms
HERS Provider:
August 2009
Prescriptive Certificate of Com
Residential Alterations�
Project Name:
A
'I -NN
Ir4R-N\
CF -IR -ALT
Page 4 of 5
Climate Zone # / # of Stories
HVAC SYSTEMS - HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating.
Minimum Duct or Piping Configuration
Heating Equipment
Efficiency Distribution Insulation Thermostat (Central, Split,
Type and C aci l•2•'
AFUE or HSPF Type and Location R -Value Type Space, Package or H dronic
External Tank
Water Heater Type/Fuel Distribution Type Number In
Energy Factor or Insulation
Type' S Reci Matin 2 44M i
;;Tank
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 (i.e., if total capacity
< 2 KW or 7,000 Bwhr 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 -.1R -ALT Form for additional requirements and check applicable boxes.
4. Indicate Type or Location (Ducts, H),dronic in Floor, Radiators, etc.)
HVAC SYSTEMS - COOLING.
Minimum
Efficiency
Duct or Piping Configuration
Cooling Equipment
(SEEPAER or
Distribution Insulation Thermostat (Central, Split;
T
COP
Type and Location' R -Value Type a or H dronic
1. Indicate Cooling Type (A/C, Heat pump, Evap. Cooling, etc)
2. Refer to the HERS' Verification section on Page 4 of the CF -IR -ALT Form for additional requirements and check applicable boxes.
3. indicate Type or Location Ducts, Hydronic 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 kitchen(s) and on all underground
hot water pipes is required in all c onent packages in all climate zones.
External Tank
Water Heater Type/Fuel Distribution Type Number In
Energy Factor or Insulation
Type' S Reci Matin 2 44M i
;;Tank
Thermal Efficient R -Value'
AS
1. indicate Type (Storage Gas, Heat Pump. Instantaneous, etc.) .
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §l50(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 pipes 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 tcation and documentation and special verification.
NEW ROOF ASSEMBLY - Radiant Barrier
The radiant barrier requirement of § 15 1 2 does not apply to roof alterations.
Slab Edge (Perimeter) Insulation O YES O 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 O YES O NO
YES: In.Climate Zones l 2, 11, 13, 14 & 16, R-8 insulation is required; 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: Registration Date,•Time:
2008 Residential Compliance Forms
HERS Provider:
August 200
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
Duct Sealing & Testing HERS verification is required for this measure.
YES ❑ NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned
spare; the ducts art -to be sealed per f Mb)tDii and the newly instalted-ducts are to be insulate&per-§I3-i(f)+0:
❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
17 YES 13 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) I 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
seated 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.
O EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space.
❑ EXCEPTION: Existing duct systems constructed, insulated or sated with asbestos.
Refrigerant Charge- Split System HERS verification is required for this measure. .
17 YES O 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
ex a refrigerant charge meauntment shall be verified per §1S b lf.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation requirements of § I o do not apply to existing residential homes.
Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure -
E3 YES 0 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 Der '5152(b)ICi to meet the requirements of §151(f)7B.
Documentation Author's Declaration Statement
• 1 certify that this Certificate of Compliance documentation is accurate and corn
N S6 ` o -R.: t O
Sign
Company,
p3� � Date:
Address: If Applicable ❑ CEA or ❑ CEPE
o o S C .�
(Certification #):
City/State/Zip: 8 % 0.w i NA 2- Phone:
Responsible Building Designe`r'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.
• 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 wi this building it application.
Nam .
Company:
Date:
Address:C-3 O _
License:
City/State/Zip:
Phone 6 gsc9 a
w 2
-3
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300.
Registration Number: Registration DatelTime: HERS Provider:
2008 Residential Compliance Forms August 200
Bin # City of LA Quinta
Buflding 8F Safety I)Mslon ,
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: z-3 a eta l �• �q� er's Name: `C e ; (k b
A. P. Number.
Address -.5,1376 Ave
Legal Description:
City, ST, Zip:
5 `1&OS' Telephone:
Contractor. CA.jy\,QS 1110�Y
Address: C7 cS S� Project Description:
City. ST. Zip: R)Y o"\.1 `�h
CK 2 Z'Z7 C c c)
Telephone. (7" ii g l 4 s O
LID �, W 0 'Q:Y
State Lie. #
Lie. C
Arch., Ertgr., Designer:
Adittess:
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft a # Sto ' # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Plan Sets
Req'd
Reed TRACKING PERMIT FEES
Plan Cheek submitted Item Amount
Structural Cala.
Reviewed, ready for corrections Plan Check Deposit
Tara: Cala.
Called Contact Person Plan Check Balance.
Title 24 Cala.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2'' Review, ready for correctionslissue Eleetrteal
Subeontactor st
U
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.L
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
Review, ready for correctionstissae Developer Impact Fee
Planning Approval
Called Contact Person A.U.P.
Pub. Wks. Appr
Date of permit issue
School Pees
Total Permit Fees