06-3775 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00003775
Property Address:
53705 AVENIDA CARRANZA
APN:
774-115-021-10 -000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
500
Tav144Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
BALUKAS DALE E
53705 AVENIDA CARRANZA
LA QUINTA, CA 92253
D
(
OCT 2 4:200]6DI Contractor:
FOY, SCOTT A.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/23/06
CITY OFLAQUINTA 43579. MAIN STREET
PINANCEDEPT. INDIO, CA 92201
�I
(760)775-9405
Lic. No..::828828264
-------------------------------------------------------------------------------------------------
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.: 828264
bate%L¢%JC Co ctor. ,♦ V
OWNE -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 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 ($5001.:
(_ 11, 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 ISec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I 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.I.
Lender's Name:
Lender's Address:
LQPEM11T
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.
fv 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 FLTND Policy Number 1576840
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall
`forth with comp) with those provisions.
ate: pplicant: //)/-
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION OV'C ERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 0100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that 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 au "ho ' representatives
of this unty to enter upon the ve-mentioned property for inspection purposes.
ate��S' ture (Applicant or Agent):
Application Number . . . . . 06-00003775
Permit . . . PLUMBING
Additional desc .
Permit Fee 22..50
Plan Check
Fee
5.63
Issue Date . . . .
Valuation
0
Expiration Date 4/21/07
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 7.5000 EA PLB
WATER HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and Comments
WATER HEATER CHANGE OUT
Fee summary Charged
-----------------
Paid Credited
Due
--------------------
Permit Fee Total 22.50
----------
.00
----------
.00
22.50
Plan Check Total 5.63
.00
.00
5.63
Grand Total 28.13
.00
.00
28.13
LQPERMIT
La La"'s
CF -1R
Project Title �7��by V\ Date --
t
SEALED DUCTS and T Vs (or Alternative Measures)
A signed CF -411 Form must be provided to the building department for each home for which the following. are
uired.
Vol
Distribution
T e
O
Sealed Ducts all climate zones Installer testing and certification and HERS rater field verification required.)
0
TXVs, readily accessible (climate zones 2 and 8-15 only)
Standby'
Loss %
nstaller testing; and certification and HERS Rater field verification required.)
0
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
0
J
'a
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapprovcd
La La"'s
CF -1R
Project Title �7��by V\ Date --
t
SEALED DUCTS and T Vs (or Alternative Measures)
A signed CF -411 Form must be provided to the building department for each home for which the following. are
uired.
Vol
Distribution
T e
O
Sealed Ducts all climate zones Installer testing and certification and HERS rater field verification required.)
0
TXVs, readily accessible (climate zones 2 and 8-15 only)
Standby'
Loss %
nstaller testing; and certification and HERS Rater field verification required.)
0
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
0
verification ' ' uired
OR
Alternative to Sealed Ducts and Refrigerant Charge /I7t"Vs (See Package D Alternative Package Features for
O Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
a OR
i
i
S
For additions and alterations, duct systems that are not documented to have been previously .
sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
aces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING_ SYSTEMS
Systems serving single dwe ing units
Water Heater
T e/Fuel T e
Distribution
T e
Number
in S stem
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
O
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Standby'
Loss %
not allowed.
0
Chock box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the system complies automatically
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapprovcd
D
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
subtnittal.
IFCheck
]
box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Systems serving single dwe ing units
Water Heater
T e/Fuel T e
Distribution
T e
Number
in S stem
Iua
Al or
BWw
Tank
Capacity
tons
Energy
Factor' or
Thermal
Efficiency
Standby'
Loss %
Tank
External
Insulation
R -Value
G US
O
System serving multiple d elling units
Water Heater
Type
Distribution
Type
Number
in System
Input
(kW or
Btu/hr(gallons)
Enemy
Tank Factor or
Capacity Thermal
Efficiency
Standby
Loss ffol
Tank
External
Insulation
R -Value
1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Pipe Insulation (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 1/4
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 (j) 2 B.
Residential Compliance Forms March 2005
'CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 4) CF -IR
Project
Project AddressSan a�- n '^
Documentation Author Telephone
Compliance Method (Prescriptive) Climate Zone
Date
Building Permit #
Plan Check / Date
Field Check / Date
Enforcement Agency Use Only
✓ ❑ Alternative Component Package Method: (check one) C D D (Alternative)
. 0 Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -IR page 3)
For Package D Alternative see Appendix B Table 151-C Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) Average Ceiling Height: ft
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C — (5% X CFA) ft
Maximum Allowed Total Fenestration Products Per Table 151-B or 151-C — (20% X CFA) ft
✓ ❑ Building Type: (check one or more) Single Family Multifamily Addition Alteration
(If adding fenestration fill out WSAR, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
Number of Stories: Number of Dwelling Units:
Floor Construction Type: Slab(Raised Floor (circle one or both)
Front Orientation: North / South / East / West / All Orientations (input front orientation in degrees from True
North and circle one).
✓ ❑ RADIANT BARRIER free uired in climate zones 2.4.8-15)
OPAQUE SURFACES INCLUDING OPAOUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
or Metal)
% Assembly U -
factor (for
Cavity Continuous wood, metal
Insulation Insulation frame and mass
R -Value R -Value assemblies
Joint
Appendix.
IV
Reference
Roof Radiant
Barrier Location/Comments
Installed (attic, garage,
Yes or No typical, etc.
f f.
-�Y
;rf
a�
J7
F
'CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 4) CF -IR
Project
Project AddressSan a�- n '^
Documentation Author Telephone
Compliance Method (Prescriptive) Climate Zone
Date
Building Permit #
Plan Check / Date
Field Check / Date
Enforcement Agency Use Only
✓ ❑ Alternative Component Package Method: (check one) C D D (Alternative)
. 0 Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -IR page 3)
For Package D Alternative see Appendix B Table 151-C Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) Average Ceiling Height: ft
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C — (5% X CFA) ft
Maximum Allowed Total Fenestration Products Per Table 151-B or 151-C — (20% X CFA) ft
✓ ❑ Building Type: (check one or more) Single Family Multifamily Addition Alteration
(If adding fenestration fill out WSAR, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
Number of Stories: Number of Dwelling Units:
Floor Construction Type: Slab(Raised Floor (circle one or both)
Front Orientation: North / South / East / West / All Orientations (input front orientation in degrees from True
North and circle one).
✓ ❑ RADIANT BARRIER free uired in climate zones 2.4.8-15)
OPAQUE SURFACES INCLUDING OPAOUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
or Metal)
% Assembly U -
factor (for
Cavity Continuous wood, metal
Insulation Insulation frame and mass
R -Value R -Value assemblies
Joint
Appendix.
IV
Reference
Roof Radiant
Barrier Location/Comments
Installed (attic, garage,
Yes or No typical, etc.
1) See Joint Appendix IV in Section IV.2, IV.3 and IVA, which is the basis for the U -factor criterion. 0 -factors can not
exceed prescriptive value to show equivalence to R -values. .
Residential Compliance Forms
March 2005
: RESIDENTIAL. (Page 4 of 4) CF -1R
Project Title ` `p .� � Date
SPECIAL FEATURES NOT REQUIRING HERS VERIFICATION (add extra sheets if neccssaar
Indicate which special features are part of this project. The list below only represents special features relevant to the
prescriptive method.
✓ I
Feature
Required Fortes if applicable)
Description
❑
Metal Framed Walls
CF -1R
Refrigerant Charge
❑
Radiant Barriers
CF -1R
CF -6R part 6 of 12
❑
Exterior Shades
WS4R
O
Cool Roof
N/A; Attach CRRC Label to
Forms.
❑
Dedicated Hydronic Heating
Performance Calculation
system
R wired Attach Run to Forms.
❑
Combined Hydronic System
Performance Calculation
Required; Attach Run to Forams.
❑
Gas Cooling
Performance Calculation
Required.
❑
Buried Ducts
N/A; Indicate on building plans.
❑
Kitchen Pipe Insulation
See Section 5.6.2 Distribution
Systems in Residential Manual.
Multiple Water Heaters Per
See Table 5-13 or use
❑
Performance Calculation and
Dwelling Unit
attach Run to Forms.
❑
Central Water Heating System
Performance Calculation and
Serving Multiple'Dwellings
attach Run to Forms.
❑
Non-NAECA Large Water
CF -IR
Heater
See Table 5-13 or use
❑
Indirect Water Heater
Performance Calculation and
attach Rpn to Forms
See Table 5-13 or use
❑
Instantaneous Gas Water Heater
Performance Calculation and
attach Run to Forms
See Table 5-13 or use
❑
Solar Water Heating System
Performance Calculation and
attach Run to Forms
❑
Wood Stove Boiler
Performance Calculation and
attach Run to Forms
SPECIAL FEATURES REOUMNG HERS RATER VERIFICATION
(add exL-a sheets if necessary) Indicate to the HERS Rater which credits are part of this project and need
verification.
✓
Feature
Required Forms if applicable) Description
❑
Duct Scaling
CF -611 part 4 of 12
❑
Refrigerant Charge
CF -611 part 5 of 12
❑
Thermostatic Expansion Valve
CF -6R part 6 of 12
Residential Compliance Forms March 2005
V f
o
1154
Catty Of Lauilita'
L( � Building ar Safety Div OD
p O Boz 1504 78-495 Gille Tampico
Permit j1�'J La Quinia, CA 92753 - (760) 777-7012
3 Building Permit AoUcation and Tracking Sheet
", Project Address: S
A. P. Atunrber.
Legal Description:
Contraciur. ����'s'`i
r l �� i ler lephot:et =ar_�r.-.;3-3
Address: 1--l--?;c7 �j nlj a
n Z7:y -e4'_4r " PcojcctDc=i;;tion:
City, STIC1L�C)}C li•-
GE 7.2
Tclephonc: �,
Amnunl
State Lic. d (p er
.o._...._
i Plao Cheek Deposit
City Lir. `t:� +
—
Arth., Ergr., Designer:
Called Coatar-r Ferson
Address:
E
Ci y, ST. zip:
Ptoas picked up
Tclephonc:
Conswiction Type: ,� occup3acy:
Aojxt tytrs(Citcie oma): Nc-.%- Add'a FJter !Tfcpair) DCM0
Jwlc 1-ic. R:
tJantt: of Contact Person:
S¢. Ft.:�
Stories:
4 Units -
Telephone k of Contuct Perkin:
Estimated Value of Proj!tL2
APPLICANT: DO NOT t§f ME BELOW THIS ME
e sulmatrat
I'lao Sets
Stroetaral Cala.
Tnai Calcs.
Tkt1n 24 (?arcs.
hood plain pirn►
Grntding plan
f
Subconrartor List
Grant Dccd
II.0_4. Approval
1N HOUSE:-
Ytanning Approval
Pult.1C m. Appr
School Fees
1
M
ReNd
TRACKING PF. irr FEES
Plia Check subtaitted
item
Amnunl
Rm ie4, rndy for ocrrections
i Plao Cheek Deposit
Called Coatar-r Ferson
Plan Check Ba!'rtete
Ptoas picked up
li Construction
Plans resubmitted
I18edraaical
}' 2"' Review, really for correctionsilssae
Ltxtrical
Caller Contact Person
d t�tumbcrtg
Finns picked op
Pions resubmieted
" Grzding
Rettiew. rwdr for correedousfiis9ue
Developer Impact Fee
Called coama Ftr son
�1
7Late of permit issue
t�
�
F
�
!Total Permit L-'ecs