BRES2014-113378-495 CALL E TAMPICO
LA QUINTA, CALIFORNIA 92253
'T e
COMMUNITY DEVELOPMENT DEPARTMENT
t�-BUILDING PERMIT
0 -CT 0 S 2014
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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.: :LIC -762330
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
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 APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose
(_) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under -or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or
the Contractors' State License Law.). , following issuance of this permit. .
(_) I am exempt under Sec. B.&P.C. for this reason 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.
Owner:
MIRIAM JOHNSON
, 92253
Contractor:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/8/2014
RENEWAL BY ANDERSEN OF ORANGE
OUTSIDE CITY LIMITS
Llc. No.: :LIC -762330
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:
Carrier: Policy Number:
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 forthwith
comply with those provisions.
Date:
Applicant:
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.
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 Na
Lender's Address:
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
1
Application Number:
BRES201441133
Property Address:
54865 AVENIDA CARRANZA
APN:
774294018
Application Description:
REPLACE 2 WINDOWS
Property Zoning:
Application Valuation:
$950.00
Applicant:
RENEWAL BY ANDERSEN
OF ORANGE
OUTSIDE CITY. LIMITS
0 -CT 0 S 2014
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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.: :LIC -762330
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
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 APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose
(_) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under -or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or
the Contractors' State License Law.). , following issuance of this permit. .
(_) I am exempt under Sec. B.&P.C. for this reason 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.
Owner:
MIRIAM JOHNSON
, 92253
Contractor:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/8/2014
RENEWAL BY ANDERSEN OF ORANGE
OUTSIDE CITY LIMITS
Llc. No.: :LIC -762330
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:
Carrier: Policy Number:
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 forthwith
comply with those provisions.
Date:
Applicant:
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.
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 Na
Lender's Address:
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
DESCRIPTION 1�n
ACCOUNT n QTv u'PAID'DA,
-PAID- T
It
W!, 1W W"'! WN4
BS . AS SB1473 FEE 101-0000-20306
"0 $1.,00 $0.00
M
N I MET HO�g
'R
1NV`i-11_ ,
ul",
MM nN "INk mm
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
)g,
ON-
DESCRIPTION' ON
T
6 6 Wf,
Rr,
R, RM
SMI -RESIDENTIAL
10170000-20308
-'0.
$0.50
$0.00
Wm-""
�1,;. H,
x g On 'I-
'BYg;,
4wgI
Total Paid forSTRO,NG' MOTION INSTRUMENTATION SMI: $0*150 $0.00,
DES, 11IRTIONWw
Y.
IOUNTMg'� 3m
PAID
.g
"PINOR N
fa:
_PAID.,
-DOOR/WINDOW REPLACE FIRST 7
101-0000-42400
--0
$60.91
$0.00
,,S
ff) V
Nam
lr
Im
mqwv"
CRIPTION"'N"
ONE
-Offl' t T
",AMOL JNT-R-
W
1-� "PAIM.1
PAIDVATE-�,
,A=11YM1 K,
0_
MIN
�V,
ki'm
DOOR/WINDOW, REPLACE, FIRST 7 PC
101-0000-42600
0 .
$11.0.22
$0.00
S zAl— m.
D
RECEIPT
C H I XV
C
'T
kt A,
RON,-, Pill,
NMI
Total 'Paid for WIN DOW/SLI DI NGG LASS, DOOR/FEN ESTRATION. $171.13 $0.00
•iplgl 11! 01:1�0'
Kim i i
JIM
Description: REPLACE 2 WINDOWS
Type: BUILDING, RESIDENTIAL
Subtype: REMODEL Status: SUBMITTED
Applied: 10/8/2014 MFA
Approved:
Parcel No: 774294018 Site Address: 54865 AVENIDA CARRANZA LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA AT
VALE LA QUINTA Block: 309 Lot: 6
Issued:
UNIT 28
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $950.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: REPLACE 2 WINDOWS WITH ANDERSEN RENEWAL WINDOWS
w- `
Printed: Wednesday, October 08, 2014 3:19:43 PM 1 of 2
SYSTEMS
DESCRIPTION m
��e ACCOUNT ' T
QTY
AMOUNT V
PAID
PAID DATE
RECEIPT #
CHECK #
~METHOD
"PAID BY v
CLTD
BY
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
DOOR/WINDOW,
101-0000-42400
0
$60.91
$0.00
REPLACE FIRST 7
DOOR/WINDOW,
101-0000-42600
0
$110.22
$0.00
REPLACE, FIRST 7 PC
Total Paid for WINDOW/SLIDING GLASS
$171.13 $0.00
DOOR/FENESTRATION:
TOTALS:• 00
Printed: Wednesday, October 08, 2014 3:19:43 PM 2 of 2 C N
SY57EM5
INSPECTIONS
SEQID INSPECTION TYPE .. INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT. REMARKS'. NOTES`
FINAL"
Printed: Wednesday, October 08, 2014 3:19:43 PM 2 of 2 C N
SY57EM5
Din. #
Qt}/ of La Qurnta
Building 8r Safety Dh*ion
P.O. Box 1504,78-495 Calle Tampico
14.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 54-865 Avenida Carranza
Owner's Name:. Miriam Johnson
A. P. Number.
Address: 54-965 Avenida Carrenza
Legal Description:
City, ST, Zip: La Quirita 92253
contractor. Renewal b Andersen of Oran e'Co.
y g
Telephone: ,,, .
Adams: 22982 Alcalde Drive
Project Description:
City, ST, Zip: Laguna Hills, CA 92653
Replace 2 windows with Andersen Renewal windows
Telephone: 7 14-259-5120
State Lic. # : 990416 City Lie. #; 762330
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: '.
p ti r - <+
State Lic. #: »"
Name of Con= Person: Steve-Janosik
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL: #Stories: #Univ:
Telephone # of Contact Person: 7.14=259-5120
Estimated Value of Project: 950
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG PERMIT FEES
Plan Sets
Pian Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cafes.
Called Contact Person
Plan Check Balance.
Title 14 Cates.
Plans picked up
Construction
Flood plain plan
Pians resubmitted
Mecharilcal
Grading plan
2i° Review, ready for rnrrectionsPissue
Electrical
Subeoutactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"` Review; ready for corrections/Issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION sew=
CERTIFICATE OF COMPLIANCE MR -ALT -01-E
Prescriptive Residential Alterations (Page 1 of 4)
Project Name: Date Prepared: IC9 v8 - /Z
A. GENERAL INFORMATION
01
02
03
Project Name:
kl�lf\ c
02
Date Prepared: l c7 b Ff I
11
Project Location:
7 t{ /`h d1 A Z-
04
Building Front Orientation (deg or cardinal):
rO3
CA City:
L PC � 'A
06
Number of Altered Dwelling Units:
I LI -Factor
Zi Code:
Aged Solar Thermal SRI
Reflectance Emittance (Optional)
08
Fuel Type:
Climate Zone:
10
Toial Conditioned Floor Area (ft2):
Building T pe
S D
12
Slab Area (ft2
13
Project Scope:
w I,J•o 0 w 4'la, 9r1 f�(✓
B. BUILDING INSULATION DETAILS (Section 150.2(b)1) -
01
02
03
04.,
05
06 - •07 08 08
10
11
Tag/ID
Assembly Type
Frame
I Type
Frame
Depth
inches
Frame
Spacing
inches
Propos d
Required
Comments
.-.Continuous ..IAppendixJA4
Cavity Insulation Reference
R -value R -value 'U -factor Table Cell
I LI -Factor
'Initial Solar Aged Solar Thermal SRI
Reflectance Reflectance Emittance (Optional)
Aged Solar Thermal SRI
Reflectance Emittance (Optional)
C. ROOF REPLACEMENT (Prescriptive Alteration, Section 150.2(b)1H),
01
02
03
04
05
06
07% 08 09 10
11 12 13
Method of
Compliance
Roof
Pitch
Exception
CRR_C Rroduct-ID
Number
-
ProductT a
R -value
Deck
Insulation
Proposed
Minimum Required
'Initial Solar Aged Solar Thermal SRI
Reflectance Reflectance Emittance (Optional)
Aged Solar Thermal SRI
Reflectance Emittance (Optional)
NOTES
o Roof area covered by buildigg integrated ph6tovoltaic•panels and solar thermal panels are exempt from.the above Cool Roof requirements.
o Liquid field applied coatings must comply with installation criteria from section 110.8(i)4.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION `=
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 2 of 4)
Project Name: njlvoo ar PLA Date Prepared: (I, 10 ^ (moi'
D. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.2(b)1)
04
01 02 03
Alteration Type Orientation Maximum Allowed ft2 Comments
E. FENESTRATION/GLAZING PROPOSED AREAS AND EFFICIENCIES (Section 150.2(b)1)
01
02
03
04
05
06
07
•08 -
-09
10'
11
12
13
14
15
Tag/
ID
Fenestration
Type
Frame
Type
Dynamic
Glazing
Orientation
N, S, W,IE, or
Roof
Area
Removed
ft2
Area
Added
ft2'
Net
Added
•'Area ft2
Maximum_
AllowedShading
U -factor
-
U -factor
Source
SHGC
Source
Exterior
Device
Combined
SHGC
from
CF1R-ENV-03
W&
I a WI J L
i8
n
Eft$" "'
7 L
YLA
0.32
0- a1nfrr-d,
a l
nfrc
IU
a
Net Added ,West facing Fenestration Area,
'
b
Existing + Added :West -facing Fenestration Area
c
Maximum Allowed West -facing Fenestration Area
d
Is West -facing Fenestration Area.:S Maximum'Allowed West=facing Fenestration
Area-
'
e
Nst Added Fenestration Area (all orientations)
f
'.Existing+Added Fenestration Area (all orientations)
g
Maximum -,Allowed-Fenestration Area (all orientations)
h
Is Existing + Added- Fenestration Area -e Maximum Allowed Fenestration Area (all
orientations
Registration Number. Registration Date/Time: HERS Provider.
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION �a='
CERTIFICATE OF COMPLIANCE i CF111-ALT-01-E
Prescriptive Residential Alterations (Page 3 of 4)
Project Name: Date Prepared:
F. SPACE CONDITIONING(SC) SYSTEMS — HEATING/COOLING (Prescriptive section 150.2(b))
01 02 03
Dwelling Unit Name Dwelling Unit CFA'(Ft2) Comments
G. WATER HEATING SYSTEMS (Section 150.2(b)1G)
01
02
03
04
',05
06
07
08
09.
1011
Dwelling Unit:
Alteration to the Space
Conditioning System(s)?
12
13
.14
15
Water Heating
# of
Water
Heater
'
Back -Up
System
Water
Water
Water
Heaters
Storage
Rated
Rated
'Heating
- Heating
Exterior
Solar
Dwelling Unit DHW
Iderftlfication or
Heating
Heater
In
Volume
Fuel
Input
-' Input-
Efficiency
Efficiency
Standby
Insul.
Savings
Central DHW System
System
Name
System Type
Type
system
(gal)
Type
Type •
Value
Type
Value
Loss (Y)
R -Value
Fraction
Distributlon.Type
Distribution Type
H. SPACE CONDITIONING SYSTEMS AND WATER HEATING SYSTEMS [N MULTIFAMILY DWEUING UNITS.
I.
01
02
03
04'
05
06
Dwelling Unit Name
Dwelling Unit Total CFA
.(ft2•)
Centra l.1/Vater-Heating
System Identification or-
i Name
Dwelling Unit
Water Heating System
Identification or Name
Dwelling Unit:
Alteration to the Space
Conditioning System(s)?
Comments
i
I
1 '
Registration Number: I Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
MCOMCK11"All Al TI`DATIr1AIC
\1...V ILJI.IY l I1-11. /1 1 F ate\ %W tV
:EC-CFIR-ALT-01-E (Revised 06115) CALIFORNIA ENERGY COMMISSION �m
CERTIFICATE OF COMPLIANCE MR -ALT -01-E
Prescriptive Residential Alterations I (Page 4 of 4)
Project Name: Date Prepared: /bZOP'll if
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
t
j
Documentation Author Signature:
Company: Renewal by Andersen of Orange County
Signature Date:
Address:
22982 Alcalde Drive I
CEA/ HERS Certification .. '
_ Id applicable) • • '
Gty/State9p:
Laguna Hills CA 92653
Phone: _
714-258-5120 '
RESPONSIBLE PERSON'S DECLARATION STATEMENT i
I certify the following under penalty of perjury, under the laws of the State of California:
1. The Information provided on this Certificate of Compliance is true and correct.
2. I am eligible under Division 3 of the Business and Professions Code to accept responsibility forthe building desig . system design identified on this Certificate of Compliance (responsible
designer). -
3. That the energy features and performance specifications, materials, componehts,•and manufactured -devices for the building design or system design identified on this Certificate of
Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of'Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the Information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted to the -enforcement agency for approval with this building permit application.
5. '1 will ensure that a registered copy ofthis Certificate of Compliance:shall be made available with the building p it(s) )ssued for the building, and made available to the enforcement agency'
for all applicable inspections. I understand that a registered copy of this Certificate of Compliance )s required' o e included with the documentation the builder provides to the building
owner atoccupancy.
Responsible Designer Name: � ' "
1
i
Responsibl es 5 a re: '
Company:
Date Signed:
Renewal by Andersen, of Orange County
Address:
License:
22982 Alcalde Drive
990416
City/5tate/tip: -
Phone:
.Laguna Hills CA 92653 !
714-259-5120
For assistance or -questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
i
Registration Number. Registration Date/Time: HERS Provider:
CA,Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
j