11-0133 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4&t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: d1-00000133.\ Owner:
Property Address: 54985 AVENIDA CARRANZA RUMSEY SHARON
APN: 774-294-024-12 -000000- PO BOX 4216
Application description: REMODEL - RESIDENTIAL NEWPORT BEACH, CA 926
Property Zoning: COVE RESIDENTIAL
Application valuation: 8000
Applicant: o Architect or Engineer:
--------------------------------------------------
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: B License No.: 786114
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).:
1—) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
( 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date- �% .Z 7n.r.
CONSTRUCTION LENDING AGEN
I hereby affirm under penalty of perjury that there is a construction lending agencyor the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: 1��t
Lender's Address: I lT
LQPERMIT
Contractor:
RM STIPKOVICH INC
70630 GRANITE COURT
MOUNTAIN CENTER, CA 92561
(760)578-6848
Lic. No.: 786114
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
--------------- - --
WORKER'S COMPENSATION DECLARATION
Date: 2/08/11
O
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.
1 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 238-0004288
D41 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: pplicant:
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 h by authorize representatives
of this county to enteruponthe above-mentioned property f r inspection purp e .
Deie: e�6idnAture (Applicant or Agent):
Application Number . . . . . 11-00000133
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee 99.00 Plan Check Fee
64.35
Issue Date . . . . Valuation . . .
. 8000
Expiration Date 8/06/11
Qty Unit Charge Per
Extension
BASE FEE
45.00
6.00 9.0000 THOU BLDG 2,001-25,000
54.00
----------------------------------------------------------------------------
Special Notes and Comments
CHANGE OUT 8 WINDOWS AND 2 DOORS, SEE
CF -1 -R -ALT FORMS FOR FENESTRATION AND
ORIENTATION. 2010 CODES.
-----------------------------------------------------------------------------
Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
6.44
STRONG MOTION (SMI)-- RES
.80
Fee summary Charged Paid Credited
-------------------------------------=-------------------
Due
Permit Fee Total .99.00 .00 .00
99.00
Plan Check Total 64.35 .00 .00
64.35
Other Fee Total 8.24 .00 .00
8.24
Grand Total 171.59 .00 .00
171.59
LQPERMIT
Prescriptive Certificate of Com
Residential Alterations
Project Name: I
nce: Residential
Climate Zone H,or IS
CF -IR -ALT
Pae 1 of 5
N of Stories
Opaque Surface Details For the furred
A B C
Proposed °"
Framing
Tag/ Assembly Name Material
iD' I or Type I and Size
-tinned of Mass Walls see Furring St
D E F
Standard
Thickness,
Spacing, U- JA4 Table
or Other 1 factor Numbers
Construction Table below.
c H 1 J
Values From JA4 Table
Framed Continuous JA4 Proposed
Cavity insulation Assembly Assembly
R-valueb R -Value Cell Value° U -factor°
Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-/. For calculating furred walls use the Mass and
Furring Construction table below.
L For Tag/ID indicate the identification name that matches the building plans.
2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc... Indicate the Frame type and Size: For
Wood, Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter,, 16 "or 24 "OC: or Other for all other assembly description
such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc....
4. Based on the Climate Zone: enter the Standard U factor from Table /5I -B, C or D for each different assembly Name or type.
5. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R -value that is being installed in the wall cavity or between the framing: otherwise, enter
7. Enter the Continuous Insulation R -value for the proposed assembly: otherwise, enter "0 ".
8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J
9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor in Column E to comply.
Furring Strips Construction Table for Mass Walls Onl
A B I C I D I
E
F
I G I
H 1 J I
K
L M
Proposed Properties of Masons• and Concrete
Added Interior or Exterior Insulation
Walls From Reference
in Furring Space from Reference
Joint Appendix Table 4.3.5, 4.3.6, 4.3.7
v
Joint A
endix Table 4.3.13
Assembly _�
j
o g •°
FT o m'� .�
a ".
Final
Mass
Name or JA4 Table —'�
;, a`,
E
t
v �
Assemb�7
Thickness
T Number' < >
Si X i
L"
Q >
U factor ' Comment
Registration Number: Registration Date. -Time:
2008 Residential Compliance Forms
HERS Provider:
August 2009
paqt-,24
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations Page 2 of 5
Project Name: / Climate Zone a # of Stories,
. SA /2 /A -M %?- 15
Mass and Furring Strips Construction(footnotes)
/. Indicate the type of assembly to include: Hollow Unit Mosonry Walls, Solid Unit Hosonrv, Solid Concrete Walls, Etc. Additional assemblies can
be found Reference Joint Appendix JAa.
2. This is the U -Factor based on the thickness of the assembly? in inches.
3. The R -value of the insulation to be added on the interior or exterior of the assembly.
4. The Calculated R- Value is the R -value of the furred out section of the assembly.
-6. The Final Assembly is calculated using Equation 4-2 or Equation a-aof the Reference Joint Appendix JA4. The equation is the inverse of Column
added to Column L Column K is the inverse from column J.
7. Insert the calculated U -(actor value on to the Opaque Surface Details in Column J
FENESTRATION PROPOSED AREAS
Ot
Replacing window alone — Replacement windows shall meet the U -Factor and SHGC i%alue requirements of Component Package D in
Table 151-C. The Total Fenestration and West facing Area requirements are not applicable.
❑ Adding 50ft2 or less of window area —.Newly installed windows shall meet the U -Factor and SHGC Value requirements of Component
Package D in Table 151-C.
❑ Adding more than 50fe of window area — Newly installed windows shall meet the U -Factor and SHGC I'alue and the Fenestration
Area requirements of Component Package D in Table /5/-C. Complete the Altered Fenestration Al/owed Area Table on Page 2 of the CF -/R -ALT
Orientation
Fenestration Type and Frame (North, East. PropsedArea� Maximum Maximum NFRC or Default
Window, Glass Door or Skylight) South, West(ft') U -factor' ' SHGC'- 1.4
Values
a' -PIC( W5d" = SO D
e 5 31AIPA-1•�%
ln '" vip .30
i b " - AS .30 ..2/
1. Fenestration area is the area of total glared product (i.e. glass plus frame). Exception: When a door is less than 50% glass. ►he fenestration
area may be the glass area plus a -2 inch frame " around the glass.
2. Enter value from Component Package D Requirements in Table 151-C.
3. Actual fenestration products installed and as indicated in CF -6R -ENI' Form shall be equivalent to or have a lower U factor and/or a lower
SHGC value than that specified on the CF -I R ALT Form.
4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading.
J. If applicable at this stage enter NFRC - or NFRC Certified windows or are CEC "Default - valuesfound inZable I I6 -A or B.
ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50fr of fenestration is added)
A
B
C
D
E
F G
Allowed
Existing
Fenestration
Total Area
CFA of Entire
% of
Fenestration
Area
Fenestration
Allowed Proposed Area'
Dwelling
CFA
Area
Removed
Area Added
(A x B) (E -D) + C
Total Fenestration Area
(ft')
20
>
West Fenestration Area
(Required In
.05
>
CZ's 2,4&7-15
t. nest r enestratton Area includes west-sioptng skylights and any skylights with a pitch less than l: 12.
2. West facing glazing area removed cannot be "counted - twice. - In order to distribute the west glazing area removed to the other orientations,
input the west glazing area removed in the Total Fenestration Area row, column D.
3. include the Proposed Area of the West facing fenestration in both Area columns below.
a. To meet compliance. the Proposed Area must be less than or equal to the Total Allowed Area for BOTH the Total and West Fenestration Areas.
Registration Number: _ _ Registration Date -Time:
2008 Residential Compliance Forms
HERS Provider:
August 2009
Prescriptive Certificate of Compliance: Residential CF -IR -ALS'
Residential Alterations Page 2 of 5
Project Name: Climate Zone h it of Stories `
e2am§eV 1
Mass and Furring Strips Construction(footnotes)
1. Indicate the type of assembly to include: Hollow Unit ;Wasonry 61'olls, Solid Unit A4asonrv. Solid Concrete Walls, Etc. Additional assemblies can
befound Reference Joint Appendix JA4.
2. This is the U -Factor based on the thickness of the assembly, in inches.
3. The R -value of the insulation to be added on the interior or exterior of the assembly.
4. The Calculated R- 6'alue is the R -value of the furred out section of the assembly.
-6. The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA4. The equation is the inverse of Column
added to Column I. Column K is the inverse from column J.
7. Insert the calculated U- actor value on to the Opaque Sur ace Details in Column J
FENESTRATION PROPOSED AREAS
eplacing window alone — Replacement windows shall meet the U -Factor and SHGC 1•'alue requirements of Component Package D in
Table 151-C. The Total Fenestration and West -facing Area requirements are not applicable.
❑ Adding 50ft' or less of window area —Newly installed windows shall meet the U -Factor and SHGC l'alue requirements of Component
Package D in Table 151-C.
❑ Adding more than 50ft' of window area — .Newly installed windows shall meet the U -Factor and SHGC 1'alue and the Fenestration
Area requirements of Component Package D in Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF- IR -ALT
Orientation
Fenestration Type and Frame (North, East, PropsedArea' Maximum Maximum NFRC or Default
window, Glass Door or Skylight) South, West ft' U-factorz-' SHGC'- 1.4 Values
,,o it
3 y
o
aka k)16 � 110
11
/�/ . 102/ 30
o?b" G
1. Fenestration area is the area of total glared product (i.e. glass plus frame). Exception: When a door is less than 50% glass, the fenestration
area may be the glass area plus a -2 inch frame " around the glass.
2. Enter value from Component Package D Requirements in Table 151-C.
3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower
SHGC value than that specified on the CF -IR ALT Form.
4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading.
5. If applicable at this stage enter NFRC ** or NFRC Certified windows or are CEC "Default - values found inZ'able 116-A or B.
ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50ft' offenestration is added)
A
B
C
D
E F G
Allowed
Existing
Fenestration
Total Area
CFA of Entire
% of
Fenestration
Area
Fenestration Allowed Proposed Area'
Dwelling
CFA
Area
Removed
Area Added (A x B) (E -D) + C
Total Fenestration Area
(ft)
.20
_
West Fenestration Area
(Required In
.05
>_
CZ's 2, 4 & 7 -15)
1. West Fenestration Area includes west -sloping skylights and any skylights with a pitch less than 1: 12.
2. (fest facing glazing area removed cannot be "counted'* twice." In order to distribute the west glazing area removed to the other orientations.
input the west glazing area removed in the Total Fenestration Area row, column D.
3. Include the Proposed Area of the West facing fenestration in both Area columns below.
4. To meet compliance. the Proposed Area must be less [lion orequal to the Total Allowed Area or BOTH the Total and West Fenestration Areas.
Registration Number: _ _ Registration Date Time: HERS Provider:
2008 Residential Compliance Forms August 2009
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations Page 5 of 5
Project Name: Climate Zo e 4 4 of Stories
ayl&MA&4!�
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to ie HERS Measures specified in this
checklist below. A completed and signed CF -4R Form for all the measures specified shall be sub fitted to the building inspector before final
inspection.
Duct Sealing & Testing HERS verification is req/Dand
for this measure.
❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, re than 40 linear feet o ew or replacement ducts are installed in unconditioned
space. the ducts are to be seale§ 152(b) I Dii and th newly installed ducts are to be insulated per § 151([)10.
❑ EXCEPTION: Existing duct ms that are exte ed, which are constructed, insulated or sealed with asbestos.
❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, iexisting space onditioning system (HVAC equipment and ducting) is replaced, the
ducts are to be sealed per § 152i.
❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, iexisting AC equipment is replaced (including the replacementof the air handler,
outdoor condensing unit of a sstem. ooling or heating coil. or the furnace heat exchanger) the ducts are to be
sealed per § 152(b) I E.
❑ EXCEPTION: Duct systems r documented to have been previously sealed confirmed through HERS
verification in accordanceicedures in the Reference Residential Appendix RA3.
❑ EXCEPTION: Duct systems less than 40 linear feet in unconditioned space.
❑ EXCEPTION: Existin ductms constructed, insulated or sealed with asbestos.
Refrigerant Charge - Split System HERS v rification is required for this measure.
❑ YES ❑ NO YES: In Climate Zones 2 and 5, when the existing HVAC equipment is replaced (including the replacement of the air
handler. outdoor conde ing unit of a split system A/C or heat pump. cooling -or heating coil, or the furnace heat
exchanger) a refri e t chara measurement shall be verified per 152(b)I F.
Central Fan Integrated (CFI) Venti tion System and Fan Watt Draw
The ventilation requirements of § 150(o) do got apply to existing residential homes.
Ducted Split Systems - Air Condit
io ers and Heat Pumps: Airflow HERS verification is required for this measure.
[3 YES 13 NO YES: In Climate Z es 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is
replaced. th airflow and fan watt draw shall be verified per § 152(b)ICi to meet the requirements of §15I(f)7B.
FA
Documentation Author's Decfaration Statement
• 1 certify that this Certific a of Compliance documentation is accurate and complete.
Name:
Signature:
Company:
Date:
Address:
if Applicable ❑ CEA or ❑ CEPE
(Certification #):
City/State/Zip:
Phone:
Responsible Bu ding Designer's Declaration Statement
• I am eligibl under Division 3 of the Califomia Business and Professions Code to accept responsibility for the building design identified on
this Certif, ate of Compliance.
• 1 certifyt at the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the re uirements of Title 24. Parts 1 and 6 of the Califomia Code of Regulations.
• The bu' ding design features identified on this Certificate of Compliance are consistent with the information provided to document this
buildi g design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement
agency fora roval with this building permit application.
Name:
Signature:
Company:
Date:
u r o2D �l
Address:
License:
City/State/Zip:
Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300:
Registration A"umber: _ _ Registration Date•Time: _ HERS Provider:
2008 Residential Compliance Forms August 2009
Windows & Doors PLAN
T --
Garage
22'-0' x 20' 0"
New Self Closiri
20 -minute fire rte ,
--Doorfor-Extende a
2'-8" x 6'�"
6 5/8" wide jamb
� N
-=- - - - - - - - - - - - - - - - - - - - - - - -
I
i
All Doors are T.M. Cobb Therma Tru ''Fiber Classic".
These doors are fiberglass framed, full lite glass doors. —
Each door has the same energy values:
U=.26
S=.17
CITY OF LA;'QUINTA
BUILDING & SAFETY DEPT,
APPROVED
FOR CONSTRUCTION
DATE ? 1 0Y
Replace Replace
Existing 6-0" x 6-8" slider Existing 2'-0" x 5'-0"
with single hung bathroom window
T-0" x 6'-8" in -swing glass door with
and 12" x 6'8" operable side lite 'tempered"
-0" x 5'-0" casement window
Broom Clo
Existing sliding
�j-----
3-0x 2-0
5'-
Tub/ShblSh owerwee
l
' ting Master B room
15-0 x 10-6 -
Existing:
Master, -.
Bathroom
i
Existing
-Guest
x
Bathroom
L15-0
ily Area
Existing Guest Bedroom
15'-0 x 10'-0 xv
Bedroo
Closet
Existing sliding istin sl
5-0 x 5-0 x 5-0
_4 Vr x ,r_011�
J
Existing Kitchen
All Windows are Casement Windows,
except the guest bathroom is an Awning window.
These windows are Milgard Ultra fiberglass framed,
and the Energy Package is rr3D Max South
and includes SunCoatMax.
Each window has the same energy values:
U =.30
S =.21
V=.46
Existing sliding
Existing Dining 5-0 z 5-0
Area 1- window
1
M
1
i
� Replace
Existing Living Area I ng Slider 8-0 x 6-8
with
two '-6"x 6-8 out -swing doors
( io; ne 2'16"x 6-8 fix panel door
i
Existing sliding
3-0x[Replace w entry
wln6-0 d
3-0 x 6-8 entry door win c
with a 3-0x 6-8
fiberglass. frame,
full light glass door
Prepared by Homeowner
Sharon Rumsey
949-887-5 3
M
t!.r/Y1 7/11
si nature
_ NORTH
Bin #
City of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
- 3
Project Address: _ 8 B r
Owner's Name: arm m
A. P. Number:
Address: 5Y -
_Legal
Legal Description:
Contractor: nz
City, ST, Zip: a C 9a
Telephone: t:.t•,.;:•<.;•.>;;::`.,:.;..::r::<:;�.,w,::
:>>:4f><<.;<::.?::�•:;:#:,^•,«;:,>:t<.> ;
Addres .
Project Description:
City, ST, Zip:
e lQC!/i GtsZJ T Pf1
Telephone:
:Tr:v: �. tiCf,.:;:�'FS�i::}.;:}L�::iir%i:4:: ('rr:
Z.�•'".iiii::i:` :i.2^4:ib%:}:S:.v�4 Biu
i " ,<
d6
State Lie. # :
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lie. #: A%""''s?i}<z:s::r;;::::s: %% x%:>
Construction Type: Occupancy:
Project type circle one New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: D bb
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Tide 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
L
Total Permit Fees