07-2847 (AR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00002847
Property Address:
77165 AVENIDA ARTEAGA
APN:
658-210-032- - -
Application description:
ADDITION - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2667
T4tyl 4 4 Q"
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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.: 756174
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 Cade: 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.:
(_ 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 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project 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 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:
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:
LQPERMIT
Owner:
VOSSLER ERNEST O
77165 AVENIDA ARTEAGA
LA QUINTA, CA 92253
Contractor:
GRAY, DON
P O BOX 131
LA QUINTA, CA 92247
(760)574-3561
Lic. No.: 756174
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/02/09
PFJAVIN
3 0 2009
CITY OF LA QUINTA
FINANCE DEPT.
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 EXEMPT Policy Number EXEMPT
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.
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 this county to enter upon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
.;t%
LQPERMIT
Application Number . . 07-00002847
------ Structure Information 33SF ADDITION/V-NR/RES-3 (CONVENTIONAL) -----
Other struct info CODE EDITION 2001/2004/2005
FLOOD ZONE NO
1ST FLOOR SQUARE FOOTAGE 33.00
----------------------------------------------------------------------------
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee 54.00
Issue Date . . . . 9/08/08
Expiration Date 3/07/09
Plan Check Fee . . 35.10
Valuation . . . 2667
Qty Unit Charge Per Extension
BASE FEE 45.00
1.00 9.0000 THOU BLDG 2,001-25,000 9.00
----------------------------------------------------------------------------
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . . 16.16 Plan Check Fee 4.04
Issue Date . . . . 9/08/08 Valuation . . . . 0
Expiration Date 3/07/09
Qty Unit Charge' Per Extension
BASE FEE 15.00
33.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 1.16
----------------------------------------------------------------------------
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 19.50 Plan Check Fee
Issue Date . . . 9/08/08 Valuation
Expiration Date . . 3/07/09
4.88
0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50
----------------------------------------------------------------------------
Special Notes and Comments
33SF ADDITION/V-NR/RES-3 [CONVENTIONAL]
2001 CALIFORNIA BUILDING, PLUMBING, -
MECHANICAL, 2004 ELECTRICAL, 2005 ENERGY
CODES.
September 3, 2008 9:54:52 AM AORTEGA
***CHANGE OF CONTRACTOR ON 1/30/09.
$4.50 FEE CHARGED***
LQPERMIT
Application Number
. . . . .
07-00002847
----------------------------------------------------------------------------
Other Fees . . . .
. . . . .
CHANGE OF CONTRACTOR
4.50
ENERGY REVIEW FEE
3.51
STRONG MOTION (SMI) - RES
.50
Fee summary
-----------------
Charged
----------
Paid Credited
------------------------------
Due
Permit Fee Total
89.66
89.66 .00
.00
Plan Check Total
44.02
44.02 .00
.00
Other Fee Total
8.51
8.51 r00
.00
Grand Total
142.19
142.19 .00
.00
LQPERMIT
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 4 of 5) CF -1R
Project Title
Date
T7C)g
�2Z I 7ZO -7
SPECIAL FEAJURES REOUHUNG BUILDING OFFICAL or HERS RATER VERWICATION
Indicate which special features are parts of this project. The list below only represents special features relevant to the prescriptive method.
whenk Annheahle, hnvi-e)
Category
Building Official
Verification of
Special Features
HERS Rater
Verification
HERS Rater
Diagnostic
Testing
Measure
Ducts
13
Y
100% of ducils In cravvispacetbasement
E3
Y
Buried ducts
13
Y
Diagnostic supply duct location, surface area, and R -value
13
Y
Duct increased R -value
13
Y
Duct leakage
0
Y
Ducts in attic with radiant barriers
C3
Y
Less than 12 ft. of duct outside conditioned space
13
Y
Non-standard duct location
13
Y
Supply registers within two ft of floor
13
Envelope
E3
Y
Air retarding wrap
C3
Y
Cool roof
13
Y
Exterior shades
0
Y
High thermal mass
0
Y
Inter -zone ventilation
13
Y
Metal Cramed walls
E3
Y
Non -default vent heights
13
Y
Quality insulation installation
E3
Y
Radiant barrier
Y
Reduced Infiltration (blower door). May also require mechanical ventilation.
13
Y
Solar gain targeting (for sunspaces)
C3
Y
Sunspace with interzone surfaces
13
Y
Vent area greater than 10%
HVAC Equipnient
0
Y
Adequate air flow
0
Y
Air conditioner size
13
Y
Aii handier fan power
E3
Y
High EER
13
Y
Hydronic heating systems
[3
Y
Mechanical ventilation
13
Y
Ri frigerant charge
0
Y
Thermostatic expansion valve (TXV)
13
Water Heater
13
13
Y
Y
Y
Zonal control
Cornbined hydronic
High EF for existing water heaters
E3
Y
Nun-NAECA water heater
E3
Y
Non-standard water heaters (wh/unit)
13
Y
Water heattr distribution credits
Residential Compliance Forms December 2005