06-3179 (PLBG)-176.1
-
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00003179
Property Address:
78005 LAGO DR
APN:
658-270-003-3
-3941
-
Tiht
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
IPr
-
-------------------------------------------------
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
ate:5%Sc�� ontractor.
OW ER- UILDER 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, 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.).
(_) 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 perf
ormance of the
work for which this permit is issued (Sec. 3097, Civ. C.1.
Lender's Name: -
Lender's Address:
LQPERMIT
C
Owner:
FOLEY MICHAEL C
78005 LAGO DRIVE
LA QUINTA, CA 92253
Contractor:
FOY, SCOTT A.
43579 MAIN STREET
INDIO, CA 92201
(760)775-9405
Lic. NO.: 828264
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/31/06
SFP 112006
QUINTA
CITY__...•c WEPT.
----------------------------------------------—
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 STATE FUND 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 t� or Code, I shall forthwith comply with those provisions.
ate: plicant:
WARNING: FA URE TO SECURE WORKERS' COMPEN ATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS J$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 -
IMPOR7ANT 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 co rect. I agree to comply with all
city and county ordinances and sta aws relating -to building construction, and he by authorize representatives
�of this cou '10 enter upon th ove-mentioned property for inspection ur es.
Si ature (Applicant or Agent):
Application Number . . . . . 06-00003179
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 22.50
Plan Check
Fee
5.63
Issue Date . . . .
Valuation
. . .
.
0
Expiration Date 2/27/07
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 REPLACEMENT
Fee summary Charged
-------------------------------------
Paid Credited
Due
_Permit Fee Total 22.50
----------
.00
----------
CO
22.50
Plan Check Total 5.63
.00
.00
5.63
Grand.Total 28.13
.00
.00
28.13
J
OF CONTIJANCE: RESIDENTIAL (Page'3 of 4) CF -1R . .
SEALED DUCTS and TXVs (or Alternative Meas es)
A signed CF -4R Form must be provided to the building department for each home for which the following. are
rrnuirpA
Alternative to Sealed Ducts and Refrigerant Charge f1XVs (See Package D Alternative Package Features for.
Proiect Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-14 `
OR
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
spaces shalt meet the requirements of Section 1"(m) and dud insulation requirements of Package D.
\i/ • .:-.ter: m,
.. rmlrn JOM1M1u11V Oxax141Y1D
Distribution
Type
❑
Sealed Ducts all climate zones ler testing and certification and HERS rater field verification urn
❑
TXVs, readily accessible (climate zones 2 and 8-15 only)
Inputs
ler testing and certification and HERS Rata field verificationrequired.)
❑
Refrigerant Marge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
Otwor
verification ' ' uired
Alternative to Sealed Ducts and Refrigerant Charge f1XVs (See Package D Alternative Package Features for.
Proiect Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-14 `
OR
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
spaces shalt meet the requirements of Section 1"(m) and dud insulation requirements of Package D.
\i/ • .:-.ter: m,
.. rmlrn JOM1M1u11V Oxax141Y1D
Water Heats
Type
Distribution
Type
Rated
Check box if system meets criteria of a "Standard" system Standard system is one gas-fired water heater per
❑
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Inputs
not allowed.
p
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Otwor
Mamral. No water heating calculations are required, and the system complies automatically.
jMaftel Type
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
Alternative Water Heating -table, In this case, the Performance Method must be used and must be included in the
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Water Heats
Type
Distribution
Type
Rated
EneW Tank
En"y
Tank Factor' or
Capacity Thermal
Efficien
Standby'
Loss NO
Inputs
Tank Facto or External
Water Heater
Distribution Number
Otwor
Capacity Thermal Standby' Insulation
jMaftel Type
TNVe in S
B
ns Effrci Loss /o R Value
-
e_...Z—
Water Heats
Type
Distribution
Type
Number
in System
I p�
(kW or
Buff(Wim)-
En"y
Tank Factor' or
Capacity Thermal
Efficien
Standby'
Loss NO
Tank
External
Insulation
R -Value
-- "- a -- ------b- •••---•• "`^"""" %-.--,,.- ver xvbb u -m W uLlmu to /J,uw 13W/N),es
electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Bhft), 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 /4
inches or greater in diameter shall be thermally insulated as specified by Section 150 6) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 4) CF -1R
Documentation Author Telephone
Compliance Method (Prescriptive) Climate Zone
Date
Building Permit g
Plan Check /Date
Fmid Check / Datc
Enforcanan Agency Use Only
✓ ❑ Alternative .Component Package Method: (check one) C D _D (Alternative)
Package C and Package ( require HERS rater field verification and/or diagnostic testing (see CF -IR page 3)
For Package D Alternative see }appendix B Table 151-0 Footnotes 7-14
ti
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) ____.fe Average Ceiling Height ft
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-0 — (5% X CFA) f
Maximum Allowed Total Fenestration Products Per Table 151-B or 151-0 _ (20% X CFA) g
✓ 0 Building TPVpe: (check one or more) Single Family Multifamily Addition Alteration
(If adding fenestration fill out WS -4R, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 83.3 for Alterations.)
Number of Stories: Number of Dwelling Units:
Floor Conon Typc: 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 (required in climate zones 2, 4, 8-15)
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Walk
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
Assembly U -
factor (for
Cavity Continuous wood, metal
Insulation Insulation Same and mass
R -Value R -Value assemblies)'
Joint
Appendix
N
Reference
Roof Radiant
Barrier
Installed
Yes or No
Location/Comments
(attic, garage,
typical. etc.
1) See Joint Appendix IV in Section IV.2, IV.3 and IVA, which is the basis for the U -factor criterion U -factors can not
exceed prescriptive value to show equivalence to R -values.
r
Residential Compliance Forms March 2005
Indicate which special features are part of this project. The list below. only represents special features relevant to the
prescriptive method.
✓
Feature
Reguired Forms(if applicable)
Description
❑
Metal Framed Walls
CF -IR
Refri
❑
Radiant Barriers
CF -1R
CF -6R part 6 of 12
❑
Exterior Shades .,
WS -4R
❑
Cool Roof
N/A; Attach CRRC Label to
Forms.
A
❑
Dedicated Hydronic Heating
Performance Calculation
System
Rqcluir� Attach Rim to Forms.
❑
Combined Hydronic System
Performance Calculation
Rcquutd.- Attach Run to Fomes.
❑
Gas Cooling
Performance Calculation
13
Buried Ducts
N/A; Indicate on building laps.
❑
Kitchen Pipe Insulation
See Section 5.62 Distribution
Systems in Residential Manual-
Multiple Water Heaters Per
See Table l3 or use
Dwelling Unit
Performance Calculation an
attach Run to Forms.
13
Water Heating System
Performance Calculation and
Saying
Sayin Mul ' le Dwellings
attach Run to Forms.
❑
Non-NAECA Large Water
CF -1R
Heater
See Table 5-13 or use
❑
indirect Water Heater
Performance Calculation and
attachBa to Forms
See Table 5-13 or use
❑
instantaneous teas Water Heater
Performance Calculation and
attach Run to Forms
See Table 5-13 or use
O
Solar Water Heating System
Performance Calculation and
attach Run to Forms
❑
Wood Stove Boiler
Performance Calculation and
attach Run to Forms
SPECIAL FEATURES REOUEMG HERS RATER VERIFICATION
(add ext a its if necessary) Indicate to the HERS Rater which credits are part of this projed and need
verification.
✓
I Feature
Required Forms fif applicable) tion
❑
Dud Scali
CF -6R 4 of 12
❑
Refri
CF -6R 5 of 12
❑
Thermostatic Expansion Valve
CF -6R part 6 of 12
(residential Compliance Forms March 2005
w
j Dili it
,L
Permit N
Project Address
A. P. Ntnitbcr.
ILegal Dcseriptian:
Contraclur DC
Address: eaa�,`J
City, ST, Zip-badd
Telephone: -7W--7
State Lie. tl : &-;Ro
Arch.. Er$r.. Designer:
Address:
City, ST, Zip:_
Telephone:
State Lie.
Nanta of Contact Person: S
Tdopltone9 ofConnrcl PeMen:
t: Suhnittai Ragd
Plan Sets
Straetoml Coln.
Truss Calm
Titic 24 (ales.
Flood phft plan
Grndlogn plan
Satirostacior List
Gtnnt Dccd
ILO.A. Approval
IN HOUSEc-
Planning Approval
Ptdt. WIm Appr
Seboal Fees 1
t
WA
city of La Q=ta 13
Btrit ft W Safety Ditrision
P-0. Box 1504, 78-495 GWM TampioD
La Qaitlta, CA PM3 - (760) 777-7012
Building Permit ApOfi adon and T'raddng Sheet
I Owrtet'sNmner_
City, ST. Z: r
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v e Telephone:-
a� ProjeaDeseri plion:
ME
City Lir- 4:
TOW Permit Fees
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Chan TAW Occopntcy:
Pmjeei tvnefeindeoer Nc:•c Add'n Nter cpt Dano
Q. F
a Statics:
M Unit-: -
e:s t'•+ 5ialue oq a li s -
APPLICANT: D® NOT WRITE BELOW THIS UNE
Reed
s
TRAC MG N£Ri►IITFEFS
PianCheek ashmitted
kern
Amount
LL
R"Wext, ready Forecrreclim
pian CheckDepait ,
Caged CondaecPetson
Pun Cheek salanoc
Plass pkktd up
r Consanetion
Plats resubmitted
pjecimniw
Z' Review, ready for eorrectionsil tie
Eretricai
Called Coataet Person
Plu-b +c
Pinus picked op
Plats resobmleted
Grading
Revievr, reedy for earreadaastissue
Developer Impact Fee
Called Contact Parson
AXP -P.
Rete of permit avec
;j
t
TOW Permit Fees