001054 (SFD)PERMIT APPLICATION F(AJL6City of La Ouinta ' 1
Department.of Building and Safety
This permit becomes void if work not commenced within 180 days from date of issuance. OR, if work has been suspended or abandoned fora period of 180 days.!
r -
LICENSED CONTRACTORS DECLARATION: I hereby affirm 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. j 1 ,1 i 1 C,
License Class Lit. Number '
r
Date `1 ! • ? • Contractor ' If
OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the
following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to
construct• alter, improve, demolish, or repair any structure; prior to its issuance, also requires the applicant for.
such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor,'s License Law
(Chapter 9 (commencing.with section 7000) of Division 3 of the Business and Professions Code) or that he is exempt
therefrom and the basis for the alleged exemption. Any,vjolation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than, five hundred dollars ($SOD.): - .
O 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 Contractor's License
Law does not apply to an owner of property who builds, or improves thereon, avid who does such work himself or
through his own employees, provided that such improvements are'not intended'or offered for sale. If, however, the
building or improvemnt is sold within one year of completion, the owner -builder will have the burden of proving that
he,did not build or improve for the purpose of sale.).
,❑ 1, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec.
7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for such projects with a'contractor(s) licensed pursuant to the'
Contractor's License Law.). -
17.1 am exempt under Sec. B.'8 P.C. (Attached Certificate).
Date Owner
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a
certificate of Workers' Compensation Insurance .or - a certified copy thereof (Sec. 3800. Lab. C.): .
Policy No. Company
❑ Certified copy is hereby furnished. -
❑ Certified copy is filed with the City Building Inspection Department or City Department.
Date Applicant
APPLICANT NAME (L. F. MI) Fdzk Johnson
ADDRESS P.O. Flom 2288'
CITY/COMMUNITY/STATE/ZIP `
Indio, CA 92201
JOB SITE ADDRESS/SPACE 54_645 Avenida Rubio
CITY/COMMUNITY/STATE/ZIP La duihia' CA 92253
BOK
774,271
PAG
PRC
019
C
TWN
PING
SE
S
TRACT
I LOT
oomt. Fee
376.00
MOD
so
SMI Fee
TRACT NAME
OWNER NAME (L. F, MI) Pd& Johnnsm Ctinst.
CONTRACTOR -FIRM NAME
Ri&nn'' yy +� may. -
U0 �.
ADDRESS
abme
CITY/COMMUNITY/STATE/ZIP M -
aboV e
PHONE •
347-7171
LICNC 0
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE M
TOTAL
FEE
LICNC 11
USE OF PERMIT
S.F.D.-
BIL
ZON
FSB
I SSB
SSB
RSB
OFC
ZONE .ORD t o
LOT SZ
END
, SIDE
CERTIFICATE OF EXEMPTION FROM WORKERS`COMPEN ;ATION INSURANCE: This section need not be completed if
the permit is.for one hundred ($100) o, less. 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 Fsto become subject to the Workers' Compensation Laws of
California.
Date Applicant
NOTICE TO APPLICANT: IL after making this Certificate of Exemption, you should become subject to the Workers''
.Compensation provisions of the Labor Code, you must -orthwith comply with such provisions,or this permit shall
be deemed revoked.
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICAT'ON:
O I hereby certify that no excavation five (5) or more fee' in depth into which a person is required to descend, will be
made in connection with work authorized by this permi , and that no building structure; scaffolding, falsework, or
demolition or dismantling thereof, will be more than thirysix (36) feet high. (Chap 3.2, Grp 2, Art 2; Sec 341• Title 8,
C.A.C.)
O As owner -builder, I will not 'employ anyone to do -work which would require a permit from the -Division of
Industrial Safety, as noted above, unless such person -ias a permit to do such work from that division.
O Division of Indusj:,rial Safety Permit No. ,
._ Date Applicant
" CONSTRUCTION LENDING AGENCY: I hereby affirm that :here 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
I certify that,I have read this application and state that -he 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
h of this county tenter uponpon the
1 above -'mentioned property for inspection purpose.
Signature of Applicant or Agent Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify l have read this application and state that
the information given is correct. Iagree to comply with all state laws and county ordinances relating to buidling
construction, and authorize a representative of the CiLv of La Ouinta Department of Building and Safety to enter
upon the property for which I have applied for this pewnit.for the purpose of making. inspections.
Signature'df Applicant or Agent Date
/ Ir rfry
Print Applicant/Agent Name /
APPVPRMTOnt „rim 4
17T 2i"84 S.F.D.
Pexmit to constrict 1592 sq. ft. of
S.F.D., 91 sq. ft.
of pore and 430
sq. ft. of garage as per approved
Plans.
Mech. Fee
22.00
Plan Check Fee
244.40
oomt. Fee
376.00
Effect. Fee
SMI Fee
5.64
Plunbing Fee
50.50
Prop. Deva. Flee
450.00
TOTAL
FEE
1,191.67
BLDG. DEPT.
VALUATION 80,628.80
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
•
34
Plenums.&.Ducts
2A
Slab Grade
35
Furnace Compart.
3
Steel .
j
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
❑
43
Final
10A
fireplace T.O.
❑
OP'N ADDITIONAL INFORMATION
NO.
d�
SEWAGE SYSTEM SIZE &.LOCATION
11 Exterior Lath§Value
12 Internal Lath12A
Dr wally
13 Finish Gradev�INSULATION
Thick/���
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb �' p
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25 Final
Tank Pit
L. Line
ELECTRIC APPROVALS
REAWOF PROPERTY
P/L
STREET NAME
LINE
P/1
26 Power Pole 1 ,
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
,%F I E S
o
Desert Unihed.* S: pool District
y BERMUDA DUNES r
.Sands
RANCHO MIRAGE,CF
82-879 HIGHWAY 111 O INDIO,'CALIFORNIA 92201-5678 *_-619) 347-8631
INDIAN WELLS ' H
PALM DESERT
-November 26, 1984
%P - LA OUINTA
'JQ
_
INDIO 1�
_City of La Quinta.
Department'of Community"Development
.
78-105 Calle Estado
• La Qui7nta, CA 92253 `.
Re: Lot 7, Block 270,,'Santa
Carmel ita at Vale La Ouinta, Jnit: No. 2.5
Gentlemen:
The developer of.the
above: referenced lot
has mitigated its iJnpacts
on our overcrowded schools by-payment
of the amount of $628
per, unit to be applied toth.e cost-of
district educational
facilities made necessary,by such. new
development.
Sincerely,
John D.'Brooks
Assi Stant Supe.ri ntende.nt, -
' Business Services
JDB/crm
A
. � � . R_E.�:I_D_E_L� T LA_�:._ . _T_I T L•_E� � :2
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11641 url.6
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MECHANICAL-. SYSTEMS DESIGN
134 SOUTH GLAS.SELL STREET
ORANGE, CALIFORNIA 92666
(714) 643-6571
--.__...-Hoi�_ --
058:10 R2• _,28/84 VH/dr
Attachment D
Form 2
(Revised 3/84)
Climate Zones. 2, 4, 6, and 8-15
COMPLIANCE,CHECKLIST
t*' For Low -Rise Residential'Buildings
- (except hotels and motels).
Step 1: Enter on the form the values for each measure from your building plan
' and specifications sheet.
Step 2: Enter points on".this page while working through the point system
Building Shell Measure Points
F, *Total Floor Area �ft2
1. Slab -on -Ground; Perimeter ft.,�Depth � in. R- .
-n. 2. Raised Floor R -Value. R-
t. 3. Ceiling Insula.tion or Construction*Assembly R-
x Attic, Percent of Roof Over Conditioned Space LL ft2
Z
#.. 4. Wall Insulation or Construction Assembly. . . . . . . . . . . . R-
? Glazing; Total % Floor Area Single Double' Triple
5. North -Facing.' ft; ft2 ft2
6. East -Facing . .ft2 ft2 ft
2
.. 7. South -Facing.'.... % ft2ft2 ft
2
8. West -Facing % ft �ft ft
9. •Skylight. X -ft 2 -ft 2 ft
2
x 10. Shading Coefficient
(excluding overhan )
a. East L� Q�i�05C .
b. South. SC . . . . . . . . . . . .
c. West . . . . . . . . . . . . . SC . . . . . . . . . . . . .
d. North. . . . . . . SC . . . . . . . . . . .
e. Skylight SC . . . . . . . . . .
11. Horizontal South �Overhang Length. ft . . . . . .
12. Movable Insulation, % Floor Area. % . . . . . . . . . . . . .
13. Infiltration (indicate Standard, Medi di or ig t)
14. Thermal Mass
Exterior Wall Thermal Mass
Area, Heat Capacity, R -Value . . . . . . . ft2, HC; R-
Interior Thermal Mass �1
Area, Heat Capacity, R -Value . . . . . .ft2, AHC.TZI
HVAC System•*
15. Gas Furnace without Refrigeration -Cooling
(Seasonal Efficiency). . . . . . . . . . .. SE
',. 16. Heat Pump (Energy Effic.iency�Ratio) . . . . . . . . . . SEER
•°1% 17. Gas Furnace with Refrigeration Cooling
Seasonal Efficiency and Seasonal
Energy Efficiency •Ratio... . . . . . . . . SE SEER
18. Active Solar (Net Solar Fraction, %). . . . . . . . . %NSF
19. Zonally Controlled Electric
Resistance Space Heating . . . . . . . . . . . . . (Yes/No)
Domestic Water Heating•*
20. Solar With -Gas Backup (Net Solar Fraction, %) . . . . . . . . %NSF
21. Other Water Heating (Describe type)
i
Point System Compliance Total. . . . . . . . . . . +
'Checklist items;. not a point system measure.
,'' "Attach documentation for efficiencies and NSF.
i.6 •
A
"HEAT TRANSFER COEFFICIENT
Form
PROPOSED CONSTRUCTION ASSEMBLY. (eiet)
Enforcement Agency Use Only
F2�I ��o h r►so n' I� ! �: ow��
owner
project -title Dalloln0 permit number •
r L ITS
0r01eCt 10utlon CneCkeC by
r` ( t- ter
OOCumentation author dale
eeeeee>,�ae .
Sketch of Construction Assembly List of Construction Components R
(for section between framing,members) (from Table }11 '
^�1.
_V�e �-rrl-� n
2.��f'IIN`
3
l _
q.
5.
Framing Size : 6.
n'_.
Framingc
Soacin '�" D.C.
7.
Check one:
8. Inside Surface Air Film (from Table J-18). ........... ���)
Ceiling/Roof
Floor 9. Outside Surface Air Film (from Table 3.18)..:. .
Wall
Total Thermal Resistance (RT) — —
,. 11 'Nall. Check the � - tum o/ the aDa ve
apW00r+ate weight:
less than 25 Ib/h2
25 to aQ ID/ft2 AVERAGE U VALUE OF ASSEMBLY
;rester ;^an 40 :bih2
Btu/(hr .h2 ',FI
Framing - AT from above 1
Pa:tor from
f Table 3.6
Use this U value for hut. load
• 4lculatior, or Code comparison -
0
HEAT TRANSFER COEFFICIENT FOri1l R
:.` PROPOSED CONSTRUCTION ASSEMBLY (alai)
Enf3rcement Agency Use Only
owner - ..project title .3ullding permit number
project location chacke0 by
aocumentallon author pate
Sketch of Construction Assembly List of Construction Component3 R
(for section between framing members- (from Table 3-1)
/,d--
.2. —31
3.F(
4.
5.
I
// ,� Framing Size 6. ��•• " x S!G_" '
Framino Sbacin o.c.
%.
Check one:
8. Inside Surface Air Film (from Table'3.18)......
Ceiling/Roof
Floor 9. Outside Surface Air Film (from Table 3.18)..
Wall
Total Thermal Resistance (RT)
11 Wall• check the sum of the above
appropriate weight: -
less than 25 Ib/ft2
25 to 40 lb/ft2 AVERAGE U VALUE OF.ASSEMBLY
greater than 40 Ib/ft2'
/� Btu/(hr . ft2 •eF)
,Framing. 'RT from above
factor from
Table ]•6
Use this U value for hast load .
cslculatior or Code comparison
ZONE:
ENGINEER:
DATE:
PROJECT:r
SHEET.
-
ENGINEER: ��-
DATE:
OF
?enc:
--
Irl
Ft's
Volume:
Ft3
Time:
SUM?iARY
L 0 A D S
COOLING;
MU/IIR
IMEAT INr,
MT.�1
SENSIBLE,
L1TE11T
I B'IU/I IR
err,,
WALLS-
RX)r•/CSILItIr.
'
FIZOR
TOTAL
' LIQ rTS
-PMI)LE
cep
?'ISlS
p
TOTAL
Sensible T
Cr-Tt .
1.I
RS,IR Sensible
Sens.
V771-r-ILATION
do0
nIFILTRATIO"I
T rAL .
TSAR
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.
srs.ecTlcr,:
To�gsp
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