Loading...
14-850 (RER)i �S Q 78-495 CALLE TAMPICO c&,,, 4 yaw LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: RER-14-850 53545 AVENIDA BERMUDAS 774135014 WINDOW CHANGE OUT Applicant: PEDRO R. BELLO 53545 AVENIDA MERMUDAS LA QUINTA, CA 92253 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.: 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 \�k VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/8/2014 Owner: PEDRO R. BELLO 53545 AVENIDA MERMUDAS LA QUINTA, CA 92253 Contractor: 0, wit co e—/&. e -I __ :� Llc. No.: WORKER'S COMPENSATION DECLARATION A 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. and Professions Code) or that he or she is exempt therefrom and the basis for the alleged Date:=y(f— /40M Applicant: exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the licant to a civil penalty of not more than five hundred dollars ($500).: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE compensation, will do the work, and the structure is not intended or offered for sale. HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'S FEES. 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.). 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.). 36jam exempt under Sec. B.&P.C. for this reason t -,Date: — ©Z 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: APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official 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 city to enter upon the above- mentioned property for inspection purposes. D -U Signature (Applicant or Agent) ��'�J DESCRIPTION FINANCIAL • ACCOUNT ' • QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY. METHOD RECEIPT# CHECK#. CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DOOR/WINDOW, REPLACE FIRST 7 101-0000-42400 0 $60.06 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DOOR/WINDOW, REPLACE, FIRST 7 PC 101-0000-42600 0 $108.68 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forWINDOW/SLIDING GLASS DOOR/FENESTRATION: TOTALS:0• $168.74 $0.00 Permit Number: RER-14-850 Applied: 6/12/2014 Issued: Status: APPROVED Parent Permit: Parent Project: Approved: Finaled: Description: WINDOW CHANGE OUT Site Address: 53545 AVENIDA BERMUDAS City, State Zip Code: LA QUINTA, CA 92253 Applicant: PEDRO R. BELLO Owner: PEDRO R. BELLO Contractor: <NONE> Details: REMODEL - CHANGE OUT 6 WINDOWS AND 1 SLIDING DOOR PER APPROVED ATTACHED PLANS. 2013 CALIFORNIA BUILDING CODES. Printed: Tuesday, 08 July, 2014 1 of 1 YS 1:41$ 6 W14 , j! � & A --%1,e to r cue-- �,¢.l w•V �s CITY OF lA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE /E P0.�1 v 4031( CAI&A Y --t Genera) Information Site Address: �3� f1M1w Enforcement Agency: A I B C I D E F Building Typc)KSingle Family 0 Multi Family Circle the Front Orientation: N. E. S, W, or degrees ^ Conditioned Floor Area (CFA): Project Type: j Alterations 0 Envelope O Fenestration 0 Roof O HVAC R laccment or c Out 0 Dud Re laocmcnt 0 Water Heater O(1 Q� ThIs form Is not to be used for lVewo Cacsimcted Bulldings or Addidons Insulation Ya/ues For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration O Opening of framed cavity alone -Alterations that involve the opening of the framed cavity of a wall• ceiling or floor must install the mandalory minimum insulation value per §130 for the altered assembly. Fill in Columns A -C and enter mandatory insulation value in Column H. 0 Replacement of entire assembly- Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component Packs e- D insulation values in Table 151-C Fill in Columns A - J. Opaque Surface Detalls For the furred mtiontd of Mass Walls see Furring Strips Construction, Tabk below. A B C D E F G H. I I I J Pro Standard Values From JA4 Table Framing Thickness, Framed Continuous JA4 Proposed Ta� Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly. Assetnbl� iD or Type' and Size or Oder factor Numbers R-valueb R -Value Cell Values U -factor Noce: Forfiaxdasscmblies, amounting for Contimrorer insulation R -value, see Pagr JA4-3 and Equation 4-1. For calculating fumed walls use the Mats and F Construction table below. 1. For T09/1D indicate the identification name that matches the building plans. 2. Indicate the Assembly Name or type: Roq/7Ceiling, Walls, nue elle Frame type and Siu: For Wood• Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 fonother possible frame type assemblies. 3. Enter the this mess for neoss in inches or Spacing between framing members enter,. 16 "or 24 "OC: or Other for all other assembly description such as Concrete Sandwich Panel. Span. -el Panel, Logs. Straw Bale Panel and etc.... 4. Based on the Climate Zone: enter the Standard U jailor from Table 15 I -B. C or D for each different assembly Name or type. S. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R -value (hot is being installed in the wall cavity or between the framing: otherwise. enter 7. Enter the Continuous Insulation R -value jor the proposed assembly: otherwise, enter "0 8. Enter the row and column of the U factor value based on Column F Table Number and erter.thhe Assembly U factor in Column J 9. 77w Proposed Assembly U jailor, Column J. must be equal to or less than the Standard U -factor in Column E to comply. Furri2& Strips Construction Table -for Mass Walls Onl A I B C I D E F G H I J K L M Proposed Properties of Masonry and Concrete Walls From Reference Joint A epcndix Table 4.3.5, 4.3.6 4.3.7 Added - c a 0 9 3 c "V. Interior in Furring Joint A u Ft- or Exterior Insulation Space from Reference endix Tabk 43.13 qq F m^ > y o u t i v '� < > LU 0�� Final Assemb� U -factor Comment Mass Thickness, U a Assembly �? Name or 1A4 Table ,f Type' Number' < > Registration Number: Registration Date:Time: _ HERS Provider: 2008 Residential Compliance Forms August 2009 Presaiptive Certificate of Compliance: Residential CF -1R -ALT Residendal A terations age 2 of Project Name:5 i t Climate Zone 9 4 of S` orka ` t tj�:ll if . '.J11(`AMlieW 1 ass and Purring Mrips Construction . oowotes 1. Indicate the type ofassembly to include: Hollow Unit Masonry Watts. Solid Unit Masonry, Solid Concrete Walls. Etc. Additional assemblies can found Reference Joint Appendix JA4. 2. This is the U -Factor based on the thicbuss of the assembly in inches. . Tne R -value of the i trulation to be added on the inter.'or or exterior of the assembly. . 771e Calculated R -Value is Me R -value of the furred out section of the assembly. S. b. The Final Assembly is calculated using Equation 4-2 or Equation 4-4ofthe Reference Joint Appendix J44. The equation is the inverse of Cal ac(ded to Column L Column K is the inverse from column J. 7. Insert the calculated U-ortor value on to the C11x quc Surface Details in Column J FENESTRATION PROPOSED AREAS P(Replacing window alone -- Replacement windows shall meet the U -Factor and S1lGC Value requirements of Cor iponent Package D rn Table 157-C ?7w .Taint Fenestration and West facing Ara requirements are flat apidicable. IfAdding 50fe or fess of window area -- Newly irstalted windows shall meet the U Factor'and SHGC Value requirements ofCompanent Package.D in Table 151-0 13 Adding more than 50f? ofi4indow a res — Newly installed windows shall meet the U-Focior and SHGC Yatue and the Fenestration ,Area requirements of Component Package D b: Table ISI -C. Complete tine Altered Fenestration. Allowed Area Table on Page 2 of the CF -JR -ALT E Orientation G CFA of Fenestration Type and Frame (north, East, ProgsedAreat Maximum Maximum NFRC or Defautt (wirniow, GIasS Door or S !i t) South, West) (fts) U-faclor10 SHGC"-' Values `•�a�.dt�t,� � �,...lt... `3 b ( 'ate "�aC D-4tlling �A1 t y.,uir✓ S�; vtt}.� 1sry i Vi �o �.��-�`T' i Z'� -S' _ W iL�P(tLd .i E N)Ul •��'!4/'/4d/�'ss >T 33 Vit? I. Fenestration area is the area of total glazed product (i.e. glass plus frame). Exception: When a door is less than SO/ glass, 1hr jenestrarioa area tray 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 specifted on the CF -1 R ALT Form, 4. Submit a completed WS -3R Form 1a reduced SHGC is calculated with exterior shading. S.i applicable at this stage enter ' NFRC" or NFRC Card ted windows or -are CEC "De oulf" values ouad in Table 116-A or B. ALTERED FENFSTIUNTIONt ALLOWED AREAS (Complete if more than S. offenestration is added ~ A B C D E F G CFA of Allowed Existing Allowed Entire %of Fenestration Area Fenestration Arca Proposed Aire" D-4tlling CFAa•' Arca` Removed' Area Added6 A x B) D + C - ToW Fenestration Areaz( West Feoestraiion Area'j (Required In CZ's 2, 4 & 7 -15) ' 1. The Proposed West Fenestration Area includes West -sloping skylight area and any other skylight area with a pitch less than ):12. 2. Enter 2O'/o when no West orientation restriction or 13% when Westfenestration is being installed in Climate Zones 2. 4,'& 7-15. Note that the maximum allowed fenestrotion can only be S'. of the CFA as indicated in Column F. Column G must be equal to or less than Column F. 3. 1n climate zones 2. 4, 1-13, no more than S% of the CFA is allowed for west facing glazing 4. Existing Fenestration area must be counted toward the maximum allowed 15% or 20% of the whole building and calculated in Cohan G. Die Proposed Area must be less than or equal to Column F. 5. Enter the fenestration removed as part of the alteration if any in column D. 6. Enter the Fenestration area that is being added as rt o the alteration. '+Y_d,?it���2�'rt?1�i`.�.h'�"�n3�ltt+�l£2tlr�athl3tt' :mss- 2008 Residential Compliance I Marcht t Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 2 of Project Name: Climate Zone tl # ors� tones 5 � � �� • cl c G,5 Mass and Furring Strips Construction(footnotes) 1. Indicate the type ofassembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can found 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. . The Calculated R- Value is the R -value of the furred out section of the assembly. -6-77ie Final Assembly is calculated using Equation 4-2 or Equation 4-4oflhe Reference Join! Appendix 144. The equation is the inverse of Col added to Column L Column K is the inverse from column J. 7. Insert the calculated U factor value on to the ue Surface Details in Column J FENESTRATION PROPOSED AREAS ,.Replacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in Table 151-C The Total Fenestration and Wes! facing Area requirements are not applicable. Adding 50fe 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 Value 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, PropsedAreal Maximum Maximum NFRC or Default (Window, Glass Door or Skylight) South,West) (fi') U -facto' SHGC - s• 4 Values <-:,W l 13 - o f S3 -,3o jt,l ; mil uv SQ " 4A- E114- V, .i.-E114 V, CW N064- ' 33 3 0 1. Fenestration area is the area of total glazedproduct (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 -I R ALT Form. 4. Submit a completed W3 -3R Form if a reduced SHGC is calculated with exterior shading. 5. If applicable at this stage enter "NFRC" for NFRC Cert i ed windows or are CEC "Default " values found in Table 116-A or B. ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50ftr of fenestration is added) A B C D E F G CFA of Allowed Existing Allowed Entire % of Fenestration Area Fenestration Area, Proposed Area' .4 Dwelling CFA 2.1 Area4 Removeds Area Addedb A x B D + C Total Fenestration Areas ft West Fenestration Area" (Required In CZ's 2,4&7-15) 1, the Proposed West Fenestration Area includes West sloping skylight area and any other skylight area with apitch less Jhan 1:12. 2. Enter 20•10 when no West orientation restriction or 15% when West fenestration is being installed in Climate Zones 2, 4, & 7-I5. Note that the maximum allowed fenestration can only be 5% of the CFA as indicated in Column F. Column G must be equal to or less than Column F. 3. In climate zones 2, 4, 7-15, no more than 5% of the CFA is allowed for west facing glazing. 4. Existing Fenestration area must be counted toward the maximum allowed 15% or 20% of the whole building and calculated in Column G. The Proposed Area must be less than or equal to Column F. S. Enter the fenestration removed as part of the alteration if any in column D. 6. Enter the Fenestration area that is being added as part of the alteration. a.I•l'�V-ft•.T..I_r� r�'.S1,. r rr. �Ir: ..rte =s:.:_ .: v.-;v'R i'rYE..• ...:�"7 "' - - - ,d.'rsi�' :i'•' '�i7'1?.t r�'Y, fi- •:. 2008 Residential Compliance Forms March 2010 .ni>i: ..q• a',• - :'ay., s -,. f'o) f.<a 010 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 5 of Project Name: Climate Zone # # of Stories 555 —1-5 kegj, Q✓,R()J&,S HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealing & Testing HERS verification is requiredfor this measure. ❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned space, the ducts are to be sealed per §152(b)1Dii and the newly installed ducts are to be insulated per §151(f)10. EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑YES []NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the ducts are to be sealed per § 152(b)1 Di. DYES ONO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be sealed per § 152(6)1 E. ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Refrigerant Charge -Split System HERS verification is required for this measure. ❑ YES ❑ NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat exchanger) a refrigerant'charge measurement shall be verified per §152(b)IF. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of § 15 o do not apply to existing residential homes. Ducted Split Systems -Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. ❑ YES ❑ NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced, the airflow and fan watt draw shall be verified per § 152(b)ICi to meet the requirements of § 151(07B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and co ete. Name: Signature: Company: Dam_ — J l a avl� Address: Z 3 �/ S If Applicable U CPA or CEPE Q,l� l (.t'� 0�2� M t%� (Certification #): City/State/Zip: , Phone: Responsible Building Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for ap proval with this building permit application. Name: Signature: Company: Date: Address: License: City/State2ip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. !t'.%i:�-J/• :.tri.+. '_:l`.' .ti..:•S':.::'.:: - -'�R" - _ jf. dai.}x14•%.j':ir'-';;i .'•c ..,..c iJ> bK... , 2008 Residential Compliance March.. 2010 BUILDING & SAFETY DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 PlyOPERTY OWNER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits 'ORTANTI NOTICE TO Y-RQPEitTY QWNER Dear Property Owner. An application for a building permit has been submitted .in }roar name listing yourself as builder of the property improyctrients spocified at L�/ � A I(I to r � dQ r rvt,✓Gd 0. � . " 6. t r ^t• We are providing you with an Owner -Builder Acknowledgment,and information Verification Form to make you awac+a of your responsibilities and possible risk you may -incur by having this permit issued in your name as the Owner -Builder. We will not Issue a building:permit until you have read, inii� your., understanding of eack'gtrevision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute thisrnotice unless you, the property owner, obtain the prior approval of the permitting authority. DIRECZ70NS;R ru! ale `r"n [iaf'oarii.sialerrieri'i`beloiv is signify you i I. 1 .understand a frogvent practice of unlicensed persons is 'to..Iulve fire piofma . owner obtaiJn an "Owner-tuiwe, building fiermi.f that eironoously implies that the property owner is providing his or tier own .labor arid. material. rersouallj+. I, as an Owner-13ui(der, may be held liable and subject to serious financial risk for any °irijurics :sustained bj+ an wtliccascd pmou and his or Iter employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Q.� 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. pfd 3. I understand as an "Owner -Builder" I am the re sponsible party of record on the pernut. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. M4. I understand Contractors are required by law to be licensed and bonded in California and to list their license.numbers on permits and contracts. U5.1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. h6. I understand if I am considered �n "employer" under state and federal law, i must register with the state and federal -government; withhold-payroll-taxes;-provide-workers'—compensation--disability-insurance,—and-contribute-to-unemployment-- compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. �WT I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. t.. ( S. i understand as an Ow nee-IIuilder if I sell the property for which this permit is issued, t may be herd liebla for any financial or. pe,(sonal 3rr arirs sustained by any subsequent owncy(s) chit result from any latent constmction defects in the wortcmahship oi'materials. l ti D4. t understand I may obtain reore ittfomKition regsiding aly oblifp iotts xS rill'°cn1t11ctYC"', hunt the kltcnlal licvrrute Service, the United States Sildall ltuSiness Administlz:tient, the C.� ifbf nix t)t-partlitcnt of ilencf'tt 1ay1r61's, and the Cldlifbruis Division of Lodustrial Accidents, l also understand i may millers( dt(; C:liforuia Cc}lttyactols' State License ffoard Mn) at I- 800-321-CSLB (2752) or www.cslb.ca.gov for more informatioa about licensed contractors. [110. I am aware of anrd consent to an Owner -Builder building permit applied for in my name, and understand that I am the Trttv legally a1tc1 firrartcially responsible [of r.mposed construction activity at the fotlowittg address: rgrct drat, as the party legally and finattrcutity responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owt►or-Buitekrs as welt as etriptoyc m at 12. i agm to notify the issuer of thtis form immediately of any additions; deletions, or chWV'.M to any of erre ,infoiixc&tioil t have provided on this form Uctnsed contractors arc regulated by laws dcsirncd to protect the public. Ifyou certtract with sornaono who dots not have a tic*=sc, flit Conmetore State Ltceasc Borrel tn5y be uaabit to x-,st.`f You with 8;dy Grutae *1 toss YOU racy sustain as a resat( of a complaint You only remedy against tntliceas.ed Contractors lnay be in civil tours It is also iatportaat far you to:.Understand that if an ualiceastd Oobftctor or employee of tical individualor fitter is injuMd kirite v 0d6ng on your Property: you way be held LiteW for damages, If ).ou ortrttoirr A l,crruit as Owacr_Builder and wish to hire Costtrkctors, You wiit t1t resiras RAR for verifying Vbd1w or not dais ConAmclors ase prolmiy lierxlsod unci. tim atlttty of their workers, oompm ution iu�tttrrzoe � , Before it hail ug permit ten be issued, this fortis trust be completed and signed by the property omen x" rete med to the agency responsible for Isstsif;, Ow..M=k. ureic. A copy of 4t r propeny ewncerls a'dver't!& ei farm ne 600M ttM or other yrrificatian acecptabte k the agency is rteg' u&ed to ire gresealr.4 wher: ike permit is issWd to verify 44e Pevlr" owirer'ssign a.ure. Signature ofpropertyotivner..�t/ Note: The following .A uthorization Fors is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the tamer -Builder. 14>iJ'1 If E?R.Z.�:I'LQN QYF Agri NT TO ACTC3t�t pRt?��Ii1'Y OWNER 5.> Excluding the I iotiee to Pro(ze rty Owner, ttsc,KewEion ofKhrch 1 xuxl rStasld rs rn.y petso1.4 responsibility, i beieby authorize tat f0U0Wift9 t:trson(.y to act as m} aperat.(v) to apply for, siM anti file the docurutots accessary to obtain au ownet-Builder PerwSt for my project. 1 Scope of Construction Project (or Dcscri}r=.ion of Worley. Project Location or Address: S J / A,i/w tai c ;,? .:' Narnt of Ikuthorizcd Agent:_h Tet No �a3%.._t..1.t.O Address of Authorized Agent: ! 1 b Gt lug 14 the C I declare under penalty of perjury that I ant the property owner for the address listod above and f personalty filled out (be above nform.atiot-and certif}r its accuracy, h'ote.. ,A copy of the o,y t '4 driver's license, form notarization, or other verification acceptable to the agency is requir to be presented where • ermit is issued to verify the property owner's Signature- Date: signatureDater_l.ii be 6 mo4S�Je. pC'A Din # 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 # c-- Project Address: Owner's Name: A. P. Number: Address: 53 S rW✓e(4-a Legal Description: City, ST, Zip: L1oZ. Contractor: Telephone: Address: Project Description: U6,A61i ,e City, ST, Zip: Telephone: :. S State Lic. # : City Lic. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: ".<.:,,<:>.•. • <^.^::.«•>::: xx 'Qi i... - in:i: i::: 3::<4:!(; ;.. :?:�Si%r''i, i. ::;< < >;:;<>:>>::» : z >;:».::;::>:::::>: ...................................... Construction Type: Occupancy: YP • P cY:Xm f Project type (circle one): New Add n Alter Repazr Demo of Contact Person: kb _&et[o Sq. Ft.: f �4v V 1 # Stories: # Units: _164ho.nq # of Contact Person: �36 o��Q S Estimated Value of Project. SO O • !cry 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 Cala. Called Contact Person Plan Check Balance • Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2qd 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 corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees i Tot'h1 Permit Fees ? - i 0 4U14 CITY 0� LA