07-1894 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00001894
Property Address:
78645 BRADFORD CIR
APN:
604-225-006-89 -23268 -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
500
Tavl 4 XP Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
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 Prof sionals Code, and my License is in full force and effect.
License ss: C36 License No.: 828264
ate: •3
tractor:
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:
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: y�
LQPERMIT
Owner:
W. RAY HENDERSON
78645 BRADF
LA QUINTA,
Contractor:
FOY, SCOTT
43579 MAIN
INDIO, CA 9
(760)775-94
Lic. No.: 8
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
WORKER'S COMPENSATION DECLARATION
Date: 6/29/07
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 ENDR' INS Policy Number WEN000882301
_ 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 be me subject to the workers' compensation provisions of Section
.{3\770-110 of the abor Code, I sh fo ith comply with those provisions.
ate: 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 abo 'formation is correct. I agree [o comply with all
city and county ordinances and state laws relating to build g onst coon, and hereby authorize representatives
of this county to enter upo he above-mentioned property r spe tion purposes. ' _
Date: ignature (Applicant or Agent
<16
0
Application Number. . . . . . 07-00001894
Permit . .
. PLUMBING
Additional desc .
Permit Fee . . .
. 22.50
Plan Check
Fee
5.63
Issue Date
Valuation
. . .
.
0
Expiration Date
12/26/07
Qty Unit.Charge Per
Extension
BASE
FEE.
15.00
1.00 7.5000 EA PLB
WATER HEATER/VENT.
=-----=-------------------------------
7.50
-----------------------------
Special Notes and
---------
Comments
REPLACE 50 GALLON
GAS WATER HEATER
WITH
NEW UNIT
Fee summary
-----------------
Charged.
Paid Credited
Due
Permit Fee Total
---- ----- ----------
22.50
----------
.00
----------
.00
22.50
Plan Check Total
5.63
.00
.00
5.63
Grand Total
28.13
.00
.00
28.13
LQPERMIT
Dill it
city of La Quilva
Bud&ng a Safety DAM0011
P.O. 8wr 1504, 78-495 C21A* Tampico
Ptrntft 11 a Quinta, U. 92253 - (e 60i 777-7012
4bK1 - Building Permit Application and Tracking Sheet
Projoel Addresm: "5 owlies Nmnc:
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Comracurr.--Dc Telephozze.Win. I
Address: 4-/w,7 9 nk4i'm sLf-ee P1
-jea Description:
city, L-ij, �jokJ
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TLlephune:,7
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Stott Me. 0Li..
S_Dg�_) sa%, city — —
AnI., Engr, Designer`
Addram:
• Ci. !, ST. Zip:
TAcphone; -------
Coastruclioa Typr- occupmqv:
Stalc Lic. Prqj_—A tyctc (circle em)- Nv.nr Add*n 'ter CP Demo
wrtmo of Conlan Pcrsan: Sq Ft.: stayies: tl UniL,:
Telephone J) of Cowur;t Ferwn.
Estimated Value of Proj
APP.MMY: DO . NOT Ili ME BELOW TMS LRE AM.=
fi sulmilltal Id Reed I I TRAC3MGPMJrFT?EFS
!
I —
Ilan Sets Plan Ciiecit subtaitted Frezu
Ntractoral CnIcs, ready for ccrreclioas Pion Clierk Deposit
Tmv Cafes. Cdlcd CoamerFema ?I= Check Balance
Title 14 01lmCn
Construction
- �pikcd up
I -load plain Pion Plot:,- resubmitted
Gy"din? titan
2d Review, ready for correction-Asme EtWrical
Calltd Contact. Person Plumbing
Cont Deed Plans piched up
S.M.I.
Approval Plans resubmitted Cr2ding
IN MUSE:- Review, ready for carrecdonsfiLisue Developer Impact Fiet
Phoning Appratml Called Contact Ptrscn
i Pult. Whi. Appy Data Of pernlit, iSSUC
t. School Fens
Tow Permit Y.
a .1
C
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (2ge3 of 4) CF -IR
Project Title Date
k
SEALED DUCTS and Ms (or Alternative Measures)
A signed CFAR Fenn must be provided to the building department for each home for which the following. are
reauired.
j 3 I Alternative to Sealed Ducts and Refrigerant Charge fMs (See Package D Alternative Package Features for
j j Proiect Climate Zone in the RM Amendix B Table ISI -C. Footnotes 7-14.
M
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 shall mcet the Muirerrients of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
>r
Distribution
Type
0
Sealed Ducts fall -climate zones installer testing and certification and HERS rater field verificationrequired.)
0
,I'XVs, readily accessible (climate zones 2 and 8-15 only)
-(Installer testing and certification and HERS Rater field verificationrequired.)
0Refrigerant
Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
j 3 I Alternative to Sealed Ducts and Refrigerant Charge fMs (See Package D Alternative Package Features for
j j Proiect Climate Zone in the RM Amendix B Table ISI -C. Footnotes 7-14.
M
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 shall mcet the Muirerrients of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
>r
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system_ Standard system is one gas-fired water heater per
O
dwelling unit If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Standby'
Loss 0/6
not allowed.
0
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required,and the system co lies automatically.
50
Check bo x if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
O
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
0
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Systems serving sinde dwelline units
Water Heater
efFuel TM
Distribution
Type
Number
in System
Rated
u
(kW or
au,
Tank
Capacity
tm,a)
Enerfy
Factor or
Thermal
Effrcierr
Standby'
Loss 0/6
Tank
External
Insulation
R Value
VI bbd 1-6prs
C lctS
yo 000
50
015F)
System serving multiple dwelling units
Water Heater
['
Distribution
T e
Number
in S stem
Rated
Input'
(kW or
BwJhr
Enemy
Tank Factor or
Capacity Thermal
Imp Efiicienc
[Standby'insulation
oss %
Tank
External
R -Value
1. ror sinau gas storage water, heaters (rated inputs of less than or equal to 75,000 BbAr), electric resistance, and heat
pump water heaters, Iist Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Brit/hr). list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated input and Thermal Efficiencies.
rive Insulation (kitchen lines ? 314 inches) All hot water pipes from the heating source to the kitchen fixtures that am 1/4
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B.
Residential Compliance Fonns March 2005
7
,r
i
f
`CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page I of 4) CF -IR
Project Title Date
Project Address Building Permit #
f
f Documentation Author Telephone Pkn C / date
Field Check / Date
Compliance Method (Prescriptive) Climate Zone Enforcement Agcncy Usc Only
d ❑ Alternative Component Package Method: (check one) C D D (Alternative)
Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF- t R page 3)
For Package D Alternative see Appendix B Table 151-0 Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) fl2 Average Ceiling Height R
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-C — (20% X CFA) g
✓ 13 Building Type: (check one or more) Single Family Multifamily Addition Alteration
(If adding fenestration fill out WS4R, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 83.3 for Alterations.)
Nwnber of Stories: Number of Dwelling Units:
Floor Construction Type; 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 (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
or Metal)
Assembly U -
factor (for
Cavity Continuous wood, metal
Insulation Insulation frame and mass
R -Value R Value assemblies '
Joint
Appendix
IV
Reference
Roof Radiant
Barrier Location/Comments
Installed (attic, garage,
Yes or No tyeical. etc.
I) 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.
Residential Cumpliancc Forms
March 2005
f
CERTIFICATE OF*COWLIANCE: RESIDENTIAL (Page4of4) CF -1R
Project Title Date
SPECUL FEATURES NOT REOUIRING HERS VERIFICATION (add extra sheets if necessary)
Indicate which special features are part of this project. The list below only represents special features relevant to the
Prescriptive methrni.
SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION
-(add exit sheets if necessary) Indicate to the HERS Rater which credits are part of this project and need
verification.
f
Feature
Reauwed Forms if a licabie
pemiation
17
Metal Framed Walls
CF -IR
Refrigonnt ChRrgc
❑
Radiant Barriers
CF -IR
CF -6R part 6 of 12
❑
Exterior Shades
WS4R
❑
Cool Roof
N/A; Attach CRRC Label to
Forces.
❑
Dedicated Hydronic Heating
Performance Calculation
System
Required; Attach Run to Forms.
O
Combined Hydronie System
Performance Calculation
Required; Attach Run to Forms.
❑
Gas Cooling
Performance Calculation
R uired.
_
❑
Buried Ducts
NIA; Indicate on building plans.
❑
Kitchen Pipe Insulation
See Section 5.6.2 Distribution
Systems in Residential Manual.
Multiple Water Heaters Per
See Table 5-13 or use
❑
Dwelling Unit
Performance Calculation and
attach Run to Forms.
Central Water- Heating System
Performance Calculation and
Serving Multi 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
attach Rpn to Forms
See Table 5-13 or use
❑
Instantaneous Gas Water Heater
Performance Calculation and
attach Run to Forms
See Table 5-13 or use
❑
Solar Water Heating System
Performance Calculation and
_I
attach Run to Forms
❑
Wood Stove Boiler
Performance Calculation and
t
I
I
attach Run to Forms
SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION
-(add exit sheets if necessary) Indicate to the HERS Rater which credits are part of this project and need
verification.
f
Feature
Regutred Fortes(if applicable) Description
❑
Duct Sealing
CF -611 pan 4 of 12
❑
Refrigonnt ChRrgc
CF -611 part 5 of 12
O
Thermostatic Expansion Valve
CF -6R part 6 of 12
Rrzidential Compliunce Forms March 2005