09-0850 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Appljcatjon_Number.:-09-00000850
Contractor:
FOY, SCOTT A.
Property Address:
45040 RAMBLEWOOD CT
APN:
604-291-016-16 -23995
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application, valuation:
500 --
i
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ARCIERI RESIDENCE
45040 RAMBLEWOOD CT
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/05/09
Applicant: Architect or Engineer:
Contractor:
FOY, SCOTT A.
43579 MAIN STREET
INDIO,, CA 92201
(760,)775-9405 ynG �Q
Lic. No.: 828264 t�OrQ �9
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LICENSED CONTRACTOR'S DECLARATION -
---------- ------------
- - WORKER'S COMPENSATION DECLARATION .
I hereby affirm under penalty of perjury that I am licensed under, provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 70001 of'Division 3 of the Business and Professionals Code, and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License C ass:', C36 License No.: 828264
_
for by Section 3700 of the Labor Code, for.the performance of the work for which this permit is
`.
O 9
issued.
Date: Contractor:
�S
— I haveand 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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier FIRST COMP INS Policy Number WS1004457
following reason (Sec. 7031 5, Business and Professions Code: Any city or county that requires a permit to_
I certify that, in the performance of the work for which this permit is issued,.) shall not employ any
construct, alter, -improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000).of Division 3 of the Business and. Professions Code) or
- 3700 of the Labor Cqgte, I shall forthwith comply with those provisions.
f7.�t
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031..5 by
for five hundred
Date: V' v�
any applicant a permit subjects the applicant to a civil penalty of not more than dollars ($500).:
1 _ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and -
Applicant:
�+
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who Coes the, work himself or herself through his.or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). -
APPLICANT ACKNOWLEDGEMENT
(_ 1 1, as owner of the.property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1.. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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 ryc unty to enter upon the above-mentioned prope for insp ion purpo s,. /
Date: Signature (Applicant or Agentl: ) Y
Application Number . . . . . 09-00000850
Permit . . . .
. PLUMBING
Additional desc .
Permit Fee . . .
. 22.50
Plan Check.Fee
5.63
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date .
. 2/01/10
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 7.5000
EA PLB
WATER HEATER/VENT
7.50
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Special Notes and
Comments
INSTALL TANKLESS
WATER HEATER
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG
STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
--------------------
22.50
--------------------
.00 .00
22.50
Plan Check Total
5.63
.00 .00
5.63
Other Fee Total
1.00
.00 .00
1.00
Grand Total
29.13
.00 .00
29.13
LQPERMIT
08/05/2009 11:10 7607755222 CANON #7121 P.003 /003
CERTIFICATE OF COMPEfANCE: RES1,DENTIAL. l'' e 3 of.4) CF -IR
Pro}eex Tide Date
SEALED DUCTS .TXVs for MUNOW
:A sighed CFAR Form must be provided to &e buiRling dent for each home for which the following. are
J I
p Sealed Ducts all.climaae zones Installer tesdag and certifre;ation a -d 11F.RS rater field verification to
TXVs, readily accessible (climate Zones 2 and 8-15 only)
El Installer t and cetfxcatioo and HERS Racer field vcrifa ation uircd-
Refrige rant Charge (climate zeins 2 and 8-15 only) (Installer testing and certification and HERS Rater
13
OR -
Alternative to Sealed Ductsi and Refitattrnt Chxtge rIYVS (See Pack13 age D Alternative Package Features for
P. iPn Climate Zone -iii -the RM Appendix 13 Table 151-C.1•ootooics'7-14.
For additions and alterations, duct systems mal ate not documcrted to have been previously
sealed as confumed through field verification and diagnostic testing in accordance with procedures in the
Residential ACIM Manual and duct systems with more thaw 40 linear feet in unconditioned
spaces sliall meet die, requixemcnts of Section 156(m) and dud insulation' uiremenrs of Package D.
Cheek box if system meets criteria of a "Stud" $ystem• Standard system is one gas-fired water heater per
dwelling unit. If the waterage _ heater is a stortype, 50 gallons is the maximum capacity and recirculation system is
not allowed_ table, Table 5 1 in Chapter 5 in the Residential
Check box whoa using P>�proved Altery.
rrattve.Water Hee g
Manual. No wafer h caiculatiorrs ark and the s steric complies aUtOinatlG2ll
Check criteria of system, and does not comply with the Preapproved
box if system does not refect
13 Alternative Water Heating table. In this case, the Perfor mance Method must be used and must be included in the
heck box to verify tit a time control is`rmpired for a redrew
13 units
S s dF• tsmrts
Rated
Input
Water Heater Distribution Number pew or
-r.— Tvne i in System , fku_ )
2�(r*3CEs �s ck..
ung system pump for a system serving multiple
fir- , m le units
Energy
Rated
Tank I Factor' or
input I
Distribution Number (kw or Capacity i Thermal
Water_—Heat" Tvoe in systetn &urty Ions Efficienc
Tank
External
Standby' I Insulation
Loss (%) I R -value
„ heaters ( ; of less tban or equal LO X5,000 Btu/1u), electric resistance, and heat
t. For small gas storage. heate rs (rated input of greater than 75,000
pump water healers, list Energy Factor., Far large gas j Efficiency
a and Standby Loss. For instantaneous gas water
Btulbr), list RaW Irk Recovery Efficie WY. Th i Efficieatcy
l eateM list Rated Mpa and Thermal g naie:s.
rC1 > 3/4) AD 1r piP� from the heating source to the kitchen fixtures that are'/a
e �� filed by Section -150 0) 2 A or 150 6) 2 B.
inches or greater in diameter shall be thermally itnsul as spec
March 2005
Residential Compliance Forms
Energy
Tank
Tank
Factor or
External
Capacity
Tben"al
Standby'
Insulation
lions)
I Efficiency
Loss %
R -Value
itr
I o �2
fir- , m le units
Energy
Rated
Tank I Factor' or
input I
Distribution Number (kw or Capacity i Thermal
Water_—Heat" Tvoe in systetn &urty Ions Efficienc
Tank
External
Standby' I Insulation
Loss (%) I R -value
„ heaters ( ; of less tban or equal LO X5,000 Btu/1u), electric resistance, and heat
t. For small gas storage. heate rs (rated input of greater than 75,000
pump water healers, list Energy Factor., Far large gas j Efficiency
a and Standby Loss. For instantaneous gas water
Btulbr), list RaW Irk Recovery Efficie WY. Th i Efficieatcy
l eateM list Rated Mpa and Thermal g naie:s.
rC1 > 3/4) AD 1r piP� from the heating source to the kitchen fixtures that are'/a
e �� filed by Section -150 0) 2 A or 150 6) 2 B.
inches or greater in diameter shall be thermally itnsul as spec
March 2005
Residential Compliance Forms
Note: Low-rise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used.
More stringent compliance requirements from the Certificate of Compliance supersede the items marked with an asterisk (') below.
When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum
component performance specifications for the mandatory measures whether they are showti elsewhere in the documents or on this
checklist only.
Instructions: Check or initial applicable boxes when completed or check NA if not applicable.
DESCRIPTION
NA
Designer
Enforce
%meat,
Building Envelope Measures:
✓
✓
✓ ,
' § 150(a): Minimum R-19 in wood frame ceiling insulation or equivalent U -factor in metal frame ceilirig.
❑
❑
❑ ci
§150(b): Loose fill insulation manufacturer's labeled R -Value:
❑
❑r-❑
' §150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -factor in metal frame walls (does not apply
to exterior mass walls).
❑
❑
r
�.
' §150(d): Minimum R-13 raised floor insulation in framed floors or equivalent U -factor.
❑
❑
' ` ❑' .
§150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs.
F +
1. Masonry and factory -built fireplaces have:
a. closeable metal or glass door covering the entire opening of the firebox
❑
❑
" .
b. outside air intake with damper and control, flue damper and control
❑
❑
„0,:.'
2. No continuous burning gas pilot lights allowed.'
❑
❑
0.
§150(0: Air retarding wrap installed to comply with §151 meets requirements specified in the ACM Residential Manual.
❑
❑
� ❑ ,
§150(8): Vapor barriers mandatory in Climate Zones 14 and 16 only.
❑
❑
1 jisc
§150(1) :Slab edge insulation -water absorption rate for the insulation material alone without facings no greater thanr
0.3% water vapor ermeance rate no greater than 2.0 er/inch.
m
❑
❑
A
.,_i #
§ 118: Insulation specified or installed meets insulation installation quality standards. Indicate type and include CF -6R=
Form:
❑
❑
` '
. ❑ ;� f.
§116-17: Fenestration Products, Exterior Doors, and Infiltration/Exfiltration Controls.'.;
`p
1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage.
❑
❑
:' 1�❑ ".
2. Fenestration products (except field -fabricated) have label with certified U -factor, certified Solar Heat Gain
Coefficient SHGC , and infiltration certification.
❑
❑
�` t�
3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed.
❑
❑
❑ '
Space Conditioning, W ter Heating and Plumbing System Measures:
§ 110-§ 113: HVAC equipment, water heaters, showerheads and faucets certified by the Energy Commission.
❑
❑
§ 150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or ACCA.
❑
13
1:1.
§150(1), Setback thermostat on all applicable heating and/or cooling systems.
❑
❑
, ,❑w!.tit
§ 1506): Water system pipe and tank insulation and cooling systems line insulation.
❑
,�4 r,
1. Storage gas water heaters rated with an Energy Factor less than 0.58 must be externally, wrapped with insulation
having an installed thermal resistance of R-12 or reater.
❑
❑
t;.
:.•.,x• ._
2. Back-up tanks for solar system, unfired storage tanks, or other indirect hot water tanks have R-12 external insulation or
R-16 internal insulation and indicated on the exterior of the tank showing the R -value.
❑
❑
,>' "I.
3. The following piping is insulated according to Table 150-A/B or Equation 150-A Insulation Thickness:✓
Lt. _First 5_feet of hot and cold _water pipes closest to water heater tank, non -recirculating systems, and entire length
of recirculating sections of hot water pipes shall be insulated to Table 150B.
❑
❑
sem, ` 3
eF.
2. Coolingsystem piping suction, chilled water, or brine lines),
Y P P g ( )piping insulated between heating source and
indirect hot water tank shall be insulated to Table 150-B and Equation 150-A. _
❑
❑...
4"
t•,
4. Steam hydronic heating systems or hot water systems s15 psi, meet requirements of Table 123-A.
❑
❑
. ".,0 '
Residential Compliance Forms April 2005
08/GS/2009 11:10 76077SS222
CANON #7121 P.002 /003
Bin #
City of La Quintd
.
Bu&ft ec Sdety nomm
P.O. Box' 1504, 7"'75 Cage Tw*0
P
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Li Qtbra, CA 92253 - (760) 777-7012
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Address:
City, ST, Zap: ,
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cmLqYssction Type: 0=ipancy:
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' projoet.typc (circle one): New Add'a Aher Repair Demo
Name of Cotttact Pmx?n:
S4 Ft: #Stories: #Units:
Tel am # of Ca»ce Person:
Fare Vahee of Prolcot:
APPUCANT- DO NOT WFWM BELOW Tm LlkF-
# Sinal Rag'd accId TRACKEMG PERMUFEES
Pisa COo&Item Aseoeat
Saudssl Cala,
ite¢ks►td,Y Plan Chctk Deposit
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fide 21 Csia.
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CtiCesssct Per$- A iP.P.
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Pub_ Wks. 4r
Date of Pwwz casae
School Fca
Total Femadt Fear