9710-079 (AR)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that.I am licensed under provisions of
Cliapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
590090 B 3.131/98
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Co - e).
I am exempt un er.§ection B&P.d..t ffZ this,reia'son �
/Date �'a t", . C. ' (Signature of Owner }�
s �
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 & policy no. are: .
Cartier Policy No.
STA'.1E FU1+7D 1297971-97
(This section need not be completed if the permit valuation is for $100.00 or 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 as to become subject to the
work/s' compensation laws of California, and agree that if I should become
F
'ect tothe workers' compensation provisions of Section -3700 of� Labor
e;tl,3halbIforthwith-comply with those"prov�sions!e:� 1 Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his, o
application.
I
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon ,
t e above-mentioned property for inspection purposes' 1
Signature (Owner/Agent) %`'"`' `1 �' ` , -X(m e��
t: -
BUILDINGPERMIT.PERMIT# .. °°NTRDL#
DATE �. ' VALUATION LOT 9710-079 TRACT 6047 ® �
r�'� $7,299.80
JOB SITE APN
ADDRESS /-
W579 PEBBLE BEACIf 769 ' 3(r I -.0 -)
OWNER I CONTRACTOR/DESIGNER/ENGINEER
KJT FESTA
W579 PEBBLE BEACH
LA QUINTA
USE OF PERMIT
Z
CAL TECH BUILDERS
52-711 AV8N[DA VELASCO
CA 92,253 LA QUINTA C.A. 92253
(760)564-13179 C:BL#. 402
ATRIUM ENCLOSURE j 113 s f .
REMODEL - CUSTOM 7,299,80 S.F.
ESTIMATED COST OF CONS'fRUC'leION
PERMff FEE SUMMARY
PLAN CHECK FEE 101-000-439-318 $161.35
CONSTRUCTION FEE 101 -OW -418-4100 $99.00
STRONG MOTION FEE - RF -SID . 101-000.241-0049 $.73
c
'�,2�19.f198
PAI
SUB-TaCAL CONSTRUC UNAND PLAN CHECK $164.08
0 C T 2 2 1997 . LESS PRE -PAID FEE 50.00
TOTA , PERMIT FEES DUE NON'
1TYOF LA. 05 -NN+;
RECEIPT DATE ji BY I,' I DATE FINALED INSPECTOR
LJy
$164.08
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
.INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade jtY
Return Air
Steel
Combustion Air
Roof DeckExhaust
Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation 7
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final — -
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS"
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
-t
n::
-a
..... .................
....... ty-
of La n
.. .............
............
..........
'Mild g� a Safety, y'Divkion'
78495'CIII�:,.t�qipico
La Q6intai-kA�92251'..-.
:Ap-p c [6Wa-hd-TrkkIhg Sheet
Rernii
at
.,'�qjldlng
r%u.
Protect Address'n
Owners s Nam
A- P. -N umb,er:-
t
�Le al Descriptiom, .'Ci�y.;ST„Zip:
. ..........
.................
. . ....... . . . . .. ......................
... ............. ..
. . ... .. ...........
�o -7 71 I'd '.1 ... ... . . .
Cont
C 04 - - , X.;
C ntractor: p pe: -
W.
Project Description- -Ewx s^ INJ C -Las v le
Address:
e7V V
City.ST, Zip:
Telephone: 10 ....................... 4
43 T
State Lic. 4 City Lic. #:
SA
Arch.. Engr.. Designer .,
Address:
City. ST, Zip:''
.............
...............................
.............
..............
Telephone: Construction Type: Occupancy:
'P '(circle,bne)--; New Add'n •- Alter Repair Demo
State Lic. type
roject
'
Name of Contact Person:! Sq .,FtVStofies: # Units:
Telephone 9 of Contact P6rsorf-. of -T�rbjqct:�
Estimated
.!;, . : - ... 7.7.;.;.;.;.7.7.7.7.7.7.7.7.7...7...7,.7..S....7............-.............�.-I 11-1.1 - � - -I................................................................. ....... - -4
..............
...................
................. .
....................
. ...... ..................................
...... ......
..............................
7»>::»7�.. . . . ....................
7” ............ .'.'."� ............................
. . ............
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
N0. PLUMBING FEES
IST FL. SO F ;r E
2ND FL. SO. FT,
POR SO. FT tg
GAR SO FT. q
CAR P jO FT .2
WALL SO FT 2
50 FT. ;rr
ESTIMA7EO CONSTRUCTION VALUATION S
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAP SINK
ROOF DRAINS
1 DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Net to be ;,sea as ,rooeny tax +a:uatlon
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATEP SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXOISHI
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT 'WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T.0
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE. TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT, 4g, c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT. B.T.U.
SU. FT. R E S I D r,* Iua c
SEWAGE DISPOSAL
SO.FT.GAR @ 4C
HOUSE SEWER
REMARK
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE LPL.C..FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING f AIR GOND. ' SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE
ROUGH PLUMS.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINALS
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
f plug xf
-
-f
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARK
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIOWSOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
Iwsve� r vKa aruww � uweanwt � �w�s
GARDEN WALL FINAL
Notice:
Document Cannot Be Duplicate,
Desert Sands ,Unif ed=School'District
82-879 Highway 111 j
d - Indio, CA 92201
619-775-3500
CERTIFICATE; OF COMPLIANCE
Date 10/22/97 APN # 769-361-030
No. 16194. Jurisdiction .: La-Q.uinta
Owner Name Kit Festa `Permit #
Ivo. 80579 street Pebble Beach;: Log:#
City La Quints Zip, 92253 Study Area
Tract # Lot # Square Footage 113
Type of Development Residential Addition- No. of Units 1
Comments
At the present 4ime, the,Desert Sands. Unified School£ District does not, collect fees on garages/carports, covered
patios/walkways; reside'ntial'additions under'500;square feet detached accessory. structures'o'r replacement mobilehomes.
It has been determined- th'e above-named owner is exemptfroin paying school fees at this time. due to the `following
reason:
Residential, Additiop 50.,0,',,Sq•Feet. or Less,
EXEMPT
This certifies that school facility fees imposed pursuant to Government Code 5360 in,the amount of
0.00 X. 113 ' or $" 0:00. the'pro0,ertyjlisted above and.,that building
permits and/or Certificates of Occupancy for this .square footage in this proposed -prod ct may now be issued
Fees Paid By Telephone 564-1309
Name on'the check
By Dr. Doris Wilson
-Superintendent
Fee collected /exempted by Pauline`Pearson • Exempt
' Check No. n/a
Signature
NOTICE: Pursuant.,ot Assembly Sill 3081 (CHAP. 549,._STATS. 1996) this will serve to!nobfy you that the 90 -day approval,period in whit :you: may protest the fees or other payment identified
above will begindo rurifrom the date on.whiofi:the building or installation permit for this proles is sssued'or on which they are paid to the bistrict(s)'or to another public entity authorized to
tolled them on the Distrid('s)(s')behslf; whichever is earlier:' v
Collector: Attach a copy of county or city plan check application form'.
orm to district co' for all waivers.
.. ;..
Embossed Original- Building Dept./Applicant Copy - ApplicaritZReceipt Copy .= Accounting ;
1
ro -
Certificate of Compliance:. Residential t
— a
Pr 'ect Title ,.
Project Addresa;
S'jaj
Do�ju�m�e teflon Author ` /(�.� ` ,,, TelePhone
Compllance•Method (Package, Point Syster..or Computer) Climate Zone' ,
(Page 1 of 2) CF -1 R
Date s
Building Permit 0 ,
Plan Check/ Date
Field Check/ Date
Enforcement Agency Use Only
GENERAL INFORMATION
Total Conditioned Fl�oorArea" 13:, ' M . f12
.
Building -Type: ngle,Family - Addition ;, r
(check one,ormore) Mufti-Fami ly. ''Existing-PIusAddition
Front Orientation: Noah•/. East: °Bout /West /,All Orientations
(Input onentation•in Degrees and circle ooe:)
Number of Dwelling Units '
Floor Construction Type:• Sf Raised. Floor"(circle one or.boih)
i
BUlLDING'SHELL INSULATION'
t"Construction
Component Insulation Assembly LoCatlon/Commen'tsr
Type R=Uuea .,; ,-U-Value (attic, to•garage;-typical, etc.) -
tc.)Wall.......
Wall .......... " 13 ''_ ��1 SSI y: EST•` InlAlti` .�
/�'rl h
Wall .............. 4�� ;
Roof ........F—t VIM, I7oF
ILI N- -
r
Roof ..............
Floor..........
Floor .............
Slab Edge .... 4.
FENESTRATION 7` ,• r Shading Devices. -
Fenestration Area. �' Fenestration Interior• Exterior
Overhang Framing Type
Orientation ."(sf) : U -Value (roller.blind, etc.) (ihidescreen, etc.)
.(yes/no) (metaVwood,vinyl)
Front.....
Front.....
Left.......
Left......:
Rear..... ( ) r• .
Rear.....:(
Right.. ( ) "
.Right.
Skylight .... L) -� '" z. �L-C�S LI:I��6.
Skylight .......
THERMAL MASS
Type/Covering ':rt Area:' a, Thickness
(slab/ex sed, tile, etc.) sf (inches) ... L6cati6iVDescrl ion kitchen, bath, etc.)
.. k
Compliance Fors
January 1, 1995
Certificate of Compliance:_, Residential � (Page 2 of 2 CF -1 R
,.
_ )
.Y'
Project TitleA
I, -, •- .. f r Dale
s
HVAC SYSTEMS 5` '
Note: Input hydronic or combined hydropic data under Water Heating Systems, except Design Heating Load.
'bistribution
Heating Equipment t0nimum Type and or , Heat Pump
Type (furnace, heat:. Efitcieney Location Piping; -Thermo_ stat Configuration
um ,:etc.);(AFUE/HSPF) (ducts/attic,.e.tc. R -Value �'T, e' (split or ack� e)
Cooling Equipment `' Minimum Duct w
Type (aiicoridhioner, Ef-ficiency' Locaiion Duct Thermostat Configuration
heat pump, eva . cooltn SEER (attic..etc.) R' -Value Type,,, (sDlft or;, acka e
WATER HEATING SYSTEMS
. `,Energy: • External
r
'A
ated* .r Tatk Factor.or Tank
Water Heater. Distribution Number input W ?Capacity Recovery' _.Standby' _Insulation
Type Type in S stemor Btu/hr allons : .Efficien-toss % *-R-Value
1. For small gas storage (rated input 5 75 OOO; Btu/hr) electric reslatance,and heat pump; watek heatera, list Energy Fac�o�.
For large gas storage water hea;te`rs`(iated input 2!j 000, Btu%hr),'IistRated Input, Recovery. Effiaenry acid Standby Loss.
For Instantaneous gas water heaters, fist Rated Input:and`Fieco°ver Etficioncy, * F
SPECIAL FEATURES/REMARKS (Add extra sheets if'necessary)
COMRLIANGE STATEMENT
This certificate of compliance lists lhe•building fealu�eS and,performance specificabons.needed.to comply with Title 24; _Parts 1 and 6. of
the California Code of Regulations andaie,administiai9ve regulationsr_lo implement them. This certificate has been signed by the
individual -with overall design responsibility:, Men chis ceriifrate of compliance is:.submitted for a -single building plan to be built in rci7ple
' orientations, any shading feature That is varied is indicated iri the Special Features/Remarks section.
Designer or Owner (per 6usi neva a Prorescu
aions code) bo'tne tatlon Au'th1 or
Name: 'J='1 F D Name: W
Title/Firm: -mow Tide%FirTn.
Address: J '' G . }. Address;,..
Telephone: Q. % '' ' Telephone
Lic.
11
dale s na a date
(signal e),, ( y). (i9 ( )
Enforcement Agency _.
Name: .,. .
{ ' Tide:
r. Agency:
Telephone:
(signature/stamp)
Compliance Forms r January 1, 1995
Mandaftdry-Measdfbs Checklist:; 'Rpsidend
MF -1R
NOTE:- Lowrise residential buildings subject to theStaiid�arcls,must '.contain thesemeasures regardless of the compliance
approach - .used. It6rfis and ed with ao asterisk may ba. superseded 6y more stringent compliance -requirements
listed on the Certificate' of Cornplian`6e.,�When thishecklst',,"6 i 'is' perm
incorporated.into.the it documents, the features
noted shall be cons' ide'red by,all, parties as -binding "' 1 6 � i � `- t -
minimum �f - ific;Mions for the
pc�njponen pe . ormance�spec
mandatory 'measures whether they arq,show6,eIsewh&6 ih t.he'd6cumerits'or on this checklist only.
D.ESC-RIPTION
Building Eny�'ifope.Mdasures
_
* §150(a): Minimum R-19 ceiling ihi*61afion.
§150(0): Loo'se fill i6sulaboii.*m'anufacturer's labeled R-W'ue.,
* §150(*'MinimumR-13 wall insulation in fr�imed waJIs,(dces not apply -lo exterior masswalls);
!, , . 4
*
§150(d) - 'Min i
mum R,13 raised floor insulation -in traimed'floors; minimum R' '8, in concrete raised floors.
§150(1)* Sla]5,edge insulation - water ,ai�—'rp'tion"ra-le no creates than 0;3%water vapor transmission rate no
greater:than 2.0 perm/inch.'
§118 rInsulafion specifi4oi, installeft-e'eits; California'yEr.-&`oy Commission q`u'aJily,stindards;,' i
7
Indicate typ�e and form.ti
§116.17: Fenistrition PtoduEts, Exii�rio,rDoois, and- InfilUzlion/Wiltraboh Conu.0"Is
v '. �ed, —, - designed . 1 P
a. Doors' and w'ind6w's betwe"e"h conditioned and un6oncition spaces i to limit aii leakage.
b. Manufactured fenestration pir6�16cts'h`av'6 label with certified 0-valUe _a�nld infiltration certification.'
c. Exl6iidr doors and windows wea'edrstripp4,,,aJI joints and '� ne'trAiio'�n$s`ca'uIked1 an: ds'e'aled.
pe
!Q . i
§1,50(8): Vapor, barriers mandatory, in. Climate Zon'es.1 4.aM 16o''nly.-
§150((): SpepaNnfiltration barrier, installed to comply-.,�ith §151 meets -Corfimissiori*qu,�i
ty standards.
§150(e): Iristallationof Fireplaces, Decorative Gas,Appliances' nd, -Gas Lo'gs"'
i Masonry and fbctory-builffirepiaois
a: Closeable metal or glass door,
b. Outside air intake with -damper and control ,
c. Flue damper and control
2. No continuous burning gas;oilots allowed.
Space Coriditi,oning,*Water.Heating.and Plumbing System Measures
§110 -13: HVAC equipment; water heaters, showerheads.and faucets certified by"Ahe Commission.
§150(i): Setback thermostat on afl'appli6able heating systems:,
§1500): Pipe,'andTank Insulation
1. Indirect hot wate"f"tanks (e g.; unfired storage tanks or, backup solar hot water tanks)'have insuladori�
blanket (R-12 ovgrqater) or combined inte- 66i/exter*'('ins6lation-'(R-16or:'gr.ealef).*.
2. First 6" feet of pipei c16ses I to wAte'f'h4Wa'te ftin K non- rculating systems insulated (R-4 or greater)."'
3. All buried 6r.exposed piping iris6lae in re6iouIadrg.sections of hot.watec system.
4. Cooling syitem piping below 5'5 -*F insulated .
5. Pipinginsulated betw6e'h he"i6hg si'o'urce and i41rec.,.hot water tank.
§150(m): Ducts and Fans
1. Ducts constr . ucled, installed and sealed to comply wiai UMC,Sections 1,002 and 1004; ducts insulated
16 a. minimum installed value cif Rl -A'. 2 o(duc ts e nc!csc-d� entirely within 'c6qdi.donedl. space.
2. Exhaust fan, ysfems ha`vAickdrk or;automatic dam. 'p'e-ts
`
3. Gravity ventilating systems,servingconditioned space hivE`_ieer automatic or readily accessible,
manually..operated dampers..
§114: Pool Y
and*Spa Heating S 'sfemi-zhd;Equipment
'
1. System is certifiedwith .78 ' % lhir6al effi6a_-ehcy,-.on-oH' 'sivitch,' 'weather prloof�operating instructions,
no electric, resistance heating and no pilot light.
T
2. System is installed with:'
a. At least 36* pipe between filter and heater -for f6ture solar heating.,
b. Cover for outdoor pools or outdoor spa.
3. Pool,syslem has directi6nal inlets and a circulation pump time switch.
§115: Gas-fired'.c6nlralf urn ace;,pool -he ale r,-#a.he ate( cr'hb,usehold,cc>okingappli'ancel.,hav7e*no
continuously Wring pilot light,,(Ex6ep Non-electricatcooking applia6de with Pilot ,< 150,BKdhr.),
Lighting Measures
§150(k): 401umehs/watt or greater fovgeneral lighting in kitchens and r6bms, with water closets; and
recessed ceiling fixtures IC (insulation cover) approved.
Compliance Forms
DESIGNER ENFORCEMENT
E
:r
NIA
"N
J,Lnunry 1. 1995