10-0446 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: -0-0-0000446
Property Address: 44665 CALLE SANTA BARBARA
APN: 604-382-039-130 -25953 -
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3500
Applicant: Architect or Engineer:
L.." — A_A_
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that-) am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: El License No.: 818261
Date.5 —2,�;—/O 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 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.).
(_) 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:
LQPERMIT
Owner:
WORRELL BOB
44665 CALLE
LA QUINTA,
SANTA
CA 9225
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
5/25/10
Contractor:
THREE D CONST
320 E. STUART AVENUE
REDLANDS, CA 92374
(909)335-4846
Lio. No.: 818261
------------------
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 and policy number are:
Carrier SOUTHERN INS CO Policy Number WS1001852202
_ 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
3/700 of the Labor C de, I shall forthwith comply with those provisions.
05 -2J—!D� APP' licantf
WARNING: FAILURE TO SECURE WOR ERS' 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 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 county to enter upon the above-mentioned proper for inspection pueposes.
r,
D�at�e* �% �'✓ ig Agent): �'t./"lh V.
Application Number . . . . . 10-00000446
Permit . . . . .
. BUILDING PERMIT
Additional desc .
.
Permit Fee . . .
. 63.00 Plan Check
Fee
40.95
Issue Date . . .
. Valuation
. . .
. 3500
Expiration Date
11/21/10
Qty Unit Charge Per
Extension
BASE FEE
45.00
2.00 9.0000 THOU BLDG 2,001-25,000
18.00
--------------------------------=-------------------------------------------
Special Notes and
Comments
REPLACE (4) RETRO
FIT WINDOWS & (1)
-'-"- -- - -— -- -'- SLIDING GLASS DOOR PER APPROVED PLANS.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
4.10
Fee summary
-----------------
Charged Paid Credited
----------------------------------------
Due
Permit Fee Total
63.00 .00
.00
63.00
Plan Check Total
40.95 .00
.00
40.95
Other Fee Total
5.10 .00
.00
5.10
Grand Total
109.05 .00
.00
109.05
LQPERMIT
Bin #
City of La Quints
Bullding•8s;' Safety Dh!islon
P.O. Box 1504, 78-495 Cabe Tampko
La Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and.Tracking"Sheet
Permit # �
l7 ^
Project Address:
Owner's Name:
A. P. Number.. _
'Address:
Legal Description:f
'Ctty, Sl, Zip: n
Contractor: V ` 8
Telephone:
Address: _11NIZO IS. $ - U a C `� & V C,
�Prpioct Description: c,
Z
City, ST, zip: e d 1 d /i dS " C.a • T
e `{ i ��ct i n
Telephone: 335- c
State Lie. #: City Lie. 0"
Arch., Engr., Designer
o p,
• / `
Address:
I SS D D
City., ST, tip:
Telephone:
State Lie. #:
Name of Contact Person: `/
7
.
Construction Type: 1 /i d D W S Occupancy:
.-Project type (circle one): New. Add'n Alter Repair Demo
Sq. Ft.:
sl Stories:
#Units:
Telephone # of Contact Person: G]0 q _[24 — �?
Estimated-Value of Project:
'A
DO NOT. WRITE: BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACIONG
PERi4IIT FEES
Plan Seta
Pian Check submitted.
Item
Amount
Structural Cales.
Reviewed, ready for corrections.
Plan Check Deposit
Tress Cees.
: Called Contact Person
Plan Check Balance
Title 24 Cales.
Piaav picked up
construction "
Flood plain plan
• Plans resubmitted
Medmaical
Grading pian
2`' Review, ready for correctionsrissue;
Electrical
Subcontector Lint
Called Contact Person
Plumbing
Great Deed
Plans picked up
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:- .
''' Review, ready for eorrectlonsraisae
Developer Impact Fee
Planning Approval
Called Contact Person
AXP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total, Permit Fees
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations a e 1 of
Project Ha
K„ L i. I I I Climate Zone N I N of Storks
General Information
Site Address:Uq� A nforcement Agency: Date:
Building Type Single Family O Multi Family Circle the Front Orientation: N , W. or degrees
Conditioned Floor Area (CFA): Project Type: O Alterations O Envelope 0 Fenestration O Roof O HVAC
Replacement or Change Out O Duct Replacement O Water Heater
• This orm Is not 16 be`WW err New Constructed &l difigs or Addldons ------------_.....
lnsuladon Values For Opaque Surfaces (for Furring use the Mass amid Furring.StrSps Consnxction 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
mandatory minimum insulation value per §150 for the altered assembly. Fill in Columns A -C and enter mandatory insulation value in Column H.
O- Replacement of entire assembly - Replacement of an entire wall, cellGtg, or floor assembly requ&w the ltwdlation of Component
Package- D insulation values in Table 151-C Flit «_ n
Opaque Surface Details For the furred portioned of Maar Walla see Furring Strips Constmictlon Table below.
A B C D E I F G I H I. J
Pro Standard Values From JA4 Table
Te�/
ID
Assembly Name
T
M Framing
�' Framed Continuous JA4, Proposed
U- JA4 Table . Cavity Insulation Assembly Ass tanblp
E
or
and Size'
or Otber? factor' Numbers R-valueb R -Value Cell Valued U -factor"
[ J I K_ __
Insulation
from Reference
Table 4.3.13
a
V.
I S -� Z.
t > < jLLJ '
L_ M
Final
U -factor '7 Comment
Macs
Thickness
Aem
Name oir
T
U.
JA4 Table S
Number' < >
Nae: For fiortd aueneblfeA 00eomting for Commow laswatroe R -value, see P JAI -J and
Ferri C-aructton table below. Fgration I -l. For cwlcrlat6tg fwrYd walls use ilk Alasand
1. For Tagl1D irrcliccue the identification name that matches the building plans.
2. Indicate the Assembly Nome or type: RoofJCeiling, Walls. Floors, Slabs, Crawl Space, Doors and etc ... In&cate the Frame type and Sire: For
Wood Metal. Meld Buildings, Mass. enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter; 16 "or 24 "OC. or Other for all other assembly description
such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc....
4. Based on the C/!Wrote Zone; utter the StarKiirrrl U_fact from Table 151-B. C or D for each difirerent assembly Name or type.
S. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R_va/ue that is being instilled in the well cavity or between the framing; otherwise, enter -0 "
7. Enter the Continuous Insulation R -value for the proposed assembly: otherwise, enter "0"
8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J
9.7he Proposed Assembly U factor, Column J. must be equal an nr love .t.,.., a- . r � . i• �..�_ e . _r..
Furring Strie
Construction Table -for Mass Walls tAti
A B C D -A
Proposed Properties of Masonry and Concrete
Wails From Reference
Joint A adi: Table 43.5 4.3.6 4.3.7
E
F
Added
b
o�
o
E 9
x
I G I
Interior
in Furring
Joint
..
=
r
H
or,Exterior
Space
pendix
ISE
a
F °
"
[ J I K_ __
Insulation
from Reference
Table 4.3.13
a
V.
I S -� Z.
t > < jLLJ '
L_ M
Final
U -factor '7 Comment
Macs
Thickness
Aem
Name oir
T
U.
JA4 Table S
Number' < >
Registration Number: Registration DateTime:
2008 Residential Compliance Forms
HERS Provider:
August 2009
Prescriptive Certificate of Compliance: Residential CF=IR=ALT
Residential Alterations
age 2 of 5
Project Na e:
60 WJDrr�r
Climate Zone H
q of Stories
Hass and Furring s.Consvucdon(footnotes),
1. Indicate the.type ofassembly to include: Hollow Unit Masony Walls, Solid Unit Masonry, Solid Concrete Walls. Etc. Additional assemblies can
found Reference Joint Appendix J44.
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.
4. The Calculated R -Value is the R-valueTof the furred out section of the assembly.
5. -6. The Final Assembly is calculated using. Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA4. The equation is the inverse of Colum
added to Column 1. Column K is tlieinverse jrom-columnJ. -
7. Insert the calculated U- actor value on to the Opaque Surface Details in Column J
FENESTRATION PROPOSED AREAS
Replacing window alone – Replacement windows shaH meet.the'U-Factor and SHGC Value requirements ofComponem Package Din
Table 151-C. The Total Fenestration and West facing Area requirements are not applicable.
❑ Adding 50112 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 50f 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 ojthe CF -/R -ALT
Allowed
Orientation
Fenestration Total Area
Fenestration Type and Frame
(North, East,
PiopsedArea'
Maximum Maximum NFRC or Default
window Glass Door or Sly li t
South; West
f
U=factor SHGC'''.4 Values
Removed Area Added A x B) (E -D) + C
Total Fenestration Area
pLkio DOO/_
U41 1
o 0 os0
.20
>
West Fenestration Area
16
.05
1. Fenestration area is the area of total glazed product (i.e. glass plus frd*e). 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 jaetor and/or a lower
SHGC value than that specified on the CF -I R ALT Form.
4. Submit a completed WS -3R Form tf a reduced SHGC is calculated with exterior shading.
5,1fqpplicable at this stage enter "NFRC" for NFRCCertired.windows ar aro ('FC "riAnu6" „ol.,o, fmind.in Tnhle 116-A ar'R
ALTERED FENESTRATION ALLOWED AREAS (Co e1e 1 Maar ,rhuar vaWo enesttntlon is added)
-- .•w—us —i -sloping sr yagnts and any shytights with a pitch less than 1:12.
2. West facing glazing area removed cannot be -counted" twice.. In order to distribute the west glazing area removed to the other orientations,
input the west glazing area removed in the Total Fenestration Area row, column D.
3. Include the Proposed Area of the West facing fenestration in both Area columns. below.
4. To meet compliance, the Proposed Area_ must be less than or equal to the Total Allowed Area for BOTH the Total and West Fenestration Areas
Registration -umber:
2008 Residential Compliance Forms
Registration Date, -Time: HERS Provider:
August 201
A
B
C.
D E F G
Allowed
Existing
Fenestration Total Area
CFA of Entire
% of
Fenestration
Area Fenestration Allowed Proposed Areae
Dwelling
CFA
Area
Removed Area Added A x B) (E -D) + C
Total Fenestration Area
.20
>
West Fenestration Area
(Required In
.05
>
CZ's 2, 4 & 7 -15)
–
J__ -
-- .•w—us —i -sloping sr yagnts and any shytights with a pitch less than 1:12.
2. West facing glazing area removed cannot be -counted" twice.. In order to distribute the west glazing area removed to the other orientations,
input the west glazing area removed in the Total Fenestration Area row, column D.
3. Include the Proposed Area of the West facing fenestration in both Area columns. below.
4. To meet compliance, the Proposed Area_ must be less than or equal to the Total Allowed Area for BOTH the Total and West Fenestration Areas
Registration -umber:
2008 Residential Compliance Forms
Registration Date, -Time: HERS Provider:
August 201
Certificate of Co
Residential Alterations
Project Name: _<.•, --�
CF -IR -ALT
Pa e5of5
Climate Zone # I # of Stories
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 required for 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.sealedper.§.152(b).iD.ii. and.the newly installed.ducts.are to_be insu1ated.lzer..§.151 010,
❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
13 YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the
ducts areto be sealed per § 152(b) l Di.
13 YES ❑ NO 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 §I52(b)IE.
❑ 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 leas than 40 linear feet in unconditioned space -
E3 EXCEPTION: Existingducts ems constructed;insulatedor sealed with asbestos.
Refrigerant Charge- Split System HERS verification is required for this measure.
17 YES 17 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 beat
exchanger) a refrigerant chaW nmsumnent shall be verified per § t 52(b) t F.
Central Fan Integrated(CFI) Ventilation System and Fain Watt Draw
The ventilation requirements of § I 50(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 O NO YES: In Climate Zones 10 through i5, when the existing space -conditioning system (HVAC 'oquipment and ducting) is
replaced, the airflow and fan watt draw shall be verified per 4152(b)tCi to meet the requirements of § 15l(f)7B.
Documentation Author's. Declaration Statement
• I certify that this Certificate of Compliance documentation inaccurate and complete.
Name: /� k
V ice/
V
Signature:
22W
Company •Date: ,
I Gon 5-- 5 -ID
Address: 3.2-0 /l if Applicable ❑ CEA or 13CEPE
�r
-f - (Certification #):
City/State/Zip Phone:
and GG, q10q - 33s` 12
Responsible Building:Designer's Declaration Statement
• t 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 approval with this building permit application.
Name: ' <
y G
Signa
Company: Date:
Address: 1' ' s License- (� vG .�
City/State/Zip: D ( /' �j 2SCJ Phone•
P 33S ` 1-2
Cid. C 4, J5 CA r " l (�
For assistance or questions, regarding the Energy Standards, contact the Energy Hotline at: /-800-772-.1300.
Registration Number: Registration DaterTime: HERS Provider:
2008 Residential Compliance Forms August 21
CL0 go rid trn 613 I-
J�eplacem n lndoW
Detail Specifications
d
Store:
Date:
Customer:>Di �D l�iG
Customer phone #-1 UQ— )
Installer: ; rGG —.D
Customer—must be home for Installation
All measurements mest.be in inches
Loc.ationQty an //h
m. $� SCO.
2 - - `o ' s
alf
3L/Ven X0
'° O n x
qkp 5
%,
FA (y 0
6
,
7
8
0
I Cornments —_
c �
Store 208 Project No. 295617241 for BOB WORRELL
W
1
.5`4e F I an -- o1, Per /h 14 N
Width Height
Style
C>
° b
S 71?
c
N
t
8 3%y
.V
Page 4 of 4
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.Comment
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Page 4 of 4
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