10-0115 (PLBG)Applicant:. Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DIANE DICK
78880 SANI
LA QUINTA,
x
Contractor: `Its
CALIFORNIA DELTr
6052 E..BASELIN�
MESA, AZ 85206
(480)898-00.0.7
Lic. No.: 811114
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS.(760) 777-7153
QV\ Date: 2/18/10
5A
O
#155
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" LICENSED CONTRACTOR'S DECLARATION
P.O. BOX 1504
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA
92253
Application Number:1.0,-0000.0315
�7888y -0
Property Address:
ANITA DR
APN:
604-163-013-113 -23269 -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
924
Applicant:. Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DIANE DICK
78880 SANI
LA QUINTA,
x
Contractor: `Its
CALIFORNIA DELTr
6052 E..BASELIN�
MESA, AZ 85206
(480)898-00.0.7
Lic. No.: 811114
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS.(760) 777-7153
QV\ Date: 2/18/10
5A
O
#155
--------------------------------------------------------------------------------------------------
" 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 thefollowingdeclarations:
Section -7000) of Division 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 Class: B -.C10 -'C36 License No.:.. 811114
- for by Section 3700 of -the Labor.Code, for the performance of the work. for which this permit is
�/j�`` ���r
/ �0 ntrar. ' �� - `-� J"SG j! �G/!�(i �i✓C
ate: cto
issued. -
I-have-and'.will-maintain workers'' -compensation -insurance, as required by_Section 3706 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:"
hereby, affirm under penalty of perjury that I am exempt from the Contractor's State LicenseLawfor the
Carrier STATE- FUND Policy. Number 1697823 _
following reason.lSec. 7031 .5, Business and Professions Code: Any city, or countythat requires a permit to -
I certify that; in the performance of the work for which this permit is issued, I 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 oftheBusiness and Professions Code) or
3700 of the Labor Code, I shall forthwith comply -with those provisions. ..
that he or she is exempt therefrom and the.basisfor the alleged exemption. Any violation of Section 7031.5 by
nn��
applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS5001.:
e: 10 1-4 A -cant:
_any
1 _ 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.
WARNING: FAI E TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND. SHALL
Contractors'_ State License Law does not apply to an owner of property who builds or improvesthereon,
SUBJECT.AN EMPLOYER TO CRIMINALFENALTIES'AND CIVIL FINES UP TO ONE HUNDRED THOUSAND -
and who does the work himselfor herself through his or her own employees,provided.that the:
DOLLARS ($.100,0001'• 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 .
I, asowner of the property, am exclusively contracting with licensed contractors to construct the project (Seca
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
f I d h kb'
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: �nq/
Lender's Address: f
LQPERMIT
of La Qwnta, its officers, agents and employees or any act or omission re ate to t e wor emg
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 upo the above-mentioned property vrtyffor inspection purposes.
�:0 �� gnature (Applicant or Agent): xo r/
Application Number . . . . . 10-00000115
Permit . .
. PLUMBING
Additional desc .
.
Permit Fee . . .
. 22.50
Plan Check
Fee
5.63
Issue Date . . .
.
Valuation
. . .
. 0
Expiration Date
8/17/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB
WATER HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and
Comments
INSTALL NEW 48 GALLON GAS WATER
HEATER.
2007 CODES.
----------------------------------------------------------------------------
Other Fees . . .
. . ... . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged
----------
Paid Credited
---------- ---------- ---L
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
f
Birt #
City. of Lel Qudnt3
Buildfnga[ Safety Diytsiori,: '
P.O. Box 1504,74'495Gl/e Tampico'
La, Quanta, CA 92253 (760) 777-7012
Building Permit :4Op l6don and Tracking Sheet
Permit #
i�
Project Address: g a v S a4 -L i CL /" ,
Owner's Name: ° U � O I S (� hi
A. P. Number:
Address:
Legal Description:
City, ST, Zip: ZO x.14; yuta-253
Contractor. C m4 0
ProjectDeseript on:
Address: 9)a4,e,4 yam. ISj
City, ST, Zip:. Z 6
j
Telephone: 966 4* -
City Lia #4..10t(00 4 `
State Lia # : j
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
P
State Lie. #:
...a,.
Name of Contact Person: .J2
Coiistrltction Type: Occupancy:
Projecttype (circle one): New Add'n Alter ..epair Demo
Sq.Ft : #Stories: #Units:
ry,flty
Telephone # of Contact Person: 96616 'I Z: — 5Z -3' J •
Estimated Value of Project: q 2
'APPLICANT: DO'NOT WRITE BELOW :THIS LINE_
N
Submittal
'Req'd
ItWd
TRACIONG
PERMIT FEES
Plan Sets
Plan Check submitted
Item `
Amount
Structural Cales.
Reviewed, ready, for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Cales.
Plans picked up
.
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Revicw, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
-Plumbing
Grant Deed
Plans picked op,
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
Total Permit Fees
Of Cotn:plfaace: Residential
Project Name: I O D o
Climate Zone #
CF -LR -AI
(Pae I of
# of Stories
General Information
Site Address:h�
S:
C)(� Enforcement Agency' + Date:
Building Type Single Family ❑ MultiFamily Circle the Front.O>ientad,,: N, F, S, _'' ar degrees.
Conditioned Door Area (CFA): Project Type: ❑ Altdshons ❑ Envelope L1 Fenestration ❑Roof .❑ HVAC
R lecema t or.Cban e,Out ❑ Duct Re laceme rt Water Heater
NOTB: This form is not to be used for Newly.CanrlruetedBulldings orlrltlltitins. 1
Insulation Values For'Opaque Surfaces (far Furring use the Mass and Furring Str ps Cortrtructlon table below)
Assembly Alteratian
❑ Opening of framed cavity alone—Alterations that involve the openingafthe framed cavity afa wall, ceiling, orfloor must install the
mandatary minimum insulation value per. §150 for the altered assembly. Fill in Columns A —C and elder mandatory insulation value in Column H.
❑ Replacement of entire assem bly- Replacement ofan entirewall ceiling, or floor assembly requires the installation of Component
Package- D insulation values in Table 151-C Fill in Columns A—J.
a ue Star•face DetaW For the furred ortioned of 1`4tass Wall s' 11 see Furriu Stri s Construction Tible'below.
A ;ZJosed""
t7 E F
PGStandard VaIaas From JA4 Table
Tbiciosess, Framed ContJA4 Proposed
Tag/ Assembly NameSPka� U JA4 Table Cavity. Tnsulatidri Assembly Assembly
ID or a or Othe? . factor4 Numbers' R -value'',, - R-Vahier CeIl Values Assembly
Note For furred assemblies, arc
oiau*zgfar Contacrous hLudation R40alue; see Page JA4.3 and &quatinn 4.1. For colca
Furrlatingfrvred walls use the Mass and
ht Construction table below.
1. For TagILD indicate the identification name that matches the buildingplans,
2. Indicate the Assembly Name or type: Roof/Ceiling, )falls, Floors, Slabs, Crawl Space Doors and etc* ... Indicate the Frame type;and Size: For
W004 Metal, Metal Buildings, Mass, enter 2X4, 2x6, or etc.., see J44for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"CC,•• or Other far all other assembly description
such as Concrete Sandwich Panel, Sparub•el Pane4 Lags; Straw Bale Panel and:etn..,.
4. Based on the Climate Zane; enter the Stmulard ufactar from Table 151-B, C or D for each different assembly Name or type.
5. Enter the Table number that closely resembles the proposed assembly. `
6 Enter the R -value that is being installed in the wall cavity or between thej�paming,• otherwise, enter IT
7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter "j
8. Enter the row and column o(ihv U -factor volae based on Column F Table Number arui enter the Assembly U -factor in Coltvnr i
9. The Proposed ,4ssernoly iJ;factor, Column J, must be equal tr, or less than the S�arcd¢rd..ryfactor in Colunvi E to car,�pFd.
u Luh ,7, { .'vliJtli?<:iii7 1:.1.71' Loi 11'i..59 _ vJaii,q Cm. i
Proposed Fraperties ,f Nfsserr• ami C, — its
1 ncrere ded %nccrior or Extel io,r insulation
?Palls From'?eferenrc in IurringSpsce from, Reference
Joint Appendix Table 4.3.5; 4.3.6, i.3.9—��Toiat A enciix Table 4.3.13
Assembly o `1 ^ Fina[
Mass I lame3�r ' IA4 Table 4 °
Thickness'
a Number' Q > � oAssembly
Q > U factor' Comment
sdatton Number:
Registration Dateflyme:
i
MRSPravider•
Residential A UeFadons
Project Name:
so
Climate Zone .#
HVAC SYSTEMS - REATIN
Minimum 'or Piping
Duct
Heating Equipment Eff2ciancy Distribution
aeitVIA1.3 astilition
Type and Cap W MMI Thermostat
or F) e and Location4 R -Value
I
,'-B'-1R-ALT
Lage 4 6
# of Stories
Configuration
(Central, Split,
Package or HY,
1. Indicate Heating Y)pe (Central Furnace, Wall Fw7urca, Heat pump, B0 iler, .,67ec tric Resistance, etc)
2. Electric resistance heating is allowed only in Component Package C, or except where electric'heating is supplemental (Le., if total capacity
< 2 KW or 7,000 Btu/la electric heating is contr
olled.by a time -limiting device not�exceedngM mbnqes).,.8ee §151(b)3 exception:
3. Refer to the RMS Verification section on Page 4 of the CF-JRALT Form far additional requiremend'dnd check applicable'baxes.
4. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc.)-
11VAC SYSTEM - COOLING
Efficiency Duct o',Pi
Cooling EquipmentEH�AFR or Distribution F p Configuration
ydon Iasulatibn
Te and aci
Thermostat (Ceutra.1, Split,Split,ypCapty J-2 COP T and Location' cc, Package or Hydroi
L.Indicate Caolingl)pe Beatpump, Bvap. Cooling etc)
2. Refer to the J= Verification section 'onPage 4':of die CF-lR-ALTForm for addiliondrequire
3. Indicate Y�pa or Location ts, Ilydronic hh-Kom Badiatorsefc.) Men& and check applicable. boxes.
WATM HEATING
List water heaters and boilers for both domestic hot water (Z)HW) hean?,;, and hyafokc space hearing., Individual dwellingMiW&aters must be
gas or propane fired and may not exceed 50 kallOnff- Hot-water pipe &wdation from the DHT heater to the kitchen (s) and on all underground
hot water 2ives is r .din all co onEnt ackd es
in all climate ones.
Water Heater. Type/Fuel Distribirlio . a Type' Number In Tank Energy Factor or External Tank
Insulation
2 1
(Standard, Recirculating ulafin system Ca Thermal Efficiency R -Value'
CCU d- b,-R-on.4 —
1 159 1
1. Indicate Type.(Storage Gas, Rearl'ump, Instantaneous, etc)
2. . Rerirculafing systems serving multiple dwelling units shall meet the recirculation requ !
not allow the installation of a recirculating water heating system for single I dwell,
Ing UT
3. The external water heating, tank and pipes Shall be insulated to meet the reauirentenh, i
The ,.P,rescriptiverequirements do
V 15AJ. UKE-6 The j
-pec I c --ion t,peci, 7 -es A, a.- Mis cher nv.
ft , the S SDECI-IF In
'hese im-"s In'7'' - ;,r
-7
R(570P ASSEP-1VOI.-Y - RadilnL.Barrier
'lie radiant barrier requii-erneut of 415IQ2 does, not apply to roof alterations.
lab Edge (Perimeter) Insulation OYFS 0 No
, FS: In Chmate Zone 16 in Component Packages D, R--/ insulation is required.
eated Slab Insulation 0 YES 0 NO
ES: Slab edge insuiaiion required for all licated slabs in all Climate Zones. See details in Table 118-A of the standards.
Rised Slab Insulation, 0 YES -M NO
ES. In Climate Zones 1, 2, "1 13, 1
iermal Mass Climate Zones 12 & 15, R-4 is required under component Package
1 obtain Compliance
of thermal mass. use the * Perfnrrnsn(,F-. A—i—rh
MratfonNumber ------ HFAV Prrrkd,1—
I - .. .. I — , RegWration Data/77me:
Prescriptive Certificate of Compliance: Residential'
Residential Alterations
Project Name:
71—i't. Zone _#1_1
CF -IR' -ALT
Zage 5 of 5)
# of Stories
HERS VERMCATION SUMMARY The enforcement agency should pay special attention to the -RFM Measures specified in this
checklist below, A com
inslection. pleted and signed CF -4R Form for all the measures sped fled shall be submitted to the 'building inspector beforeffiUd'
Duct Sealing & Testing Imm-veificatton
is Mquiredfor this measure.
0 YES . 13 NO YES: in climate Zones 2 and. 9-16, if more than 40 linear feet ofiew or replacement ducts are installed in. unconditioned
space., the ducts are to be sealed per §152(b)1Dfi and the newly installed ducts are to be im'lafbd`p&`§151(f)10.
❑ EXCEPTION: Existing duct systems that are extended, 1"ic4i are c6"ctedjoiiiiatid or sealed with asbestos.
0 YES ®NO YES: Climate Zones 2 and 9-16, if the existing space- ` c;
nditioning system '(RVAC eqwpment and ducting) is:replaced, the
ducts are to be sealed per §152(b)IDL
E3 YES [I No YES: in climate zl;;es 2 and 9-16; if theexrsting HVAC AC equipment is replaced (including,the replac4imerit of the air handler,
outdoor condensing unit of a Split system, cOOHhg or heating;c6i], or the furnace 1:icat'exichang6rj the ducts are to be
scaled per §15.2(b)IE.
0 EXCEPTION: Duct systems that are documented to'have been.".previously sealed confirinedthrough HERS
verification in accord2lice with procedures in the Reference Resl6ntiai,Xppei dij kA3.
El EXCEPTION: D ct gys+--Ms with le ne
ss than 40 linear feet. Wunconditio opiicc.
El ExCEpTIojT: Existing '
,duct systems constructed, insulated or sealed with asbest6s.
I Refrigerant'Charge -Split Sygtem Akv0i
,�cation is required for this me
E3 YES El NO YES: In climate Zones 2 and 8715, when the ds�j�*i�4C
handler, outdoor condensing ..li . equipment is rEplaced'(inLudh2g the replacement of the air
unit of aspLt system A/C or huh. pumi; cooing of heating coil, or the fimmace heat
czebanger) a reftigurairt c6rge mcasurcinent'sW bo verified
pI52(b)IP.
Central Fan Integrated .(CF1)' Ventgijjon=T6 and Fin Watt Dra-W.
The ventilation requiremencs of §150(o do not'
residuetial Ducted' Split Systems -Air Condidonen and fTeRf'PjjjhP9:`Ajrflo* . LMS y'errficzWon is required
0 YES 13 NO YES: In Climate Zones- 1.0 through - 15, when the'em' ....fbr1hJsm�aWP_
space -co onmg system,
Sting . nft ' i qrVACequJipmciitand ducdog)ls
�Laced, the airflow and fan-watt'drawshaU-beveiifledpErji52('b)lCi'tb'me'et,ther
c4uifaments* of § 151( 7B.
® 1 certify that this
Name:
Comp
�qp_mf —I
Address:
ity stale/zip:
JL
-511"Gine w i2
;:sVuLU1W. - Declaration.
:;),I bde. L-nder 'h
ihe buiidi-rig design ';dentfim', 7!-,
1h;
uiis Cprtificate of Coin ulia, ire.
--itiffy ihat the energfeatures andet10175 fw- building dezigo iderailie-d n :his Czrtificatc of (.:rrDjianc�_ i.0nyC.j-j-,1
Lo the requirements of Title 144, Parts I and 5 of the Ca)if0j-nJa Code ofRegullations.
The building design teatures,identified on this Certificate of Compliance are consistent with the information
building e apphcabie iompance forms, worksheets, calculations. Dims and qnp.r.ifirnti—
on the other provided to document this
)rrLpany:
L , 0
assistance or questions regarding the Energy Standards, contact the
I -
Ytration Number. Registration Dateffime:
HERSProvider: