10-0686 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
1000000686~
51635 AVENIDA JUAREZ
773-113-007-1 -000000-
PLUMBING
COVE RESIDENTIAL
1200
T4ht. 4XPag&&
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 70 0) of ivision 3 of the Bu ' ess and Profes ' Is Code, and my License is in full force and effect.
Licen e C ss: 45713 icense No.: B
Date: o tract r:
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 1, 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
nne 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:
LQPERAtIT
Owner:
LARRY MUCK
51-635 AVENIDA JUAREZ
LA QUINTA, CA 92253
_ Contractor:_
ECOWIZE INC
73081 FRED WARNING DRI
PALM DESERT, CA 92260
(760)898-2655
Lic. No.: B
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/27/10
--—————————————————————————————————————————————
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 DELOS Policy Number 01 28906
I certify that, in the Performa f the work for whic his permit issued, 1 shall not employ any
person in any manner o as to come subject to a workers' c pensation laws of California,
and agree that, if I ssJJ�� uld bec a subject to th ,wor om0 sation provisions of Section
/��� 0 of t aboy� I forthwith co m with rhos r isions.
nates Annlicant(/
WARNING: FrAILURE TO SECURE WORKERS' COMPENSATION COVMAGE 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 ACKNOWLEnGF,MENT
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 appl' anon and state that the ab rmation is correct. ogre to comply with all
�andunty ordinances an state laws relating to bui g const coon, and heeb authori a representatives to en r upo eabove-mentioned pr in ction purposes.
gnature (Applicant or AgentI.
LQPERAIIT
Application Number . . . . .
10-00000686
Permit . . PLUMBING
Additional desc .
Permit Fee . . . . 22:50
Plan Check
Fee
5.63
Issue Date . . . .Valuation
. . .
. 0
Expiration Date . . 1/23/11
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 40 GALLON GAS WATER
HEATER.
— —
2"007-CODES.---
----------------------------------------------------------------------------
Other Fees . . . . . .
BLDG STDS ADMIN (SB1473)
1.00
r. f
Fee summary Charged
Paid Credited
Due
D.0
Permit CFee Total. 22.50
.00
.00
22.50
main
Plari Check Total 5.63
.00
.00
5., 63
Other,-Fee Total-1.00
.00
.00
1.00
c-
Grand Total 29.13
.00
.00
29.13
LQPERAIIT
S
ZF
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations - Pae 1 of
Project Name: Climate Zone # # of Stories
5 I
General Information
Site Address: Js �, 6a5 n . _
Enforcement Agency: L
Date: 7 _a -7
Building Type ❑ Single Family ❑ Multi ily
Circle the Front Orientation: N, VS, W, or degrees
Conditioned Floor Area (CFA):
Project Type: ❑ Alterations ❑ Envelope ❑ Fenestration ❑ Roof ❑ HVAC
Assembly
d
Name or JA 3 Table
Type' Number' Q >
Replacement or Change Out ❑ Duct Replacement ❑ Water Heater
NOTE: This form is not to be used for Newly Constructed Buildings or Additions
insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
❑ 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.
❑ Replacement of entire assembly— Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component
Package- D insulation values in Table 151-C. Fill in Columns A —.1
Opaque Surface Details For the furred rtioned of Mass Walls see Furrin Strips Construction Table below.
A B C D E FG H I J
Pro sed O1 Standard Values From JA4 Table
Framing Thickness, Framed Continuous JA4 Proposed
Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity insulation Assembly Assembly
iD� or T and Size or Other' factor' Numbers R-value6 R -Value Cell Valuer U-factor9
Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page J44-3 and Equation 4-1. For calculating furred walls use the Mau and
Furring Construction table below.
1. For Tag9D indicate the identification name that matches the building plans.
2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc... Indicate the Frame type and Size: For
Wood, Metal. Metal 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 Sdndwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc....
4. Based on the Climate Zone: enter the Standard U factor from Table 151-B, C or D for each different assembly Name or type.
S. 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 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. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard 11-fnrinr in f niumn F. to rmmnly
Furring Strips Construction Table for Mass Walls Onl
A B I C D I E
F C H 1 J I K
M
Proposed Properties of Masonry and Concrete
Walls From Reference
Joint Appendix Table 4.3.5, 4.3.6, 4.3.7
Added Interior or Exterior Insulation
in Furring Space from Reference
Joint Appendix Table 4.3.13
Final
Assembl}
U -factor
Comment=R1
Mass
Thickness
Assembly
d
Name or JA 3 Table
Type' Number' Q >
N
g V ;, _ ;,
o.?' oa
h ? ° —'�
c X e ' ¢ >
I
y
Registration Number: Registration Date Time: HERS Provider:
2008 Residential Compliance Forms
August 2009
• i
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations Page 4 of 5
Project Name: Climate Zone ti h of Stories
61
HVAC SYSTEMS - HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
Heating Equipment
Type and Capacity 1.23
Minimum Duct or Piping Configuration
Efficiency DistributionInsulation Thermostat (Central.. Split.
AFUE or HSPF Type and Location° R -Value Type Space, Package or H dronic
1. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance, etc.)
2. Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental (i.e., if total capacity
< 2 K6V or 7.000 Btidhr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(b)3 exception.
3. Refer to the HERS Verification section on Page 4 of the CF -/R -ALT Form for additional requirements and check applicable boxes.
4. Indicate Type or Location (Ducts, Hydronic in Floor. Radiators, etc.)
HVAC SYSTEMS - COOLING
Energy Factor or
Insulation
Minimum
Cooling Equipment
Ty and Capacityi.z
Efficiency Duct or Piping Configuration
(SEER/EER or Distribution Insulation Thermostat (Central, Split
COP T and Location] R -Value Type Space, Package or H dronic
Thermal Efficient
R -V lue3
O tit STHc(tA'
I. Indicate Cooling Type (AIC, Heat pump, Evap. Cooling, etc)
2. Refer to the HERS Verification section on Page 4 of the CF -I R -ALT Form for additional requirements and check applicable bores.
3. Indicate Type or Location (Ducts, H dronic in Floor, Radiators, etc.
WATER HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane fired, and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground
hot water i es is required in all omponeril packages in all climate zones.
External Tank
Water Heater Type/Fuel Distribution Type
Number In
Tank
Energy Factor or
Insulation
Type (Standard, Recirculatin Z
System
Ca aci (gal)
Thermal Efficient
R -V lue3
O tit STHc(tA'
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §I50(n). The Prescriptive requirements do
not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank and pipes shall be insulated to meet the requirements o l50 506).
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
These items may require written justification and documentation and special verification.
NEW ROOF ASSEMBLY - Radiant Barrier
The radiant barrier requirement of §+15 1 2 does not apply to roof alterations.
Slab Edge (Perimeter) Insulation O YES O NO
YES: In Climate Zone 16 in Component Packages D. R-7 insulation is required.
Heated Slab Insulation O YES O NO
YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation O YES 0 NO
YES: In Climate Zones 1. 2, If. 11 14 & 16, R-8 insulation is required: in Climate Zones 12 & 15, R-4 is required under component Package D.
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach.
Registration Number. Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms
August 2009
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations Page 5 of
Project Name: Climate Zone # # of Stories
n
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 sealed per §152(b)IDii and the newly installed ducts are to be insulated per §151(f)10.
❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the
ducts are to be sealed per § 152(b)l Di.
❑ 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 § 152(b) I E.
❑ 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 less than 40 linear feet in unconditioned space.
❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Refrigerant Charge -Split System HERS verification is required for this measure.
O YES 13 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 heat
exchanger) a refrigerant charge measurement shall be verified per §152(b)I F.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation requirements of § 15 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 15, when the existing space -conditioning system (HVAC equipment and ducting) is
replaced, the airflow and fan watt draw shall be verified per 152(b)tCi to meet the requirements of 151(f)7B.
Documentation Author's Declaration Statement
• 1 certify that this Certificate of Compliance documentation is accurate and com
Name: � Q/ � A / �
Signature:
I^
Company: lefc
Date:
Address: r
If Applicable ❑ CEA or ❑ CEPE
(Certification #):
City/State/Zip:
Phone:
Responsible Building Designer's Declaration Statement
• I 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.
• 1 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 1 and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information to document this
provided
building design on the other applicable compliance forms, worksheets. calculations, plans and specifications submitted to the enforcement
agency fora roval with this building permit application.
Name:
Signature:
Company:
Date:
Address:
License:
City/State/Zip:
Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. ,
Registration Number:
2008 Residential Compliance Forms
Registration DateiTime: HERS Provider:
August 2009
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # 1
Project Address:
Owner's Name: /'4ve- V L
A. P. Number:
Legal Description:
Address:
City, ST, Zip: t�
Contractor:4- 0 4"jf
Address: 73 ,. jj �' W r
Telephone:NO c:
Project Description:
City, ST, Zip:G �a
Telephone:
City Lic. #,
State Lic.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:;.
rS '
Construction Type: Occupancy:
State Lic. #:
Name of Contact Person: i
i
Project type (circle one): New Addn Alter Re
air Demo'
P
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: .
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
i
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'a Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. A r
PP
Date of permit issue
School Fees
i
Total Permit Fees