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13-0191 (RER)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 3/13/13 Application Number: 13-00000191 Owner: Property Address: 53525 AVENIDA JUAREZ LARRY THIBOUTOT APN: 774-103-013-1 -000000- 53525 AVENIDA JUAREZ n Application description: REMODEL - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL ( p Application valuation: 4500 201 I I r Contractor: QtSSi+l f A Applicant: Architect or Engineer: Owner e1Ty pF llk rlNAM C)E T ---------------------- ---------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATIONWORKER'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 7000) 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 Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. .. Date: Contractor: _ 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 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 Policy Number 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, 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 of the Business and Professions Code) or 700 of the Laborode, I shall forthwith comply h those w ns. 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).: Date: Ap licant: a (_ 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 ISec. 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 does the work himself or herself through his or her own employees, provided that the DOLLARS 1$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.). (_ 1 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.). I—) I am exempt under Sec. , B.&P.C. for this reason 1[ Date: wner: 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 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 pro erty for inspection purposes. ,� /, III X03 Dater-I-�-� Sig1nature (Applicant or Agent): ' LQPERMIT Application Number 13-00000191 ------• Structure Information CHANGEOUT (4) WINDOWS_ /(2) DOORS ----- Other struct info CODE EDITION 2010 ------------------------------------------- --------------------------------- Permit BUILDING PERMIT INV FEE Additional desc . Permit Fee . . . . 144.00 Plan Check Fee 46.80 Issue Date . . . . Valuation . . . . 4500 Expiration Date 9/09/13 Qty Unit Charge Per Extension BASE FEE 90.00 + 3.00 18.0000 THOU BLDG 2,001-25,000 54.00 ----------------- ------------------ �7---------------------------------------- - Special Notes and Comments CHANGE OUT (3) WINDOWS ALONE,.AND (2) SLIDING GLASS DOORS AND (1) WINDOW FOR, FRENCH DOORS IN EXISTING OPENINGS [CONVENTIONAL] THIS PERMIT DOES NOT INCLUDE ALTERATION TO THE EXISTING LOAD BEARING CONSTRUCTION, OR ELECTRICAL INSTALLATIONS ***INVESTIGATION FEE ASSESSED PER 2010 CALIFORNIA RESIDENTIAL , CODE CHAPTER 1 §108.6 FOR WORK COMMENCING BEFORE PERMIT ISSUANCE*** 2010 CALIFORNIA BUILDING CODES. March 13, 2013 2:29:52 PM AORTEGA ---=------------------------------------------------------------------------ Other Fees . . . . . . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 4.68 STRONG MOTION (SMI) - RES .50 Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 144.00 .00 .00 144.00 ° Plan Check. Total, 46.80 .00 .00 46.80 Other Fee Total 6.18 .00 .00 6.18 Grand Total 196.98 .00 .00 196.98 LQPERMIT Bin.# CityO i s Qutnta Buildlrig 8t Safety Division P.O. Box 1504,78495 Calle Tampico ia.Quinta, CA 92253 -:(760) 777-7012 Building Permit Appl►cation and Tracking Sheet 50� Owner's Name:. �r T� , bO.d f ey Pe t 1 Project Addtess:3 A. P. Number. Addrsss:3 52 ✓� ASC Legal Description: City, ST, Zip: Contractor. — Telephone: Address: Project Description: City, ST, Zip: Telephone: Stats Lie. # : City Lic, #; Arch., Engr., Designer. Address: City., ST, Zip: Telephone: State Lie. #: Name of Contact Person: La Construction Type: • r 2 /tM C—Occupancy: Project type (circle one): New Add'n Alter Demo r Sq. Ft.: # Stories:! 1J #Univ Telephone # of Contact Person: (� (00 Q & (o C' Estimated Value of Project: Z -Z? 00 APPLICANT: DO NOT WRITE BELOW THIS UNE p Submittal Rcq'd 'Rec'd TRACMG PERhIIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance Titre 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted.'. Mechanical Goading plan Z`! Review, ready for correctiousliissu Electrical Subcoutactor List Called Contact Person Plumbing Groat Deed Plans picked up SMI. H.OA. Approval Plans resubmitted Grading IN HOUSE:- ''' Review, ready for eorrectionslissue Developer Impact Fee Planning Approval Called Contact Person Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Tiht a& 4 a" P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760)777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has' been submitted in your name listing yourself as the builder of the property improvements specified at p, *. We are providingryou with an Owner -B ilder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. . I understand a frequent practice of unlicensed persons is to `have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner. is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. __ . I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. _4Z3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. Z41nderstand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. �6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. _�/- 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. _,e!1'8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. __V-"'9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. v/ 10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and . financially responsible for proposed construction activity at the following address: 53 5 -1;k, 5 . � JNV•e_V N1 0— , La Lto 47 Z53 _Lzr'i agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. . I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors maybe in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. _ Signature of property owner L p, �� }jag� Date: 7. 1.0 Q p k'3 Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: S -3 S a— S IcAv , .f ',.. 6 (�k— k3 a-�---,e- —z. SITE REQUIREMENTS INTERIOR LOT Qg� SIDEYARD: 5 FEET REARYARD: 10 FEET MINIMUM TACH SIDE -1 MIlM�41 YM its. GrTY OT LA QUINTA, BUILDING & SAFETY DEP-i APPROVES FOR CONSTRUCTION DATE �J BY , ' FROrTTYARD: 20 FEET mmmum low G ,olv tabes 001 Ott- I��— (ai oeaa.. Air �� W �►1 Poch L►t„NZ' 0 M4*. CURBLME Prescriptive Certificate of Compliance- Residential CF -IR -ALT Residenllai Aiteradons (Page I of Project Name: Climate Zone M A of Storks tau 0 v� c 1 General information Site Address: Enforcement Agcacy: Date: Building Type �iogk Family O Multi Family Circle the Front Orien i N, E, S, W, or degroes AS'r Conditioned Floor Arca (CFA): Project Type: O Ahaatipu O Envelope O Fenestration O Roof O HVAC a T R laocmcnt or Out O Dud t O Water Hasa : llots neve Is as to be !T`e or N Co�tstnrded 6w or Aid klens Insulation Velma For opatue Surfooa (for Furring use the Mass and Fwring Str(w Construction table below) Assembly Akeration O Opening of framed cavity alone - Alterations that involve the opening of the framed cavity of a watt, ceiling, or floor must install the muadotorl' minimum insulation value per f 150for the altered asstarbly. Fill in Colutow A -C raid enter awndatory mentation value in Column H. ReplactareW O Reptantgr- entire risen blyTab of an entire wall, ceiling, or floor assembly requires the ii6ta1Wioh'of Cotrporrceit D len at P - D ivulalion vnlrurs in Table /S/ -C Fiu in rnt d..... A _ r a Opaque Sarfaoe Details For the furred of Mesa Walls see Fa Calm moo Tabk below. \ A B C D E F I C I H Il J P Standard Valoes From JA4 Table To i iD Assembly Name FFromi% Tbiclmess, Fraased Continuous JA4 Propooed SP B. U• JM Table Cavity insulation Artxmbly Aaaa Assembly Name or JA! Table T = Number' a T and Size= or Older' factor' Numbers R•vnlue� R-Vahser CtU Values U- 1 Nae: F fi—Cauvd atrsuwblies, acc+a-dit. fir CowNnrort /asuularion R-vatae. see P JAI -3 and • alb p4 s �... F CawnKtlow sable below. °gr E9�+� 1. For t1,6`hlou swat 1. For Ta&gD irKdaue the ident0cation name that m aidws the building plant. 2. Indicate the Assembly Name or type: RoofiCtiling, Walls, a the From type : For W0064 Metal, Metas Buildings. Mass, enter 2x4. 2r6. or etc... see JAI or other 1 f possible jrssemblits. J. Ereoer the thiebrcss for make in Locher or �ttg between frnnring members enter. 16 "or gY om swag as Conaiete Sandwich Panel. SparKi,d paW4 logs. Straw Bate Panel and etc.... I. Based on the Climate Zone: enter the Standard U factor jinn Table 131-B. C or D for each d*rent assembly Name or type. S. Enter the Table number rhos closely rcmmbks the proposed assembly. 6. Enter dee R-vahue that is being installed in the wall cavity or between the f Gunning, otherwise. enter "0 " 7. Enter the Continuous Insulation R -value for the proposed assembly: otherwise, teeter " 0" 8. Enter the row and column of the U factor vatue based on Column F Table Number and enter the Assembly U Jxtor in Column J 9.77w Prepaae0 Assembly Ufaaor. Column J, must be eoewl to or Iwcv tlnn rl.. _a....t..a ►t_t..,..... i.. r..1—.. F r., .,n..oJ.. Furring StZ5 Construction Table for Mass Walls pal A B C D E F G H I J I K L M Proposed Properties of Masonry and Concrete Walls From Reference Joint A adix Table 43 43.6 4.3.7 Added Interior or Exterior Insulation in Furring Space from Reference Joint mudix. Table 43.13 $ i` H S Z; ^ - r - Final $ S a Assembl o < > ' U -fa= 15 Comment Mass Thi' Assembly Name or JA! Table T = Number' " < > Registration Number: Registration Date.Time: 2008 Residential Compliance Fortes HERS Provider: August 2009 -Prescri tive Certificate of Com liance: Residential CF -IR -ALT Residential AIterations a e 2 of Project Name: ` Climate Zooe q N of Stories 1� �� ` 0 O �"t ; r t ran and Furring Stdps Construcdon (lootnotes) Indicate the type of assembly to inch de, Hollow Ynit Masonry Walls, Solid Unit Masonry, Solid Concrete WaUs, Etc. Additional assemblies can found Reference Joint Appendix JA4. Thus is the U -Factor based on the thickness of the assembly in inches. The R -value of the insulation to be added on the interior or exterior of the assembly. The Calculated R- Value is the R -value of the fwred out section of the assembly. -6.7he Fina! Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA4. The equation is the inverse of Colua adlded to Column L Column Kis the inverse from column J. Insert the calculated U factor value on to the Opaque Surface Details in Column J ALTERED FENESTRATION ALLOWED AREAS (Convide if more than SW of fenestration is added) aWeststrationArea quired In 4817-15 I. The Proposed West Fenestration Area includes West -sloping skylight area and any other skylight area with a pitch less than 1:12. 2. Enter 200/ when no West orientation restriction or 15% when West fenestration is being instalkd in Climate Zones 2, 4, dal 7-/S. at that the maximum allowed fenestration can only be S% of the CFA as indicated in Column F. Column G must be equal to or less than Column F. 3. In climate zones 2, 4, 7-15, no more than S% of the CFA is allowed for west facing glazing. 4. Existing Fenestration area must becounted toward the maximum allowed 15% or 200/ of the whole building and calculated in Column G. The Proposed Area must be less than or equal to Column F. S. Enter the fenestration removed as part of the alteration if airy in column D. 6. Enter the Fenestration area that is being added as part of the alteration. 2008 Residential Compliance Forms March 2010 A B C D E F G CFA of Allowed Existing Allowed Entire - Dwell' 9'0 of^- CFA z j -Fenestration . Area Fenestration Area Proposed Aroai•• Total Fenestration Area' Removed' Area Added6 A x B D + C - aWeststrationArea quired In 4817-15 I. The Proposed West Fenestration Area includes West -sloping skylight area and any other skylight area with a pitch less than 1:12. 2. Enter 200/ when no West orientation restriction or 15% when West fenestration is being instalkd in Climate Zones 2, 4, dal 7-/S. at that the maximum allowed fenestration can only be S% of the CFA as indicated in Column F. Column G must be equal to or less than Column F. 3. In climate zones 2, 4, 7-15, no more than S% of the CFA is allowed for west facing glazing. 4. Existing Fenestration area must becounted toward the maximum allowed 15% or 200/ of the whole building and calculated in Column G. The Proposed Area must be less than or equal to Column F. S. Enter the fenestration removed as part of the alteration if airy in column D. 6. Enter the Fenestration area that is being added as part of the alteration. 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations a e 5 of Project Name: t f Climate Zone S 1 0 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 beforefinal 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 am installed in unconditioned space, the ducts am to be sealed per 1152(b)1Dii and the newly installed ducts am to be insulated per §151(f)10. ❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑YES ONO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the ducts am to be sealed per § 152(b)1 Di. ❑YES ONO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handier, outdoor condensing unit of a split system, cooling or beating coil, or the furnace beat exchanger) the ducts am to be sealed per 1152(b)IE. ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures is the Reference Residential Appendix RA3. ❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. EXCEPTION: Existing duct system constructed,insulated or sealed with asbestos. Refrigerant Charge- Split System HERS verification is requ&,ed for dgs,neamm. ❑ YES ❑ NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air handier, outdoor condensing unit of a split system A/C or heat pump, cooling or beating coil, or the furnace heat ex a rtfrigerant charge measurement shall be verified per § i S 1 F. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of § 1 o do not to exksdM residential homes. Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is requiredjbr this measm. ❑ YES ❑ NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system equipment and ducxing) is replaced, the airflow and fan watt draw shall be verified per § 1 S 1 Ci to meet the reguhzments of §151(07B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is aceturate and complete- om e.Name: Name: (nz�F j5� Company: - BUILDING &'SAFE�e Address: AP��` PR 'If 1eCEA or CEPE n #)ICity/State/Lip: FOR - Responsible Building Designer's Declaration Statement • I am eligible under Division 3 of the California Business and P e� B' 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 1 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 agencyfor approval with this building rmit application. Name:_sqr S . O') Company: Date: Address: ' ` 5 15 X41 � � �•'c v� a License: City/State/Zip: Act rA �'3- 5 Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300. 2008 Residential Compliance Forms March 2010