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08-1400 (RER)9 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00001400 Property Address: 79740 NORTHWOOD APN: 762-022-024- Application 62-022-024 Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4000 T41�t 4 4 Q" Applicant: 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 7000) of Division 3 of the Business and Professionals Co and my Li cen ' -in full force and effect. License Cl a s: B n No 34 r - - Date: 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 (5500).: 1 _ 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 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 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: LQP&RMIT r VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 WORKER'S COMPENSATION DECLARATION 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 EXEMPT Policy Number EXEMPT 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 37 _O of the Labor Code, I shall fort co with those provisions. Date:2S✓71 &+pplicant: . WARNING: FAILURE TO SECURE WORKERS' 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 coulPeto a er upon the above-mentioned property for inspectio n "- Dater Zignature (Applicant of Agent): Date: 8/14/08 Owner: TED MARTENS 79740 NORTHWOOD LA QUINTA, CA 92253 (760)771-2929 n Z 0 Contractor: n r- F— BRAUCKMANN INC m D 50855 WASHINGTON STREET; #227 m c a >� LA QUINTA, CA 92253 . Z (760)485-9269 D c ID Lic. No.: 781834 WORKER'S COMPENSATION DECLARATION 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 EXEMPT Policy Number EXEMPT 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 37 _O of the Labor Code, I shall fort co with those provisions. Date:2S✓71 &+pplicant: . WARNING: FAILURE TO SECURE WORKERS' 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 coulPeto a er upon the above-mentioned property for inspectio n "- Dater Zignature (Applicant of Agent): Application Number . . . . . 08-00001400 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee 63.00 Plan Check Fee 40.95 Issue Date . . . . Valuation . . . . 4000 Expiration Date 2/10/09 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,000 ---------------------------------------------------------------------------- 18.00 . r Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 16.50 Plan Check Fee 4.13 Issue Date Valuation 0 Expiration Date 2/10/09 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 .7500 PER ELEC DEVICE/FIXTURE 1ST ------------------------------------------------------- 20 -------- 1.50 ------------- Permit . . . PLUMBING Additional desc.. Permit Fee . . . . 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/10/09 Qty Unit Charge Per Extension BASE FEE 15:00 1.00 3.0000 EA PLB FIXTURE DRAIN/VENT REP/ALT 3.00 „ -------------------------------------------- Special Notes and Comments REMODEL / MOVE SHOWER DRAIN & (2) GFI RECEPTICLES REPLAVE (2) SLIDING DOORS PER APPROVED PLANS PER A.J. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE ,4.10 Fee summary Charged Paid Credited Due Permit Fee Total 97.50 .00 .00 97.50 Plan Check Total 49.58 .00 .00 49.58 Other Fee Total 4.10 .00 .00 4'.10 Grand Total 151.18 .00 -.00 151.18 LQPERMIT Cffy 0� LA QUIM' BUILDING & SAFETY & APPROVES FOR CONSTRUCTION DATE--- By oe--rH woc�)D � FUILDINIG & SAFETY DEPT. APDIl"V FOR CONSTRUCTION DATE__ gY LLA 'D�Sic-�t� - Y go �8 L OA Alj"v"Lk---, N N� cgP1 LcAm. CITY OF LA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DAT144 19wo B Q d 7 I N © OLD p rL Or l to d ticA7rtoi4 CERTIFICATE Or COMPLIANCE:. RESIDENTIAL (Pagel of 4) CIS' -YR Pro e T tleDate Proj,,,�ect Address Building Permit C.il�t .DocumentationAuthoiTelephone. T Plan Check Date Compliance Method (Prescriptive) Field Chock / Datp Climate Zone Enforcement Agency Use Only �! ❑ Alternative Component Package Method: (check one) _ C D D (Alternative) Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF=1 R page 3) For Package D Alternative see Appendix B Table 151-0 Footnotes 7-14 GENERAL INFORMATION Total Conditioned Floor Area (CFA) �fe Average Ceiling Height:. 9. ft Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C -- (5% X CFA) fe Maximum Allowed Total Fenestration Products P Table 151-B or l5l-C _ (20% X CFA) ft ✓ ❑ Building Type: (check one or more) Single Family Multifamily Addition Alteration Of adding fenestration fill out WS -4R, Fenestration Maximum Allowed Area.Worksheet and see Section 832 for Additions and 8.3.3 for Alterations.) Number of Stories: / Number f Dwelling Units- 'e nits: r Floor construction Type: la 'sed Floor (circle one or both) Front Orientation: North / South / East / West /All Orientations (input front orientation in degrees from True North and circle one). ✓ �. RADIANT BARRIER (required in climate zones 2A 8-15) I) S oint Appendix IV in Section 1V2, IV -3 and IVA' which is the basis for the U -factor criterion. U -factors can not teed prescriptive value to show equivalence to R -values: Component Assembly U - Type (Wall, Root; Floor, Frame Type factor (for Cavity Co uous. Joint Roof Radiant Slab Edge, (Wood wood, metal Insulation ulation frame and mass Appendix IV Barrier .Location/Comments Installed . (attic, garage, Doors or Metal R. -Val R -Value. lies)' Reference . Yes or No ical, etc, c9O pp I) S oint Appendix IV in Section 1V2, IV -3 and IVA' which is the basis for the U -factor criterion. U -factors can not teed prescriptive value to show equivalence to R -values: e: CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 4) CF-1R Project Title Date FENESTRATION PRODUCTS — U-FACTOR AND SHGC ❑ FENESTRATION MAXIMUM. ALLOWED. AREA WORKSHEET WS4R —must be-included for New Construction, ` Additions and Alterations. Fenestration #/I'ype/Pos. (Front, Left, Orien- / _ Exterior 6 7. Shading/Overhangs Rtw, Right, tatierL_ Area U-factor SH v" box if WS-31K is S li t Tl, S Wt (ft U-fador2 Sourced GG'� S included rLb 'f E3 ❑ AWJ i ❑ 1) Skylights are now included in West-facing fenestration area if the skylights are tilted to the west or tilted in any direction -when the pitch is. less than 1:12. See. § 151(1)3C and in Section 3.2.3 of the Residential Manual 2) Enter values in this column are either NFRC Rated value or from Standards default Table 116A. 3) Indicate source either from NFRC or Table I I6A, 4) Enter values in this column from NFRC or from Standards Default Table I I6 or adjusted-SHGC from WS-3R_ 5) . Indicate source either from NFRC or Table 116B.' 6) Shading Devices are.deSned in Table 3-3 in the Residential Manual and see WS-3R to calculate Exterior Shading devices. 7) See Section 32.4 in the Residential Manual. \HVAC SYSTEMS [_f:fUmaoe, Equipment. Minimum Distribution Type Capacity Efficiency Type and Location Duct or Piping Thermostat Configuration teat m Her. etc. AFUE.orHSP ducts etc. R-Value itor Cooling Equipment Minimum Type and Capacity Efficiencyuct Location Duct Thermostat Configuration A/C Heat uni eva ..cooli SEER'orEER i etc. R-Value litor wk e Residential Compliance Forms. March 2005 CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 34R' of C&IR Project Title e SEALED DUCTS and .TXVs (or Alternative Measures) A signed CF -4R Form must be provided to the building department foreac ome for which the following. are required; O Sealed Ducts all climate zones Installer testing and cerdfl n and HERS rater field verification uired. HoT3CVs, readily accessible (climate zones 2 and 8-15 on (install er testin' and certification and HERS Rater field erification r aired. Refrigerant Charge (climate zones 2 and 8 -IS only) ler testing and certification and HERS Rater field verification required.) V Alternative to Sealed Ducts and Refrigerant e f'XVs.(See package D Alternative_Package.Features for Pro ed Climate Zone in the RM A n ' Table 151-0, Footnotes 7-14. OR For additions and alterations, dud stems that are notdocumented to have been previously sealed as confirmed through fie verification and diagnostic. testing in accordance with procedures in the Residential ACM Manual dud systems with more than 40 •linear feet in unconditioned spaces shall meet the r ements of Section 15 m and dud insulation requirements of Package D. WATER HEA SYSTEMS Check box if sy em in criteria of a "Standard" system. Standard sysfem is onegas-fired water heater per dwelling ani f the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is not allow Check x when using Preapproved Alternative Water Heating table, Table 5-4 mi -Chapter 5 in the Residential Man : No water heatingcalculations are required, and the system corn lies automatical . box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved tentative Water Heating table. In.this case, the Performance Method must be used and must be included in the submittal. Check box to Se * thata time control is required for a recirculating system pump'for a system saving multiple units .Tat 'Aub bcuvtn sm re a urn units Enemy Tank Water Heater Distrib ' n Number input, T� Factor or Extemal rel OW or Capacity Thermal Standby Insulation Type/FType in S stem Btu/hr lops) Efficien Loss % R -Value Water'Heater units Distribution Rated Number - Input (M or Errerpy Tank Factor or External Thermal. Standby.t Insulation 1. For small gas storage water heaters (rated inputs of less .than or equal to 75,000 Btu/hr), electric resistance, and heat PUMP water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe Insulation. (kitchen lines 2:3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are '14 inches or greater in diameter shall be thermally insulated as specified by Section 150 (j) 2 A or 150 (j) 2 B. Residential Compliance Forms March 2005 CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 4 oN Project Title Date JrEUTAL YEATURES NOT RE UHUNG ITERS VERIFICATION add a sheets if neves Indicate which special features are part of this project.. The list below only represents special eatures relevant to the rescri tive method. ✓. Feature Required Forms(it applicable Descri tion ❑ Metal Framed Was CF -IR ❑ Radiant Barriers CF -IR - F -IR ❑ Exterior Shades 1.1 WS -4R ❑ . Cool Roof N/A; Attach CRRC Label to Forms. Dedicated Hydronic Heating Performance Calculation stem R uired; Attach Run to Forms. ' ❑ Combined Hydropic System Performance Calculation R uired;•Attach Run to Forms ❑ Gas.`Cooling Performance Calculation R uired. ❑ Buried Ducts N/ Indicate on buildin tans. ❑ Kitchen Pipe Insulation See Section 5.62 Dis ution stems in Residen ' Manual. Multiple Water Heaters Per . See Table 5-13 or pte Dwelling Unit Performance lation and . Central Water Heating System ❑ attach Run to rms. . Performance culation and Servin Multiple Dwellin s attach R o Forms.. ❑ Non-NAECA Large Water Heater CF -1 R ❑ Indirect Water Heater See le 5-13 or use Pe ormance Calculation and ch Run to Forms ❑ Instantaneous Gas Water Heater ee Table 5-13 or use. Performance Calculation and attach -Run to Foams ❑ Solar Water Heating Syst See.Table 5-13 or use Performance Calculation and attach Run to Forms ❑- Wood Stove Boiler Performance Calculation and attach Run to Forms SPECIAL FE S RE UIItING HERS RATER VERIFICATION add extra sh if necess Indicate to the HERS Rater which credits are part of this project and need verification. ✓ Feature Re uired Forms ita livable Deseri tion ❑ Duet Sealin CF -6R art 4 ❑ Refri erant har a CF -6R part 5 of 12 ❑ Thermo c Ex anion Valve CF=6R art 6 of 12 Residential Compliance Forms. Bin# City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # \� Project Address: yQ J f%r.. ©Bcl Owner's Name:I!F-p -WRW-'rf-As A. P. Number: Address:?? i'/0 Legal Description: City, ST, Zip: jM,4 �A . Contractor. 2_k -e_ Telephone: 7& 77/ 2-929 = x Address: S-0 n -r CAI" 2 K fir! 2. � City, ST, Zip: twT o� Project Description: - 15)F; Ae,--epfi'c taj Telephone:76 W 2 - State State Lic. # : g g3 50 . City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: /may Telephone: x Construction Type: Occupancy: State Lic. #: Name of Contact Person: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Sto- s: # Units: Telephone # of Contact Person: Estimated Value of Project: ©©� APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT 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 Energy Calcs. Plans picked up p Construction .----• Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for corrections issue Electrical Subcontactor List Called Contact Person o Plumbing,— --_. Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- drd 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