06-1498 (PLBG)P:O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00001498
Property Address: 54100 AVENIDA CORTEZ
APN: 774-1.92=00$=20
Application description: PLUMBING D
Property Zoning: COVE RESIDENTIAL
Application valuation: 500 I
. Ta�/440"
APR
"BUILDING & SAFETY DEPARTMENT
BUILDING -PERMIT
Applicant: A hitect 81Miin er_:�y
Fl6?iaUCy � ���lNyq
VOW �IA
------------------
LICENSED CONTRACTOR'S DECLARATION
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.
Licens : C3- -i ense No:: 828264
ate, ontrector 6 '
n DER 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,. Businessand Professions Code Any city or county that requires a permit to
construct, atter, 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 thwalleged 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 (8500).:
(_ 1 1, as owner of thw property, or my employees with wages as their sole compensation, will do the work,, and
the structure isnot intended or offered forsale,(Sec.7044,.Business and Professions Code: The
Contractors' State License Law does not'apply to an owner of property who -builds or improves'thereon,
.arid who does the work himself or herself through his or her own employees, providedthatthe
improvements are dot 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, 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 town 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.).
(_J 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: tR
Lender's Address:
VOICE (760) 777-7012
FAX (760) 777-701.1
INSPECTIONS (760) 777-7153
Date: 4/12/06
Owner:
CORDOVA FRED T
54100 AVENIDA CORTEZ
LA QUINTA, CA.92.253
Contractor:
FOY, SCOTT A.
43579 MAIN STREET
INDIO, CA 92201
(760)775-9405
LiC. No.: 828264
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 oftne work forwhich this permit is issued: My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1576840
I certify that, in the performapce of the'work for which this permit is issued, I shall nat employ any
person in:any manner so -as to become subjectto'the workers' compensation laws of California,
and agree that, if 1 should become subject to the+workers' compensation provisions of Section
-3700
f theLiabor'Code, I shall f rth omply with those provisions:
fl:zzzplicam:
WARNING: FAILURE TO SEC WORK PENSATION 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 madeto the Director of Building and Safety for a permit subject tothe.
conditions and restrictions set forth on, ihis.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 asta result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quints, 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 ISO days from date of issuance of. such permit, or cassation 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 h thorize:representatives
of this cou enter upon the above-mentioned property for inspection - os
Si _ re (Applicant or Agent):
Application Number . . . 06-000014;98
Permit . . . PLUMBING
Additional.desc .
Permit_ Fee . . 22.50
Plan Check
Fee
5.63
Issue Date . . . .
Valua__ti_o_n
. . .
. 0
Expiration Date 10/09/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB WATER
HEATER/VENT
7.-50
------------------------------------ -----------------------------------------
Special Notes and Comments
REMOVE & REPLACE E1.EG7e/L WATER
HEATER.CF1-R APPROVEIJ.
Fee; summary Charged Paid
------------------
Credited
Due
--------- ----------
Permit Fee Total 22.50
-----------
.00
--------
.00
22.50
Plan Check Total 5.63
.00
.00
5.63'
Grand Total 28.13
.00
.00
28.13
WPERmff
r'
irm
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CERTIFICATE OF COWLIANCE: RESIDENTIAL (Page I of 4) CF -1R
Project Title Dat
Project Address B path#
Documentation Author Telephone Pa° Check I Dau
Fidel Chodi IDM
Compliance Method (Prescriptive) Climate Zone F„ f Agency Use 001y
O 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 -1R page 3)
For Package D Alternative we Appendix B Table 151-0 Footnotes 7-14
l ; : 1QL 08141UT VOIRI
Total Conditioned Floor Area (CFA) Average Ceiling Height ft
Maximum Allowed Weal Facing Fenestration Products Per Table 151 B or 151-0 — (5% X CFA) f
Maximum Allowed Total Fenestration Products Per Table 151-B or 151-0 (20% X CFA) g
O Building Type: (check one or mored Single Family Mnitifamnly ' Addition Alteration
(If adding fenestzation fiU out WS -4R, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
Number of Stories: Number of Dwdling Units:
Floor Cation Type: Shh(Raised Floor, (circle one or both)
Front Orientation: North / South / East /-West,/ All Orientations (input front orientation in degrees from True
North and.cirde one).
x(13 RADIANT BARRIER (required in climate zones 2.4.8-15)
OPAQUE SURFACES INCLUDING OPAQUE DOQRS
Type Component Frame
Roof, Floor, Type
Slab Edge, (Wood
Doom) or M
Cavity
Insulation ,
R-Valcm
Continuous
Insulation
R -Value
Assembly XJ--
factor ((for
wood, metal
frame and mass
assemblies '
Joint
Appendix
IV
Reference
Roof Radiant
Barrier Location lComments
Installed (attic, garage,
Yes or.No etc
See Joint Appendix IV in Section IV:2, IV.3 and IVA, which is tire basis. for the U -factor criterion. U -factors can not
exceed prescriptive value to show equivalence to R -values.
Residential Compliance Forms
March 2005
a
CERTIFICATE OF COMPLIANCE: RESU DENTIAL (Page 3 of 4) CF -1R
nate
SEALED DUCTS and TXVS (or Alternative MeOMMI .
A signed CF -4R Form must be provided to the building department fun each home for which the following: are
rewired.
113 1 Alternative to Sealed Duds and Rehignant Charge /TXVs '(See'Paclrage D Alternalive:Package Fab= for 1
For additions and alterations, duct systems that are not docomaertod to leave been previously
0 sealed as confirmed through'field verification and diagnostic testing in ice with procedures in the
Residential ACM Manual and duct systems with mm than 40 liuew feet in uneonManed
MA
ME -1-
Sealed Ducts all'clilrete m m and certification anti HERS rater field vetificati�
rD
TXVs, readily accessible (climate zones 2 and 8-15 only)
ler and er rtificatwn and HERS Rater field verification
❑
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and eatific ation and HERS Rater field
verification '
113 1 Alternative to Sealed Duds and Rehignant Charge /TXVs '(See'Paclrage D Alternalive:Package Fab= for 1
For additions and alterations, duct systems that are not docomaertod to leave been previously
0 sealed as confirmed through'field verification and diagnostic testing in ice with procedures in the
Residential ACM Manual and duct systems with mm than 40 liuew feet in uneonManed
Systems serving siude dwdEm nails
A" A
MA
ME -1-
Check box if system meets criteria of a "Standard" system Standard system is one gas-fired water heater per
Tank
Capacity
uomv
dwelling unit. If the water heater is a storage type, 50 gallons is the m m mnuma capacity and recircuMm system is
Standbyrlnsulatico
Loss .
not allowed.
0
Check box when using Preapproved Alternative Wats Heating tabK Table 5-4 is Chapter"5 in -the . Residential
Manual. No water heating calculations are recluired, and the vistarn comlias au omati
Check box if systan does not meet criteria of"StandarW system, and does not comply with the Preapprnved
13
Alternative Water Heatingtable. In this case, the Performance Method must be used and must be included in the
submittal.
E3
Check box to verify that a time cantrol is inquired fo; a recirculating system pump far a systema serving multiple
units
Systems serving siude dwdEm nails
A" A
MA
ME -1-
Rated
(kw or
WOW
Tank
Capacity
uomv
li
1-
I I I FIRM
�I,�
Standbyrlnsulatico
Loss .
IIP I•;
-
Svstem seftinremuMDle dweiflieg units
Water Heater
Type
Distribution
Number
in
Rated
(kw or
WOW
Tank
Capacity
uomv
Ewa
ForExternal
Thermal
Effidency
Standbyrlnsulatico
Loss .
Tank
R Value
1. ror EM11 gas storage Water heaters (rated inputs of less than or equal to 75,000 BbAw), electric resistance, and beat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
BtudK list Rated Input, Reonvery Efficiency, Thermal, Efficiency and Standby Loss. Fcw mstantaumw gas Water
heaters, list Rated Input and Thermal Efficiencies.
Me Imlation Qdtchm lines >_ 3/4 inches) All hot water pipes firm the heating source to the kitchen fixtures that am %
inches or greater in diameter shall be thermally insulated as specified by Section 150 G) 2 A or 150 G) 2 B.
Residential Compliance Forms
March 2005
CERTIFICATE OF'COWLIANCE: RESIIDENTUL (Page 4 of 4) CF -1R
Pmjeet Tide Date
SPECIAL FEATURES NOT REODUMG HERS VERIFICATION (add extra sheets if necessary)
Indicate which special feauhres are part of this project. The list below only represents special features relevant to the
memintive method_
V
Feature
PtegulM Forms a livable
❑
O
Metal Framed Walls
CF -IR
RefrigerantCF-6R
❑
Radiant Barriers
CF -IR
Valve CF -6R part 6 of 12
❑
Exterior Shades
WS4R
❑
Cool Roof.
N/A; Attach CRRC.Label to
Forma.
❑
Dedicated Hydrvruc Heating
Performance Calculation
system
• Attach Run to Forms.
O
Combined Hydropic m Syste
Performance (�ailabon
Attach Run to Forms.
❑
Gas Cooling
Petfonnance,CaloAdon
Required
❑
Buried Ducts
N/ • Indicate on building-
❑
Kitchen Pipe Insulation
See Section 5.6.2 Distribution
in Residential Manual
Multiple Water Heaters Per
MulfiPle W
See Table 5,13 or use
❑
a e
Dwellinattach
Pexi'ormance Calculation and
Run to Forms.
❑
Central Water Heating System
Performance Calculation and
Serving Multiple Dwelling
attach Run to Forms.
❑
Non-NAECA Large Water
CF -IR
Heuer
See Table 5-13 or use
❑
Indirect Water Heater
Performance Calculation and
attach to Forms
See T"5-13 or use
❑
Instantaneous Gas Water Heater
Performance Calculation and
attach Run to Forms
See Table 5-13 or use
❑
Solar Water Heating System
Performance Calculation and
attach Run,to Fomss
❑
Wood Stove,Boiler
Pa*mmae Calculation and
attach Rnn to Forms
SPECIAL FEATURES MOUIItING MRS RATER VERIFICATION
Gadd dki sheets if Indicate to the HERS Rater whichvredits are part of this project and need
verification.
Residential Compliance Forms March 2005
Featare
Reauhvd Forms Of a Ficable
❑
Dud SealingCF-6R
4 of 12
❑
RefrigerantCF-6R
3 of 12
❑
Thermostatic Expansion
Valve CF -6R part 6 of 12
Residential Compliance Forms March 2005