11-0075 (PLBG)- r
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: c11-00000075
Property Address:
80934 SPANISH BAY
APN:
775-310-006- -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
. 750
"&t�v 4 w*fP Q" .
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C36 License No.: 880103
{Date: _L. o-/1—Contractor:
~ 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).:
(_) 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
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.).
(_) 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 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:
LQPERMIT
Owner:
BAUER PATRICIA A
80934 SPANISH BAY
LA QUINTA, CA 92253
(760)777-8311
Contractor:
ALVAREZ, JORGE A.
P.O. BOX 984
THERMAL, CA 92274
(760)777-361 3,
- Lic. No.: 880103
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777=7153
Date:
IAN 2 01011
LA QUINTA
--------------- - - -
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 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
3700 of the Labo de, I shall forthwith comply with those provisions.
Date: / �r��// Applicant:
WARNING: FAILURE TO SEC ORKERS' 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 persori 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 Ouinta, 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.
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 proq9y for inspection purposes.
Date:/ / Signature (Applicant or Agent):
t'
LQPERMIT
Application Number .
. . . 11-00000075
Permit . . .
PLUMBING
Additional desc .
Permit Fee
22:50 Plan Check Fee-.
5.63
Issue Date . . . .
Valuation
0
Expiration Date
7/19/11
Qty Unit Charge
Per.
Extension
BASE FEE
15.00
1.00'' 7.5000
EA PLB WATER HEATER/VENT
7.50
-- - - - - - - - - - - - -- -- - - -- - ---
Special Notes and Comments
REPLACE 75 GALLON GAS
WATER•HEATER.
----------------------------------------------------------------------------
Other Fees
BLDG STDS ADMIN (SB1413)
1.00
Fee summary Charged_
Paid Credited_
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
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations
Pae I of
Project Name:
Climate Zone #
17�
# of Stories
General Information
Site Address:
Enforcement Agency:
g Y�
Date:
—
Building Type ❑ Single Family ❑ Multi Family'Circle
the Front Orientation: N, E, S, W, or degrees
Conditioned Floor Area (CFA):
Project Type: PrAlterations ❑ Envelope ❑ Fenestration ❑ Roof ❑ HVAC
Comment
Replacement or Change Out ❑ Duct Replacement j2VVater 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 - J.
Opaque Surface Details For the furred e2rtioned
A B C
of Mass Walls see Furring Strips
D E F
Construction Table below.
G H —E——J
L
ProPa.
,edStandard
Proposed Properties of Masonry and Concrete
Walls From Reference
Joint Appendix Table 4.3.5,4.3.6,4-3.7
Values From JA4 Table
Final
Assembly
U-factorG
Comment
Ta�/
iD
Assembly Name
or T '
Framing
Material
and Size'
Thickness,
Spacing, U- JA4 Table
or Other' factor` Numbers
Framed
Cavity
R -value°
Continuous
Insulation
R -Value'
JA4
Assembly
Cell Values
Proposed
Assembi
U -factor
Note: For furred assemblies, accountingTor Continuous Insulation R -value, see Page JA4-3 and Fquarion 4-1. For calculating fwred walts use the Mau and
Furring Construction table below.
1. nor l ag(tt) inatcate 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 Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc....
4. Based on the Climate Zone; enter the Standard U factor from Table 15 I -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 the framing; otherwise, enter
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 U -factor in Column E to comply.
Furring Strips Construction Table for Mass Walls Ont
A B C D E
F G I H 1 J K
L
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
Assembly
U-factorG
Comment
Mass
Thickness'
Assembly
Name or
Type'
g
.° j
1A4 Table
Number' Q >
T
O t T
° g .r F- F- o
.X E £
° 2 L° L
U„"v > d
W', A
'
' Q1, 04 > Cz
Registration Number: Registration Date; -Time: HERS Provider:
2008 Residential Compliance Forms August 2009
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations Page 4 of 5
Project Name: Climate Zone # q of Stories
HVAC SYSTEMS - HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating.
Minimum
Duct or Piping Configuration
Heating Equipment
Efficiency
Distribution Insulation Thermostat (Central, Split,
Type and Capacity 123
AFUE or HSPF
Type and Location" R -Value Type Space, Package or H dronic
External Tank
Water Heater Type/Fuel
Distribution Type
Number In
Tank
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 KW or 7,000 Bhdhr 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 -I R -ALT Form for additional requirements and check applicable bores.
4. Indicate Type or Location (Ducts, Hydronic in Floor. Radiators, etc)
HVAC SYSTEMS - COOLING
Minimum
R-Value3
Efficiency Duct or Piping
Configuration
Cooling Equipment (SEER/EER or Distribution Insulation
Thermostat (Central, Split,
Type and Capaci 1.2 COP) Type and Location R -Value
Type Space, Package or H dronic
1. Indicate Cooling Type (A/C, Heat pump, Evap. Cooling, etc)
2. Refer to the HERS Verification section on Page 4 of the CF -IR -ALT Form for additional requirements and check applicable boxes.
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 pipes is required in all omponent packages in all climate zones.
External Tank
Water Heater Type/Fuel
Distribution Type
Number In
Tank
Energy Factor or
Insulation
Type'
Standar ecirculatin Z
System
Capacity (gal)
Thermal Efficient
R-Value3
"-
}c--mc
r Z-
9,- t2
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(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 of §1506).
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 x+151 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 0 YES O NO
YES: In Climate Zones I, 2, 11, 13. 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 5
Project Name: Climate Zone k $1 of Stories
IP
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.
13 YES 13 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)1Dii and the newly installed ducts are to be insulated per §151(f)10.
E3 EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
❑ YES 13 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) I Di.
Cl YES 13 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)1 E.
13 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.
0 EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space.
17 EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Refrigerant Charge -Split System HERS verification is required for this measure.
17 YES O 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)l 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.
O YES O NO YES: In Climate Zones 10 through I5, when the existing space -conditioning system (HVAC equipment and ducting) is
replaced, the airflow and fan watt draw shall be verified r' 152(b)1Ci to meet the requirements of 15l 7B.
Documentation Author's Declaration Statement
%
• 1 certify that this Certificate of Compliance documentation is accurate and pomplete.
Name
Signature:
O
CompanX
5�2 p \wrlr�bi r1
Date:
1- 2 o•- I I
Address:
If Applicable O CEA or O CEPE
S Ll
(Certification 4):
City/State/Zi
If\H
Phone-
7(c6 -77-7-,_S4 G
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 provided to document this
building design on the other applicable compliance forms, worksheets. calculations. plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Name:Signature:
5v
'Q
Company:
Date:
111
/-20-
Address:
License:
ox
&&OICA
City/State/Zi
Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number: Registration Date Time: HERS Provider:
2008 Residential Compliance Forms, August 2009
#
,;Bin
GtY of La. Quince ,
Building a Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
�J'( BUilding Permit Application and Tracking Sheet
Projcct:Adcl c �� ������-µ�V��u•-����-M•���
c:
V r s. ��3 y Owner's Name' .� `• :
A. P. Number:
-- li �l rldresg. �1
�
Legal Description: — sA — t
Contritcior
-`—J[" .�...,� e Z , c hots ::,:F�::�•�,+=�:��� �"�: ��� �5'
-
City, ST, 7.ip:--� sciil1 0-1):
Telephone: '7 f 7 t CCk
QA U.11 I -
j State Llc. fF (.7 is
i $0103 C.it,_i ie. fF:-li�33
--
Arch., Engr., Designer:
a'
l Address:
!' City, ST, Zip:
i Telephone:,.';Y'';`r`'„f=r„ `=;7 -
3R. Construction Type: Occupancy:
i
State Lic. It: ' ' �' � � '' � �-����•
t. -',tl y-. y....i'-••5C-s.-5i•5�•nj i Project type (circle m
o
one): Nexv Add'n Alter Repair Deo
Name, of Contact Person:
t1 Sq. FL: it Stones: FF Units:
1 Telephone #. of Contact Person_ Estimated value of Project: _ Q
_
APPLICANT: 170 OT WRITE i3E!_GW THIS LINE
r, Submittal 1tcLl'ur 1 cc'd TRACKIENG 1'E12MI T �FEM
Plan Sets i
�s -,
i flan Check Submitted � r� Wince Amount
l � �
{
Structural Cales.
_
Reviewed, ready for currections ;i Plan Check Deposit
ii
is
TV Cales.
�
4
j (;ailed Contact 1'crson � I'Ian Cheek Balance
Energy. Csalcs.
l�
Plans (ricked uD tt Construction
-
Mood plai►j plan
�j flans resubmitted �icchanical
Grading plan
1 2•d Review, ready fur correctionsfissue i Electrical
Subcuntactur List
Called Contact Person '� PtuuLYling
it
Grant feed
i Plans picked uta ti.A
ii
I1.U.A. Approval
+ I'l:ms resulnnitted Grading
ij
IN 1IOUSE:-
r
7 Review, ready for corrcetiuns/issue � Developer Impact Pee
Planning Approval
^�
! Called Contact Person
Pub. Wks. Appr
�
Date of permit issue
'
School Dees
i•
j
lVees
�-�