10-0523 (RER)P.O. DOX IJ504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:– 10-00000523
Property Address: 54940 TANGLEWOOD
APN: 775-052-003- - -
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 9000
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 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: B License Nck,�. 818261
Date: 6 -- l6 -/OContractor.
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.). '
(— 1 1 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:
JENSVOLD ROGER
54940 TANGLEWOOD
LA QUINTA, CA 92253
(818)519-5500
—Contractor:
THREE D CONST
320 E. STUART A
REDLANDS, CA 92
(909)335-4846
Lic. No.: 81826
VOICE (760)777-7012
FAX (760) 777-7011
INSPECTIONS (760).777-7153
Date: 6/16/10
0
VE
37
1 :JUN 1 6 2010
Cmr OF LA QUINTA
FINANCE OEPI _ _
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
in5uranee carrier and policy number are:
Carrier SOUTHERN INS CO Policy Number WS1001852202
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 Labor Cod I shall forthwi comply with Zhose provisions. ,
Date: _6- 16 lDApplicant:
WARNING: FAILURE TO SECURE 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 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 propertor inspection purposes.
Date: 4 ignature (Applicant or Agentl:,
LQPERMIT .
Application Number 10-00000523
Permit BUILDING PERMIT
Additional desc .
Permit Fee 108.00
Plan Check
Fee
70.20
Issue Date
Valuation
. .
. 9000
Expiration Date 12/13/10
Qty. Unit Charge Per
Extension
BASE FEE
45.00
7.00 9.0000 THOU BLDG 2,001-25,000
63.00
Special Notes and Comments
RETRO FIT (3) SLIDING GLASS DOORS. PER
APPROVED' .-PLANS.----
PLANS._-_----------------------------------------------
--------------------------------------------- 7--
Other Fees . . . . BLDG STDS ADMIN (SB1473)
1.00
ENERGY
REVIEW FEE
7.02
Fee summary Charged., Paid
Credited.
Due
Permit Fee Total 108.00
.00
.00
108.00
Plan Check Total 70.20
.00
.00
70.20
Other Fee Total 8.02
.00
.00
8.02
Grand Total 186.22
.00
.00
186.22
LQPERMIT .
Bin #
Oty of La Quinta
Building 8f Safety Division
P.O. Box 1504, 78-495 Calle Tampko
La Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # /�,
J
Project Address: S" -! �O 7Anq IE? D
Owner's Name:
A. P. Number:
Address: S _l - q L 14,nifeidobj
Legal Description:City,
ST, Zip: (a Qu' t q012 s
Contractor: ! e S f
Telephone:
Address: 3.2Q G, s Ar 4 1
Project Description: -- 4
/ cU
City, ST, Zip: CAo CUM
(1 d) 6l
Telephone: q 6 �33S — a�
State Lic. # : oC 6 I
City Lie. #, J�D6
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
f
State Lie. #:
Name of Contact Person: jo ei
Construction Type: S M t Occupanc},:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL:#Stories:
# Units:
Telephone # of Contact Person: O q 3S �.
[Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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
Title 24 Cales.
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:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
2 010 46- U 201012::�`�tPM D WICK ENTERPRISES INC- _ F
° No. 2516•, P.
o,
WINDOW PF.UMIT
Cuszort &N S �'
Address.,
i
i
Project Dcacription: r ► S'� A I Ny u �. GL .� . \ '� S
Window Type 118\1. I Nc,, \ j cj C G d Mmufiicturor._�� i ��
UFaetor._ . Selar Heat Gain Coefficient Q Natural Light and Veptiladon
Window TMps: S. I l
U Factor_ : 3 ,Solar Moet Gain Coefficient. a O Natural Light and Vaadiatlort_ . C
Windovu'ijpo; � ` O IN �
•--�,---^-. IG a MaAufxr rarer:. -I
U Factor- _ �_�M`Solar Htai Gain Coefficicnt • 01 O Natural Light and VeaUlatioil' O
Window Type:. anufactmr:
U Factor: Solar H[at Gain Coefficient__ Natural Light And Ventltation
LII. ri„ �!xnpr'tiw cac7 017[0.1• V n'7_7nim7,�
P 1
1:l!a w £ietall Specifications
Store: G.�� �'Y ®ate: �.
aCust(wrrt�mr ' t) v D
Custc�rrie=r pi• and #. � tt "
_ Int -��tp
4
a
dl
Vnstalller:ILI
j 1 ICustcNru1t13T lrr9l,tsi be homlte for installation '
d CustOt^Mm to apply finish (paint / stain) C
moor rrnits dfo measure — one doorper row - All measurements must be in inches
�. I - Patio — Patio — Prehung Location
P ir'�.', Storrs :. Entry Sidelight -transom Swing Slider interior or Slab
J- ----- _
F h n
i M
a .A (:
6
I a
5 �- L
l s l�
��- . � �l.
r,
• �..',. �'', O; �jSC, t' X 3 f `i0 �d ct�
J +00 aC_ ti door
I+IF
StorE 208 Projekt No. 2931!93511 for ROGER JENSVOLB
,
l
►.40
I G,
,N
ii
j Lo W &5 m. V.5+-. 5e 1(.
)j�,ftlnit 5ira: F
Jamb �� =
n Width' . Height Depth
q-3 1/ S
f
I t1.
;l
Page 4 oi, 4
Prescriptive Certificate of Compliance: Residential CF -11;. -AIT
Residential Alterations Page 2 of 5
Project Name:Climate Zone # # of Stories
__
Muss and FurringStri s Construction(footnotes)
!. Indicate the type ofassembly to include: Hollow Unit Masonn, Walls, Solid Unit Masonry. Solid Concrete Walls, Etc. Additional assemflies can
be found Reference Joint AppendixJ44.
2. This is the U -Factor based on the thickness of the assembly in inches.
3. The R -value of the insulation to be added on the interior or exterior of the assembly.
4. The Calculated R-balue is the R -value of the furred out section of the assembly.
5.-6. The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA4. The equation is the inverse of Column
D added to Column 1. Column K is the inverse from column J.
7. Insert the calculated U factor value on to the Opaque Surface Details in Column J
FE ESTRATION PROPOSED AREAS
Replacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in
Table 151-C. The Total Fenestration and West facing Area requirements
are not applicable.
❑ Adding 50ft2 or less of window area — Newly installed windows shall meet the U -Factor and SHGC Value requirements of Component
Package D in Table 151-C.
❑ Adding more than 50fe of window area — Newly installed windows shall meet the U -Factor and SHGC F'alue and the Fenestration
Area requirements of Component Package D in Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF -IR -ALT
Orientation
Fenestration Type and Frame (North, East PropsedArea'
Window. Glass Door or Skyfight2
Maximum Maximum NFRC or Default
South, West ft2
-5 ` o Q
U-factorz' 3 SHGC- 3' 4 Values
t CIO 0 r -L 6 J
-.2 .30
Total Area
CFA of Entire
% of
Fenestration
Area
Fenestration Allowed Proposed Area
Total Fenestration Area
1. Fenestration area is the area of total glazed product (i. e. glass plus frame. Exception: When a door is less than 50016 glass, the fene--tration
area may be the glass area plus a ••2 inch frame •• around theglass.
2. Enter value from Component Package D Requirements in Table 151-C.
3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower
SHGC value than that specified on the CF- I
R ALT Form.
4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading.
5./fapplicable at this stage enter '•NFRC•• for NERC C'erriR,,d wi..d.,,. ,,. �e r cr ••r, -r ..1. _._,_._._� :_ , _ki_ , 14 A _ D
a uun vusue3 vunu In iuule i iirn yr U.
ALTERED FENESTRATION ALLOWED AREAS (Conrlde an 50ft2 offenestration is added)
%nwre
Allowed
Existing .
tion
Total Area
CFA of Entire
% of
Fenestration
Area
Fenestration Allowed Proposed Area
Total Fenestration Area
Dwelling
CFA
Area
Removed
Area Added A x B) (E -D) + C
(ft)
.20
>_
West Fenestration Area
(Required In
CZ's 2,4&7-15)
.05
>
1. West Fenestration Aran
i—t„dog ,o
:__ _t_.,__,_._
-- --- - - ---w any,lgnu una any stryngnts with a pitch less than !: 12.
Z West facing glazing area removed cannot be "counted” twice. '• 1n order to distribute the west glazing area removed to the other orientations
input the west glazing area removed in the Total Fenestration Area row, column D.
3. Include the Proposed Area of the West facing fenestration in both Area columns below.
4. To meet compliance, the Proposed Area must be less than or equal to the Total Allowed Area for BOTH the Total and West Fenestration Aree
Registration Number: Registration Date 'Time: HERS Provider:
2008 Residential Compliance Forms — August
;-
Prescriptive Certificate of Compliance: Residential . CF -IR -ALT
Residential Alterations a e 1 of -5)
Project Name:
[% .. _ —_ - _ . , r Climate Zone N k of Stories
General Information
Site Add rss
e: Enforcement Agency: Date:
Building Type Single Family O Multi Family
Circle the Front Orientation: N, E, S, W, or degrees
Conditioned Floor Area (CFA): Project Type: O Alterations O EnvelopeFenestration O Roof O HVAC
Re la0ement or Change Out O Duct Replacement O Water Heater
NM: 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
O Opening of framed cavity alone - Alterations that involve the opening of the framed cavity ofa 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.
O Replacement of entire assembly - Replacement ojan entire wall, ceiling, or floor assembly requires the installation of Component
Package- D insulation values in Table 151-C Fill i., r„1.,_. � d t
Opaque Surface Details For the furred POrtiOued of Mass Walls see Furring Strips Construction Table below.
A B C D E FG H I J
Proposed ` Standard Values From JA4 Table
Framing Thickness, Framed Continuous JA4 Proposed
Ta�/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assambi
ID or T and Size' or Others factor' Numbers R -value' R -Value' Cell Values U -factor
Note: For jarred assarrblies, acowuit►g for Conti
F—ng Construction table below. nuous insulation R -value, see Page JAI -3 and Equation 4-1. For calculating furred walls use the 11= ad
1. For T0911D indicate the identification name [hat matches the building plans.
2. Indicate the assembly Name or type: RooflCeiling, 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 -0`C: 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 151-8, C or D for each different assembly Name or W.
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 1.0 ".
8. Enter the row and column of the Ufactor 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 eouni to Ar I— tt.,,...t.e e._:.,_ -J r, r--.- - :- r -._- V .....-...r..
- -- ---- ..— .. .... ..—J-- , , ...F.r.
Furring Strips Construction Table for Mass Walls Oral
A I B 1. C I D I
Proposed Properties of Masonry and Concrete
Walls From Reference
Joint A radix Table 4.3.5, 4.3.6, 43.7
E
F
Added
I G
Interior
in Furring
Joint Appendix
N
H I J
or Exterior Insulation
Space from Reference
Table 4.3.13
K
L M
Mass
Thickness'
Assembly -?
Name or JA4 Table
T Number` < >
ta.
o` c
`o g .W
x
a o
L�
v
V
w
F c c -? -V
R 7 n
25 t > o �,
Q >
> �?
A
Final
Assemb�•
U -factor Con neral
Registration Number: Registration Date.Time:
2008 Residential Compliance Forms
HERS Provider:
A rgus12009
Prescriptive Certificate of Compliance: Residential CF -1F: ALT
Residential Alterations Page S of 5
Project Name: Climate Zone # # of S:ories
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 fnal
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 uncondit,oned
space. the ducts are to be sealed per § 152(b)I Dii 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 rep aced, the
ducts are to be sealed per.§ 152(b) I 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 HEiRS
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.
❑ YES ❑ NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of :he air .
handler. outdoor condensing unit of a split system A/C or heat pump. cooling or heating coil, or the furnace Beat
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 ❑ 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 Der 61521b11Ci to meet the requirements of §1540413.
Documentation Author's Declaration Statement
• 1 certif
y that this Certificate of Compliance documentation is accurate and complete.
Name:
Signature:
Company: Date:! t %ir% � O l/� � � U l� �t 0 � � � l ✓ � l v
Address:
3(�o 1 ' p If Applicable 13 CEA or ❑ CEPE
5 lJ ��
I V �i (Certification #):
City/State/Zip: II /
e4 .l - t4 -�; qt)3 Phon • o 4 y 335 '20
Responsible Building Designer's Declaration Statement
• 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design id:ntifred on
this Certificate of Compliance. .
• 1 certify that the energy. features and performance specifications for the building design identified on this Certificate of Compliarce conform
to the requirements of Title 24. Parts I 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 en'orcement
agency for approval 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: I-800-772-3300.
Registration Number: _ _ Registration Date -Time: HERS Provider:
2008 Residential Compliance Forms -Tu -gust 2(