10-0117 (PLBG)�.y i•
P.O. BOX 1504.'
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
, 10=00000117 -
Property Address:
-_55183 TANGLEWOOD
APN:
775-152-081- -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
965 .
Applicant: Architect or Engineer:
/Pf
------------------
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 -C10 -C36 License No.: 811114
ate: tractor: ~
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 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penaltyof 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/18/10
Owner:
MARIANNE.BERNADOFFY
55183 TANGLEWOOD
LA QUINTA, CA 92253 D n
Contractor: FEB 18 20!0
CALIFORNIA DELTA MECHNICA 'I CITy4:F
6052 E. BASELINE RD, #155
MESA, AZ 85206 "-�cpp
(480)898-'0007
LiC. No.: -811114
-----------------------------------------------
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 STATE FUND Policy Number 1697823
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
fj3700 of the Labor Code, I shall forthwith comply with those provisions.
ate:0 /v Vdcant:
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 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 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
;off th' countto enter upon th above-mentioned propertt for 'nspection purposes.3YE: /a �a Si ture (Applicant or Agent): "'� N�� • ��"r
N
y
Application Number .
. . . .
10-00000117
y
Application Number .
. . . .
10-00000117
Permit ;.
PLUMBING
Additional desc .
Permit Fee . . . .
22.50
Plan Check Fee
5.63
Issue Date . . . .
Valuation . . .
0
Expiration Date
8/17/1.0
Qty Unit Charge.
Per
Extension
BASE FEE
15.00
1.00 7.5000
EA PLB
WATER HEATER/VENT
7.50
-----------------------------------------------------------------------------
Special.Notes and Comments
INSTALL NEW 48 GALLON
GAS WATER
HEATER.
2007 CODES.
-----------------------------
Other Fees . .' .
. . BLDG.STDS'ADMIN (SB1473)
--
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
Yrescri tine Certificate of Corn Bance: Residential
ResidendalAlterations CF-I.R ALT
Project Name; a e 1 of �
r -aA (�1,i1)lr� — Climate zone # # of Stories
General Information
Site Address: '
EnforcemeatAgency; i (A bate:
Building Type X.Single Family 0 Muni Family Circle the Front Orientation: N. E, S, W. or degrees
Conditioned Floor Area (CFA): Project Type; 0 Alterations ❑ Envelope 0 Fenestration 0 Roof 0
R laceme f Chan
NOTE.- 27ds forma is not to be used forNewly ConstructedBu}I or a Out ❑ Duct Replacement Watat Heater
drags or.
Insulation Values For Opaque &daces (for Furring use the Mass and F4ddidlons
Assembly Alteration urring Steps Construction table below)
❑ Opening of framed
in cavity alone Perter. Sof that involve the opening of the framed cavity ofa Wali; ceiling, or floor must install the
mandatary minimum fire assembly
value per. §!50 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, orloor assembly requires the installation of Component
Package- D insulation values in Table 151-C Fill in Columns A - J.
3a tie Sllrface Detaijo For the furred 10r—d--ed of Mass Walls see
A E C
I ll F
Tag/ Assembly Name Matetiagl Tbtclmess'
TJ
Sacro
ID or T e' and Sizes or Other' factor°
rurrfug Strips C,oasiruction Table below.
—F I G I H I
J
Values From JA4 Table
Framed Continuous JA4
JA4 Table Cavity asulation Assembly
Proposed
Assembl
Numbers R value° R -Vetoer Cell Values
U -facto
Note: Forfurred assemblies, aacormting far Continuous lrxrulation R value yea Page Jf1¢3 and Equation ¢I. For cnlculatin
F CanstrucHon table below. gjmrd walls use the Mass and
1. For Tag/W indicate the identification name that matches the bulldingplans.
2. Indicate the Assembly Name or type: Rnof/Ceiling, dPa"', Floors, Slabs, Crawl Space, Doors and etc...Indicate the Frame type and SFze: For
lFood Metal, Metal Buildings, Mass, enter 2x4, 2x6, ar etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches Or. Spacing between franing 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. Bared on the Climate Zone; enter fire Stmrdard U -factor {ram Table 151-B, C or D for each different assembly Name or type
S. 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 "0 "-
7. Enter the Continuous Insulation R -value for the proposed assembly; cthe:nytiye, enter "0".
8. Enter the row and -chile,: cf rhe U -factor -value based on Column F Table enter N:onber mut er the ,?sserzbly U-fc<ctor in Column J
9. The P, oposed Assembly U factor, Column .I must be equal to or less than the Standard U factor in Celum; t E to corm[y.
+'d711i{_ Cl lit iJ:= .ii, STi•l,i '.li f.•�i jgJlg =tip•A.I,
A 3T
_ :!„�tirr+ 8rii@ iii U A'Concrete—i—'—'--:_...._...__--.^_..._ lesti sad a �.dded fnterior ;r E:ttzrior Insulation —
!1' ifs.F'rom Reference biin
Joint diT'
iurringSpace from Referee^e
erix ae 4.3..5, 4.3.6,
—T-- - _ 1'oitttA di Table 4.3.13
� I i .-
�
Assembfy
M
Final
ass hi
! ame or 'JA4 Table � h [ •' . J � � � � � 4 � .,-', ='
ricfaiesse T e` _ Numbed Q y c o> v o Assembly
w Q y � U -factor
sh anon Number: Registration DateMme:
AF&Provider.
CER'T'IFICATE OF COMTLIANCE: 'RESEDENTIAL (Page 3 of 4
CF --IR
Project Title Date
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the following. are
reanired '
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C Footnotes 7-14.
OR `
For additions and alterations, duct systems that are not documented to have been previously
sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned '
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATRR RV.ATTNG S'VCT1 .MS
Distribution
Type
❑
Sealed Ducts all climate zones Installer testing and certification and HERS rater field verification required.)
❑
TXVs, readily accessible (climate zones 2 and 8-15 only)
Tank
External
Insulation
R -Value
nstaller testing and certification and HERS Rater field verification required.)
❑
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
❑
verification required.)
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C Footnotes 7-14.
OR `
For additions and alterations, duct systems that are not documented to have been previously
sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned '
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATRR RV.ATTNG S'VCT1 .MS
Svstems serving single dwelling units
Water Heater
Type/Fuel Type
Distribution
Type
Rated
Input'
Number (kW or
in S stem Btun,r)
16
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
Energy
Factor' or
Thermal
Efficiency
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Tank
External
Insulation
R -Value
not allowed.
❑
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the system complies automatically.
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
Alternative Water Heating table. In this case, the Performance Method must be.used and must be included in the
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Svstems serving single dwelling units
Water Heater
Type/Fuel Type
Distribution
Type
Rated
Input'
Number (kW or
in S stem Btun,r)
16
Tank
Capacity
(gallons)
Energy
Factor' or
Thermal
Efficiency
Standby
Loss' %
Tank
External
Insulation
R -Value
ivstetn serving multinle. dwelling units
Water Heater Distribution Number
Type Type in System
Rated
Input'
(kW or
BnJhr)
Energy
Tank Factor' or
Capacity Thermal
(gailons) Efficiency
Tank
External
Standby' Insulation
Loss % R -Value
1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/ r), 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 > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/4
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A.or 150 0) 2 B.
Residential Compliance Forms March 2005
M
HVAC SYSTEMS - $r,T]NG
Minimum
Heating Equipment Efficiency,
T and Ca ' (AME or HSI
Duct or Piping
Distribution Insulation Thermostat
ie and Location I R Value N—.
1. Indicate Heating7j pe (Central Furnace Nall 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 l z e., if total capacity
< 2 KW or 7, 000 BtOir 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 -IR ALT Form for additional requirements and check opplicable boxes.
4. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc.)
.HVAC SYST MS - COOLING
Minimum
--------
Efficiency Duct or Pi vT
Coohn ui ment P
gEq p (SEER/EERor Distribution Configuration
Type and C aci 31 CR
1. Indicate Coaling Type (A1C Heatpump, Rvep. Cooling etc)
2. Refer to the H S Verification section on Page 4 of the CF -IR- LT Form for additional regrdrerxertts and check applicable bates.
3. Indicate T3?pe or Location (Ducts�onic in Floor. Ra&,wnra >t, 1
WATER MATING
List water heaters and boilers for bath domestic hot water (DHW) heaters and dr.onic
narvidual
gas or propane frrer4 and may not exceed 50 gallons. Hot water pipe insulati f om t/ DaHFV he ce � to dwelling DHYF underground
� � be
hot water i ss is r Ped in all co anent acka s in all climate zoneson all
Water FIeater Type/fYtel Distribution Type Number In Exterml Tank
Tye 2 EnergyFactoror Insulation
3
(Standard, Recirculatin System Capacity (gal Thermal Efficiency R-Value3
16S-ov4 g
o�
1. Indicate Type (Storage Gs Heat Pump, Instantaneous, etc.)
2. A.rcirculating,systems seruj�jg multiple dwelling units shall meet;he recirculation requirement
not all—of•J150(n). The Prescriptive requirements do
1. the itutallation of a recirculating water heating system for single dwelling units.
The ezteriwl water heating tank and pipes shall he insulated to. meet the reauirementc nr St .nni
Y I: ,Pt_..i_3�_, .L{.:_;.:._;- iJ.r.?� �• lie.:;;?*orer,rre:;i <;�.;rccy s;ieulci j.:czr;;pec+ia cr��e,ition tn.tl�re Jp2cicxi ,''eut.v"es• .--- _----'�-- .._ .�,�J...•�.-
�ieSe 1?E7S l:i_Tr J"&A[tti'e 11-T I gn SDECii2er' i14 ti7iS C17eI7jJ1,S1 he(?rN.
Y Jl iusiEJ!CCufon 017 <rr;Cr F.IcR?0t Cit (!P,,^_`;e�jJt l' -'p l Liiii..:rl.
�. rbr ROOF' A��SEiVI13.I-�' -Radiant $ar[ries � — — ----- _ _
'he radiant hauier requirement of §1;1(1)2 dies not apply to roof alterations. � z
tab Idge(Perim eter)Insulation 0 YIS 0 N
ES: In CILmate Zone 16:'n CnmpOnent Packages D, R-1 insulation is required.
eafed Slab Insulation ❑ YES ffNO
71,"S: Slab edge insulation_ required for all heated slabs in all
wised Stab Insulation ❑ YES ❑ wo
ES: In Climate Zones 1, 2, 11, 13, I4 & 16 R.8 insulation
iermal Mass
1 obtain Comuliance Credit fnr+ha I„f.,rr..:__ _r.z
Zones. See details in Tnh1, 11
4utreo; !n t;trmate Lones 12 & 1
use the Performance Annroach.
of the
is reau
stration Number: Registration Date/T ime:
7 D_� r ., , ., ,. _. HER.'? Prmd lar-
Prescriptive Certificate of Com lianc
Residem&d Alterations
Project Name:
Residential CF-IR-ALT
Pa e5of5
%„ ; _ 00
Climate Zone # of Stories
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the JHMMeamees specified in this
checklfst below. -1 completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final
ins ection
-Duct Sealing & Testing He&Ver?. frcation fs 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 unconditioned
space, the ducts are to be sealed per § 152(b)1Dii and the newly installed ducts are to be insulated per §151(M o.
E3 EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
0 YES 11 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)IDi.
® 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 emit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be
sealed per §152(b)IE.
❑ .IMCEPTION: Duct systems that are documented to have been previously seated confirmed through HERS
verification in accordance with procedures in the Reference Residential !appendix RAS.
EJ EXCEPTbold: Duct systems with less than 40 linear feet in unconditioned space.
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
R.eMgerant Charge - Split System fiF&verficatfon 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 the air
handler, outdoor condensing unit of a split system A/C or beat pump, cooling or heating coil, or the fumace heat
exch a refrigerant charge mea m=eat sba11 be verified per 152(6)1F.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation requirements of §150(o) do not applyto residential homes
Ducted Split Systems -Air Conditioners and Heat PUMPS: Airflow RFMverfication it 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 per § 152(6)1 Ci to meet the requirements of 6151(fl7B.
tes nnsible.Building s i "LJr-,—
F �L'e,iglaer, Dccl�_r„uon $t:�.te;x;ent -
11115 '..81'Cificate of Compliance. on i''i t!'?' ... .... _. '!` U�_. c,^•;i 3Fll C. C.oS E?;.:., C.:i:: ac' pi 1'r ;v0i�5i i.71`iJ :sir C1F, b1111U11 , �p$!.IA ?if..nCul•'d'.ri
y Jiiat thr ci?ci1•.-3iU1'CS a7ri pCiiG!'lliar.Ce 5pcc.lilcafi0115 for the 1bui)ding design ide-nii led o0 ;llis Cprtl licate 01 ' �Or pliance �:OnfOr?il
tile ie(lUlreinents of Title 24, marts l and 6 of the California Code 0f 12e„tllat1011S.
The building design features identified on this Certificate of Compliance are consistent with the information provided to docum. t
building design on the other applicabie compliance forms_ %,rr;-.ii1PPtC ��?�„?�� _i-..... ____-
this
- ----• a..--.W••w'• ate, «.uucc ore cnergy,r[ottme at.• 1-900-772-3300.
stratlon Number: Registration Dalen}me:
n_�._u_. _ HMPravi&r:
Din #
City of La Quinta
Budding Sr Safety Division
P.O. Box 1$04, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # ^
,�� `
�u
Project Address: 3 1 aM ocI4
Owner's Name: G,9 Y
A. P. Number:
`"
Address: 5551 3 Ivo o cl
Legal Description:
City, ST, Zip: vtiC 2 ZS 3
Contractor C" f`t I'p k
Telephone: Wo -39q— �Z3
?,I;aq,"^a
Address: 6OS6 . pjCt�p� j- j
Project Description:
City, sr, Zip: Z - 95Zo 6
Qty as .
Telephone: 966 -�92 " SZ�-3
:a s• . , x.<..,„ M ; `.
State Lie. # : 1 j
City Lie. # 10 i oo I{
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
ea
Construction Type: Occupancy:
State Lie. #:`A<`
Project type (circle one): New Add'n Alter" : repair Demo
Sq. Ft.: # Stories: # Units:
Name of Contact Person: �Li O bv�oJ2.--,
Telephone # of Contact Person: 86 6-6 '1�y Z -- JrZ:T 3
atimated Value of Project: 65�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req;d
Reed TRACKING
PERMIT FEES
Plan sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Pians resubmitted
Mechanical
Grading plan
21' Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
' Reyiew, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A•I.P,P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
le