10-1317 (PLBG)P.O. BOX 1504
78-495.CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: C10-00_001317,
Property Address: 78373 TERRA COTTA CT
APN: 604 -022 -037 -
Application description: PLUMBING
Property Zoning: MEDIUM DENSITY RES
Application valuation: 100
Applicant: Architect or Engineer:
°F`lwQ�«tw
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT. '
------------_-7------------------------------------
.. LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bu iness and Professionals Code, and my License is in full force and effect.
License)Class: CC336 _ _ License -No.: 936147
DatVo4 3- (-% �Comrac ri
OWNER -BUILDER DECLARATION
1 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).: _
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
r' 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 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 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 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:
LQPERAIIT
Owner:
COMBS MARLENE A
78373 TERRA COTTA CT
LA QUINTA, CA'92253
(760)360-4346
Contractor:
STATEWIDE SERVICES INC
48605 EL CASTILLO ROAD
COACHELLA, CA 92236
(760)393-6115
LiC.. No.: 936147
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Date: 12/03/10
0� e
0 6 2.10,
• , 1
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, ifjshuId become subject to the workers' compensation provisions of Section
3700 of the Laboe,shhalUorthwith complywith those provisions.
`Date:' 3.10c�x—t 1 ��CT 1 �•'(
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 1$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.
certify that 1 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 b lding construction, and hereby authorize representatives
of this county to enter upon the above:mentioned pr y,for inspection purposes.
Date 3-!e� Signature (Applicant or Ag t):
Application Number
10-00001317
Permit . .PLUMBING
Additional desc
Permit Fee
22.50
Plan Check
Fee
5-.63
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
6/01/11
Qty. Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 7.5000
EA PLB WATER HEATER/VENT
7.50
Other Fees . . . . .
---
. ... . BLDG STDS ADMIN (SB1473)
7
--------------
1.00
Fee summary Charged
Paid Credited
Due
- -= - - - - - - - - - - - - ----
Permit Fee Total
-- - - - -=---
'22.S0
-- - - - - ------ - - -
.00
- ----
.00
-- - - - - - -
22.50
Plan Check Total
S.63
.00
..00
5.63
Other Fee Total
1.00
.00
.00
1.00
Grand Total-
29.13
.00
.00
29.13
LQPERNIIT - '
Prescriptive Certificate of Compliance: Residential
Residential Alterations
.b WA aYF�lne: '2.1 1)V✓n I G .1 T
Climate Zone q
CF -IR -ALT
_Pae 1 of 5
N of Stories -
General Information
Site Address: Enforcement Agency: Date:
Building Type>J n41 Family O Multi Family Circle the Front Orientation: N, E. S. W, or degrees
Conditioned Floor Area (CFA): Project Type: O Alterations O Envelope O Fenestration O Roof O HVAC
Replacement or Change Out O Duct Replacement aur Renter
Y(,j7TE: Thu 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 framedcavity 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 eatire assembly - Replacement ofan 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 portioned of Mass Walls see Furring Strips Construction Table below.
A B C D E F G H ( J
Pro sed Standard Values From JA4 Table
Framing Thickness, Framed Continuous 1A4 Proposed
Tai/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assmbl
ID or T � and Size' or Other' factor' Numbers R -value° R -Value Cell Value U -factor
Note: Forfurred assemblies, accounting for Continuous insulation R-vatue, see Page JA4-3 and Equation 4-1. For calculating furred wills use the Mass and
Furring Coturruaion table below.
1. For Tog.'11) indicate the identification name that matches the building plans.
1. 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 J.44 for other possible fame 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 151-8. 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 rhe 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 Oral
A I B I C I D I
E
F
G I
H I J
K
L M
Proposed Properties of Masonry and Concrete
Added Interior or Exterior Insulation
Walls From Reference
in Furring Space from Reference
Joint A radix Table 4-3.5,4.3.6,4.3.7
`u
Joint
Appendix Table 4.3.13
U
U.
p C
'
t
G R
> '�
Final
Mass
Assembly
Name or JA4 TableA
j
c 4
ti 75l
- o- -�
A
Assembt;
Thickness'
Type2 Number' < >
e x c
' < >
U -factor Comment
Registration Number: Registration Date Time:
2008 Residential Compliance Forms
HERS Provider:
August 200
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations (Page 4 of 5)
Iroject-:---- - -- -- • — Climate Zone -ll
rlo'MM —1g3.73 yT-r�r rcA _ 1-5,
HVAC SYSTEMS - HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DH14' 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
Minimum Duct or Piping Configura1dronic
Heating Equipment
Efficiency Distribution Insulation (Central. S
T and Capacity' -3
(AFUE or HSPF) T and Location R -Value Pack a o
*TjSpace.
1. Indicate Heating Type (Central Furnace. lull 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 KII' or 7.000 Btu/hr 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 bates.
4. Indicate Type or Location (Ducts, Hydropic in Floor. Radiators, etc.)
HVAC SYSTEMS - COOLING
3. The external water heating tank andpipes shall be insulated to meet the requirements of §150) .
Minimum
Efficiency Duct or Piping Configuration
Cooling Equipment
(SEER/EER or Distribution Insulation Thermostat (Central. Split. .
Type and Capacity'- 2
COP) Type and Location R -Value Type Space, Package or H dronic
1. Indicate Cooling Type (A%C. Heat pump. Evap. Coding, etc)
1. Refer to the HERS Verification section on Page 4 of the CF-/ R -ALT Form for additional requirements and check applicable boxes.
3. Indicate T_vpe or Location (Ducts. Hydronic in Floor, Radiators. etc.
WATER HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DH14' 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 :ones.
External ' Tank
Water Heater Type/Fuel Distribution Type Number In • Tank Energy Factor or Insulation
T' ' (Standard. Recirculatin 2 System C i al) Thermal Efficient • R-Value3
t
1. Indicate Type (Storage Gas. Heat Pump. Instantaneous, etc.)
1. 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 andpipes shall be insulated to meet the requirements of §150) .
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
These items ma • require written justi 3cation and documentation and special verification.
NEW ROOF ASSEMBLY - Radiant Barrier
The radiant barrier requirement of § 151 2 does not apply to roof alterations.
Slab Edge (Perimeter) Insulation O YES ONO
YES: In Climate Zone 16 in Component Packages D. R-7 insulation is required.
Heated Slab Insulation O YES O NO
YES: Slab eclize insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation O YES 0 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
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass. use the Performance A roach.
Registration Number: _ _ Registration Date Time: _ HERS Provider:
2008 Residential Compliance Forms August
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations (Page �_ _ 5 of 5 )
X313
PX r-rA
Climate-Zo
L___ 1 -
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this
checklist below. A completed and signed CF -41? 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.
❑ YES O 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)IDii and the newly installed ducts are to be insulated per §15l(f)10.
❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
17 YES ❑ 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)l 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
scaled per § 152(b) I E.
❑ 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.
❑ 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.
0 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 heat pump. cooling or heating coil. or the furnace heat
exchanger) a refrigerant charge measurement shall be verified per § 152(b)t 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.
17 YES 0 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 b ICi to meet the requirements of §15l(f)7B.
i
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate d complete.
N
`
Si re: r
1 lr'
Date:
(CZ
rtil
Address If Applicable ❑ CEA or ❑ CEPE
(Certification #):
City/S Phone:
LS
51ant
-60dL22 .3c,
Responsible Building Designer's Declaration Statement '
a 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified or
this Certificate of Compliance.
1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance confon
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 fortes. worksheets. calculations plans and specifications submitted to the enforcement
agency or roval with this building permit application.
N
u^b
Signatur�
Com y: Date:
d u � Licens / 9S
i C
Ci e/ tp: `/U � �Q Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300.
Registration :\'umber: Registration Date Time:
2008 Residential Compliance Forms
HERS Provider:
August
Bin #
Cit/ Of %a Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253; (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
U
Project Address -777 3-73 Y
."
Owner's Name:
A. P. Number:
Address: --) d (-
C::(-
Legal Description:
Contractor:
lu'mb111
7 -
City, ST, Zip: ��qq
•
TelephoneU'3 Q•4?s:
Project Description ol -1
`
Address:
City, ST, Zip: j C4ck
9 a a o 3.
D.
Telephone
11,03ci 3 l
State Lie. # : S S
Arch., Engr., ROOM7,N. r
City Lie. #:
Address:
City., ST, Zip:
Telephone::.<.}
t :..:!�.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lie. #:,;
Name of Contacterson:
�,,/ lnv �.
Sq. Ft.:
# Stories:
#
Telephone # of Contact Person:
L — 3
Estimated Value of Project:
' —I
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
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
Tide 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2i° 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:-
''d 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