BRES2016-0301LICENSED CONTRACTOR'S DECLARATION
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 Professions Code,
and my License is in full force and effect.
License Class: B License No.: 818261
Dat�`e."-i(5 Contractor:/
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).:
(1 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:
(909)335-4846
Llc. No.: 818261
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 t e Ctk for which this permit is issued.
ave 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: ACE AMERICAN INSURANCE COMPANY Policy Number: RWCC48821169
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 be- or Code, I shall forthwith
comply wih those provisions.
kidal�te'316'6 Applicani�
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 Building Official 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 ci to er upon the
above -me tion d propperty for inspection purposes.
Date:' 16 26ro Signature (Applicant or Agent
VOICE (760) 777-7125
78-495 CALLE TAMPICO
D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760)
777-7153
BUILDING PERMIT
1
afe: ¢10/18/2016
Application Number: BRES2016-0301
Owner: g w
Property Address: 79695 STAR FLOWER TR
THOMAS HARTMA cli
APN: 604251016
79695 STAR FLOW R TR R
Application Description: HARTMAN / CHANGE OUT
(6)WINDOWS LIKE FOR LIKE
LA QUINTA, CA 92 53 w
Property Zoning:
Application Valuation' $2,600.00
w
v z
4 0CD
C
Applicant:
Contractor: _
D WICK ENTERPRISES INC DBA THREE D CONST
D WICK ENTERPRIS ITTC DBA' f REE D CONST
1515 CROWN ST
1515 CROWN ST
REDLANDS, CA 92373
REDLANDS, CA 92373
LICENSED CONTRACTOR'S DECLARATION
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 Professions Code,
and my License is in full force and effect.
License Class: B License No.: 818261
Dat�`e."-i(5 Contractor:/
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).:
(1 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:
(909)335-4846
Llc. No.: 818261
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 t e Ctk for which this permit is issued.
ave 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: ACE AMERICAN INSURANCE COMPANY Policy Number: RWCC48821169
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 be- or Code, I shall forthwith
comply wih those provisions.
kidal�te'316'6 Applicani�
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 Building Official 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 ci to er upon the
above -me tion d propperty for inspection purposes.
Date:' 16 26ro Signature (Applicant or Agent
Application Number:
BRES2016-0301
Property Address:
79695 STAR FLOWER TR
APN:
604251016
Application Description:
HARTMAN /CHANGE OUT (6)WINDOWS LIKE FOR LIKE
Property Zoning:
Application Valuation:
$2,600.00
Applicant: .
D WICK ENTERPRISES INC
DBA THREE D CONST
1515 CROWN ST
REDLANDS, CA 92373
Date: 10/18/2016
Owner:
THOMAS HARTMAN
79695 STAR FLOWER TR
LA QUINTA, CA 92253
Contractor:
D WICK ENTERPRISES INC DBA THREE D CONST
1515 CROWN ST
REDLANDS, CA 92373
(909)335-4846
Llc. No.: 818261
------------------------------------------------------------------------=--------------------
Detail: HARTMAN / CHANGE OUT (6)WINDOWS LIKE FOR LIKE. 2013 CALIFORNIA BUILDING CODES.
DESCRIPTION
ACCOUNT I QTY I AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid'for TECHNOLOGY ENHANCEMENT FEE: $5.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7
101-0000-42400
0
$63.84
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7 PC
101-0000-42600
0
$62.32
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $126.16
WIN
c;)
rT �
.. .. ...... ..
!LD/ LA QLJiN'rA
DEp-r
FOR C0jVS T Ij
OF
M3
PFI,
0 C0iVS"UrFIU
ZION
Provide means of emergency escape and rescue from bedroom(s). The opening shall have a minimum
net clear opening of 5.7 square.feet (5-0 square feet for grade floor). The minimum net clear opening
height shall be 24 inches. The minimum net clear opening width shall be 20 inches. All escape windows
shall have a finished sill height not more than 44 inches above the finished floor. (CRC §§R310.1.1—
R310.1.3)
§R310.1.1—R310.1.3)
C[ 7S X0
1-4
x -S31 > CO
.. .. ...... ..
!LD/ LA QLJiN'rA
DEp-r
FOR C0jVS T Ij
OF
M3
PFI,
0 C0iVS"UrFIU
ZION
Provide means of emergency escape and rescue from bedroom(s). The opening shall have a minimum
net clear opening of 5.7 square.feet (5-0 square feet for grade floor). The minimum net clear opening
height shall be 24 inches. The minimum net clear opening width shall be 20 inches. All escape windows
shall have a finished sill height not more than 44 inches above the finished floor. (CRC §§R310.1.1—
R310.1.3)
§R310.1.1—R310.1.3)
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CFC:CFjH-ALT-0t-F (revised 06/14)
. ERTIFIC.A.-1:OF COMPLIANCE
Pre' ,ripxi_' ResiResidential Alterations
Projekt N,�me: `-i'O1nn l�64Q�Vv
A. GENERAL INFORMATION
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)
01 02 03I 04 OS
E
Frame Frame
Frame Depth Spacing
C. ROOF REPLACEMENT (Prescriptive Alteration,
01 02 03 04
Roof
Pitch
CRRC Product ID
07 1 08---F-09
Continuous I Appendix JA4
Cavity Insulation Reference
1.2(ll
MR -ALT -014
(Page 1 of 4)
Date Prepared: to - X —W ,
Floor
Comments
05 06 07 08 09
10 11 12 13-
R -value Proposed
Deck Initial Solar Aged Solar Thermal Minimum Required
Ict Tye In3ulatipn Reflectance Reflectance Emittance SRI Aged Solar Thermal SRI
(Optional) Reflectance Emittance (Ootioi
NOTES
• Roof area covered by building integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Ro
• Liquid field applied coatings must comply with installation criteria from section 110.8(i)4. of requirements.
w
Registration Number:
CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Tim%.
HERS Provider:
June 2014
STATE CF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1R-,0=.T-01-E iReviseQ 081141
-- IN TE OF COMPLIANCE
Prescriptive Residential Alterations
Project Nar*+g:
D. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.
01 02 03
Alteration Type Orientation Maximum Allowed ft2
E. FENESTRATION/d LAZING PROPOSED AREAS AND EFFICIENCIES (Sectio
01
02
03
04
OS
06
07
09
10
11
12
13
14
15
Tag/
Fenestration
Frame
Dynamic
Orientation
N, S, W, E, or
Area
Removed
Area
Added
ID
Type
Tye
Glazing
Roof
.ft2
ft2
t1Jtwod
VIF
rf1A
0
1
IF6_i0-►tomes��--
Lp I Nim 0j
J IF1�!
fJ l ✓�
4J
) �0
1
a
Net Added West acing Fenestration Area
b
Existing + Added West -facing fenestration Area
c
Maximum l�llpwe4 W esRacing Ferries tation Area
d
Is West -facing Fenestration Area < h4aximum Allowed West -facing Fenestration
Ali
e
Ntt Added Fenestration Area (all orientations)
f
Existing + Added Fenestration Area (all orientations)
9
Maximum Allowed fenestration Area (all orientations)
h Is Existing + Added Fenestration Area < Maximum Allowed Fenestration Area (all
I p1>4 W
V't
orientations)
� �J �
LP INo!5v.r
wlN�w
Jit✓ -11
via &j
� `� "(
LlI►.yI
rrlyy
CALIFORNIA ENERGY COMMISSION
CF1R-ALT-01-E
(Page 2 of 4)
Date Prepared:
04
I iS0.2(6)1)
Og
09
10
11
12
13
14
15
Net
Added
Area ft2
Maximum
Allowed
I U -factor
U -factor
Source
�SSHGGC
Source
Exterior
Shading
Device
Combined
SHGC
from
CF1R•ENV-03
+�
✓�/
11 /-e
zz
. e
3z K� 2v t—W& roc r
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Conliance 0 HERS Provider:
June 2014
STATE OF CALIFORNIA
RES AMENTIAL ALTERATIONS
CFC-CFIR-ALT-01-[ Revised 06/14
'
�CERTIFICAtf,
OF COI'VIPL'IANCE
CALIFORNIA ENERGY COMMISSION �:..
cr—
L.Prpsigfive Residential Alterations
CF13-ALT-01-E
Project Name: -
(Page 3 of 4)
Date Prepared: 1(01 1g 2Q
F. SPACE CONDITIONING(SC) SYSTEMS — HEATING/COOLING (Prescriptive section 150.2(b))
01 02
Dwelling Unit Name Dwelling Unit CFA (Ft2)
03
Comments
G. WATER HEATING SYSTEMS (Section 150.2(b)iG)
01 02 03 04 05 06 07 08 09. 10
11 12 13
Water Heating aof Water
14 15
System Water Heater
Y Water Water
Back -Up
Rated Rated Heating Heating Identification or Heating Heater Heaters Storage g B
in Fuel
Exterior Solar
Dwelling UnitDHW
Volume Input Input Efficiency Efficiency
Name System Type. Type s stem ) Type
( al T e Typg
Standby Insul. Savings '
Central DHW System System
y
. Value T.ypR Value
Loss (%) R -Value Fraction
Distribution Type Distribution Type
H. SPACE CONDITIONING SYSTEMS AND WATER HE -MULTI
IN'G SYSTEMS IN FAMILY DWELLING UNITS
01 62 03 : 04
05
Central Water Heating Dwelling Unit
06
Dwelling Unit Total CFA System Identification or Water Heating System
Dwelling Unit:
Dwelling Unit Name (ft2) . Name Identification or Name
Alteration to the Space
ConditioningS s
y stem ()?
Comments
i
I
Registration Number:
Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
@
HERS Provider:
June 2014
State Of California
Residential Alterations
CEC-CF1 R -ALT -01-E ( Revised /14 California EneTy Commission
Certi icate -55mpliance C 1 R -ALT -O -
.Prescriptive Residential Alterations Pae 40f L4
Project Name: -"gyp \ 1J Date Prepared: t0 6zo 6b
Documentation Authors Declaration Statement
1. 1 certify that this certificate of CompliaRe documentation is accurate and complete.
Documentation Author Name: Roger Cummings Documentation Author Signature:
Company: Three D Construction Signature Date:
Address: 320 E. Stuart License: 818261
city/state2ip: Redlands CA 92374 Phone: 909-792-0612
Res onsible Person's Declaration Statement
certify the folowing under penalty -of penury, under the lasw of the state of California:
1. The informatioan provided on this Certificate o fCompliance is true and correct
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design
identification on this Certificate of Compliance ( Responsible Designer)
3. That the energy features and perfomance specification, material, components, and manufactured devices for the building design or system
design identified on this Certificate of Compliance conform to the requirements of title 24, Part 1 and Part 6 of California Code of Regulations.
4. The building design features or system design features identified.on the Certificate of Compliance are consistent with the information provided
on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcemant agency for approval
with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building
and made available to the enforcement agency for all applicable inspections. I understand tht a registered copy of this Certificate of Compliance
is required to be inclueded with the documentation the builder provides to the building Owner at occu anc .
Responsible Designer Name: Roger Cummings Responsible Designer Signature:
Company: Three D Construction Date Signed: 10-
Address: 320 E. Stuart License: 818261
city/state/Zip: Redlands CA 92374 Phone: 909-792-0612
For assistance regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
Registration -Number Registration Date/Time HRS Provider
CA Building Energy Efficiency Standards - 2013 Residential Compliance
WE
Bin #
Qty of La Quints
Building a Safety Dlvlsion
P.O. Box 1504, 78495 Calle Tampico
1.a Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: STAe- !
Owner's Name:- esti
A. P. Number:
Address: 73�S' c5TA2 F TAU � �
Legal Description:
Contractor. ` ^'� i (�-
Address:sZO F-
City, ST, Zip: C4 agi, N,A o - 0-4- 9e-z��>
Telephone: __15rco�7Z
Project Description:
City, ST. zip:140�-�s �i2 37 Y1
Telephonc:qoq `
v�c� c>,r►,�.�Oc'�v—S a.l t til
V 1W �� ��� �-1 ��• �o
State Lic. City Lia M
Ll
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: Construction Type: Occupancy:
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq. Ft.: # Stories: #Units:
Telephone # of Contact Person: g B ' - s3S QZ 46
Estimated Value of Project:
APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Pian Sets
Plan Check submitted
Item
Amount
Structural Cala.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Titre 24 Cala.
Plans picked up
Construction
Flood plain plan
Plana resubmitted
Mechanical
Grading plan
2'! Review, ready for correctionvissue
Eleem.cal
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plana picked up
SALL.
H.O.A. Approval
Plana resubmitted
Grading
IN HOUSE:-
3-' 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