07-2610 (RER)P.O. BOX 1504 TA
• 4 4Q"
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00002610
Property Address: 79705 STAR FLOWER TR
APN: 604-251-015-15 -24208 -
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 17260
Applicant: Architect or Engineer:
r
C
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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 Professionals Code, and my License is in full force and effect.
License Class: B License No.: 870641
Date: /-Z %O%Contractor: 1eC-A1 n&),b,9?,05 /ZW,!;,V,4 z
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.).
(_ 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 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:
BLAKE SANDRA C
79705 STAR FLO
LA QUINTA, CA
(760)360-8347
Contractor:
RENEWAL BY ANDER
18890 SEATON AVENUE
PERRIS, CA 92570
(951)436-3348
Lic. No.: 870641
VOICE (760) 777-7012
FAX (760)'777-7011
INSPECTIONS (760) 777-7153
11
SEP 2 72007
Date: 9/27/07
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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 SIRIUS AMERICAN Policy Number OIDKRM11001159
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 Code, I shall forthwith comply with those provisions. f
DateApplicant: 94W Mu/ /e�}J1iLfF� /�'y s4r✓Gi«�
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 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 property for inspection purposes. .O ..... l �.e., /11/
Date: —F- 7w7 Signature (Applicant or Agent):.%�% 4r""WS /`C` C'!./✓'[� � �
Application Number . . . . . 07-00002610
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . . 189.00
Plan Check
Fee
122.85
Issue Date . . . .
f Valuation
17260
Expiration Date 3/25/08
Qty Unit.Charge Per
Extension
BASE FEE
45.00
16.00 9.0000 THOU BLDG 2,001-25,000
144.00
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Special Notes and Comments
CHANGE OUT EXISTING SLIDERS 3/ NO
MODIFICATIONS.CHANGE OUT DOUBLE ENTRY
DOORS TO SINGLE DOOR'W/SIDELIGHTS &
SMALL DOGGIE DOOR IN WALL.
----------------------------------------------------------------------------
Other Fees . . . . . . . . ENERGY REVIEW FEE
12'.29
Fee summary Charged Paid
Credited
Due
Permit Fee Total 189.00
.00
.00
189.00
Plan Check.Total 122.85
.00
.00
122.85
Other Fee. Total 12.29
.00
:00
12.29
Grand Total 324.14
:00.
.00
324.14
LQPERMIT
Bin #
City of La Quints
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Owner's Name: 514p -Z
A. P. Number.
Address: 5
Legal Description:
ty, Zip:
Ci ST, Gr2 2s j
Contractor: EL
Address: / g q 0 L T D1v
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Telephone 0:::..•:...:. ::;�;:'�. ; •
Project Description:
City, ST, ST, Zip: 86X91,S CA . Z3770
l p D a
Telephone:
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City Lie.
State Lie. #: 8 70 (o t
Arch., Engr., Designer.
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Address:
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City., ST, Zip:
Telephone:
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Construction Type: 0bb6`, a,Occnpancy:
State Lie. #
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft:#Stories:
# Units:
Telephone # of Contact Person: Z - 3Z - 6410e Estimated Value of Project: % Z° 6O r d�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Cheek submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales•
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21! Review, ready for eorrectionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
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
CERTIFICATE OF COMPLIANCE:. RESIDENTIAL (Pagel of 4) CF -1R
Project Title
Lvcuincntauon Auuior Telephone I
Compliance Method (Prescriptive)
Climate 7 -
Building Permit #
Plan Check / Date
Field Check / Date
ne Enforcement Agency Use Only
0 Alternative Component Package Method: (check one) C D D ltemative)
Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -1 R page 3)
For Package D Alternative see Appendix B Table 151-C Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) $ Average Ceiling Height: ft
Maximum Allowed West, Facing Fenestration Products Per Table 151-B or 151-C=-- (5%X CFA) ftZ
Maximum Allowed Total Fenestration Products Per Table 151-B or 151-0 — (20% X CFA) g
❑ Building Type: (check one or more)— Single Family Multifamily Addition Alteration
(If adding fenestration fill out WS48 Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
Number of Stories: Number of Dwelling Units:_
Floor Construction Type: Slab/Raised Floor (circle one or both)
Front Orientation-. No / South / East / West / All Orientations (input front orientation in degrees from True
North and circle one).
✓ 0. RADIANT BARRIER (required in climate zones 2.4.8-15) '
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Wall,
Roo> Floor,
Slab Edge,
Doors
Frame
Type
(Wood
or Metal
Assembly U -
factor (for
Cavity Continuous wood, metal
Insulation Insulation frame and mass
R -Value R -Value assemblies
Joint
Appendix
IV
Reference
Roof Radiant
Barrier Location/Comments
Installed (attic, garage,
Yes or No typical, etc.
7\ O__ 7_C_a •----mac__,.,-.-e,
.. --•— ---- ---- - - - - - -
-1 --- ------ - -rr- �•^ ••• w„v„ , v —, a v - a,iu . v n, wurcii ib uic vabis Tor Ine V-Iact.or Criterion. U -Tactors Can not
exceed prescriptive value. to show equivalence to R -values:
Residential Compliance Forms
March 2005'
i
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 4) CF -1R
Project Title Date
FENESTRATION PRODUCTS — U -FACTOR AND SHGC
✓ ❑ FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS4R —must be included for New Construction,
Additions and Alterations.
Fenestration
Minimum
Efficiency
AFUE or HSPF
#/Type/Pos.
(Front, Left, Orien-
Exterior
Shading/Oyerhangs6,
Rear, Right, tation, Area
✓box if WS -3R is
Sour=SHGCfactor'
i htU-facor2 ft SourcSource'
included
❑
t�usncfc,
❑
El
1) Skylights are now included ' W f '
m est- acmg fenestration area if the skylights are tilted to the west or tilted in any direction
when the pitclh is less than 1:12. See §151(f)3C and in Section 3.2.3 of the Residential Manual
2) Enter values in this column are either NFRC Rated value or from Standards default Table 116A.
3) Indicate source either from NFRC or Table I I6A,
4) Enter values in this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -3R.
5) Indicate source either from NFRC or Table 116B.
6) Shading Devices are defined in Table 3-3 in the Residential Manual and see WS -3R to calculate Exterior Shading devices.
7) See Section 3.2.4 in the Residential Manual.
HVAC SYSTEMS
Heating Equipment
Type and Capacity
furnaceheat um boiler etc.
Minimum
Efficiency
AFUE or HSPF
ution
�:aZ
Typocation Duct or Piping Thermostat Configuration
dc, etc. R -Value Type lit ora e
L
Cooling Equipment
Type and Capacity.
A/C heat pump,eva . cooling)
Minimum
Efficiency Duct Location Duct Thermostat Configuration
SEER or EER attic etc. R -Value Type lit or package)
Residential Compliance Forms March 2005
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