09-0634 (RER)P.O. BOX 1504.. VOICE (760) 777-7012-
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA,.CALIFORNIA 92253. BUILDING & SAFETY DEPARTMENT--- INSPECTIONS (760)•777-7153-
BUILDING
760)•777-7153.BUILDING PERMIT
Y Date: 6/26/09
Application -Number: 09-00000634 Owner:
Property Address: 78880 SUNBROOK LN JESUS CONTRERAS
" APN: 604-291-010--10 -23995 - 78-880' SUNBROOK LANE
Application description: REMODEL - RESIDENTIAL LA QUINTA; CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 4437
- l
Contractor
Applicant: ' ' Architect or, .Engineer: Owner...
2
,�A;� 2G i� .�
• LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION '
hereby affirm under penalty of .perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. -
Date: Contractor: _ 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
hereby affirm under penalty of, perjury that I am exempt from the Contractor's State License Law for the Carrier - Policy Number.
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that,,in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the " person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensedpursuant to the provisions of the Contractor's State and agree that, - should became �the ' compensation provisionsof SectionLicense Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or '3700 of the bo Code, I shall fosepttisions.that he or she is exempt therefrom and the basis for the alleged exemption: Any violation of Section 7031.5 by I/, fJany applicant for a permit subjects the applicant -to a civil penalty -of not more than five hundred dollars ($500).: Date ' Applicant.V ��"`•� ��
(_) 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 WARNING: FAILURE TO SEC E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the - DOLLARS ($100,000). IN A DITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN -
improvements are not intended or offered for sale. If, however, the building or improvement issold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND. ATTORNEY'S FEES. - -
one year of completion, the owner -builder willhave the burden of proving that he or she did not build or
improve for the purpose of sale.). " - . •1,- APPLICANT ACKNOWLEDGEMENT
(_) I, as owner ofthe property, am exclusively contracting with licensed contractors to construct the project (Sec.. IMPORTANT Application is hereby made to the Director of Building and Safety fora permit subject to the _
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed - 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt.under Sec. , B.&P.C. for this reason , 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.
• Date: �♦� •� i v -Owner: L 2. Any permit issued as 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 -
CONSTRUCTION LENDING AGENCY - permit to cancellation. .�
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certifythat I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.):< _ - - ,city and .county ordinances and state -laws relating to building construction, ere authorize representatives
of this county to enter upon the above-mentioned pro y for inspection urpo s.
_ Lender's Name: tN� / - -
• Date: f [L �gnature(Applicantor Agentl: Wli'
Lender's Address:
• LQPEILIIIT - ' -
` Application Number . . . . . 09-00000634
----- Structure Information 118SF GARAGE CONVERSION/VB/RES-3
[CONV] ----- .
Other struct info . . . . . CODE EDITION 2007CBC
-----------------------------------------------------------------------------
Permit BUILDING PERMIT•
Additional desc .
Permit Fee 72:00 Plan Check Fee
46.80
Issue Date Valuation
4437
Expiration Date 12/23/09
Qty Unit Charge Per
Extension
'BASE FEE
45.00
3.00 9.0000 THOU BLDG 2,001725,000
27.00
'Permit . . . ELECT.- ADD/ALT/REM
'Additional desc .
Permit Fee 19.13 Plan Check Fee
4.78
Issue. Date Valuation
0
Expiration Date_. 12/23/09
Qty Unit. Charge Per
Extension
BASE FEE
15.00
118.00 .0350 -ELEC NEW RES -•1 OR 2 FAMILY
4.13
Permit . . . MECHANICAL
Additional desc-.
Permit Fee 19.50 Plan Check -Fee
4.88
Issue Date Valuation
0
Expiration Date 12/23/09
Qty Unit Charge Per
Extension
BASE FEE
'15.00
1.00 4.5000 EA MECH VENT INST/.DUCT ALT.
4.50
Special Notes and,Comments
'118SF 3RD CAR GARAGE CONVERSION/VB/RES-3
-.
[CONVENTIONAL]'- GARAGE MUST MAINTAIN A.
20 FOOT BY 20 FOOT CLEAR VEHICLE SPACE.
' PER CITY MUNICIPAL CODE REQUIREMENTS.
2007 CALIFORNIA BUILDING CODES.
June 26-, 2009 11:12:51 AM AORTEGA
--------------- ------------------------ - ----------
Other Fees .. . .' BLDG STDS ADMIN (SB1473)
1:00
ENERGY REVIEW FEE
4.68
Fee summary Charged Paid Credited
Due
LQPERNITT
Application Number
. . . . .
09-00000634
• Permit Fee Total
110.63:
.00
.00
110.63
r Plan Check Total
56.46
.00•
.00
56.46 -
Other Fee Total.
5.68
.00
.00
5.68
. Grand Total.- '.
172.77'
. 00 '•
.00
172.77
LQPERMIT
Bin #
City of La Quinia ,
Building & Safety Division -
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
'Permit #P.O.
nn
Project Address: .SVAJO a6eL.4N�
Owner's Name: '
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone(146)
t:i%j+� `..:} ivtti:.`•:L•>:'),.:Y:iYYS:y;rY,;;;
Address:
City, ST, Zip:
Project Description: / iZ> G CA
Telephone:
''>:>'%'�"%s<::>:tis<::�:»<<•r:;:z::::•<,•>,::-.
.;%`` 77 �// II
State Lie. # :
City Lie. #;
"
Arch., Engr., Designer:
Address:
City,, ST, Zip:
v..v: jvCivi4 is?+:•:i:: ::-:::::.. 4�. v.ir•:3. i:.
Telephone: ::::..:<;..• ;: <:::> :<:::><::>:::;%,;<:#:<
`
State Lie.#:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one):. New . Add'n Alter Repair Demo
Sq. Ft.:. 1`� #Stories: #Units:
Telephone # of Contact Person; �j� � D —7
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 Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cale a.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical a,a
Grading plan
2"" Review, ready for correctionsAssue
Electrical X18
'Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up.
H.O.A. Approval
Plans resubmitted
Grading
M HOUSE:-
'^' Reyiew,.ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Perso (p4
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
1
School Fees
Total Permit Fees
uwl—
�1� � - us• A-�POoN►o�,C -
o Uwtrta Fxwoe't, *W Sc*0U W sevvcwr1
CERTIFICATE OF COMPLIANCE
Desert.Sands_Unified'School District `zo
4
47950 Dune Palms Road _ Q BERMUDA DUNES r
! Ln RANCHO MIRAGE d
Date 1/28/10 La Quinta, CA 92253 f," INDIANWELLS.
SERT
No. 30593 (760) 771$515 PALM.OENTA,
LANDINTA, y
I_NDIO r�
Owner -Jesus Contreras _ APN # 604-291-010
Address 78-880 Sunbrook Lane r r Jurisdiction La Quinta
City La Quinta • Zip Permit #
Tract # No. of Units 1
Type .Residential Addition
Lot # No.' Street S.F. Lot # , No. Street S.F..
Unit 1 78880 . tlSunbrook Lane 118 Unit 6
Unit 2 r
Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10 -
Comments Y:
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping; cooking, eating or sanitation) or replacement mobile ho
mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: '
- Residential Addition 500 `Sq Feet or Less
EXEMPT. _
This certifies that school facility fees imposed pursuant to,
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 118 S.F. or $0.00 have been paid for"the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By Exempt - Jesus Contreras Check No.'
Name on the check Telephone 760-578-8772
Funding Exempt
By Dr. Sharon P. McGehee�'k
Superintendent
Fee collected /exempty f0 CGII r y Payment Recd • x:00 LL r
• =Geer/Under` •�� z '
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will rve t notify you that the 90 -day approval period in which you may protest the fees o
r other payment identified above will begin to run from the date on which t e building or installation permit for this project is issued, or from the date on which
those amounts are paid.to the District(s) or to another public entity authorized to collect them on the. District('s) behalf, whichever, is earlier.
NOTICE: This Document NOT VALID without embossed seal'
Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting
i
CERTIFICATE'OF,COMPLIANCE: RESIDENTIAL `:; (Page tof5) • .'..CF -1R
Pro'act Tale,
Date
1609
BuildingPeriiitr# r
Pro" cAddi91, gss'
4
S0,111031.
Documentation Author ..
dw11,.�—
Telephone
A IN
WN
WField Ctieck`/,Dat�Y t
*u .; •_ :5+�`,
Compliance Method (Prescriptive)
D
Climate Zone
1aJ.EnforcementA
enc ;I1seOnl' "
Alternative Component Package Method: (check one) • C D (Alternative)
' Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF4R page 3)
For Package D'Alternative see Appendix B Tab ° ' • " mpliance Manual (RCM)
CIWOF LA QUINTA
GENERAL INFORMATION BUILDING & SAFETY,DEPT.
D
Total Conditioned Floor Area (CFA) Ag�ft APP ROVED Y �O
Average Ceilin Hei ht•
g g g . �' FOR CONSTRUCTION
• R
Check Applicable Boxes
DATE BY -
Building Type: (check one or more) X Single Fa Alteratio
(If adding fenestration fill -out WSf4R, Fenestration Maximum Allowed Area Worksheet and see Section 83.2,
for Additions and 8.3.3 for Alterations in the RCM.)
' t.
• Maximum Allowed Total Fenestration Area Z� Y ftz (from •WS -4R)
• Maximum Allowed West Facing Fenestration Area ft' (from WS -4R)
•• Number of Stories: Number of Dwelling Units:
• Floor Construction Type:Slab/Raised Floor (circle one or both) t A
• Front Orientation: IEW North / South / East /West: All Orientations (input front orientation in degrees
' 1 from True North and circle one).. " '
$9 RADIANT BARRIER (check box if required in climate zones 2 4 8-15)
F .
OPAQUE SURFACES INCLUDING OPAQUE.DOORS `
Component
T e Wall
YP (
Roof, Floor,
Slab Edge, ;
Doors)
Frame`'
Type
(Wood or
Metal)R-Value.
c.
Cavity
,Insulation
Assembly U-
factor (for wood,
Continuous '• metal frame and '
Insulatiori mass-
R -Value assemblies 1
Joint
} Appendix
IV
Reference
' rs
'RoofRadtant; .:
B.ar e."
;Installed
YesoNo'
°Location
Comments ,
-(attic, garage,
'ical, etc.
i) Jee Juml fippenuix iv In Jecuon 1 v .L, l v .s, ana 1 V A, which is the basis Tor the U -factor criterion. -U-tactors can not exceed
prescriptive value to show equivalence to R -values.
2) This column is for the Inspector to verify installation of roof radiant barrier. ,
Residential Compliance Forms
December 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 5) CF -1R
Proiect Title Date
FENESTRATION PRODUCTS — U -FACTOR AND SHGC
✓ ❑ FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS -4R — must be included for New
Construction, Additions, and Alterations.
Fenestration
Minimum
Efficiency Distribution
(SEER or Type and Location
EER) (ducts attic etc.
Exterior
#/Type/Pos. (Front, Orien-
Configuration
(split or package)
Shading/Overhangs6' 7
Left, Rear, Right, tation, Area
U -factor SHGC ✓ box if WS -311 is
Skylighq N, S, E, W' (ft2)
U-factor2
Source SHGC4 Sources included
1
0
M01 ❑
❑
r ..
❑
■
❑
k, .,
l 4
❑
1) Skylights are now included in West -facing fenestration area if the skylights are tilted to the west or tilted in any direction when
the pitch is less than 1:12. See §151(f)3C andin Section 3.2.3 of the Residential Manual.
2) Enter values in this column from either NFRC Certified Label or from Standards Default Table 116-A.
3) Indicate source either from NFRC or Table 116-A,
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, Table 116B or WS -3R
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 Minimum Distribution
Type and Capacity Efficiency Type and Location Duct or Piping Thermostat Configuration
fumace heat pump,boiler, etc. AFUE or HSPF ducts attic etc. R -Value Type (split or package)
:u%t,a.l4
Cooling Equipment
Type and Capacity
(A/C, heat pump, evap.
cooling)
Minimum
Efficiency Distribution
(SEER or Type and Location
EER) (ducts attic etc.
Duct or Piping
R -Value
Thermostat
Type
Configuration
(split or package)
�1 ilt�
Residential Compliance Forms December 2005_
a\�
t4i
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 5) CF -1R
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 required.
❑
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)
❑
(Installer 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
❑ IAlternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Proiect Climate Zone in the RM Atmendix B Table 151-C. Footnotes 7-14.
OR
❑ No ducts installed.
New ducts from existing space conditioning equipment, not exceeding 40ft. in length.
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.
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.
WATER HEATING SYSTEMS
❑
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per dwelling
Number
in System
unit. If the water heater is a stora a type, 50 gallons is the maximum capacity and recirculation system is not allowed.
❑
Check box when using "Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Standby
Loss %
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.
❑
1 Check box to verify that a time control is required for a recirculating system pump for a system serving multiple units
Systems serving single dwelling units (See RM Table 5-4, Alternative Water Heating Systems for recirculation requirements)
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Rated
Input'
(kW or
Btu/hr(gallons)
Tank
Capacity
Energy
Factor' or
'Thermal
Efficiency
Standby
Loss %
Tank
External
Insulation
R -Value
System serving multiple dw Iling units See' Residential Manual Section 5.3.3
Water Heater
Type
Distribution
Type
Number
in System
Rated
Input'
(kW or
Btu/lu(gallons)
Tank
Capacity
Energy
Factor' or
Thermal
Efficiency
Standby'
Loss %
Tank .
External
Insulation
R -Value
1) For small gas storage water heaters (rated inputs of less than or equal to.75,000 Btu/hr), 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
December 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 4 of 5) CF -IR
Project Title Date
SPECIAL FEATURES REOUIRING BUILDING OFFICAL or HERS RATER VERIFICATION
Indicate which special features are parts of this project. The list below only represents special features relevant to the prescriptive method.
(Check Anolicable boxes)
Category
Building Official
Verification of
Special Features
HERS Rater
Verification
HERS Rater
Diagnostic
Testing
Measure
Ducts
❑
Y
100% of ducts in crawlspace/basement
❑
Y
Buried ducts
❑
Y
Diagnostic supply duct location, surface area, and R -value
❑
Y
Duct increased R -value
❑
Y
Duct leakage
13
Y
Ducts in attic with radiant barriers
❑,-
Y
Less than 12 ft. of duct outside conditioned space
❑;:
Y
Non-standard duct location
❑
Y
Supply registers within two ft of floor
Envelope
❑
`
Y
Air retarding wrap
❑
Y
Cool roof
❑
Y
Exterior shades
❑
Y
High thermal mass
❑
Y
Inter -zone ventilation
❑
Y
Metal framed walls
❑
Y
Non -default vent heights
❑
Y
Quality insulation installation
❑
Y
Radiant barrier
❑
Y
Reduced infiltration (blower door). May also require mechanical ventilation.
❑
k
Y
Solar gain targeting (for sunspaces)
❑
Y
Sunspace with interzone surfaces
❑
Y
Vent area greater than 10%
HVAC Equipment
❑
k
Y
Adequate air flow
❑
Y
Air conditioner size
❑
Y
Air handler fan power
❑
Y
High EER
❑
Y
Hydronic heating systems
❑
Y
Mechanical ventilation
❑
Y
Refrigerant charge
❑
Y
Thermostatic expansion valve (TXV)
❑
Y
Zonal control
Water Heater
❑
Y
Combined hydronic
❑
Y
High EF for existing water heaters
❑
Y
Non-NAECA water heater
❑
Y
Non-standard water heaters (wh/unit)
❑
Y
Water heater distribution credits
Residential Compliance Forms December 2005
• CERTIFICATE OF COMPLIANCE: RESIDENTIAL" (Page 5 of 5) , • , CF -1R
Project Title Date
Special Remarks.
a
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and specifications needed to comply with Title 24,
Parts 1 and 6 of the California Code. of Regulations, and the administrative regulations to implement them. This
certificate has been signed by the individual with overall design responsibility. The undersigned'recognizes that
compliance using duct design, duct sealing, verification of refrigerant charge and TXVs, insulation installation
quality, and building envelope sealing require installer testing and certification and field verification by an
approved HERS rater. r
Designer or Owner( er Business and Professions Code) Documentation Author
Name:Name:
Qa11►��
, S 6a j4t tJ6. .�
Title/Firm:
Title/Firm:
Address:".
Address: j
•
Telephone: ",
Telephone:
License #: ��
License #: (if applicable) -, •r•+ ,
(signature) (date)
I (signature).. 3 (date)
"
Enforcement Agency ;
Residential Compliance Forms ' December 2005
FENESTRATION - MAXIMUM ALLOWED AREA WORKSHEET WS -4R
Project�tl� I Date�l��l�
FENESTRATION PRODUCTS — NEW CONSTRUCTION- NEW BUILDINGS
Use this table for new buildine construction to account for total buildine % of fenestration.
A B
C
D
E
F
G
#/Type/Pos.
(Front, Left,
Rear, Right,
Skylight) Orientation
Total
Fenestration,
West Facing
Area (ft
Total Fenestration for
N, S, E Orientations
Area (W)
(fe)
Total Percent of
West Facing
Fenestration'
(C/E) x 100%
Total % of
Fenestration
Including West
/E x 100% + F
North
Total Area
Added
Fenestration
- E)
Total % of West Facing
Fenestration
(G/C) x 100%
Total % of
Fenestra -
tion 2, 3'
/C x 100%+
North
North
South
North
East
West
�-
South
South
Totals
East164o
East
East
1) If west facing area exceeds 5% of CFA in climate zones 2, 4, and 7-15, the performance approach must be used.
2) If total percent of fenestration exceeds 20% including West facing orientations then performance approach must be used. West facing area includes
skylights tilted to the west or tilted in any direction when the pitch is less than 1:12 for Package D only.
FENESTRATION PRODUCTS — NEW CONSTRUCTION- ADDITIONS
✓ 1:1 Less than 100 ft', Less than or Equal to 1000 ft2, ❑ Greater 1000 ft'
A
B
C
D
E
F
G
H
#/Type/Pos.
(Front, Left,
Rear, Right,
Skylight)
Orienta-
tion
Proposed
Addition's
CFA', 2,3
Proposed
Addition's
Fenestration
Area(ft2)4
Fenestration
Area Removed to
make way for
Addition (fl?)'
Total Area
Added
Fenestration
- E)
Total % of West Facing
Fenestration
(G/C) x 100%
Total % of
Fenestra -
tion 2, 3'
/C x 100%+
North
North
North
South
�-
South
South
East164o
East
East
West
West
West
West
Total
Total
Total
1) Additions :5100 sf are allowed to install up to 50ft of fenestration and are exempt from the 5% west facing and 20% maximum total area
limits and shall meet the U -factor and SHGC requirements of Package D. See Table 8-2 in the Residential Manual. Note: Leave columns E, F,
G, H, and I blank.
2) Additions :_1,000 ft2, the maximum net allowed fenestration is 20% and may be increased additionally to by the amount of glazing removed in
the wall that separates the addition from the existing house. However, the total West facing fenestration can not exceed 5% of the proposed
addition's CFA including skylights orientated in any direction and tilted with a pitch of < 1:12. Column G can not exceed 5% and Column H can
not exceed 20%.
3) Additions >1,000 ft2, must meet Package D requirements. See Table 8-2 and Table 151-C in Appendix B of the RM or use Performance Approach.
4) The 51/owest orientation restrictions are only for Climate zones 2, 4, and 7-15; for Climate Zones 2, 4 and 7-15 enter zero (0) in column E.
FENESTRATION PRODUCTS: ALTERATIONS
use tms tame
ror anerattons to an existing ounaing wnere fenestrations
3roauclus kwmaows are oeing removed and/or added.
A
B
C D
E
F G
H I
Existing
CFA
ft
Existing
Orientation
Existing
Area Removed
ftZ Orientation
Removed
Area
ft2
Proposed
Proposed Installed
Installed New Area
Orientation ft2
Total Net Total % of
Fenestration Fenestra -tion'• 2
(ft2) (WA) x 100%
C-E+G Max of 20%
North
North
North
South
South
South
East
East
East
West
West
West
Total
Total
Total
When 50 ft or more of fenestration area is added to an existing building, then the fenestration must meet the requirements of Package D.
The area requirement for the total fenestration area for the whole building, including the added fenestration, must not exceed 20%.
Otherwise, the Performance Approach must be used. See Section 8.3.3 in the RM for further details.
Residential Compliance Forms December 2005
P.O. Box 1504
LA QUINTA, CAL[FORNIA 92247-1504
78-495 CALLE TAMPICo
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 7,77-7011
PROPERTY OWNER'S PACKAGE,
Disclosures & Formsfor Owner -Builders Applying for Construction Permits
IWOURTANTt NQITICE TO PRQPERTY OWNER
Dear Property Owner.
An. application for a building permit has been submittedin your. name hstiqg yourself as the builder of the ,property
impraventents specified at 7 S", 64 gyp! �1&3
We are .providing you with an Owner -Builder Acknowled ent and Information Verification Form to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will not issue a building permit until you,have read, initialed your understanding of each' provision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute thisMotice
unlessyou, the property owner; obtain the prior approval of the permitting authority.
OMTMWS ACKNOWLEDGMM AND VERMCATION OF WFORMATLflN
DIRECTIONS: Read and initial eachstatement below to signify you understand or'dert)r this information.
�OQL I understand'a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildei"
ilding permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as
an Owner -Builder, may be held liable and subject to serious, financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
'on my. property. +
2. I understand building permits are not required to be signed by property owners unless they are responsible for the
_nstruction and are not hiring a licensed Contractor to assume this responsibility.
�3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my,
own.
I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
J'e4mis and contracts.
,I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
6. I .understand if I am considered an "employer" under state and federal law, I must register with the state and. federal
ove-mment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unempoyment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
risk.
W7. I understand under California'Contractors' State License Law, an Owner -Builder who builds single-family residential
4ructures cannot .legally build them with the .intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
nancial or personal. jgj.aries sustained. by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
rvice, the United States Small Business Administration, the California Department of Benefit Payments, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CS -LB) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
arty . le�ally and finanFi V res�onsib4e for, _proposed construction Activit at the following address:
__A
11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
pplicable laws and requirements that govern Owner -Builders as well as employers.
12. t agree to notify the issuer of this, form immediately of any additions;. deletions, or changes. to any of the information I
have provided on this form. Licensed contractors are regulated by laws designed to protect the. public. If you contract with
someone who does not have a license,. the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in;civil court. It is also
important for you to. understand that if anunlicensed Contractor or employee of that individual or firm is injured while working
on your property, you may be held. liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors,
You will be responsible for verifying whether or not those Contractors are properly licensed. and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issuing, the. permit. Note: A copy of the property owner's dkiver'sl?eenset form n0IMMadon; or
other verification acceptable to the agency is r�rEired to be presented when the permit is issued to verify the property
owner's signature. 1 _
Signature of property owner
Date: ®/" —M
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understandis my personal responsibility, I hereby authorize
the following person(s) to act as. my agents) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is r fired to be pres. a when he permit is issued to verify the property owner's signature..
Property Owner's Signature: _ Date: 10/ V
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E y �T . I Z CQ P P'F. A RE -INSPECTION FEE OF $30CONSTRUC'T'ION HOURS
WILL BE CHARGED IF THE APPROVED
October 1st - Apra 30 - - -
.ow-
- PIANS AND 146 CARD ARE NOT ON AN ADEQUATELY SIZED DEBRIS CONTAINER Monday - Friday: 7:00 a.m. to 5:30 P.M.
THE SITE FOR A SCHEDULED IS REQUIRED ON THE JOB SITE DURING ALL Saturday: 5:00 R.M.-to 5:00 P.M.
INSPECTION. PHASES OF CONSTRUCTION AND MUST BE Sunday: None a
NO EXCEPTIONSI EMPTIED AS NECESSARY. FAILURE TO DO SO Government Code Holidays: None
' " Construction is NOT PERMITTFD
�y MAY CAUSE THE CITY TO HAVE THE CONTAINER May 1st -September 30th
iAjT I t�..� � Monday ;Friday: 6:OOm. to 5.00.0O�p.m.
(Z�`P L L on the following Code Holidays: DUMPED AT THE EXPENSE OF THE OWNER/
I Ll S T H E N I O.. L ► Saturday.
�,�, s Vh CONTRACTOR." Sunday. None p•
"+��'
NewYears Day Government Code Holidays: NOW
O- `alll MTA CK Dr. Martin Luther 1(ing 1r. Day
LA � President's Day.
Memorial Day
Independence Day
120 VOLS � .. 2 0 m � Labor Day o � ,�� `� Fx
Veteran's Day
PIS ek'W aROL)"D LEVE L. ThanksgiVing Day S O E
Christmas Day
61-ot03q QUIC SZ25
CITY OF to QUINTA• !
BUIIDING & SAFETY DEP" (760)Sv7B-w-9rTr'7Z
APPROVED
P NN I RE 0 N;
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