0004-101 (AR)LICENSED CONTRACTOR 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 # Lic. Class Exp. Date
704742 04/30/2(
4 rA c%) Signature of Contractor .'-0�'� •� U�
f
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner' of the property, am exclusively contracting with licensed
contractors to cot struct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
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 & policy no. are:
Carrier ',.gMpTION ON re L� Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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
/ Cd6, I shall forthwith comply with those provisions_
ate: • 4c �10 Applicant
Warning: Failure to secure Worketrsl Compensation coverage is _unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and. Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
const(uction, and hereby authorize representatives of this City to enter upon
the/above-mentioned property for inspection purposes.
Signature (Owner/Agent) (�vkN Date
-440
j6U BUILDING PERMIT PERMIT#�9` O
DATE VALUATION LOT' / TRACT
VA74=
JOB SITE APN
ADDRESS !&2,43 S0UrF=N.EtU.L3 -775-181-013
OWNER CONTRACTOR/DESIGNER/EN (NEER
EU & MARY 3 IASR vt AL1T;R 4014 'Ft'UCn0X
55.143 5- OVII ER ki U -0 :x/45 VIAEBWi
LAQUINTk CX- X12253 P.ALMSP WGB CA 322612
(760)327.61340 CBL# 4261
USE OF PERMIT -
;RXTEN TION OF BEDROOM, REiltt'C7VE SIJD1N0 MORS & POUR 3L.A5 &
FRAME & FINISH AS PER DRAWIN09,
CUSTOM CONSTRUCTION , . 60.00 5P
rS'nMATM COsr OIF CONSMtranON
PERMIT FEE SUMWARY
PLAN CHECK FEE 101-.000.434-318 $46,90
CONSTRUCTION FEE 101-000-E418-000 M.08
MECTRICAL FES 101.OW420-000 $0,00
STR.ONO MOT1011- FEE - R.F,SID 101-000-241-000 $.50
RM -TOTAL CC%NftRUC110M AND PLAW C`.i1ECK
L OS PI E 4PAM EM
DATE
DATE FINALED I INSPECTOR
4,674.00
$134.30
$0.00
$1134.10
�I
R
RM -TOTAL CC%NftRUC110M AND PLAW C`.i1ECK
L OS PI E 4PAM EM
DATE
DATE FINALED I INSPECTOR
4,674.00
$134.30
$0.00
$1134.10
w
INSPECTION RECORD
w__
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings O
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test '
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
bin #;
r
City of La Quinta -
`f
.Building 8[ Safety Division
P.O.. Box 1504
.
Permlt a4e
78-495 Calle Tampico W:001�La
CA.92253
Quinta, t
Building Permit Application and Tracking Sheet 8?6mal
Project Address:
Owner's Name: �'0AQJL4 _
A. P. Number:
Address: Sw /U
Legal Description:
City.ST. Zip:
Contractor: A L� LA—)
L
Telephone:
Address:
Project Description: ,^ • s60N
Cit%.ST. Zip: rp,,,Y 1 l2wo4
9' 22Z z:
> &rnov-r- I v_k
Telephone: 7o_ 3Z b
ovlL YriC
State Lic. i o4 q 4Z
City Lic. ti: 354-
E�
Arch.. En_r.. Desimer ANAs
�:.
,.
`
Address:
�/
f 7,
Cit. ST. Zip:
Telephone:
Construction Type: Occupancy: x
Stale Lic. _.:
* .: :'<:::,`:'::%> <>
Project type (circle one): New Add'n Alter pair Demo
Name of Contact P rs r�
Sq. Ft :6Q 0#Stories:
'
# nits:
Telephone = of Contact Person:
''
_Estimated Value ofProject* eCo,
..: :....:...<:11PPUCS>1N�.
,00 WOT:.E .. .: IS .
.....................
a
Subm�tml;....TSAE$�IING�s:;;:':>
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Plan Sets
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Title 24 Calcs.
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Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 4/19/00 APN # 775-181-013
No. 20317 Jurisdiction
Owner NameEd & Mary Walker Permit #
No, 55-143 street Southern Hills Log #
City La Quinta Zip 92253 Study Area
Tract # Lot # Square Footage 60
�r
Type of Development Single Family Residence No. of Units
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory structures or replacemenrmobilehomes. It
has been determined 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 t
EXEMPT
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
0.00, X 60 or $ 0.00 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 Gary Walker Telephone
i
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by J^ James KOZero
Exempt
Ch k N
9
Signature
NOTICE: Pursuant of Assembly.13I113081 (CHAP' STATS. 1898) this will serve to notify you that the 90 -day approval period In which you may protest the fees or other payment identified
above will begin to run from the date on which thwilding or Installation permit for this project Is sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the DlaMct('s)(s') behalf,,whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
n
PGA WEST
RESIDENTIAL ASSOCIATION, INC.
April 05, 2000
Edward & Mary Walker
•55-143 Southern Hills
La Quinta, CA 92253
Dear Mr. and Mrs. Walker:
.Your request, for an architectural variance has been approved by Mr:- Don Adolph, the Architectural .
Committee Chairman. Specifically, you have the approval to proceed with the room addition to your,
55-143 Southern Hills residence. Upon completion please submit the enclosed Notice of Completion
form to this office. .
We reserve the right to make a final inspection of this change to make sure that it matches the
original request. An approval is based only on the aesthetics of your proposed change and -should
not be taken as any certification as .to the constructio'-worthiness or structural integrity of the
proposed change. .
We appreciate your cooperation in submitting this request for approval. Should you have any further
questions regarding this matter, please feel free to contacHffi
t me at the OA oce, (760) 771-1234
extension 15.
Sincer ly,
McGal liard
Operations Manager.
cc: Architectural Committee
enclosure (1)
P.O. Box 1060, La Quinta, California 92253, Telephone 760-771-1234 FAX 760-771-5125.
i
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 2)
JAY(-�'(� � (l o►� ..
�y'T1lE2N ,�t-L.
uthor Telephone
L:T-6 t._ 32x? -6r
Building Permit k
Plan Check / Date
Field Check / Date
CF -1R
Compliance Method (Package or Computer) Climate Zone Enforcement Agency Use Only
GENERAL INFORMATION
Total Conditioned Floor Area bo ft, Average Ceiling Height: ft
Conditioned Slab Floor Area (cV ft'
Building Type: Single Family �� Addition
(check one or more) Multi -Family Existing -Plus -Addition
Front Orientation: o / South / East / West / All Orientations
input front orientation in degrees from True North and circle one)
Number of Stories
Number of Dwelling Units:
Floor Construction Type: &IRaised Floor (circle one or both)
BUILDING SHELL INSULATION
Component
Type
Frame Type Cavity
wd = wood Insulation
stl = steel R -Value
Sheathing Total R-
Insulation Value'
R -Value
Assembly
U -Value'
Location/Comments
(attic, garage, typical, etc.)
Wall
W-000 9
Standard
Front
5
Wall
Standard
Left
Roof
Left
Standard
Roof
Standard
Standard
Right
Floor
Standard
Right
Floor
Standard
Skylight
Slab Edge
Skylight
Standard
FENESTRATION
Shading Devices
Fenestration Orien-
#/Type/Pos. tation
Area
(ft')
Fenestration Fenestration
U -Value SHGC
Interior Exterior Overhangs
Shading Shading Att. /Fins
Att.'
Front
55
'777
Standard
Front
5
s
Standard
Left
Standard
Left
Standard
Rear
Rear
Standard
Standard
Right
Standard
Right
Standard
Skylight
Standard
Skylight
Standard
' For prescriptive compliance, Total R -Value and Assembly U -Value are not required for a wood -framed wall that meets
cavity R -value insulation requirement for the Prescriptive Package.
' For prescriptive compliance, there are no credits for any interior shading except the default or " Standard" drapery. These
default interior shading devices (draperies) need not be installed for compliance purposes.
July 1, 1999
C
Y
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 2) CF -1R
Project Title
HVAC SYST1;111S
Note: Input h\drwtic of eo:n! iucJ Iwrhnuicd.rc! iinilr 1',;;t: t ll:a(ir, Sc'slrct>. eNcL-pt I?isi^_n lie;rtim_ Load
Date
SPECIAL FEATURES and MODELING ASSUMPTIONS (Add extra sheets if necessary)
Including Thermal Mass (thermal mass type, covering, thickness. and description)
COMPLIANCE STATEMENT
This certificate of compliance lists the building fcututcsand performa;:cc specifications needed to comply with Title 24. Parts.l and 6 of
the California Code of Regulations, and the administratic e regulations to inip!encnt them. This certificate has been signed by the
Indic idual ccitlt ocetall design responsibility. \\.hen this certilicatc of compliance is submitted for a single building plan lobe built in
multiple oricntatit, ns. any shad in f-0,11 tit e that is c at i.(! i indicated in the Special Features / Rc•ntarks section.
Designer or Owl �r (per Business and Professions Code)
Name: O_ i-�gp _�sz,L-�—R _
Title'Firm: co( --3 "C--YZ,
Address:
Telephone.
Lica f:
(si n
e) (` ` Idai-I
Enforcement Agency
Name:
Title:
Agency:
Telephone:
(signature / stamp) (date)
Docuntcniatinn Author
.1111y t, 1999
�.
l.)IStrlbUIIOn
Heating Fquipment
MininIUM
Type and
Duct or
Heat Pump.
Type (furnace. heat
Efficiency
Location
Piping
Thennostat
Configuration
pump. etc.)
(F,rue.n I ISIT)
(chefs, attic. ctc.)
R -Value
Type
(split or package)
s
Cooling Equipment
Minimum
Duct
' Heat Pump
Type (air conditioner.
E1•ficiencv
Location
Duct
Thermostat
Configuration .
heat pump, evap. cooling)
(SEliit)
(attic. ctc.)
R -Value
Type
(split or. package)
WATER HEATING SYSTEMS
Energy'
External
Rated'
Tank
Factor or
Tank
Water Heater
Distribution
Number Input (1AV
Capacity
Recovery
Standby' Insulation
Type
Typc
in S\•stem of Biti'hr)
(gallons")
Efficiency
Loss (%) R -Value
IICatCCs (rated inputs
of less Ihan of equal to 75.000 131u/hr). electric resistance,
and heat pump water heaters, list Energy
L For small gas storage \cater
Factor. For laree gas stonice
wlict,h_•2tcrs (rated
input of ercaicr than 75.01)1) Mu/hr). list Rated Input. Recovery Efficiency and Standby Loss.
For instantaneous gas coater
hcatcrs. list tared input
and recovers efficiencies.
SPECIAL FEATURES and MODELING ASSUMPTIONS (Add extra sheets if necessary)
Including Thermal Mass (thermal mass type, covering, thickness. and description)
COMPLIANCE STATEMENT
This certificate of compliance lists the building fcututcsand performa;:cc specifications needed to comply with Title 24. Parts.l and 6 of
the California Code of Regulations, and the administratic e regulations to inip!encnt them. This certificate has been signed by the
Indic idual ccitlt ocetall design responsibility. \\.hen this certilicatc of compliance is submitted for a single building plan lobe built in
multiple oricntatit, ns. any shad in f-0,11 tit e that is c at i.(! i indicated in the Special Features / Rc•ntarks section.
Designer or Owl �r (per Business and Professions Code)
Name: O_ i-�gp _�sz,L-�—R _
Title'Firm: co( --3 "C--YZ,
Address:
Telephone.
Lica f:
(si n
e) (` ` Idai-I
Enforcement Agency
Name:
Title:
Agency:
Telephone:
(signature / stamp) (date)
Docuntcniatinn Author
.1111y t, 1999
TABLE NO. 1413
.
ALTERNATIVE COMPONENT PACKAGES
'
FOR CLIMATE ZONE 15
PACKAGE]
COMPONENT?`
A
B
C
D
BUILDING ENVELOPE
Insulation Minimums2
Ceiling
R30
R38
R49
R38
Wood Frame Walls
R19 •
R19
R29
R21
"Heavy Mass" Walls
(R5.5)
(R4.5)
NA
(R4.76)
'Light Mass" Walls
[R7.0]
[R6.0].
NA
NA,
Below Grade Walls
NA
NA:
NA
RO
Slab Floor Perimeter
R7
R7.:
R7
NR
Raised Floors
R19
R19
R21
R19
" Concrete Raised Floors
NA
NA
NA
R4
GLAZING
Maximum U-value3
0.65
0.65
0.40
0.65
Maximum Total Area
NR
16% .
16% . '
16%
Maximum Total Nonsouth Facing Area
9.6%
NR
NR
NR
Minimum South Facing Area
6.4%
NR
NR,
NR
SOLAR HEAT GAIN COEFFICIENT4
South Facing Glazing
035
0,15 .
0.40
0.40
West Facing Glazing
0.15
0.15
0.40
0.40 '
East Facing Glazing
NR
NR
0.40
0.40
North Facing Glazing
NR
NR
' NR
NR '
THERMAL MASS5
REQ: d
NR
REQ
NR
INFILTRATION CONTROL
Continuous Barrier
NR
REQ
NR
NR
Air -to -Air Heat Exchanger
NR
REQ
NR
NR
SPACE HEATING SYSTEM6
Electric Rsistant Allowed
NO
NO
YES7
-NO
'IJGas, AFUE =
78%
78%
78%
MIN
If Heat Pump,
Split System HSPF8 =
6.8
6.8
6.8
MIN
Single Package System HSPF =
6.6
6.6
'6.6
MIN
SPACE COOLING SYSTEM
If Split System A/C, SEER =
10.0
10.0
10:0
MIN
I(Single Package A/C, SEERS =
9.7
9.7
9.7 ,
MIN
DOMESTIC HATER HEATING TYPE
System must meet budget, see
ANY,
ANY
ANY9
ANY
151(b)I and 15109(9)
LEGEND: NR = Not Required; NA = Not
Applicable; REQ = Required; MIN = Minimum
SEE NOTES FOLLOWING TABLE NO. 1-Z16
3-42
July 1, 1999
Residential Manual
Additions of less than 1,000 square feet meet the Dual -Glazed Skylights and Dual -Glazed
requirements of package D -for the applicable Greenhouse Windows
climate zone with the following exceptions: walls,
meet only the mandatory insulation level of R-13 Dual -glazed skylights or dual -glazed greenhouse t
in a wood frame; glass area -is limited to the windows are treated as though they�.have the U
percentage allowed by:Atie'package plus any value required for prescriptive compliance.' ' -
glass removed because of the addition.
Dual -glazed skylights and dual -glazed
Additions of 1,000 square feet or more meet all of greenhouse windows should be included in
the requirements of package D. compliance calculations as a fenestration product
with a U -value equivalent to the Package D f
requirement for the appropriate climate zone (or
0.75 for additions of less than 500 square feet).
TaOt 7-1: Prescriptive Compliance of Additions -
Summa�' of Section 152(a)1 Requirements of the Standards
> 500 but
COMPONENT < 100 ftz(') < 500 ftp <1000 fe >1;000 fe
Insulation
Ceiling R-19 Package z Package Package
Wa113 R-13 R-13 R-13 Package
Floor Mir:idatory5 Package Package Package
Fenestration
Max.. U -Value" 0.75 0.75 Package Package
of CFA < 50 ft2 Pkg. + Removed5 Pkg. + Removed' Package
Shading N/A Package Package Package.'
Space. Heating' Mandatory6. Package- Package -Package
& Cooling (No electric) (No electric) (No electric) (No electric)
Water Heating5 `
V Replacement , N/A .'.N/A N/A N/A
Increase See Table 7-2 See Table 7-2 See. Table 7-2 See Table 7-2
•
1. This approach does 'not allow credit for glass removed. Compliance with the requirements • for
additions of less than 500 square feet is allowed, in which case credit for glazing removed is allowed.
2. Meet the component prescriptive requirement for Package D (see Chapter 3) and all mandatory
requirements: v
3.. "Heavy Mass" and "Light Mass" walls may r:.eet the Package D requirements for mass wall insulation
instead of R-13 (see Chapter 3).
4. For .addition and alteration compliance only, dual -glazed greenhouse windows and dual -glazed
skylights are assumed to meet this requirement. '
5. The PackageD fenestration area plus the area of any glazing removed because of the addition.
6. All applicable mandatory measures must be met (see Chapter 2).,
7. No electric resistance space heating may be installed.
I
9
Additions and Alterations July 1, 1999 7-7
4
, "AN ADEQUATELY SIB DEBRIS CONTAINER
x_
IS REQUIRED ON THE JOB SITE OARING ALL.
PHASES OF CONSTRUMN AND MUST BE
EMPTIED AS NECESSARY FAILURE TO DO SO
MAY CAUSE THE CITY TO HAVE THE CONTAINER
mimpm AT T14 ` FYPFNV DF THE OWNER/