12-0688 (RER)P.O. BOX 1504 ,
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application Number: 12-000_00688-
Property Address: 51545 AVENIDk VALLEJO
APN: 773-131-014-2 -000000-
Application description: REMODEL —RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 900
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provision Chapter 9 (commencing with
Section 7000) of Division 3 of the Bu ' ess and Professionals od my License is in full force and effect.
License Class: B nse No.: 926128
ate: ontractor:
r1 NFR-RI III FR nrr:l A ATIr1N
I hereby affirm under penalty of perjury that I amempt from the Contra tor's State License Law for the
following reason (Sec. 7031.5, Business and Profe ions Cod Ab Any city r county that requires a permit to .
construct, alter, improve, demolish, or repair any structure, prl r to its iss nce, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the rovisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Divisionj3of.hAe Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemnyviolatonof Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty o re than five hundred dollars (5500).:
(_ 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 yearofcompletion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 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.).
(_ 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: .
LA QUINTA COVE PROPERTIES
4 RICHLAND PLACE
PASADENA, CA 91103. ,�tt� �
Contractor:
DANTOR MARTINEZ CONSTRUCT
81057 AVENIDA ROMERO
INDIO, CA 92201
(760)702-6209
tic. No.: 926128
VOICE (760) 777-7012
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153
Date:
TO
6/20/12
tl<
1
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
_ 1 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.
Y.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 STATE ' NTL INS Policy Number 19609972011
'
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner as to become subject'to the rkers' compensation laws of California,
and agree that, if I sh ul become subject the work 'compensation provisions of Section
3700 of the Labor C e, shall forthwith omply with hose provisions.
at �2 �J pplicant: IN
WARNING: F�O SECURE RKER ' OMPEN ATION C' VE GE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES A CIVIL F NES TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITIOI�TO THE COST OF COMPE SATI N, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORN EES. O7
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 thata ove information is correct. I agree to comply with all
city and county ordinances and state laws relating to b ildin construction, a hereby au orize representatives
of this county to enter upon the above-mentioned prop y f r inspection pur s
te:Si ature (Applicant or Agent):
J -
Application Number 12-00000688
Permit .. . . BUILDING PERMIT.
Additional desc..
Permit Fee 23:00 Plan Check Fee
14.95
Issue Date - Valuation
900
Expiration, Date 12/17/12 :
Qty, Unit Charge Per
Extension
BASE FEE
15.00
4.00` '2.0000 HNDBLDG .50,1-2, 000
8.00.
----------------•--------------------------------------- ----------------
`. Special. Notes and -Comments
--- ----
REMOVE EXISTING SLIDING GLASS DOOR AT
FRONT OF HOME. REPLACE WITH ONE NEW
SLIDER -WINDOW. REPLACE 2 TOILETS, 2
BATHROOM FAUCETS-& 1 KITCHEN FAUCET-,
2010 CODES.
-------------------_--------------------------------------
Other Fees . . . ." BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
1.50
STRONG MOTION (SMI) - RES
.50
Fee summary _ Charged Paid Credited
Due
Permit Fee Total 23.00 :00 .00
23.00
Plan Check Total 14.95 .00 .00
14.95"
Other Fee Total 3.00 .00 .00
3.00 "
Grand Total 40.95_ .00 .00
40,.95
LQPERMIT
13,n.#
:. Citjr of La Qulnta
Building 8r Safety Division
P.O. Box 1504,-79-49S Calle Tampico
La.Quinta, CA 92255 -:(760) 777-7012
Building Permit Application' and Tracking Sheet
Permit #
Project Address: S
Owner's Name:. Lq Qt L h F ro G,1'4'1
A. P. Number.
Address:
Legal Description:
Contractor. C
City, ST, Zip: Lam.
Telephone: t,,,Q.
ProjectDescription.
Address: 8 40 S 7 yj
City. sT, Zip:
V e . e ,
Telephon Z (:�O7 0.2
� deo a o
State Lia # :q -z-6.1Z$ City Lie. #;
Arch, FAW., Designer:
m 4 W LI-CJCQ tIJ -0
Address:
2
City., ST. Zip:
2 5 1'1JG. �nCl
Telephone:
Construction Type: , Occupancy:
Project type (circle one): New Add'n Alter " Repair Demo
Sq. Ft.: # Stories: # Unity:
State Lie. #:
Name of Contest Person:
Person•
Telephone # of Contact 7 Q '7 G 2- 2 O q
Estimated Value of Project: Q�
APPLICANT: DO NOT WRITE BELOW THIS UNE'
#
"Mittal
Req'd
'Rec'd
TRACKING PERMITFEES
Plan Sets '
t✓
Plan Check submitted
ZO ( Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance.
Title 24 Cates.
2,
Pians pierced up . J
Construction.'
Flood plain plan
Pians resubmitted. • .
Mechanical
Gracing plan
2'! Review, ready for correctioustiissue
Electrical
Sabeonmctor List
Called Contact Person
Plumbing
1.Graut Deed
Plans picked up
ML
H.O.A. Approval
Plans resubmitted
Grading.
IN SOUSE:-
'^'•Review; ready for correctionvissac
Devdoper Impact Fee
Planning 4p, row-
Called Contact Person
A.LP.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees
Prescriptive Certificate of Com
Residential Alterations
Project Name:
: Residential
CF -IR -ALT
a elof
Climate Zone R I B of Stories
General Information
Site Address: Enforcement Agency: Date:
Building Type ❑ Single Family ❑ Multi Family Circle the Front Orientation: N, E. S, W, or degrees
Conditioned Floor Area (CFA): Project Type: ❑ Alterations O Envelope O Fenestration O Roof O HVAC
Rept ment or Change Out O Duct Replacement ❑ Water Heater
This form Is not to be used or Newly Constructed Bulktings or Addltlons
Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
❑ Opening of framed cavity alone - Alterations that involve the opening of the framed cavity of a wall, ceiling, or floor must install the
mandatory minimum insulation value per §I S0 far the altered assembly. Fill in Columns A -C and enter mandatory insulation value in Column H.
O Replacement of entire assembly - Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component
Package- D insulation values in Table ISI -C. Fill in Columns A. -
Opaque
. -
O a ue Surface Details For the furred portioned of Mus Walls see Furring Stri Construction Tablebelow.
A B C D E F G I H 1 1. 1 •J
Proposed INM Raft Standard Values From JA4 Table
Ta�/ Assembly Name
ID or Type'
Framing Thickness, Framed Continuous JA4 Proposed
Material Spacing, U- JA4 Table Cavity Insulation Assembly. Assembt1
and Size' or Othe? factor' Numbers R -value' R -Valuer Cell Values U-fadxor
A I B -c-T-5-7
E
F
I G I
H I
I I J I K
L M
Proposed Properties of Masonry and Concrete
Note: Forf &-nd assemblies, amowttft for Contimrous Insulation R -value, see Page JA4-3 and Equation 4-1. For calculating fiorrd walls uu the Mau and
Fsmng Comwucttontable below. -.-.------......_..-._.
1. For Tag/ID indicate the identification name that matches the building plans.
2. Indicate the Assembly Name or type: RooflCeiling, Walls, 'tale the Frame type and Sire: For
Woody Metal, Metal Buildings, Mass, enter 2x4, 24 or etc... see JA4 for other possible frame 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 15 1-8, C or D for each different assembly Name or type.
S. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0 ".
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
9.7he 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 Onl
A I B -c-T-5-7
E
F
I G I
H I
I I J I K
L M
Proposed Properties of Masonry and Concrete
Added Interior or Exterior Insulation
Walls From Reference
in Furring Space from Reference
Joint Appendix Table 4.3.5 4.3.6 4.3.7
Joint A
endix
Table 4.3.13
w�
V
Mass
>+
Assembly
Name or JA4 Table
O
o c c
r
G
r
"
as
u„ v.
j+,
Fid
Assembly
r �'
Comment
Thickness'
T Number' Q>
2'L6
U.
ad Q>
U -factor
Registration Number:
2008 Residential Compliance Forms
Registration Date?ime:
HERS Provider:
August 2009
Prescriptive Certificate of Compliance: Residential CF -1R -ALT
Residential Alterations age 2 of
Project Name: Climate Zone # # of Stories .
Mass and Furring Strips Construction(footnotes)
1. Indicate the type of assembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can
e found Reference Joint Appendix JA4.
2. This is the U -Factor based on the thickness of the assembly in inches.
3. The R -value of the insulation to be added on the interior or exterior of the assembly.
4. The Calculated R- Value is the, R-value'of the furred out section of the assembly.
-6. The Final Assembly is calculated using Equation 4-2 or Equation 44of the Reference Joint Appendix JA4. Tire equation is the inverse of Column
added to Column I Column K is the inverse from column J. s
7. Insert the calculated U- actor value on to the ue Surface Details in Column J
FENESTRATION PROPOSED AREAS
® Replacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package'D in
Table 151-C. Me Total Fenestration and West facing Area requirements are not applicable.
Adding 50ft2 or less of window area —Newly installed windows shall meet the U-Factorand SHGC Value requirements of Component
Package D in Table 151-C.
® Adding more than 50ft2 of window area — Newly installed windows shall meet the U -Factor and SHGC Value and the Fenestration
Area requirements of Component Package D in Table 151-C Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF -I R ALT
Orientation
Fenestration Type. and Frame (North, East,
indow, Glass Door or Skylight) South, West)
PropsedAreal Maximum' Maximum NFRC or Default
ft U-factorz• 3 SHGC2' 3'" values
. e c Xw U,.,1 _lo w
E
F
G
CFA of
Allowed
Existing
1. Fenestration area is the area of total glazed product (i.e. glass plus frame). Exception: When a door is less than 50% glass, the fenestration
area may be the glass area plus a "2 inch frame" around the glass.
2. Enter value from Component Package D Requirements in Table 151-C.
3. Actual fenestration products installed and as indicated in.CF-6R-ENV Form shall be equivalent to or have a lower U factor and/or a lower
SHGC value than that specified on the CF- I R ALT Form.
4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading.
S.I a licable at this stage enter "NFRC" or NFRC Certified windows or are CEC "Default " valuesfound in Table 116-A or B.
ALTERED FENESTRATION
ALLOWED AREAS
(Complete if more than 50f12
of fenestration is added)
A
B
C
D
E
F
G
CFA of
Allowed
Existing
Allowed
Entire
%of
Fenestration
Area
Fenestration
Area
Proposed Area' .4
Dwellin.g
CFA2. 3
Areal
Removeds
Area AddedA
x B
D + C -
Total Fenestration
' Areae ft
West Fenestration Area
(Required In
CZ's 2,4&7.-15
1. The Proposed West Fenestration Area includes West -sloping skylight area and any other skylight area with a pitch'less than 1:12.
2. Enter 20% when no West orientation restriction or 15% when. West fenestration is being installed in Climate Zones 2, 4, & 7-15. Note that the
maximum allowed fenestration can only be 5% of the CFA as indicated in Column F. Column G must be equal to or less than Column F.
3. In climate zones 2, 4, 7-I S, no more. than 5% of the CFA is allowed for west facing glazing.
4. Existing Fenestration area must be counted toward the maximum allowed 15% or 20% of the whole building and calculated in Column G. The
Proposed Area must be less than or equal to Column F.
5. Enter the fenestration removed as part of the alteration if any in column A
6. Enter the Fenestration area that is being added as part of the alteration.
s4%I�tI• U' [
2008 Residential Compliance, - ,2010
1
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations age 5 of
Project Name: Climate Zone # # of Stories
l A �.
HERS VERIFICATION SUMMARY The enforcement agency shouldpay special attention to the HERS Measures specified in this
checklist below. A completed and signed CF -4R 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 ® 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.§I52(b)1Dii and the newly installed ducts are to be insulated per §151(f)10.
® EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
®YES ONO 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)IDi.
®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 fitrnace heat exchanger) the ducts are to be
sealed per §152(b)IE.
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 requiredfor this measure.
® 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 fumaoe heat
exchanger) a refrigerant charge measurement shall be verified per §152(b)IF.
Central Fan Integrated (CF1) Ventilation System and Fan Watt Draw
The ventilation requirements of § 150 o do not apply to exiLtjM residential homes.
Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure.
®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 1 Ci to meet the requirements of § 151 7B.
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Nam
Signa
Compan
Date:
-2-
Vkc.�o�
Address:
Address:
S 10 1 V kO w,e_�- G
If Applicable CEA or L3CEPE
(Certification #):
City/State/Zip:
! �✓�t xa t7 �o� 2- 20
Phone:
Responsible Building Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified.on
this Certificate of Compliance.
• . I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24, Parts 1 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 forts, worksheets, calculations, plans and specifications submitted 'to the enforcement
agency for approval with this building permit application.
Name:
Signature:
Company:
Date:
Address:
License: .
City/State/Zip:
Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
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