11-1319 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: -11-00001319
Property Address: , 52825_ AVENIDA VALLEJO
APN: 773-323-017-4. -000000=.
Application description: PLUMBING
Property Zoning:. COVE RESIDENTIAL
Application valuation: 150
Appl
eaicant:
Architect or Engineer:
44 .
• VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 12/13/11
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 B iness and Professionals Code, and my License is in full force and effect.
License Class: C36 License No.: 731855
'Date •l!37 lI 'rCont ct &
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 permitsubjects 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.).
(_ 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 contractors) licensed_
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , BAP.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:
CHUCK WILLIAMS
52825 AVENIDA VALLEJO
LA QUINTA, CA 92253
Contractor: '
STATE WIDE PLUMBING.
40244 CATANIA COURT
INDIO, CA 92203--0
(760)636-0315
Lic. No.: 731855
WORKER'S COMPENSATION DECLARATION
I 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.
_ 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 SOUTHER INS CO Policy Number WSIO047530-01
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner s as to become subject to the workers' compensation laws of California,
and agree that, if I sh Id become subject to the workers' compensation provisions of Section
3700 of the Labor C II shall f/dnhhwwiitth comp)x/wi�th�those provisions.
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 ($100,0001. 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 b Iding construction, and hereby authorize representatives
of thiount to a ter upon the above-mentioned pro y)or inspection pur s
/ D
;Da - "�/,r� Signature.(Applicant or ent)' `
• C
t
Application Number .11-00001319,
Permit PLUMBING
Additional desc_.
Permit Fee 22.50 -Plan Check "Fee
5`.63
Issue Date . . . . Valuation
0
Expiration Date 6/10/12 -
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT.
7.50 .
Special Notes and Comments
INSTALL NEW 50 GALLON ELECTRIC WATER
HEATER. 2010 CODES.
-----------------_-_--------------------------------------------------------
_ Other Fees . ... . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid _ Credited
Due
Permit Fee Total 22.50 .00 .00.
22.50
Plan Check-. Total 5.63 .00 ..00
5•.63'
Other Fee Total .1..00. .00 :00'
1.00.
=' Grand .Total :- 29.13 00., 00:
29.13 41
• LQPERMIT
t
Prescriptive
Residendd A
ProjectrNxme:.
Certificate of
,a,
Residential
CF -IR -ALT
-- --- Pa e1_015 -
1
f5_ _
Climate Zone # # of Stories
General Information
Site Address:5' '1 4
nforcement Agency: Date: a,
Building Type Single Family 0 Multi Family
Circle the Front Orientation: N, E, S. W, or degrees
Conditioned Floor Area (CFA):
Project Type: 0 Alterations 0 Envelope 0 Fenestration 0 Roof 0 HVAC
J
Re lacementor Change Out Duct Re lacement Water Heater
NOTE: This form is not to be used for Newly Construcxed
Buildings or Additions
Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
0 Opening of framed cavity alone- Alterations that involve the opening of the framed cavity ofa wall, ceiling, orfloor must install the
mandatory minimum insulation value per §150for 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 151-C. Fill in Columns A -J.
Opaque Surface Details For the furred
Qrtioned of Mass Walls see Furring Strips Construction Table below.
A B C
D
E
F G H I
J
Proposedtwoce
H 1 JRtion
Standard
Values From JA4 Table
Proposed Properties of Masonry and Concrete
Framing
Thickness,
Framed Continuous JA 4
Proposed
Ta�
Assembly Name Material
Spacing,
U-
JA4 Table Cavity Insulation Assembly
I
Assembly
iD
or Type' and Size'
or Other
factor'
Numbers R-valueb R -Value Cell Values
U-factor9
Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For calculating furred walls use the Matt and
Furring Construction table below.
1. For TagID indicate the identification name that matches the building plans.
2. Indicate the Assembly Name or type: Roof7Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc ... Indicate the Frame type and Size: For
Wood, Afetal. Metal Buildings, Mass, enter 2x4. 2x6. 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 / -B. C or D for each different assembly Name or type.
5. 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. The 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 Oral
A I B I C I D I
E
F
G I
H 1 JRtion
M
Proposed Properties of Masonry and Concrete
Added Interior or Exterior Insula
Walls From Reference
in Furring Space from Referen
Joint Appendix Table 4.3.5, 4.3.6, 4.3.7
Joint Appendix
Table 4.3.13
Mass
Assembly 2-.
Name 1A4 Table
D
o ?
a,
E
v oDlN ?
F
Thickness'
or Q —'�
T Number` Q >
°
;, t
c x e
c
' <
omment
Registration Number:
2008 Residential Compliance Forms
Registration Date.Time:
HERS Provider:
August 200!
M
Prescriptive Certificate of Compliance- Residential CF -IR -ALT
Residential Alterations (Page 4 of 5)
SYSTEMS - HEATING
_HVAC
Heating Equipment
T • and Capacity'--'
Minimum
Efficiency
(AFUE or HSPF)
Duct or Piping Configuration
Distribution Insulation Thermostat (Central_ Split -
T and Location ° R -Value T S ace. Pack a or H •dronic)
Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation
T ' (Standard. Recirculatin )Z System Capacity (al) Thermal Efficient • R -Value'
1. Indicate Heating Type (Central Furnace. Wall Furnace, Heat pump. Boiler. Electric Resistance. etc.)
2. Electric resistance heating is allowed only in Component Package C. or except where electric heating is supplemental (i.e.. if total capacity
2 KIV or 7.000 Btulhr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(b)3 exception.
3. Refer to the HERS ! "eriftcation section on Page 4 of the CF -1 R -ALT Form for additional requirements and check applicable bates.
4. Indicate Type or Location (Ducts. Hydronic in Floor. Radiators, etc.)
HVAC SYSTEMS - COOLING
Minimum
Efficiency° Duct or Piping Configuration
Cooling Equipment (SEER/EER or Distribution Insulation Thermostat (Central. Split-
Tvpe and Capacity- COP) Type and Location' R -Value Type S ace. Package or H •dronic
1. Indicate Cooling Type (A 1C. Heat pump. Evap. Cooling, etc)
2. Refer to the HERS I'erification section on Page 4 of the CF -1 R -ALT Form for additional requirements and check applicable boxes.
3. Indicate Type or Location (Ducts. H dronic in Floor. Radiators, etc.
WATER HEATING
List water heaters and boilers for both domestic hot water (DHH•) heaters and hydronic space heating. Individual dwelling DHH` heaters must be
gas or propane fired. and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground
hot water pipes is required in all omponerapackages in all climate _ones.
External Tank
Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation
T ' (Standard. Recirculatin )Z System Capacity (al) Thermal Efficient • R -Value'
a
1. Indicate Type (Storage Gas. Heat Pump. Instantaneous. etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements 'of §150(n). The Prescriptive requirements do
not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank and i es shall be insulated to meet the requirements of §150(j). -
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
These items ma • require written justi ication and documentation and special verification.
NEW ROOF ASSEMBLY - Radiant Barrier
The radiant barrier requirement of § 151(f)2 does not apply to roof alterations_
Slab Edge (Perimeter) Insulation O YES O NO
YES: in Climate Zone 16 in Component Packages D. R-7 insulation is required.
Heated Slab Insulation O YES O NO
YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation 13 YES O NO
YES: In Climate Zones I. 2. 11. 13. 14 & 16. R-8 insulation is required: in Climate Zones 12 & 15. R4 is required under component Pack -age E
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass. use the Performance Approach.
Registration Number:
2008 Residential Compliance Forms
Registration Date'Time.
HERS Provider:
August 2
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations Page 5 of 5
_ProjecYName:: - -' --- -- - - ---- - - — - - c-limate Zone-#---- _ " #_o tor-ies.=-r
I �� 11 c -- - - `� -
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Aleasures 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
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 §152(b)IDii 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 ❑ NO 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)1 Di.
❑ 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 furnace heat exchanger) the ducts are to be
seated per § 152(b) I E.
❑ 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: Existine duct systems constructed, insulated or sealed with asbestos.
Refrigerant Charge -Split System HERS verification is required for 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 furnace heat
exchanger) a refrigerant charge measurement shall be verified per § 152(b)I F.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation recuirements of 6150(o) do not anoly to existine residential homes.
Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is required or this measure.
❑ YES ❑ 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(b)ICi to meet the requirements of §151(f)7B.
Documentation Author's Declaration -Statement
• t certify that this Certificate of Compliance documentation is accurst a d complete.
.•Name:..1� A`
Si a
i I�
_Com DatYJ)T
•AddresV_- If pplicable ❑ CEA or ❑ CEPE
LII- (Certification #):
City/State/Z� Ph e:
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.
1 certih- that the energy features and performance specifications for the building design identified on this Certificate of Compliance confon
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 forms. 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.
Registration Number: Registration Date Time:
2008 Residential Compliance Forms
HERS Provider:
August
Bin #
Qty Of La QuInta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
11' 3
Project Address` j;
Owner's Name: - a _ t t�
A. P. Number.
Address:5 t
Legal Description:
City, ST, Zip:.
Contractor:.
telephone—,. Z- —G Y: • •: >` •,.o
Address: _U /�.'
Project Description--,
City, ST, Zip:
t
Tel ,.. .:.::.
6 �<
State Lic. # : 3 City Lic: #'
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
p
� , 3� ., ... •^
t" v
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:
Estimated Value of Project: )
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRAC UNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Stractaral Calm
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2`" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3' 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