BRES2016-0315LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under perialty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License
/Class: B(� License No.: 928697
Date: Il JI�( l 1 I lv Contracto'r:
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 whd 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.).
( ) 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.).
(� 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.).
t
Lender's
Lender's
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
o work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 00 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: NORGUARD INSURANCE COMPANY Policy Number: ALWC700335
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. 'A h
Date: kC) I 1 Applicant
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 Building Official 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 city to enter upon the
above-menioned property for inspection purposes.
t
Date: �� Signature (Applicant or Agent):
C& 0
VOICE (760) 777-7125
78-495 CALLE TAMPICO
0 U
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/31/2016
Application Number: BRES2016-0315
Owner:
Property Address: 54550 AVENIDA VALLEJO
JOSE MACIEL
APN: 774282003
S4S50 AVENIDA VALLEJO
Application Description: MACIEL / CHANGE OUT (1)FRONT
DOOR AND (1)SLIDER
LA QUINTA, CA 92253
Property Zoning:
nApplication
Valuation: $3,353.00CJ
0ALLIANCE
Applicant:
Contractor:
Ut
CONSTRUCTION ENTERPRISES INC
ALLIANCE CONSTRUCTION ENTE
I If46267
MONTE VISTA DRIVE
46267 MONTE VISTA DRIVE
a
INDIO, CA 92201
INDIO, CA 92201
(760)222-8895
Llc. No.: 928697
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under perialty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License
/Class: B(� License No.: 928697
Date: Il JI�( l 1 I lv Contracto'r:
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 whd 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.).
( ) 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.).
(� 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.).
t
Lender's
Lender's
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
o work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 00 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: NORGUARD INSURANCE COMPANY Policy Number: ALWC700335
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. 'A h
Date: kC) I 1 Applicant
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 Building Official 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 city to enter upon the
above-menioned property for inspection purposes.
t
Date: �� Signature (Applicant or Agent):
Dafe` 10/31/2016
Application Number: BRES2016-0315, =
Owner:.
Property Address: 54550 AVENIDA VALLEJO `
JOSE MACIEL
APN: 774282003
54550 AVENIDA VALLEJO,
Application Description: MACIEL / CHANGE OUT.(1)FRONT DOOR AND (1)SLIDER
LA 0.01NTA, CA 92253
Property Zoning:
Application Valuation: $3,353.00,-
3,353.00,Applicant:
Applicant:
Contractor.
'ALLIANCE CONSTRUCTION ENTERPRISES INC,ALLIANCE
CONSTRUCTION ENTERPRISES INC.
46267,MONTE VISTA DRIVE
46267 MONTE VISTA DRIVE
INDIO, CA 92201
INDIO, CA 92201
(760)222-8895 ;
Llc. No.: 928697 .
Detail: CHANGE OUT (1)FRONT DOOR AND (1)SLIDER. 2013 CALIFORNIA BUILDING CODES.
FINANCIAL. •R •
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7
101-0000-42400
0
$63.84
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7 PC
101-0000-42600
0
$62.32
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $126.16
Bin #
City of La Quin'ta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet.
Permit #
Project Address'. 7�i 77 A
Owner's Name: JuE
A. P. Number:
Address: �c,-ap (6b, - Uth ((e -fn
I-_0
Legal Description: F r-- —
City, ST, Zip: LO (3UV)0,, 0�� ObTO
Contractor: nslyuoon 611+ -
Telephone:
Address: 4&X�
Project Description:
City, ST, Zip:
Telephone:.
(aCC4
. . . .........
............. .. ..........
.......
C) A00Y
State Lic. #:
City Lic.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
----------
. . . . . . . . . . . ............. . ............... ............... . . . . . . . . . . . . . . . . . .
Co nstruction Type: 5FP-- 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- $2) 5 b
-APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Reqld
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural CaIcs.
Reviewed, ready for corrections
Plan Check Deposit'
Truss CaIcs.
Called Contact Person
Plan Check Balance.
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN 110USE:-.'
Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CITC3 6F P
res►�hc�.Q c��e.r�-�tav� Ct c- CF( P-.- AL -T o1 E
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS 1
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive ResidQntial Alterations - (Page 1 of 4)
I Proiect Name: _ �,P10 CO C 0 tC6�— CSQLV_� k 2, > I Date Prepared: jn/M I I(— I
A. GENERAL INFORMATION
t
,�
01
Project Name:
Qi� 02
Date Prepared: 2,-1
03
Project Location: q fj5
2 " v 04
Building Front Orientation (deg or cardinal):
05
CA City:
06
Number of Altered;Dwelling Units: *, r ,
07
Zip Code: 41
08
Fuel Type:', &"""' *.rN %_1_1
09
Climate Zone:
10
Total.,Conditioned Floor.4j a (ft2)
11
Building Type
12
1 SIab1AreT(ft2)"
13
Project Scope:
l -0
B. BUILDING INSULATION DETAILS (Section 150.2(b)1) o'.,�
01
02
03
04
05
06 r,7 �07 1 08 1 x,` O.09
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
Frame
Spacing
(inches)
Proposed t10 O
Required
Comments
"Appendix
-1Cpntinuous
Cavity Insulation �
R -value IR -value factor
JA4
Reference
U -Factor
Table Cell
CRRC Product ID
DKc
.Initial Solar Aged Solar Thermal SRI Aged Solar
I *`
AIR%
Compliance
Pitch
Exception
"Number
Product Type
_"I n5ul on
Reflectance Reflectance Emittance (Optional) Reflectance
Emittance
(Optional)
C. ROOF REPLACEMENT (Prescriptive Alteration, Sect on�150.2(b)1H)., }
Ol
02
03
04 ~11
05;
06(`
y07id' O8 09 10 11 12 13
R -value 'i
"V4 Proposed Minimum Required
Method of
Roof
CRRC Product ID
DKc
.Initial Solar Aged Solar Thermal SRI Aged Solar
Thermal
SRI
Compliance
Pitch
Exception
"Number
Product Type
_"I n5ul on
Reflectance Reflectance Emittance (Optional) Reflectance
Emittance
(Optional)
qQ
NOTESv
• Roof area covered by, building'integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applied coati gs must comply with stallation criteria from section 110.8(i)4.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE MR -ALT -01-E
Prescriptive Residential Alterations (Page 2 of 4)
Proiect Name: , CCS UW UA S cw_ cs Q"') Date Prepared:
D. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.2(b)1) '4N
01 02
04 '¢
03
Alteration Type Orientation
Maximum Allowed ft2 CommelTt
to) "* . _1_1
E. FENESTRATION/GLAZING PROPOSED AREAS AND EFFICIENCIES (Section 150.2(b)1)
9
01
02
03
04
05
06
07
08
;` ��
10'
11
12
13
14
15
`
)
Combined
Tag/
Fenestration
Frame
Dynamic
Orientation
N, S, W, E, or
Area
Removed
Area t
AddedAdded
Net
Maximum IT
Allowed
-
Exterior
Shading
SHGC
from
ID
Type
Type
Glazing
Roof
ft2
ft2 �
Area ft2
of ctor
U -factor
Source
SHGC
Source
Device
MR -ENV -03
4.1A
12-"
..
IN
a
�..- t .
Net Added West;facmg Fenestration Areay
_`� a�.
b
Existing + Added West facing Fenestration `A`rea
c
Maximum Allowwed West facing Fen stration Area
d
+
Is West -facing Fenestration Area Maxirrium Allowed West -`facing Fenestratiori4
�{
,< a # ' � e*
.� Area.
e
- ."b` �X .f ,a
Net Added Fence traion Area (all o�rlenations)
f
` Existing + Added Fenestration Area (alhOrientations)
g
witt'' n
Maximum=AllowhedyFe"nestration Area (all o-rientations)
h
Is Existing +`Added Fenestration Area <'Maximum Allowed Fenestration Area (all
-
tt orientations)
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS +'
CEC-CF1R-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Pa e 3 of 4)
Proiect Name: _ ko lQ f 5 0VWWW nUtw. Date Prepared: (0 2-7 (U
F. SPACE CONDITIONING(SC) SYSTEMS — HEATING/COOLING (Prescriptive section 150.2(b)) N
01 02 03,E
Dwelling Unit Name Dwelling Unit CFA (Ft2) Com4;n s'o �>
G. WATER HEATING SYSTEMS (Section 150.2(b)1G) j
01
02
03
04
05
06
07
08
Q9,%
,V'10
11
12
13
14
15
SystFem Identification or
Water:Heating System
Alteration to the Space
Water
(.it2)
Nameq�,6•
w+ldentification Or Name
Conditioning System(s)?
Comments
Vy
Water Heating
Water
Heater
+�
Back -Up
System
Water
Water
Heaters
Storage
Rated
Rated
ik A,
Heating
Heating
� A\ -10
Exterior
Solar
Dwelling Unit DHW
Identification or
Heating
Heater
in
Volume
Fuel
Input
Input
Efficiency
efficiency
Standby
Insul.
Savings
Central DHW System
System
Name
System Type
Type
system
(gal)
Type
Type,
, Value
Tyrpe�
,Value
Loss. (%)
R -Value
Fraction
Distribution Type
Distribution Type
`x
~+1
- "0
r
H. SPACE CONDITIONING SYSTEMS AND WATER HHEEAT, NG SYSTEM I�N�MULTIFAMILYfDWELLING UNITS
01
02
," 03�, °
.; , 04
05
06
.���
W t ,
Central�W�ter-Heating �
'46D 'ellin Unit
�* g
Dwelling Unit:
Dwelling Unit Tota66FA
SystFem Identification or
Water:Heating System
Alteration to the Space
Dwelling Unit Name
(.it2)
Nameq�,6•
w+ldentification Or Name
Conditioning System(s)?
Comments
Vy
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE MR -ALT -01-E
Prescriptive Residential Alterations (Page 4 of 4)
Pro iect Name: , \(\1 O C (' ��nCAe c^ 1 fL Date Prepared: l(o
M
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.6
Docytnentation Author Name;
Documentation Author Signature:
l
Company:
AA ame. Cary �cuc e��
Signature Date:
10 2� i
Address: "�
CEA/ HERS Certification Ide�_tificatiom(if applicable):
ix
City/State/Zip:
11r�c�ly C�
Phone:,i'
t"4
RESPONSIBLE PERSON'S DECLARATION STATEMENT ,
RESPONSIBLE
I certify the following under penalty of perjury, under the laws of the State of California:
is
1. The information provided on this Certificate of Compliance true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibill ty�for the building design or system design identified on this Certificate of Compliance (responsible
designer).
Ca�ndmanufactured,devfcesfnr
the buildin desi n or s stem desi n identified on this Certificate of3. That the energY features and erformance s ecifications, materials com onen,
Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Re
`egulations.
�
4. The building design features or system design features identified on this Certificate of Compliance -are consistent=wlth.ttie information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted -to the enforcement agencyfo -approval with this building permit application.
-Shall tith
5. I will ensure that a registered copy of this Certificate of Compliance be made,available the building pgrmlt(s) issued for the building, and made available to the enforcement agency
for all applicable inspections. I understand that a registered eopy'of this Certificate�of Compliance is required to be included with the documentation the builder provides to the building
owner at occupancy.
Responsible Designer Name: Responsible Designer Signature:
Company: *`
1� NO eg�_ ��
DiteSign ed:
—
Address: �t `F
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: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014