08-1098 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00001098
Property Address:
54555 AVENIDA VALLEJO
APN:
774-281-015-3 -000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
500
Tity/
XP"Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
CULHANE SHARON R
54555 AVENIDA VAL
LA QUINTA, CA 922
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/26/08
Contractor:/�A� V `�
Applicant: Architect or Engineer: CALIFORNIA DELTA MEC I IN 96,
6052 E. BASELINE RD, 5 C/T
MESA, AZ 85206 /C,r0IL` �O®�
Ole(480)898-0007 NgHC�Q(/
�J 1 LiC. No.: 811114
-
-------------------=-------------------------------------------------------------
--------------—
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury that I am licens und/e.
visions 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 Prof ionals 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
Lice a Class: C36 LicNo.: 811114 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: , ZC actor: I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
77�� 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: '
I hereby affirm under penalty: of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1697823
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 becom ubject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become s ject to the w rkers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall fo with comp) ith those provisions. ,
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).: t, Ap 'ant:
1 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 WARNING: FAI E TO SECURE 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 PLOYER TO CRIMINAL 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 ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 improvesthereon, and who contracts for the projects with a contractorls) licensed
pursuant to the Contractors' State License Law.).
1 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
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 inform a ' n is correct. I a ree to comply with all
city and county ordinances and state laws relating to building construc ' n, and hereby orize representatives
of this county to enter upopA<e above-mentioned prope y for insp on purposes.
Da et :264 gnature (Applicant or Agent):
Application Number . . . 08-0000109.8
Permit . . . PLUMBING
Additional desc .
Permit Fee 22.50 Plan Check Fee 5.63
Issue Date . . . . Valuation 0
Expiration Date.. 12/23/08
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 GAS WATER HEATER
Fee summary Charged
----------------- ----------
Permit Fee Total 22.50
Plan Check Total 5.63
Grand Total 28.13
LQPERMIT
Paid Credited Due
---------- ---------- ----------
.00 .00 22.50
.00 .00 5.63
.00 .00 28.13
Sin #
City of La Quinta
Building & 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: 5
Owner's Name: Qii/1
A. P. Number:
Address: S a/A f—
Legal Description:
City, ST, Zip: Cl Z 2 r3
Contractor: a 1• �C
Telephone: 7 6 Q 57 5.11
Address: e. Q 5Q. kt k /
Project Description: �A to, z .—
+
City, ST, Zip: � Z V; 0JIO
Telephone:�86 '7
C CtA, R:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
P Y:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Per
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:LN O O�Q
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god 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 HOUSE:-
` 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
Fhb # X60 ��i i/12
CERTIFICATE OF COMPLIANCE: RESIDENTIAL. (Page 1 of 5), CF -1R
Project Title
Date
Building Permit # .
Project Address
Me
Location
Comments
(attic, garage,
typicW, etc.)
2,2 ✓ 3
Plan Check / Date
Documentation Author
Telephone
'S 211
. Field Check / Date
Compliance Method (Prescriptive)
Climate Gone
EnforcementA en Use Onl
✓ ❑ Alternative Component Package Method: (check one) C D 0 (Alternative)
Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see.CF-1R page 3)
F or Package D Alternative see Appendix B Table 151 -C Footnotes 7-14.
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) fl
Average Ceiling Height: ft
Maximum Allowed West Facing Fenestration Products Per Table 151'-B or 151-C -- (5% X CFA)
Maximum Allowed Total Fenestration Products Per 'fable 151-B or 151-C ----(20% X CFA)
ftz
if
✓ ❑ Building Type: (check one or more) Single.Family• uMultifamily Addition Alteration
(If adding fenestration fill out WS -4R, Fenestration M m Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
Number of Stories: Number of Dwelling Units:
Floor Construction Type: Slab/Raised Floor (circle one or botli)
Front Orientation: North / South / East / 'West / All Orientations (input front orientation in degrees from True North
and circle one).
✓ ❑ RADIANT BARRIER (rNuired in climate zones 44, 8-151
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Wail, .
Roof, Floor,
Slab lodge,
Doors)
Frame .
Type Cavity
(Wood or Insulation
Metal R -Value
Assembly U -
factor (for wood,
Continuous metal frame and
Insulation mass
RLValue assemblies
Joint
Appendix
IV
Reference
Roof Radiant
Barrier
Installed
Yes or No
Location
Comments
(attic, garage,
typicW, etc.)
1) See Joint Appendix Iv in Section IV -Z, 1v.3 and IVA, wntCtt is uie oasis tar the u -tactor cnrorrun. v-iacwrs can nvi uxcccu
prescriptive value to show equivalence to R -values.
Residential Compliance Forms
TO 39Vd 033 3-18Add S1N(100t1 90998TZ08b
April 2005
90:0Z 800Z/0Z/90
CERTIFICATE OF COMPLIANCE: RESIDENTLkL (page 3 of 5) CF -1R
Project Title I Dare
A signed CF -4R Form must be provided to the building department for each home for which the following. are
wired.
I/ I
❑
Sealed Ducts (all climate zones) (Installer testing and certification and HERS rater field verification required.)
C3
TXVs, readily accessible (climate zones 2 and 8-15 only)
Tank
External
Insulation
R -Value
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 !tater field
❑
verification required.)
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Proiect Climate Zone in the 12M Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not docwnented to have been previously
❑ sealed as confuted through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 401inear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATER BEATING SYSTEMS
S stents serving single dwelling units
Water Heater
F elType
Check box if system meets criteria of a "Standard" system. Standard system is one gas -feed water heater per
C3
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Tank
External
Insulation
R -Value
not allowed.
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
❑
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 ease, the Performance Method must be used and must be included in the
submittal.
Check box to ve.rify that a time control is required for a recirculating system pump for a system serving multiple
13
units
S stents serving single dwelling units
Water Heater
F elType
Distribution
INY Pe
Rated
i Tank
Number Input,
or Capacity
in System Btu/v) (gaJ10ASi
Energy
Factor' or
Thermal Standby'
Efficient Loss %
Tank
External
Insulation
R -Value
.410 Poo
Svstem serving multlnle dwelling units
Water Heater Distribution
Type Tye
Number
in System
Rated
Input' Tank
(kor Capacity
Btuthe) (gallons)
Energy
Factor or
Thermal Standby
Efficient 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 % inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150
B.
Residential Compliance Fornu•
April 005
60 30Vd Old 3_18AVd S1Nf10Od S09SBIZO80 90:0Z 800Z/0Z/90