10-0348 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00000348
Property Address: 78201 INDIGO DR
APN: 604-021-030- - -
Application description: PLUMBING
Property Zoning: MEDIUM DENSITY RES,
Application valuation: 600
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 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 Class: C36 'cense No.: 880103
Date: 2-/-/ `Contractor:_
OWNER -BUILD CLARATION
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).: '
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and t
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, 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.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/21/10
Owner:
BOCKELMANN DAN
78201 INDIGO DRIVE
LA QUINTA, CA 92253
( D d
Contractor: APR 1
ALVAREZ, JORGE A. APR 1 ZOO
PO BOX 984
THERMAL, CA 92274 C1Ty0FlAQUINT
(760)777-3613 FlN,4ly�E pEPT.
Lic. No.: 880103
----------------------------------------------—
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.
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 EXEMPT Policy Number EXEMPT
_ 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 forthw' comply with those provisions.
Date: Applican .
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO ERAGE 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 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 building construction, and hereby authorize representatives
of this county to /eriter upon the above-mentioned pro for inspection es.
Date: -z -/V Signature (Applicant or Agent):
is
Application Number . . . . . 10-00000348
Permit . .
. PLUMBING
Additional desc .
Permit Fee . . .
. 22.50
Plan Check Fee
5.63
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date
10/18/10
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50.
----------------------------------------------------------------------------
Special Notes and
Comments .
REPLACE 50 GALLON
ELECTRIC WATER
HEATER.
- ---------------------------
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
LQPERM[T
General Information
Site Address: _7S, d %
Enforcement Agency: , � � .rte, Date: L1 _ 2 _ to
Building Type'VSingle Family dMulti Family
ircle the Front Orientation: N, E, S& or degrees
Conditioned Floor Area (CFA):
Project Type: 4 Alterations ❑ Envelope O Fenestration ❑ Roof O HVAC
Ta�/
ID
Replacement or Change Out ❑ Duct Replacement Water Heater
NOTE: This form Is not to be used jos NewtConstructed Bull din or Additions
Insulation Values For Opaque Surfaca (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 f amed cavity of a wall, ceiling or f oor must install the
mandatory minimum insulation value per §1 S0 for 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 Coqvnent
Package- D insulation values in Table 131-C. Fill in Columns A - J
9 -
Opaque Surface Details For the furred
A B C
ertioued of Mass Walls see Furring Ships Construction Table below.
D E F C H I I
Pro bft Note
Standard Values From JA4 Table
A
Ta�/
ID
Assembly Name
or Type'
Framing
Material
and Size'
Thickness,
Spacing, U- JA4 Table
or Others factor° Numbers
Framed Continuous JA4
Cavity Insulation Assembly
R-value6 R -Value Cell Valuer
Rand
L M
Proposed Properties of Masonry and Concrete
Added Interior or Exterior Insulation
Walls From Reference
in Furring Space from Reference
Joint Aradix
Table 4.3.5 43,6 4.3.7
Joint Appendix
Table 4.3.13
Note: Forfurntd assemblies, accounting for Continuous Insulation R -value, see Page JM -3 and Egaanon 4-1. For calculating fiored walls —the M
Furring Construction table below.
t. ror 1 0911 tnatcate the identification name that matches the building plans.
2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc... indicate the Frame type and Size: For
W0094 Metal, 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 151-B, 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. The Proposed Assembly U factor, Column J. must be equal to or less than the Standard U -tactor in Column E to comply.
Fut-ring Stri4
Construction Table for Mass Walls Onl
A
B T C I D I
E
F
I G I
H 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 Aradix
Table 4.3.5 43,6 4.3.7
Joint Appendix
Table 4.3.13
Assembly
c c ?
FL-
F u ^ _
0
>
Final
Mass
Name or JA4 Table '
<
H
E
°
'
9
'
Assembly
Thictmess'
Type Number' >
, e
@
Q >
U -factor' Comment
Registration Number: Registration Date/Time: HERS Provider:
J008 R¢sid¢nUa/ Comp/ionc¢ Folmar
Agusl Mo
HVAC SYSTEMS - HEATING
Minimum Duct or Piping Configuration
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
Heating Equipment
Type and Capacity" 3
Efficiency Distribution Insulation Thermostat (Central, Split,
(AFUE or HSPF Type and Location° R -Value Type Space, Package or H dronic
External Tank
Water Heater Type/Fuel
Distribution Type
Number In
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 KW or 7,000 Btulhr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See f151(b)3 exception.
3. Refer to the HERS Verification section on Page 4 of the CF -IR -ALT Form for additional requirements and check applicable boxes.
4. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc.)
HVAC SYSTEMS - COOLING
C aci(gal)
Thermal Efficiency
Minimum
Cooling Equipment
Type and Capacity V2
Efficiency Duct or Piping
(SEER/EER or Distribution Insulation
COP) Type and Location R -Value
Configuration
Thermostat (Central, Split,
Type Space, Package or H dronic
1. indicate Cooling Type WC, Heat pump, Evap. Cooling, etc)
2. Refer to the HERS Verification section on Page 4 of the CF- IR -ALT Farm for additional requirements and check applicable boxes.
3. /ndicate T or Location (Ducts, Hydronic in Floor, Radiators, etc.
WATER HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. individual dwelling DHW 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 co onent packages in all climate =ones.
External Tank
Water Heater Type/Fuel
Distribution Type
Number In
Tank
Energy Factor or
Insulation
• Type,—
4 Standar ecirculatin 2
System
C aci(gal)
Thermal Efficiency
R-Value3
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 pipes shall be insulated to meet the requirements of §1506f).
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
These items may require written 'usti kation and documentation and special verification.
NEW ROOF ASSEMBLY - Radiant Barrier
The radiant barrier requirement of t;151 2 does not apply to roof alterations.
Slab Edge (Perimeter) Insulation O YES 0 NO
YES: In Climate Zone 16 in Component Packages D. R-7 insulation is required.
Heated Slab insulation G YES 0 NO
YES: Slab ed a insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation O YES E3 NO
YES: In Climate Zones 1, 2, 11, 13, 14 & 16, R-8 insulation is required; in Climate Zones 12 & 15, R-4 is required under component Package D.
Thermal Mass - — - -
To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach.
Registration ;N umber: Registration Date. -Time:
2008 Residential Compliance Forms HtRSProvider:
August 2009
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
l A
Residentialterations a e 5 of 5
Project erne: Climate Zone # # of Stories
HERS VERIFICATION SUMMARY The enforcement agency should pay 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.
O YES 13 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)1Dii and the newly installed ducts are to be insulated per §151(f)10.
O EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
17 YES O 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) I Di.
0 YES O 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
sealed per § 152(b) I E.
13 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.
13 EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space.
0 EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Refrigerant Charge -Split System HERS verification is required for this measure.
0 YES 0 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
exchange a refii Brant char a measurement shall be verified per § 152(b) IF.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation mquirements of § 15 o do not apply to existing residential homes.
Ducted Split Systems -Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure.
13 YES E3 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 r 152 b 1Ci to meet the requirements of 151 7B.
Documentation Author's Declaration Statement
l • I certify that this Certificate of Compliance documentation is accurate and complete.
Name
-..-., _ % t . _ Signature: 0 n
V U Date: /�
Add s: -` 2�^
O If Applicable 0 CEA or 0 CEPE
(Certification #):
Ci �/State2ip: Phone:
2-� 0- 7 ? 7-,3Yo
Responsible Building Designer's Declaration Statement
• 1 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 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 I 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 buildingpermit application.
Namey s rn P �\\ �, r P� Signature t1
Phon
e:
i
Bin #
City of La Quinta
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:g ;. ®�
Owner's Name: —A--b—f\
A. P. Number:
Address: ZC)t�
Legal Description:
Contractor: ,- 2 �'��c 1 mb �
City, ST, Zip: ����� �� Q 2253
Tele — - Y':, `'`` • }
phone: �-
Address:
..:.::::::.....
1
Project Description: . ccCe 6
City, ST, Zip:
Q_�, q22
Telephone:CoO 73 13
CQ '
State Lic. # City Lic. #.:. 05733
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
$�:4:ji.i vtY::i::sS'ri,.;kv:::,v„lj�:C;:}i•:ii:•:•f �,.
`•`>•.•.;•,:.,«::»>::?::v;<.w >r:•.>:> >:« y :.>.N :;
YP Construction Type: Occupancy:
`U MIDI R
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: oon
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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
Title 24 Calcs.
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 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