12-1396 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
12-00001396
Property Address:
51310 CALLE JACUMBA
APN:
770-166-004-21 -000000-
Application description:
REMODEL - RESIDENTIAL
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
40000
Applicant: Architect or Engineer:
4 4'Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Business and Profession Code, and my License is in full force and effect.
License Class: B ic se No.: 514045
Al
Date Contractor:
feempt
UILDER DECLARATION
I hereby affirm under penalty of p rjur�hafrom the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and PCode: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair ae, 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
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.).
(_) 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 cont(actors) 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: 12/04/13
Owner:
FYEE KIP
Contractor:
FREDERICKS, JEFF
28 10TH COURT n 0
HERMOSA BEACH, C (/ 5
(310)918-7548
Lic. No.: 514045 DEC 04 2013
OF I.A QUINTA
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.
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 9PT Policy Number EXEMPT
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 tot orkers' compensation laws of California,
and agree that, if I should become subject to the kers' compensation provisions of Section
3700 of the Labor Cod , I sh II rthwith m ith those provisions.
Date: pplicant:
WARNING: FAILURE TO SECURE O S' PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CR INA PEN IES 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 Ouinta, 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 1 have read this application and state that the above information is correct. agree to comply with all
city and county ordinances and state laws relating to building construction, an ere uthorize representatives
of this county to enter upon the above-mentioned proper or in tion p p e
Date:��ndture (Applicant or Agentl
Application Number . . . . . 12-00001396
------ Structure Information INTERIOR REMODEL AND WINDOW CHANGEOUT -----
Other struct info . . . . . CODE EDITION 2010
----------------------------------------------------------------------------
Permit .
. . . . .
REMODEL 2013
Additional
desc .
Permit Fee
161.59
Plan Check Fee
.00
Issue Date
. . . .
Valuation . . .
. 0
Expiration
Date
6/02/14
Qty Unit Charge
Per
Extension
1.00
48.6200
LS MISC
REMODEL, 1ST 100 SF
48.62
2.00
21.4500
EA MISC
REMODEL, ADDL 500 SF
42.90
1.00
60.0600
LS MISC
DR/WIN, REPL, 1-7
60.06
1.00
----------------------------------------------------------------------------
10.0100
EA MISC
DR/WIN, REPL, ADDL 5
10.01
Permit
. . .
PLUMBING 2013
Additional
desc . .
Permit Fee
. . . .
11.92
Plan Check Fee
.00
Issue Date
. . . .
Valuation . . .
. 0
Expiration
Date
6/02/14
Qty Unit Charge
Per
Extension
1.00
-----------------------------------------------------------------------_-----
- 11.9200•EA
PLBG
WATER INST/ALT/REP
11.92
Permit
. . .
MECHANICAL
2013
Additional
desc .
Permit Fee
. . . .
35.75
Plan Check Fee
.00
Issue Date
. . . .
Valuation . . .
. 0
Expiration
Date
6/02/14
Qty Unit Charge
Per
Extension
1.00
-----------------------
35.7500
----------------------------------------------------
EA MECH
OTHER EQUIP
35.75
Permit
. . .
ELECTRICAL
2013
Additional
desc .
Permit Fee
. . . .
23:83
Plan Check Fee
.00
Issue Date
. __. .
Valuation . . .
. 0
Expiration
Date
6/02/14
Qty Unit Charge
Per
Extension
_ 1.00
23.8300
LS ELEC
FIXTURES, FIRST 20
23.83
---- ---
Special Notes and Comments
REMOVE AND
REPLACE DRYWALL,
INSULATION
LQPERAlff
Application Number . . . . . 12-00001396
----------------------------------------------------7-----------------------
Special-Notes and Comments
AND SHOWER ENCLOSURES DUE TO WATER
DAMAGE INCLUDING REPLACEMENT OF WINDOWS
ALONE THROUGHOUT ENTIRE DWELLING AND
REFINISHING OF STUCCO (CONVENTIONAL]
THIS PERMIT DOES NOT INCLUDE ALTERATION
TO BUILDING LAYOUT OR INTERIOR FRAMING.
2010 CALIFORNIA BUILDING CODE.
December 4, 2013 8:13:00 AM AORTEGA
----------------------------------------------------------------------------
Other Fees .. . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
PLAN CHECK,
ELECTRICAL
23.83
PLAN CHECK,
REMODEL
287.43
PLAN CHECK,
MECHANICAL
35.75
PLAN CHECK,
PLUMBING
11.92
STRONG MOTION (SMI) - RES
4.00
Fee summary Charged Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 233.09 .00
.00
233.09
Plan Check Total .00 .00
.00
.00
Other Fee Total 364.93 .00
.00
364.93
Grand Total 598.02 .00
.00
598.02
LQPERMrr
Din #City
of L' Quin
'Building 8r Safety Division
P.O. Box. 1504, 78-495 Calle TampioD
La Quinta, GA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Penult #
�� ' 3q b
ProjtxtAddress: 51310 Calle Jacumba 92253
Owner's Name: klr(( + c mm
A. P. Number.
Address:
Legal Description:
City, ST, Zap:
Contractor: Jeff Fredericks Construction
Telephone 0
Address: 28 10th Court
Project Description:
City, ST, zip: Hermosa Beach, Ca 90254
Repair or remodel home back to original condition ,
Telephone: 310.918.7548
n f' do to being flooded from broken water line at toilet.
City Lie. #; b Q,S
State Lic. # : 514045
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
4, Construction Type: wood Occupancy: single family
r ray° :". �c Project type (circle one): New Add'n Alter Repair Demo
State Lie. #:�`
Name of Contact Person: J' F/`'✓ !
.S
Sq. Ft.:
# Stories: 1
# Units: 1
Telephone #;of Contact Person: 3 lo — • / — $
Estimated Value of Project: 40,000
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
• Submittal
Req'd
Recd
TRAC116NG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Cheek Deposit
Truss Calcs.
Called Contact Person
Plan Cheek Balance
We 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"! Review, ready for corrections/issue
Electrical
SubcontaetorList "
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Per Fees
cing'..--_
Job address 51310 Calle Jacumbe, La Quinta, Ca
Scope of work for Building Restoration \ Remodel
Cause : Structure had severe water damage, do to a broken toilet line.
The home is presently stripped down to the studs and ready to be put back together.
All drywall and insulation removed, do to moisture damage
All walls and ceilings will be insulated, using r-13 in 2 x 4 walls and r-38 in. the ceiling.
New windows and doors will be installed with dual glazed low E -glass, to replace
existing size, single pain windows. See attached calculations.
The entire home will be dry walled as per code.
New tub and shower pan to be installed in existing spaces.
New can lighting in living room.
New cabinets and counter tops to be installed in kitchen and bath rooms.
Structure exterior will be sandblasted and new sand finish stucco applied.
Any items that need to be changed from original home design, a permit separate from the
remodel permit, will be obtained by that trade.
Estimated cost $ 40,000
Jeff Fredericks Construction
state license 514045
city license 0105779
310.918.7548
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
BY.
Prescritive Certificate of Compliance: Residential CF -IR -ALT
ResidentMl Allertulons age 1 of
Project Name: Climate Zone kv M of Stories
Fyfe 15 1 1
General (aformation
She Address: 51310 calle Jacumba Enforcement Agency: Date: 12-3-2013
Building Type O Single Family O Multifamily Circle the Front Orientation: N. I's, S. W. or dgvtes
Conditioned Floor Arca (CFA): 1800 Project Type: 121: Alterations [ Envelope O Face uv ioo O Roof O HVAC
Lsmnlent or Change Out O Duct Replacement 'O Water Heaw
hM M orm Is 401 10 be usM for N Construded BatldWV or Add kions
Insuladon Vdua For Opaque Surfaces (%r FumAg use the Mats and Furring Str>Rs Conduction & We below)
Assembly Alteration
O Opening o1' framed cavity alone - Alterations that involve the opening of the firmed cavity of a wall, ceiling or floor must install the
matrdwory minimum insulation value per 11 S0 for the altered assembly. Fill in Columns A -C and enter mandatory insulation v+ahe in Column H.
O Reptaeemest of entire assembf y -Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component
P - D insulation values in Table 151-C Fill in Colunvts A —.1.
Opaque Surface Details For the furred of Mass Watts see Fr Construction Table below -
A B C. D E F G
H i J
P ro Standard. Values From JA4 Table
Framing
Thickness. Framed
Continuous JA4 Proposed
Ta�/
Assembly Name
Material
Spacing; U- 1M Table Cavity
Insulation Assembly, . Aumbly
ID
a T
and Sim?
or Od,cr' factor' Numbers R -values
R -Values Cell Values
Fyfe
slab
concrete
.730 4.4.7
0 a1 .730
Fyfe
walls
wood 2x4
16" . .102'
0 a3 .102
FVfe
roof
Note_ Forfivrrd assemblies, oonoiustingforCb wbuww /nsrfation R- dud. see Page JA4-3 old Equation 4-1. For catc do ft fwre�d rolls sac floc Mw and
Fwrim Catsiruaion table below.
1. For Tag/ID indicate the idcntifiaotion resort that matches the building plans.
2. Indicate the Assembly Name or type: RoofirCeiling, Walls,
Deft the From type and Size: For
Wood Metal. Meta! Buildings, Aloss, enter -2x1, 2x6. or etc... see JA4 for other possible frame type assemblies -
ssemblies3.
3 Enter the thitsbsess for mass in inches or SiPaCUT between firming members enter, 16 "or 24 "OC. or otherl6r all other assembly description
such as Concrete Sandwich Panel. Spctsoi r! Pard,•'Logr. Straw Bate Patel and etc....
1 b
4. Based on the Climate Zone: enter the Standard (-factor from Table 151-8. C or D for each different
S. Enter the Table number that,cloI . Y resenibles the pt+vposcd aasimbty.
n ( O C LA 11) NT
_&SAQ U
6. Enter the R -value than is being installed in the wall cavity or between the framing; otherwise, enter""CITY
7. Enter Cowinuous
BUILDING DE r.
the Insulation R-va/uc r the
� proposed assetrrbly: od+erwise, enter "0 ".
8. Enter the row and column of the Ufa«orvalue based on Column :F Table Number and enter [he .tsse
bly U J is PR E D
9. The Proposed Assembly U-facxor,.Colwnh J must be equal to or less than the Standard U factor in
Itnttir
Furring Strips Construction Ttible-for.Mass Walls Onl
�y 'Mi
A B CI D I E' F C I H I I J
LJ I
Proposed Properties of MasoarJ.and Concrete
Added Interior or Exterior Insulation
Walls From Reference
in Furring Space from R.eferaice
Joint A p adix Table 4.34 43.6' 4.3.7
Joint Appendix Table 43.13
'� u
ci h
Assembly3 '
`a 2 t- F- `o ,s 3 o
'" Final
Meas
Thickness'
Name or !A4 Table
T = Number' <
t v..
Assemblyr
COMM,m
>e
< >
e . U.
U -factor
Registration Number: I Registration Date: -Time:
2008 Residential Compliance Forms
HERS Provider:
August 2009
73
W I A) 00 tj S Pya- / ,/ -)-
Prescriptive Certificate of Com liance: Residential
CF -M -ALT
Residential Alterations
Q Adding $Ole or less of window area -Newly installed windows shall meet the U-Fador and SHGC Valga requirements of Conpone.ig
Project Name:
a e2 of
Fyfe
Climate Zone tl N of Storks
Orientation
(North, East, PropsedArea' Maximum Maximum
15 1
Mass and Fur * Sari Consdrrction oomotes I. indicate the type of assembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete'Walls, Etc. Additional asse U,. can
found Reference Joint Appendix JA4.
. This is the U -Factor based on the thickness of the assembly in inches.
the R -value of the insulation to be added on the interior or exterior of the assembly.
. The Calculated R-Yalue is the R -value of the f erred out section of the assembly.
.-6.7he Final Assembly is calculated using Equation 4-2 or Equation 4-iof the Reference Joint Appendix JA4. Me equation is tlae inverse of Co
added to Column 1. Column K is the inverse from column J.
7. Insert the calculated U odor value on !o 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 /S1 -C. The Total Fenestration and West faeingArea
requirements are not applicable.
Q Adding $Ole or less of window area -Newly installed windows shall meet the U-Fador and SHGC Valga requirements of Conpone.ig
Package D in Table 151-0
Adding more than 50fe of window area - Newly installed windows shall meet the U -Factor and SHGC Value and the Fenestration
Area requirements of Component Package Din Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF -IR -ALT
Fenestration Type and Frame
Orientation
(North, East, PropsedArea' Maximum Maximum
NFRC or Default
Indo, Gins Door or, S 1' t
South,West) (fl U -factor" SHGC'- 3.4
Values
window, vinyl kitchen
west 15 .40 .35
B
window, vinyl bath
east 4 .40 .35
E
window, vinyl bath
east 4 .40 .35
G
window, vinyl bedroom
east 17.5 .40 .35
Allowed
window, vinyl bedroom
south 17.5 .40 .35
1. Fenestration area is the area oftotal glazed product (ie. glass plus frame). Exception: When a door is less than S0•/ 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 151-0.
3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor a» err a lower
SHGC value than that specified on the CF -JR ALT Form.
4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading.
5.1 licable at this -gage enter NFRC" or NFRC Cert' windows or an CEC "De salt'values owed in Table 116-A or B.
ALTERED FENESTRATION
ALLOWED
AREAS
(Complete i more than SDfta of fenernadon is added)
A
B
C
D
E
F
G
CFA of
Allowed
Existing
Allowed
Entire
% of
Fenestration
Area
Fenestration
Area
Proposed Area'-
Dwell'
CFA?-'
Arca
Removed'
Arca Added'
A x B
D + C
Total Fenestration
Area; tl
West Fenestration Area
(Requited In
CZ's 2 4&7-15
1. 77te 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 fenestratioh is being Installed in Climate Zones 2, 4, & 7-15. Note dXU the
maximum allowed fenestration can only be S% of the CFA as indicated in Column F. Column G must be equal to or less than Colwnn F.
3. In climate zones 2, 4, 7-15, no more than S% of the CFA is allowed for west facing glazing.
4. Existing Fenestration area must be counted toward the maximum allowed !S% or 20•/ of the whole building and calculated in Column G. The
Proposed Area must be less than or equal to Column F.
S. Enter the fenestration removed as part of the alteration if any in column D.
6. Enter the Fenestration area that is being added as part o the alteration.
2008 Residential Compliance Forms March 2010
r
;7
Frescri live Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations $ e 2 of
Project Name: Climate Zg of Stories
Fyfe 15one./ 1.
1. Indicate the type of assembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Eta Additional auemkies caii
found Reference Joint•Appen jA4.
. This is the U-Fagor bared on the thickness of the assembly in inche3.
The R -value of the insulation 10 be added on the interior or exterior of the assembly
. The Calculated R-Valueis the R -value of the furred out section of the assembly.
-6. l he Final Assembly is calculated using Equation 4-2 or Equation 44of the Reference Joint Appendix JA4. Me equation is the inverse of Col
added to Column 1. Column Kis the inverse fram column J.
7: Insert the calculated U actor.value on the Opaque Surface Detalls in CoharwJ
FENESTRATION PROPOSED AREAS
Replacing window alone— Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in
Table ISI -C. The Total Fenestration and West facingArea requirements
are not applicable.
Q Adding 5Qft or less of window area —Newly installed windows shall meet the U -Factor and SHGC Value requirements ojCon�ponurt
Package D in Table 151-C
Adding more Wan .5011' of window area — Newly um' alled windows shall meet the U -Factor and SHGC Value and the Fenestration
Area requirements of Component Package D in Table 1S/ -C Complete the Altered Fenestration Allowed Arta Table on Page 2 of the CF-1RALT
Orientation
Fenestration Type and Frame {North, Fast, PropsedAros1 Maximum Maximum
NFRC or Default
inflow Glare Door orS li t) South. West ft U -factor) 3 SHGC2'3•4
values
window, vinyl living room south .40 .35
B
sliding door, vinyl kitchen north 40 .40 .35
D
sliding door, vinyl bedroom east 40 .40 .35
F
G
CFA of
1. Fenestration area is the area of total glazed product (i.e. glass plus franc). Exception: When a door is less tiara S0'/ glass, the fenesvialo a
area may be the glass • area phis a "2 inch frame `' around the glass
2. Enter value frrtm Component Package D Requirements in Table 131-C.
3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower .0 factor and/or a lower
SHGC value than that specified on the CF- I R ALT Fonm
4. Submit completed WS -3R Form if a reduced SHGC is calculated with exterior shading.
5.YqWlicable at This stage enter "NFRC" or NFRC Cerli ed windows or are CEC "Default " valuesfound in Table 116-A or A
ALTERED FENESTRATION
ALLOWED AREAS (Co del more than 30fr: of fenestradon is added)
A.
B
C
D
E
F
G
CFA of
Allowed
Existing
Allowed
Entire
%of
Fenestration
Area
Fenestration
Area
Proposed Areal. '
Dwelling
CFAz 3
Area'
Removed'
Area Added6
A x B
D+ C
Total Fenestration
Areax ft '
West Fenestration Area .
(Required In
CZ's 2 4&7-15
L The.Proposed.West Fenestration Area includes.West-sloping skylight area and arty other skylight area with a pitch less than 1:12.
2. Enter 20•/ when no West orientation restriction or 15% when Wes(fenestration is being installed in Climate Zones 2, 4 & 7=15. Note that the
maximum allowed fenestration can only be S% of the CFA as indicated in ColwnnF. Coli mn G must be equal to or less than Column F
3. In climate zones 2, 4, 7-15, no more than S% of the CFA, is allowed for west facing glazing
4. Existing Fenestration area must be counted toward the maximum allowed .1 Sao or 20•/ of the whole building and calculated lir Column G. The
Proposed Area must be less than or equal to Colwnn F.
S. Enter the fenestration removed as part of the operation harry in column D
6. Enter the Fenestration area that is being added as part o the alteration.
2008 Residential Compliance Forms March 2010
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations
a e 5 of
Project Name:
Climate Zone #
N of Stories
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this
checklist belaw. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector beforefinal
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 §152(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:
OYES ❑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 §I52(b)IDi.
❑YES ONO 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)l E.
Q 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 duct system 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 refrigemat charge measurement shall be verified per §152(b)IF-
Central
152(b)1F_Central Fan Integrated (CFn Ventilation System and Fan Watt Draw
The ventilation requirements of §150(0) do not apply to existing residential homes.
Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is required for 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 § I52(b)1Ci to meet the mquirements of § 151 7B.
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate an m 1 te.
Name:
Si
Company:
Date:
X -3 -?-013
Address:
If Applicable UCEA or CEPE
O R %
(Certification #):
City/State/Zip:
® 4A , v a JOY
Phone:
3/0 J - 7f !
Responsible Building Designer's Decla tion 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 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:
e
For assistance or questions regarding the Energy Standards, contact.the Energy Hotline at: 1-800-772-3300.
2008 Residential Compliance Forms March 2010
CITY- OF LA QUINTA-SU-B-CONTRACTOR LIST
JOB ADDRESS�5(3 [ O C G��►'�h�c. PERMIT NUMBER 12= OWNER --
�� � 1=`'�� � � BUILDER ����(' 1Z • C VETC-g-cc- KS
This form shall be costed on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by. the .Building Division prior to commencement of work. Failure to comply will -result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
.
Cdnt
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s licenrade
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.::. - Cityontractor
:Bisiness
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. DateCarrier
(xx/xx/xx)
Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp: Date
(xx/xx/xx)
EARTHWORK (C-12)
CONCRETE (C-81 '
�n��%�P4` G O
�. /S
FRAMING
�J
A �7-9P o
STRUCT. STEEL -(G-51) -
MASONRY (C.29)
PLUMBING (C-36)
IATH; PLASTER (C7,35)
DRYWALL (C-9) ..:
.HVAC. (C-20)`:.:;:<:'.
ELECTRICAL. (C=10)' ; •-
SHEET.METAL'(C-43)`
FL'OUtRING (C=:151:. :.•:,::,.,.
GLAZING (C -17)f.' : .-•._
INSULATIONIC72) .'
SEWAGE DISP (P.4
PAINTING (C=33) : .
CERAMIC TILE (C-54)
CABINETS (C-6)'
FENCING (C-13)