10279 (AR),
P.O. BOX 1504 No. 10279
Building 46'775 Washington St 7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner '
Phvll seter P. P&&lard -Smith
Address same
City LaQuinta Zip 92253
Tel. 564-626I
Contractor
Owner/Builder
Address
Zip I Tel.:
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
City I
Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm 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.
_SIGNATURE- DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for'such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he 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 penaftyof not more than five hundred dollars.(8500).
(( 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, Buisness and
Professions Code: The Contractor's License Law does not apply.to an owner of property who
builds or Improves thereon and who does such work himself or through his own employees,
provided that such 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 did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct. the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property -who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) , • 1
0 1 am exempt under Sec. •> "'B. 8 P.C. for this reason r
Date 11"(P141 Owner /\ A.'
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished..
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance^of thg work for which this permit is issued, I shall not,,
employ anyy person in any manner°sdas to tiecome subject to theiWorkers' Compensation"
Laws of Celiorfifaf .f (/Y/ �/ f
Data
t j ri f` towner 'i 1/ !/" . _f;/A,/1__J/ 111
NOTICE TO APPLICANT: If,%fi r making -this Certificate of Exemptions you should -become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed -and validated; and is subject to
expiration if work thereunder is suspended for 180 days.
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 the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST. . OCC: GRP.;
A.P. Number
Legal Description
Project Description Room Addition
Sq. Ft. 240 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑
Estimated Valuation
12.237.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
93.60
Const:
144.00
Mech.
20.00
Electrical
-15.00
Plumbing
INSPECTOR
S.M.I.
. 30
Grading
` 1
Driveway Enc.
Infrastructure
Validation:
.
nf": ^', A XT/A';R` �� a 4,g-74.0 __:74 �
-A^
ff...{r��i!
l i y '?
TOTAL
:L3 . 9U
REMARKS
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date o Permit
` 1
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLJMB(NG FE1ES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ, FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
0 POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET`
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT a'
SHOWER
BOILER. B.T.U.
SQ. FT. .@ c
BATH TUB
BOND BEAM
SQ. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® V4c
HOUSE SEWER
FRAMING C� l ��
FINAL INSP.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND,,
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING./ p p,
6 6 `
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—X$—=$
LUMBER GR.
FINAL INSP. — _ q2
FRAMING C� l ��
FINAL INSP.
ROOFINGZia
VENTILATION
l ` 1.
f
A
AUG �/!�/V
REMARKS:
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
w�.
THING —cil Lb
MESH
INSULATIONISOUND 2 O1�[P
I
FINISH GRADING
FINAL INSPECTION pxL
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL
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INSTALLA AS PER
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{ AND ALC-IAPPLIW.- LE CURE
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CERTIFICATE f:1F {=i1"iF'l._ 1: r"!h•-!t E : ' RESIDENTIAL
OF --:1R
Proj1_.,r_.c: Title..; ., , ..:, a :. tirrl.:i:th Addition
... 11i06!9.;
.
Project "= .sc::- i r 7 _, ' W' r ! "i on �:. t
__.__... _. - -------------'-•_---.._._.._.._
La Winta CA
Documentation r-•! a t h o r- l .. c:., R <_3 n c! a i l "-1_: h r- . _-.• t en s 6n
; P 1_I t l d .i. ! ; g Permit "rt
C'• o m 1:7 C•:11 t y . : :, ,,, ., „f „ „ . :. . „ . . ., . T-24 1:::.1' !e?rgy C is l c s 1.., 6 '
•.._.___...._........_.___
'
1e.�li_,�;t;c�ric•. . 1 4 .:.. � e , � � � C619) 360-0535 _
F'l"<_aq Check ! Este
• .
w �. .�. ..,t .�,..t r_i.�., , , 1'i .. a
Gc.smr:;Ia.�-!ncF_r •Me:'tl o1_t. n . � .., •!l...i_,.�:',�_1'r'�,-..._; L:,� Ene�r-c:c:m,- , ,.lnc:�
Field Check:/,Date
,
;
C l i. rrla tr-.' , z r_.6 .... „ "' 1:5
--_---- - -------
._..., _
L
ra_;nF5r:v3.11 File-= lT- D Wth-�l.1�' ,trccr_m-FGR1
-C=IR
l ser#-'_;v11-'10ai U:_>er-.-.--1----24 Energy Calcs Co. 4 F?!.,4n--D
F..i2ACS..;;R 3!:'0.2
G=_R( i:_. l: l`•-1F'CiF't!`rl(-5-r.l C)td
Conditioned F l c:) 61'- Area,.... : � � '�
B i ! :i. l cl, i- n g Type ....., ....... { . „ Single r=am .i. l
. D e t a r_. h e ci
.Bui.1.r_t:i.ng f=ront-: Orientation. Frcan•t-:..Fac:1'ng,
90, de '(1•) .
Number of :C we l.:l..i;g t_Jni.t:.s= .. .14
-
Nuriihr_:'r of- Stori.es.., .: ;__& � :i
'Blab
'
Floor C c:i n s t r•; 3 c- t. i. c; n T y r-, r_:' . ,, .., C:n-Grrde
(Package D)
Infiltration Control ....... ritanciar-c1 "
` OU l L_D l i' G SHE1_C INS ULA11.:�N
.-
l -r1:,1_. . - . • F�i--fir{a.l(_Ie L_r..,c�at..i.r_;n!i_:ommc,nt�.
a
Blrat;Edge l-1.::_ri to h,t:.l-t_si.de -
GLAZING }
1
Glaz i.rlC r-5rei:a # df .� 7: !-�� t: c.; l'• .i. ci e-' _ Exterior
l :r Ir- r� rr, i. r; g
, ,
� Orientation (.r f ) ".Panes Shading S11r_tf_l:! r)f;;
Overhang- T `i 1::Y(•i'
Door ' F:+r•lc:l•; (W) - a:8400 2 Rol lr_rShAd 50r,. buq
scr n Yes Metal
1...;r -•1.-,a Thickness 3...1arrtlSur..f_-;c:ed:%
Type isf) � _lri 1_:;r�c?���:'r.:! 1_",_,cat:..1:nn
rCnrnrr!i-_r;t: y .,
,
,_, .l 9 b O n G r-- r::! r_1 e 250 , , ,, Yes s
ASSUMED.HVAC SYSTEMS
- -----------------
r= 5Ni_Ime:'ci - L:fl_ir_:t. 7
1_iuct.
FsFlY=CEfficiency _?Ction
R cl _Z
tt
+ �:... 4.:'.i iri fei .. • ,. - .... 0 . S 1 :.. 3._3 t.. -t.:.1. C_'..
1 l
R-2;10
Airdonc_t C3 9 SEER i=lt:.t'i.i:,
CERTIFICATE OF C_:(fit°{PI,_
IANC:::f: ; RESIDENTIAL, ,
F aclt:•: 2,
CF -IR
r- r r..? J e c t. T .a, 't. l e .. ,... n Smith Add.i.'t..:i.r_.,n
Date . n ..
11/06/9.1
t''I, T,:
_��TH�:--CTfi5 Pr4grar--=1RM.:�-IRCFC=F
iTth:t
;
._. _..rpt di• 11t 1 •.. 1.'.-'
User -T-24 {_-rtt•_., I_ ra:I. t-.:.- Ca_. ; ` • I•�,!::!t-�.....X?:..
!=" ._ F',i_;8 „9R:►.3 o
3 •.. 2
- •w
SYSTEMS.ACTUAL HVAC
Actual. Out1:J!.d'f. 1` an!..!fAct::!..1r en
ant_I a149ode 1. #
A(_'I'.1_!a.E. SyAtem
1, .- _ for approved
Ef f.it 1.r'.ncy' � (..tt"t_!h1
C -"=q l_I c'i1 l .t.
Heating
Cooling Cc,i.:►_
i
!:_• E_: C: Maximum
t::?!,.! 'I:. f .� t_! t ,for- G s i ry Central F .! r n _a r_: c.
--•-_-•_-• _,_-. _. ___._...._. __._..._._.
_ r't t.:!_! I )' `
WATER TER {...lE AT I N( SYSTEMS
Tank fR!12 or"
its of V ] Greater trr!Pactr_r
arrModel ta:
.: .
I t-; c_• r- r_1 � �
t=iyste, Type
Hep (g.al. j Es1anket. (car- approved
equal)
Credits.
t•ieet.s CCC Mini.rTum.
n/a n/a .'Y;s
Ione.
1 SPECIAL 1=Et`::,Tt_lE"E %R1_I A K.S
-__--.___._-__.__.-__.__---
r
,
�
-250 C '1' ?'. o ct r_i C_I 1. 'I".:!. Ci!"t
_i. t=? existing a: (. � t.1 [_, s C' n -f t". ,, . home.
'
Existing HVQQ' ,:anC_i water heating �r.rl!_!i,�?mr__nt:.
f
_
_
s
CERTIFICATE DF , COMPL:..:i t:.)i`•1(-:i-_•n f li";SI L-?E!",iT I Ai:.. - - F't-tc-!q • - Z. . CF—IR;
Project Titley Smith Addition � Date ... R.n . - 11/06/9.1.
` fit-C.L,{:ji- i iS:a; 13;11 F i:l c•_:'. -••SMI Y(irlDD W?_, t (`;'l -Z 1:_ Prr_ gram-R:7R11
I I r 1 tf a li .1 •>.1.':: (_1...: c. r "T--.,_. i Energy C;ta t c.:_' C o ., F';{.:?rt--•0SF:2r',rS :: )f; .1: _'; :r ... _i o .,... _ 5
XOMPLIANCE STATEMENT.
Th.i.s c-er-t.i.fic-r3t.e of c:c:)mF'li.bnr..:4_:' :(.i.s'k:.s the building feal:.u1't_?s and pr r'•fbrm@nce "
specifications nFCbd?•i"'(_L. to? 6mi l y witk-t Title,' 4:; Chapter . —r:i.T ,_tnc1. ..fitte 20,
ChaL_?t_er 2, lt_{k.)r..:haf-?t:er 4, 5"Art icle
signed (.oj k -r • ral if`;n3l'Afminittrati+e _oF
il:c (ti-(i`icale ias been by tle inoimiduhl wilh "4?ll design
re_ponl3:itiTy a"d t"e building {riry-,Who'shall "et33nC_C+'?f itand
t.:r<an<.: mit the c_er-t:.i.far_.atr•:.:' to any •s?_?L:)CO;f-"'(n?.dCi?r't'k:. {_)?_?r(=k')<=ts(•.i{'r'ri:f ytfle f:n_?.i.:lr_l.ir.tfj., :When
this c:erti.f :daft•.' of •r_omp:i.Anc_:r_,' s jubmitted�fbr'"a pingle ta?.?: ldi.nr{. p:1.:=tn, 'tn
be, built in mult;l.pl(•'_v (SP..lr.'!.'.:tat:ipri , all isi?_?i..(.Cii.ng f=(71'jr''.:e1'-vat:ion tf.•_:'S1'(".?_?r-F_d.
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Palm r?r_:._>c.�,r t- (:r 1 5 ht i 1 .a (1?..1 i n tr.l f -(..., Phone.., 1619),160-0750 " Phone..!'
r • Z''• 1 564--•{=210 <
'License.
I?CJ{:.;t_li`1f";t• T AT 10N AUTHOR � i.,i.-•NFC{(-;(=;C-i"1Ei`d?' AGENCY
Name. o e ,: - (.: ,.
WAWA C1 c1 1, 1. --'C:. k't !' i.�� t:CnSt_?r-i ('y c'am & .-
Company. - T-14 -:�I:= i"t c_� 1'- cj y (.:..j 1. c � (; c_i . (� �i: t .i. r� a ............ '---•---•--_�_.....____.------• --- -- ---- ---
Address. rr--i •_ 3 Country C l {_{ j•_, -:t:,1... o ,^: .i=l,t j n n
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to -
CO, 1EC:;i a..:1: ST Y 'FJ_'-_'S, 1. nE1,.{_L 1: r 31._. Page 1
04R
Project T i. t.1. e , '" " ,:. R " :. � ..; . Smith Add.i.t.i.on-
11/06/91.
Project rcr" " " " " 46_::5. a:hKgtcn St.. � t .--.._...._._
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;cr_fYntrticr-_th_r-; "C. Fand_ 11-Christensen t til_irg FrlN t;
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Tele phc,ne - " ., " " " " " " " " (419! :>60_...05.35 a a Plan (_;heck.
% Date
Cnnip.1.?.ance Method . " " :. a : 1"{ICRCaF'fy 3 by EnercomF,, Inc." F='i.�E ld, f=:1-teEk
DateZ:
_
Climate Zone.. " " " .: " " " " " 15,- - ......_.. _ _...._.
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lCi-lie"_11f1lr: .s_k,cL to the Standards must contain these
measures r"f: grar-dIesh of the cC?mp.1 icanr_:e :a!p{_?r't_:at:h'i used. it',emci !1`!ar'"1':.ed
4!1.th an
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r_ r, the C:; r.•.? �'_'h:.:i. f :i. r:; ::i 'h:. e - o f ,Coni (_? I :i. r_! n r_: t•_: " When i'_ h..! �. �: checklist i s_:• - •a. n c o r'.'kr? r. a'h_ r-. r.:t
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'r?r-:?rm:t.t dor=bmF._nt.,sa'.. th';r_ '¢ety'i=.l!re's noted shall 1_:e c:nnsi.dt•_}r-ed by • All p_:tr'ties as
t'?indind" ccipF:?or';en't_ performance sF: lien.::>, fir_}r- them�andatol`-y
measuresw
h ether they �a r- e shown r•.::' 1.._: t:•_ w 1-i e: r-- e' , document . �> r: r c.., r-, this !.he•t.:1':.li s=.•t.
only.
. F!l..i:I i._:(:? I. NG . 1-N JET {..-O E MEASURES
_
Enforce-
Minimum m ce?.7. king -in'•:,r_tl a t_.1..!_ n R-19 weighted c!'.!er_Ctg'(_':. r
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' Ci..l'iP._:"CE::F; M.:_T!-ir'._: SUMMARY*" - Wgr:` J_- (:=-...;.R
F'rf_?jert Tide.%nnr,nnn n Smith Adf_!:l.'C..].o1 1.?Caten nn:,n:,•n 11i06i9.1
Project r:..c::t:. f"1ddr•'e: .:- n n :. 46-775 l+.Icr,shi.ngt.:r�?�..., St_. _---- 7=7-7 __..__..__.._..._....._..._.....__._....:.__
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LA L:�l..lint:.l:a -CA
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,T1r_ar_.umentast.i6n Author... C:n Randall_"Ct"{n1.c't:enven- : 0l_llldi.nn Permit tt
-
_ ,l.::c_?rta4'a n y n n n n n n n n ' n .. n rr rt o ' T-24 Energy f= e -a l r_:s' Co n
Telephone n a n n n rt n n n n n n n n (619)'360-0535 i Plan t_•t-{erl'•. / Date
1
Compliance te t -ad! n n n rn by ?hc n FibTSCirr'% Dal__
"I=;t=6i3 ,_crcom(?
" Climate Zone.. !:--_--_--____..._;
_
MIC'Rl:]F=AS:3 v3rt11 Fi.Ie-•_c;i"iT-1-1-iF-1C"?D Wt_WC..1_Z1.6 Program--FC1NA C ---:r"'(: V!
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- 1_jser#-1')1-'.LOI-;.i. User—T-24 E!" erC) ;/' bA !. C.=f_- Eo.1 . Run--DSF7^''.131...8; 9RI3 n ?'•_> n __. +
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'
- MJ f.:;r1i::?PA 3 ENERGY . USE SUMMARY
-:, t_ r n r1ri. Proposed: Compliance
tkFe_:sf_fr1 ie=7a"'° T:.ief3.].C}fi" r'IiHriJ.3.fi
+ a f'-F'IF:i'rat.l.r', !.in' n n.0. 9.8a i,, .<:.-:. Q.45 ....
rs. Spirace Cooling.. rt n n n n n n > 50n90 60:,17 —1.21 = -•
,
t e r Heating?: rt n n n n n :; rt 10.47 ,10;47 i; n c) i? _..
,. y
Total -r. ! .''n [;? i -0:24 -.
1:?1..1ildi.ng i_:f.:IfY)('i.lies with 1'_;r_?f<7(:uter_ fr�_,"..f6rdiic`il-ce %f.W -
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'GENERAL INFORMATION"!
Conditioned' Floor t=i{.6i:12n ., n n• 250:s,:
nn nn rnn,
Building Type rt rt n n n Si-ng.l-�_�' Family Detached'
a fst..t.i.ldi.ng (=rout_ 1: ari:entWc_?nn Front_ FaaC::i.rif{ 0 dere (L=::)
Number of Dwr la ].rich" •1.!i r, t -s :1 .14
_ { i r ?tor --ie= n 1Number ofi-it_I Building C:. _ : 1 i� ti
'1Aeaa't:i-ier Data Ty6e Q n n n n n :, n iedu_eiYetr-
,, F:_c" L: _rit_r t -q ' i Type rt n n n Slab _- _ r prc' (Package D)
Numberof Building Zones n n n i.
Conditioned Q 1. c.. m e_? w rt n n n n ' n n n � 2000 c;: f
_
Footpr.i.nt:. Area n n rt n n n .n n n n ` ?`;0 ,s
•fI _?Cn_C'_ ,rArea . n n 150 A = ,
Glazing 1='er!_ent:.aftert n n n n n n .1.9; % 6f,Ft',
Aver-cI: ge Ceiling 'F'lf::'3.ght n' n a n rr a _f -t:
+1_i7:I_.E>IN ,:ZC1i`3E 7.1'%1F-1. R1` AT10N
F'locelr-#" of Vent Special
C and -- -Area :-Volume WrII Ttiermostht Height tient" Arc': -'F:,
f'o}-ark Type it:ioned W) (C:'i4') 1_ln.t't:t Type, (ft) WT) •
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