10-0285 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&t�v44Q"
Application Number: 10-00000285
Property Address: 53230 AVENIDA HERRERA
APN: 774-0'54-011-14 -000000-
Application description: REMODEL - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 9500
Applicant: Architect or Engineer:
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 Professionals Code, and my License is in full force and effect.
License Class: B License No.: 595166
Date: OC ontractor:
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).:
(_) 1, 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 contractor(s) 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
Owner:
BACA SANDRA
53230 AVENIDA
LA QUINTA, CA
(
HERRERA
92253
Contractor:
DESIGNER SASH & DOOR
18890,SEATON AVENUE
PERRIS, CA 92570
(951)830-2131
Lic. No.: 595166
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/09/10
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 DELOS INS Policy Number 03DKRM1200
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,
IIsshall forthwith comply with those provisions.
Date:ey O , (ApIicant:
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 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 1 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 enter upon the above-mentioned property for inspection purposes.
Date: t�Y S Signature (Applicant or Agent):y
Application Number . . . . . 10-00000285
Permit . .
. BUILDING PERMIT
Additional desc .
Permit Fee . . .
. 117.00 Plan Check
Fee
76.05
Issue Date . . .
. Valuation
. . .
. 9500
Expiration• Date .
. 10/06/10
Qty Unit Charge
Per
Extension
BASE FEE
45.00
8.00 9.0000
THOU BLDG 2,001-25,000
72.00
----------------------------------------------------------------------------
Special Notes and
Comments
REPLACING (4) WINDOWS
& (2) GLASS DOORS
--- ------ -- _.- _. - PER APPROVED -PLANS
PER AJ...
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
7.61
Fee summary
-----------------
Charged Paid Credited
----------------------------------------
Due
Permit Fee Total
117.00 .00
.00
117.00
Plan Check Total
76.05 .00
.00
76.05
Other Fee Total
8.61 .00
.00
8.61
Grand Total
201.66 .00
.00
201.66
LQPERMIT
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BUILDING & SAFETY DEPT.
APPROVED
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Ar � n Andersen Windows - Abbreviated Quote Report Andersen.
NMProject Name: Baca, Sandra 'w
�-..:o-.w.l
Quote #: 371 Print Date: 03/30/2010 Quote Date: 03/24/2010 iQ Version: 10.0 Page 1 Of 2 INMAN
-
Dealer: NE=LA 715 Customer:
18890 SEATON AVE Billing 53-230 Avenida Herrera
PERRIS, CA•92570 Address: La Quinta, Ca 92253
909-208-6164 Phone: 760-564-0138 Fax:
Sales Rep: Administrator Contact:
CSR Name:
Item Qty Item Site (Operation) Location
0001 1 100GX03' 8 1/2" x 2'9 1/4" (XO)
Kitchen
RO Size- 3'9"Wx 2'9 3/4" H Unit Size=3'81/2"Wx2'91/4"H
Unit, 1" Flange Setback w/Stucco Key, White/White, XO Handing, Low E SmartSun Glass (Each Sash), Insect Screen, White
0002 1 100GD2P8068 (LS)
ROSize •8'Wx6'8"H Unit Size- 7' 111/411Wx6'71/2"H
Kitchen
Unit, 2 Panel, No Flange, White/White; LS Handing, PANEL Low E SmartSun Tempered Glass (each panel), Gliding Insect Screen, White, with Auxiliary
Footlock
0003 1 100GD2P6068 (LS) Master Bedroom — -�
ROSize=6'Wx6'8"H Unit Size= 5' 11 1/4"Wx 6'7 1/2" H aar
Unit, 2 Panel, No Flange, White/White, LS Handing, PANEL Low E SmartSun Tempered Glass (each panel), Gliding Insec�, Sc�jen, White, with Auxiliary
Footlock '!
)i
0004 2 100GXO5' 8 1/4" x 2'9" (XO) Bedroom
ROSize =5 83/4 Wx2'9 1/2 H Unit Size =5'8 1/4Wx2 9 H
Unit, 1" Flange Setback w/Stucco Key, White/White, XO Handing, Low E SmartSun Glass (Each Sash), Insect�Screen, White '
Andersen. Andersen Windows - Abbreviated Quote Report Anderxn.
'W Project Name: Baca, Sandra AA
t.
-.............. -... Quote #: 371 Print nate: 03/30/2010 Quote Uate: 03/24/2010 IQ version: 10.0 Page d UT z •-•.-•••.............. i
Dealer. NE -LA 715 Customer:
18890 SEATON AVE Billing 53-230 Avenida Herrera
PERRIS, CA.92570 Address: La Duinta, Ca 92253
909-208-6164 . Phone: 760-5640138 Fax:
Sales Rep: Administrator Contact:
CSR Name:
Item Qty Item Size (Operation) Location .
0005 1 1000XOX7' 81/2" x 4'9 1/2" (XOX) Living Room
ROSize=J'9"Wx4'10"H UnitSlze=7'81/2"Wx4'91/2"H
Unit, 1" Flange Setback w/Stucco Key, White/White, XOX Handing, Low E SmartSun Glass (All Sash), Insect Screen, White
Customer Signature
Total Load Factor
(— 0.006
Dealer Signature
** All graphics viewed from the exterior
** Rough opening dimensions are minimums and may need to be Increased to. allow for use of building wraps or flashings or sill panning or brackets or fasteners or
other Items.
51t = EcoExcel Package a Other Tax Credit Eligible Products
Specify the EcoExcel Package for replacement projects and make the homeowner eligible for a•30 percent tax credit up to a maximum $1500 combined over
200912010, Please see www.andersenwindows.com for details.
Pro ect Comments:
AndersenOD 100 Series Product Performance*
Andersen
Product
Line
Product Type
Glass Type
U -Factor
SHGC °.
100 Series
Casement Window
EcoExceI
Low -E
0.29
0128
Low -E with Fineli trm Grilles 0.29
0.25
Low -E SmartSunTM 0.29
0.19
Low -E SmwtSu Tm vMh F3neli tTm 43rilles `0.29
'0.17
100 Series
Awning Window
EcaExae
Low -E
0.29
0.28
Low -E with FinelightTT4 Grilles 0.29
0.25
Low-ESmartSun11°' 0.29
0.19
Low -E Smart$unTM with FinefightTm Grilles 0.29
0.17
100 Series
Eckxcelel
Single -Hung Window
Low -E SmartSunTM
0.30
0.21
Low -E .SmartSunTm with FinelightTM Grilles 0.30
0.19
100 Series
Excel
Gliding Window
Low -E SmartSunTM
0.30
0.21
Low -E StmartSunw- with Fineli t m Grilles 0:30•
0.19
100 Series
Fixed Window
E&Exael
Low -E with Finelightrm Grilles
0.30
0.29
Low -E SmartSunrm 0.29
0.22
Low -E SmartSunTm wig FmehgW 14 Grilles 0.29
0.20
100 Series
Transom Window
B&End'
Low -E with FinehghtTm Grilles
0.30
0.29
Low -E SmartSun''M 0.29
0.22
Low -E SmartSunTM with FinelightTm Grilles 0.29
0.20
100 Series
Eo�
GlidingPatio Door
Low -E SmartSunTM
0.30
0.21
Low -E SmartSunTM with Finelightrm Grilles 0.30
0.19
*Where grilles are identified, all grille patters apply. Andersen® 100 Series windows and doors with breather tubes are not
eligible for the tax credit.
June 3,.2009 Page 2 of..2
WINDOWS•DOORS
Andersen -L' -SIA
Manufacture
Certification Statement
for Andersen®100 Series Exterior Windows and Doors
that are Eligible Building Envelope Components under Section 25C of the Internal Revenue
Code as amended by the American Recovery and Reinvestment Act of 2009
Andersen Corporation
100 Fourth Avenue North
Bayport, MN 55003
This Manufacturer's Certification Statement ("Statement"), dated June 3, 2009, identifies Andersen@
100 Series exterior windows and exterior doors manufactured by Andersen Corporation ("Andersen") that may qualify
as "Eligible Building Envelope Components" for a tax credit under Section 25C of the Internal Revenue Code, as
amended by the American Recovery and Reinvestment Act of 2009 (the "2009 Act").
The 2009 Act modifies the tax credit for certain energy efficient components that are purchased and installed
from January 1, 2009 through December 31, 2010. The tax law requires that certain requirements be met to qualify for
the credit. For.example,.exteriorwindows,.doors.and.skylightsmay.qualify for the tax credit ifthey.achieve both .a
U -Factor of 0.30 or lower and a Solar Heat Gain Coeffcient ("SHGC") of 0.30 or lower. The components must also be
installed in a dwelling unit in the United States that is owned and used by the taxpayer as the taxpayer's principal
residence. The original use of the components must commence with the taxpayer, and the component must be expected
to remain in use for at least 5 years.
Based on Section 25C of the Internal Revenue Code as amended by the 2009 Act, as well as IRS Notice
2009-53', Andersen has determined, based on ratings certified by the National Fenestration Rating Council (NFRC)2,
that the following Andersen® products with the specified glass types noted have both (i) a -U -Factor rating of 0.30 or
lower and (ii) a SHGC value of 0.30 or lower.3 As a result, we have concluded that each of these products is an
"Eligible Building Component" that may qualify for the credit allowed under Section 25C in all climate zones of the
United States. Products with special glass options and custom sizes larger than those listed do not qualify at this time.
Under penalties of perjury, I declare that I have examined this Statement, and to the best of my knowledge and
belief, the factsare true, correct and complete.
� eAl- /
Jay Lund
President, Andersen Window. and Door Group
"Andersen" and all other marks where denoted are trademarks of Andersen Corporation. 02009 Andersen Corporation. All rights reserved
'The information contained in this Statement is based on IRS Notice 2009-53 and the language•of the 2009 Act as we -understand it as -of the, date
noted above. Andersen may, but is under no obligation to, update this Statement when new information and interpretations from the IRS are
obtained. Andersen does not intend to and is not providing legal or tax advice and recommends that purchasers consult with the IRS or their own
tax advisors to determine whether they qualify for the tax credit. Andersen bears no responsibility for validating or obtaining the tax credit and
expressly disclaims any responsibility for determining whether a particular purchase or application qualifies for the tax credit.
2 NFRC ratings are based on modeling by a third party agency as validated by an independent test lab in compliance with NFRC program and
procedural requirements.
This data is accurate as of June 3, 2009. Due to ongoing product changes, ongoing testing and certification and changing industry standards and
requirements, this data may change over. time. This Statement may also be updated periodically to reflect changes to product ratings.
Page 1 of 2
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations Page 2 of 5
Project Name: Climate Zone # # of Stories
Si4 N D Z P14 15 t
and
1. Indicate the type of assembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can
befound Reference Joint Appendix JA4.
2. This is the U -Factor based on the thickness of the assembly in inches.
3. The R -value of the insulation to be added on the interior or exterior of the assembly.
4. The Calculated R- Value is the R -value of the furred out section of the assembly.
4 The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix J44. The equation is the inverse of Column
radded to Column L Column K is the inverse from column J.
7. Insert the calculated U- actor value on to the Opaque Sur ace Details in Column J
FENESTRATION PROPOSED AREAS
IN Replacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in
Table l5l-C. The Total Fenestration and West facing Area requirements are not applicable.
Adding 50ftz or less of window area —Newly installed windows shall meet the U -Factor and SHGC Value requirements of Component
Package D in Table 151-C.
E) 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 D in Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF -I R -ALT
Orientation
E
Fenestration Type and Frame (North, East, PropsedAreal
Maximum Maximum NFRC or Default
Window, Glass Door or Skylight) South, West)(ft')
U-factorz- 3 SHGC2, 3, ° Values
#Z t.% %,.D NOrTH to
. 3v, 2.t AlFac
#Z 6r(.,4st Door WCST 53
: o - 7.1 NF4ZC
3 GL04rs Doo2 tj0r 40
3 Ai FSC
N s .5-') / 1 S
. 30 tj tz
6 wt � flo.,� 7;�tIT 3 S
� 3� • i t N F 2
1. Fenestration area is the area of total glazed product (i. e. glass plus frame). Exception: When a door is less than 50% 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-C.
3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower Ufactor and/or a lower
SHGC value than that specified on the CF -IR ALT Form.
4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading.
5./Cqpplicable at this stage enter "NFRC" or NFRC Certified windows or are CEC "Default " valuesfound in Table 116-A or B.
ALTERED FENESTRATION ALLOWED AREAS
(Complete if more than 50ftt
of fenestration is added)
A
B
C
D
E
F
G
Allowed
Existing
Fenestration
Total Area
CFA of Entire
% of
Fenestration
Area
Fenestration
Allowed
Proposed Areae
Dwelling
CFA
Area
Removed
Area Added
A x B)
(E -D) + C
Total Fenestration Area
20
>
West Fenestration Area
(Required In
.05
>_
CZ's 2,4&7-15
/. West Fenestration Area includes west -sloping skylights and any skylights with a pitch less than 1:12.
2. West facing glazing area removed cannot be "counted" twice. " In order to distribute the west glazing area removed to the other orientations,
input the west glazing area removed in the Total Fenestration Area row, column D.
3. Include the Proposed Area of the West facing fenestration in both Area columns below.
4. To meet compliance, the Proposed Area must be less than orequal to the Total Allowed Area for BOTH the Total and West Fenestration Areas.
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms August 2009
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations Page 1 of 5
Project Name: Climate Zone # s # of Stories
General Information L R- f0
Site Address: s 3 _ Z -d %i US -IV i w
Enforcement Agency:
Date:
Building Type[3Single Family ® Multi Family
Circle the Front Orientation: N, E, S, W, or degrees
Conditioned Floor Area (CFA):
Project Type: AlterationsEnvelop
Fenestration Roof HVAC
JA4 Proposed
Replacement or Chane Out
Duct Replacement 0 Water Heater
NOTE: This form is not to be used for Newly Constructed Buildings or Additions
insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
El Opening of framed cavity alone- Alterations that involve the opening of the framed cavity of a wall, ceiling, or floor must install the
mandatory minimum insulation value per §150 for the altered assembly. Fill in Columns A -C and enter mandatory insulation value in Column H.
Replacement of entire assembly- Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component
Packa e- D insulation values in Table /5/-C. Fill in Columns A -J.
O a ue Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below.
A B I C D E F G I H I I J
Proposed bee 01e Standard Values From JA4
Table
M
Proposed Properties of Masonry and Concrete
Framing
Thickness, Framed
Continuous
JA4 Proposed
Tag/
iD'
Assembly Name
or Type 2
Material
and Size
Spacing, U- JA4 Table Cavity
or Other3 factor° Numbers R-value6
Insulation
R -Value?
Assembly Assembly
Cell Value U-factor9
v
o
v
c
ir' v
U
u
.i0 . > H
iO
Assembly i "�
a
c 4
o .3 ',
F
„
o.
F c U-
Final
Mass
Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and
Furring Construction table below.
/.For Tag/ID indicate 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 in column G the Frame
material and Size: For Wood, Metal, Metal Buildings, Mass, enter 2x4, 24 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 equivalent U -factor found in JA4 Table based on the R -Value from Table 151-B, C, or D
5. 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 factor in Column E to comply.
Furring Strips Construction Table for Mass Walls Onl
A I B I C D IE
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 Appendix Table 4.3.5, 4.3.6 4.3.7
Joint Appendix Table 4.3.13
v
o
v
c
ir' v
U
u
.i0 . > H
iO
Assembly i "�
a
c 4
o .3 ',
F
„
o.
F c U-
Final
Mass
Name or JA4 Table oy
ai,
E
E o o v a
Assembly
Thickness'
T e2 Number' ¢ >
X c
12o
� ' ¢ >
U-factor6'7
Comment
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms
August 2009
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations (Page 5 of 5
Project Name: Climate Zone # # of Stories
5#9ND le F1 13 6A �S d
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.
❑ 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.
YES ❑ 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)I Di:
YES ❑ 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 §I52(b)IE.
❑ 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 ducts stems constructed, insulated or sealed with asbestos.
Refrigerant Charge -Split System HERS verification is required for this measure.
❑ 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
exchanger) a refrigerant charge measurement shall be verified per §152(b)I F.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation requirements of § 150 o 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
rep laced, the airflow and fan watt draw shall be verified per 152 b 1Ci to meet therequirements of §151(07B.
Documentation Author's Declaration Statement
• [certify that this Certificate of Compliance documentation is accurate and complete.
Name: 65- AsoA' G C_ L v o n C,-
Signature:
Company:
A 1C, SJ6- N'r,r S A J is 2 t r f T- z /"t S X- -V C.
Date:
C>
Address:
If Applicable CEA or OCEPE
J rr* Cj 4 sic w -T- N 14 u L
(Certification #):
City/State/Zip:
L-rrtS CW tS C�
Phone:
Bios-Zofl�G/6�:
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.
• 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 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 building permit application.
Name:
Signature:
Company:
Date:
Address:
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:
2008 Residential Compliance Forms
August 2009
Bin#
.0ty.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 #
b
Project Address: s S- Z 3 o AWE NIyH N C!'f^Z 12 p
Owner's Name: 5-01VC 2O4 B S C IA
A. P. Number:
Address: S 3- I -Mr(' e't-F4
Legal Description:
City, ST, Zip: t 14 04 L� 9 ti ZS
Contractor: QS51 Z,, idS NOr Vf rc!-"
Address: ice% p 4qy G v
Telephone: d�'r.'d. v�,j'3>i:'•:Kfi;r. +:a..:;
Project Description: kC e(.A C t ni Cf- Lf w i U i-.xo S
City, ST, Zip: pg r r/ I CJ't S Z 7 O
14 /V IJ Z Dao r S
Telephone: glgq,
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State Lic. # : 5"5 S / 6 C.
City Lie. #•:
Arch., Engr., Designer:
Address:
City., ST, Zip:
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Telephone:
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Construction Type: Occupancy:
Project type (circle one) New Add'n Alter Repair Demo
State Lie. #:
Name of Contact Person:
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project y, S O 0 v 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
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 HOUSE:-
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees