11465 (SFD)T4ht 4
Blk. 291 �W
Lot 22
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-320 Herrera LA QUINTA, CALIFORNIA 92253
Owner Jacques Lefebvre
Address P.O. Box 2795
City Zip Tel.
Palm Desert 92261
Contractor
SAME
Address
State Lic.77507 (City
& Classif. Lic. # a
Arch., Engr.,
Designer Anderholt
Address 4725 Sunny Dues Tel. 340-1907
City Zip State
Palm Spgs. 92262 Lic.#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) ffect. of Division 3 of the Business and Professions Code, and my license is in full force and
e
SIGNATURE DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License law for the following
reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which requires a
permit to construct, alter, 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 penalty of not more than five hundred dollars ($500).
❑ 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.)
❑ 1, 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
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
e6opy 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
=any person in any manner so as to become subject to the Workers' Compensation
Laws of Calr omnia.
Date Owner
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption 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 slate 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.
A.P. Number
Legal Description
Project Description
No. 11465
OCC. GRP.
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Sq. Ft.
Size 1635
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Permit does
not include
b1oekVw&11,
pool, or patio cover.
Date Permit
Validated by:
Validation:
Estimated Valuation
$
95,915.30
PERMIT
AMOUNT
Plan Chk. Dep.
$15 0 • 00
Plan Chk. Bal.
* 1.r b . U S
Const.
011.5 U
Mech.
97 . 5U
Electrical
t j-15. U5
Plumbing
14M UU
S.M.I.
`J . b U
Grading
20 . U111)
Driveway Enc.
Infrastructure
,= i 1 9. U 4
TOTAL
Z)b3.ri�
REMARKS
l r 1�
.� • m.� I t
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
A.C. UNIT
i
1ST FL. SO. FT. ® $
UNITS
2ND FL SO. FT.
STORAGE TANK
YARD SPKLR SYSTEM a�
SEWER Cilf5EP11Cgt41+tt/ ! ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SD. FT. ®
FOUND. REINF.
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
OTHER APPJEOUIP.
REINF. STEEL
DRAINAGE PIPING
CARP. SO. FT. ®
WALL SO. FT.
WATER HEATER SERVICE
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP. �/
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ®c
IWATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE --f--MECH.FEE
PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE N / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING1 Q UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER Cilf5EP11Cgt41+tt/ ! ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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. 3L
FRAMING L//
FINAL INSP. �/
ROOFING11
i /� (/Jn /
3y L �
• 7�
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
RING 2C�
MESH
INSULATIONISOUND��� v�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
kEm
.1
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL_ DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 111/10/921 Type of Permit I La Quinta
No. 111820 1 Permit #
Owner Name Jacquis Lefebvre Log #
No. 54320 Street Herrera
City La Quinta Zlp 92253 Study Area 110
APN # 774-251-003 1 Tract # I Lot # 0 Square Footage 11635
Type of Development Single Family Residence No. of units 0
Comments
At the present time, the Desert Sands Unified School District does not collect fees on
garages/ carports, covered patios/ walkways, residential additions under 500 square feet,
detached accessory structures or replacement mobilehomes. It has been determined
the above-named owner is exempt from paying school fees at this time due to the
following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.58 x 1635 or $ 2,583.30 have been paid to D.S.U.S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By Jacques Lefebvre Telephone
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Vickie J. Durrett
Payment Received
Signature Check No. 3302
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/ Receipt Copy - Accounting
• Point System Summary: Climate Zone 15
s
Project
r1C_
Date
P -2R
BUILDING DATA Glass Area % Glass
nditioned Floor Area 163Y Number of Stories North 1 .60 f7
Slab aised Floor East
74 4
South 4
Check all applicable Unit Type condition(s): West 21
[ ] Single Family Detached (SFD) [ ] Addition Alone Skylight ,
Single Family Attached (SFA) [ ] Existing Building Total
] Multi -Family (MF) [ ] Existing -Plus -Addition
SCORE CARD
8. Shading (Shade Closed)
Measures
Eff. % Glass
Point Scores
1. Ceiling Insulation
50
or
b. East
¢ , 5 x
11-3
R -value (381
U -value 10.0301
'Z , x =
, to
2. Wall Insulation
1 5
or
x
Z
R -value 1191
x =
U -value [0.0661
3. Raised Floor Insulation
_19"
or
10. Exterior Wall Mass
Interior Mass/CFA
R -value 1191
U -value 10.0371
r�
4. Slab Edge Insulation
6�1'1
or
11. Heating System
x =
C/
R -value 101
Zonal Control? ( Y / N)
F2 factor 10.771
Effective SE or
5. Infiltration
Standard
[0.72/6.6]
D x =
HSPF [0.56/5.15]
Iy
0
6. Glass Heat Loss
SEER 19.51 Duct Efficiency 10.741
Effective SEER [7.03]
%. 7
6
S f_N�R
Type tdouble]
U -value [0.65]
%Total Glass t 16
_
Sum 1-6
7. Shading (Shade Open)
Point Total:
% Glass
SC
Eff. % Glass
a. North
f9 7
x
. 77
_ , %
0—
b. East
A. 5
x
c. South
Z ,
x
f ,
_
>
d. West
z - �'
x
= z,
_
p
e. Skylight
, 4- x
= , 3
0
8. Shading (Shade Closed)
Form Revised March 1988
% Glass SC
Eff. % Glass
a. North
9 7 x Z =
, 7,F_:2
_—�—
b. East
¢ , 5 x
11-3
I
c. South
'Z , x =
, to
`Z
d. West
x
e. Skylight
x =
1-
9. Interior Thermal Mass
10. Exterior Wall Mass
Interior Mass/CFA
Exterior Wall Mass
g C)
90
Sum 7-10
11. Heating System
x =
i
Zonal Control? ( Y / N)
SE or HSPF Duct Efficiency 10.781
Effective SE or
12. Cooling System
[0.72/6.6]
D x =
HSPF [0.56/5.15]
Iy
Zonal Control? ( Y / N)
SEER 19.51 Duct Efficiency 10.741
Effective SEER [7.03]
13. Water Heating
S f_N�R
— _
Type (SG] Credit [none]
Point Total:
`- 2—
Form Revised March 1988
Thernial Mass Worksheet WS -1R
1'rojcct'1' le Date
INTERIOR THERMAL MASS
U,c ujie of the two following options for calculating interior mass as explained in section 4.2 of the Energy Conservation
:'.l:;nuul (ECM). Method B must be used for mass elements that have an interior unit mass capacity less than 1.7.'
Nicthod A: Look up the Interior Mass/CFA value from ECM Table 4-7 reprinted on the reverse side of this page. Type 1
,,,.,ss has a Unit Interior Mass Capacity (UIMC) greater than or equal to 4.2 (see ECM Tables 4-8a and 4-8b reprinted on
.,L,J,uu>+tl). "type 2 mass has an U1MC greater than or equal to 1.7 and less than 4.2. Mass % is the mass surface arca
by cunilitiuncd floor area (CFA). For mass elements exposed on both (two) sides to conditioned space, enter the area
„ f unly cine side to calculate the percentage.
Mass
Type I Mass Area:
Type 2 Mass Area: Z
Interior Mass/CFA from Table 4-7:
N ictliud B: Calculate the Interior Mass/CFA value using the worksheet space below. Look up the Unit Interior Mass
C:,pacity kUINIQ for each interior mass surface in ECM Tables 4-8a, 4-8b and 4-9 reprinted on the Attachment. Include the
micrior,urfaces of exterior mass walls. For interior mass walls exposed on both (two) sides to conditioned space, enter the
.uca of uuly otic side. Include the inside surfaces of exterior mass walls as explained in section 4.2 of the ECM.
Unit Interior Interior
Dcsciiption Mass Area Mass Capacity Mass Capacity
X =
X =
X =
X =
X =
Total CFA
EXTERIOR WALL THERMAL MASS
Interior Mass/CFA
Cal,:ul.,lc the Exterior Wall Mass of all exterior walls. Look up the Exterior Mass Factor for each opaque wall element from
L" - I "table 4-9 reprinted on the Attachment. Only exterior mass wall surfaces may be included in this calculation.
Opaque Exterior
Description Wall Area Mass Factor
X =
X
X =
Conventional Walls x 0 =
Total
Form Revised March 1988
Total Opaque Exterior
Wall Area Wall.Mass
Certificate of ompliance: Residential
(Paige 1 of 2) CF -1R
)CZ.C-QL Feb r�
!'reject r
h6j"I n.a...
G. FAwasd Am4erholt #396799 619-320-9809 E
ilrsrw.ntauw ww►v Tetr+MoePOINT SYSTEM r r rs
L wwOA"ca kWhad 0'.,:►W. Pww SYMm a cornp.ua) ease Zmw fidamm .r As wry We Only
GENERAL INFORMATION
Told Co"tioned Floor Arca: It
UiaildingType: SingleFwni)y Hotel(Maol
(cb"k aw w awe) IrMulti•Fwuily (Iw Ilaa 4 akwiea) Audition
MuW-Fwuily (d ur anme atotk4 ._ 6aiwittS-Hw-Ad ikw
From G►try Orientation: Nonit / lrm / Stwtlt / Won / All OriClltatkXJ& (oirve me w am*)
Nwut><r of Dwelling Units:
Floor Cotu uuWc nTypc:
lab Raisrtl Floot (riroM aw or ba1W
kulltrttion control: (,<7umdau ight wick aw ;
UULLDING S11ELL INSULATION
Component Insuluion LocadonlComments
TYN-b R•Value (attic; to rarare, wykat, sic.
Wall .............. R' FRAME WALLS
Wall .............
hoof ............. R• 38 TYPICAL_
R001 .............
atoot .............
Fluor .............
Slab Edge ..... 0 T YP
GLAZING Shading Devices
Glazing
Area
Glass TyjX
Interior Exterior
Overhang Framing Typo
Orientation
(st)
(►ingic. duuble)
(roller blind, etc2
(sha klaccn, etc.)
(Ycslno) ( "44wood)
Fri,.., (to
- 7z/
MUULL'
VERTICAL BLINDS
N014C
YES
Front .... ( )
1111 TE.+�
L at...... W)
�
(X1Ul lLt:
VERTICAL HL IMUS
tXXE
YES
W. I...... ( )
Wt 11 TE
Rear..... (E)
�z
DUUDLE
VERTICAL 8L 1 NDS
"Jr-
YF_ . Sr_
may ..... ( )
VAI 1TE
Right.... (1
O
DOUSLE
VERT 1 CAL A I NDS
bar;
_
-YES
Right.... ( )
WM 1 TE
Slc li Stu....
y b ••.
DOUBLE
LUC.
Sl►yl,�u
THERMAL MASS
Typrlcoverins Arca Thickness
(slabltaposad. tile, etc.) '(si) (inches) Location/DescriPtion'(hitchen, bath, me.)
S-AB/CXPnSED _3 /2 r_ K I TCMEN/9ATM/ENTRY
Mandatory Measures Checklist: Residential MF -111
NOTE: Lowrise residentW buildings abject to the Standards must contain these measures regardless of the compliance
approach used. hems marred with an asterisk (•) may be superseded by more stringent compliance requirements listed
on the Certificate of Compliance. When Utis checklist is incorporated into the permit document% the features noted shall
be considered by all parties as binding minimum component perfamanoe sped icatia s for the mandatory measures
whether they are slow. elsewhere in the documents or on this cheekUst only.
DESCREMON
DESIGNER l P.NPORCEMEKr
Building Envelope Measur 101
• 12.5352(a): Minantrn ceiling insulation R-19 weighted average.
12.5352(b): Loose fill insufaion manufacemv's labeled R -Value.
• 12-5352(c): Minimum vM insolation in famed walls R-11 weighted average (don not apply e
arterior mass WaW). 17
12.5352ft Slab edge haWation - water absorption mono gseaer than 03%. water vapor
transmission rate no grater than 2.0 perm/inch.
12.5311: Insulation specified or installed meets California F tergy Commission (CBC) quality
standards. Indicate type and form.
12-5352(fr Vapor barriers mandatory in Climate ?.ones 14 and 16 only. A)
12-3317: lardowkw Exfdtration Controls
a Doors and windows between conditioned and unconditioned spaces designed to limit air
leakage. /
b. Door and windows certified. Iv/
c. Doors and windows weathervMpped: all joints and penetrations caulked and soled.
12-5352(e): Special infiltration barrier installed to comply with 12-5351 meets CEC gyWity
standards.
12-5352(d): Installation of Fir lam
1. Maloney and factory -built 0visces have:
AL. Wight fitting. closeable metal or glass door
b. Outside air intake with damper and control
c. Flue damper and control
2. No continuous burning gas pilots allowed.
HVAC and Plumbing System Measure.
12-5352(g) and 2-5303: Space conditioning equipment siring: attach calculations.
12-5352(h) and 2.3313: Setback thermostat on all applicable heating systems.
• 12-5316(a): Ducts constructed, installed and insulated per Chapter 10,1976 UMC.
12.5316(b): Exhaust systems have damper controls.
12-5314(c): Gas -rued space heating equipment has intemduent ignition devices.
12-5314: HVAC equipment. water heaters. dwwerheads and faucet- certified by the CEC. J
12.53320: Water heater insulation blanket (R-12 or greater) or combined interior/exterim
insulation (R.16car greater): fust 5 feet of pipes clown to tank insulated (R-3 or greater).
12-5312(Etcepdan 1): Ape insulation on steam and steam condensate nxan & recirculating �/
piping. MIA
Swimming Pool Heating
1. System has:
L On/Off switch on heater.
b. Weatherproof instruction place on heater.
c. Plumbed to allow for solar.
2.75 percent dwwnud efficiency.
3. Pool cover.
4. Time clock.
S. Directional water inlet.
Llgbting and Appllam Measures
12.53520): Lighting - 25 umens/wau or graver for general Ughting in kitchens and bathrooms.
12-5314(e): Gas fired appliances equipped with intermittent ignition devices.
12.5314(x): Refrigerstors. refrigerator-freerers. freezers and fluorescent lamp ballasts certified
by flue CEC. Indicate make and model number.
No+a tbrtM/ D•awMr 1917
V/