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' LICENSED CONTRACTOR 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 # Lic. Class - Exp.)Date
-,Date/ �: Signature of Contractor- F,
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&RC. for this reason
Date Signature of Owner
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 & policy no. are:
Carrier Policy No.
T.+1.�'I:.i�ii;30 6RP-229.23102-01
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 1 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 370,0 of the;Labor
C,otle, I sgall forth4th comply with those,provistons. r7 �.1
,Date: ) -Applicant—'....-."
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions. and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at,
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall,.indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
:2. Any permit issued as a result of this application becomes null and void if
work is not commencedwithin.A80-days_from`date of issuance of such
permit, or cessation of work for 180, days will "subject permit to cancellation.
I certify that l.have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby 6uthoriz9�'.representatives of this City to enter upon
the above-mentioned property for Inspection purposes.
Signature (Owner/Agent )' }'` f Date: /�Y `fir f
%.; r
BUILDING PERMIT _ PERMTq
DATE VALUATION LOT (1$EYJ-13ES TRACT
-dD ila;�Ba.�
JOB SITE
APN
ADDRESS
OWNER
CONTRACTOR / DESIGNER / EN INEER
MIM COKVAN
.
1='_x.1: M D "&IRT CA 91-211
(760)345-7479 f-'1479 (ML# kct,34
USE OF PERMIT
PZIFRT):WnAL.
RC+hAODXL PER APPR(NIZ13 VI -ANS C33ai Y!tNi'Lr TICIATION t'' r,.A i3AVST FV
PM" 1997 ll'I+IFORM !`.!JM!>tiISTIt- ft'VE CODE X304,3 R)R WORK ii>?'C3UN
WITHOUT 1:if.331.rIX140 PERMIT.
RES. REMODEL OfLttillfl.I1G is
EMILVIATED COST OF CO:N•rrRIEJC ON
60,N)Od)D
F04MI' qF A nARt
PLAN CHE-CK PET' 1(71. WO -439-;51 S $29P.68
(',KY dS TRUCTIC7'N Wit 1011-00U428-000 $459.50
21,19CTR)C.AL PER 10,00W-420-000 $80.00
Pi,LIMI-0103 Ff% 101-000-119-000 $45.00
ST1247NO I IDT101'4 i;PY - Ft.1;3Dtp 301-000.241-000 $6,00
I;tdVYSTIOATzr. N FEE 101-000-423-000 M59.50
SRM
C.. -= = 'J'AaLTERbU l NXES DUE .I+ OW
$1,3410.1
I
4L1 JUL 3 0 2001 i! .
RE EIPT
ECEIPT
bAT -' I • f+
DATE FINALED
INSPECTOR
HSIP CTM RECORD
GAO
OPERATION
DATE
INSPECTOR
OPERATION DATE
INSPECTOR
WLLWHG
APPROVALS
�fliECHAMCAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steal
�`�
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U. CX
Framing
9—��
_�� Q ( PSS,!/
Compressor
Insulationa
r='2•l s�
Fireplace P.L.
Vents
Grills
Fireplace T.O.
_
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
_
Final -
Final
BLLOCKWALL AFPROVALS
POO{LS - SPAS
Steel
Set Backs
Electric Bond
Footings
Allain Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
FinaC
Gas Piping
1FLURfl3 2 -,PAPROVAL S
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
_
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELLCCT=AL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures '
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS: . t Cz
jx7 � W L 1,It-vf & A)ev
. . . . . . . . . . . . . .
F*
Project Address: g 90
A. P. Number: 6 S�91 -310 — 0)
Legal Description: p0jZ g MW m)e
Contractorl'�M RkvI'z21(
Address: 599-0 0--11TWE
CirY"-ST,Zip: PRSL M -JI ESM
Telephone: %o 1791- . %901
State. Lic.#: w0gap 1
Arch.. Eng—Designer- �Onml
Address:
City. ST. Zip:
Telephone:
State, Lic. k) Pr
Name of Contact Pam:
Telephone if of Contact Person: %4k,97
. ..... ........
. . . . . . . . . .
submittal
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H.. Dept. Apo
City of La QuInta
Building 8E Safety Division
P.O. Box 1.504
78-495 Calle, Tampico
La Quinta, CA 92253
Building Permit Application and Tracking Sheet
Owner's Name: 14 +14 WRVAk/
A&Iress: 2 8 SWAORETREPVT RX
'ST. Zip: �ICDFORU PT gqU
Y
LoIr 100
Telephone: -?=
IQ e L& Project Description: 9t=7 U r5 -n p I
City Lic.,#:
MEWIS
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C4 I cjs ovv- tvv� s7 -r,,, -x4- SW6
R6kc onC
FROM ADVANCED I NSTALLAT I ONS' "' "" ' PHONE NO. : 674 9048 Sep. 21 2001 '12: 03PM P2
ADVANCED INSTALLATIONS
State License 520860
81771 Oleander, Unit 1
Indio, CA 92201
760/3.47-16% fax 760/674-9048
September 21, 2001
General Contractor; RivizziW Construction.
Project; 48780 Eisenhower, La Quinta Golf Estates
This is to certify that Rigid insulation 2.6" thick with an R: value of 19 has been installed in
exterior walls and 2 layers totaling 5.2" of Rigid insulation with an R value of 38 has been
installed in ceilings.
Advanced Installations
CER'TIF'ICATE OF COIF T1AANCE. RES;DEN'I'IAI. (Page 1 of 2) CF -YR
13ulidias Feet o
Plan Checl:/DM?
Field Cheek / Diu
GENERAL INFORMATION
Total Conditioned Floor Area ft'
Conditioned Slab Floor a R'
Building Type: Single Family
(check one or snore) Muni -Family
Average Ceiling Height: 9 R
Addition
Existing -Plus -Addition
Front Orientation:NorahjiiEwk/ West / All orientations
(119M deem fon T=.NGM and ciMlo one)
Number of Stories
Number of Dwelling Units:
Floor Construction Type: tkyRaised Floor (*dt an of both)
BUILDING SHELL INSULATION
Component Frame Type Cavity Sheathing Tctal.R Asaea4bly
Type wd - wood Insulation ' Insulation Value' U Vahte'
stl - steel R Value R -Value
Roof
z+VWVC•rl?_ A TlfllV
(a:Wc,:,garage, typical, etc.)
Shading Devices
Fen .�
e
t m_e.l
MIN
-7-t
For prgscriptwe compliance, Total R Value and Assembly U -Value are not required.for a wood -mimed wall that.meets
cavity R--Vahte in lulation requirement for the Prescriptive Package.
: For prescriptive compliance, there are no credits for any interior shading exert the default.or "Standard" drapery. These
default interior shading devices (draperies) need not be installed for compliance purposes.
July 1, M9
TIFj'CA'I'E Ur. C:ONIPLIAt4CL: ftZSII.1f r.'TIAL (Pas"o��� c-r-irz
t
..�t�•�.c�c
Vale
H\'AC SYSTE.
Now Input hAftmic' of rrn,t! �pc
! h} •u :� :a t;+cif;;
�., :: r Jf;;cis:F �?'n:r�,. e•r►a. lb>it
�: Ilectsit:g l.osd
lti;:tri'.:utiatt
Heating. Equipmem
Minimum
l }'pc and
Duct or
Heat Pump
Type (fotwec. heat
EtTicicnc;•
l.c►ratinn
Piping Thermostat
Configtmtiion
pumps,::)
011111:0
(duct:, anic. ele.t
k -V aluc Type _
(split or pttckale)
Cooling, Eg1tipmcni
Mininvir
Duct ----
Heat Pump
Type(air enndflionrr.
Efylvlenc;
Location
Duct Thermo8tst
Con>l#uration
haat pump.eyap:cwling)
(sr-FRI
(tptie,etc..)
R -Value .Type
(splitorpttcksee)
NVATER IiEATI>\G
S]LSTEM
+
EneW1
External
Rated'
Tank Factor or,
Tank
Water Heater
Distribution
Number Input mm'
Capaciti� Recovery
Standby' insuinew
Type
Type
in SN -stern or MOO
(gallons) Efficiency
Loss /o) R -Value
E 1
,,...._ 19,000
_Z113' 0 5 L _
I. For sinall pas simp uniec hearrrs (nnted htpnts ot'les• fhan ar cruel 10 71.pAll Ktrdltrl, electric reaisunee, and heat
pump wa►orl,eaim. fin Encra
Factor. Forlatpe gtrc atptu;e wmv ht:;mcts trated inret Vitrertcr Man M111ut Mufir). Its, Rated Input. RecmYry Efficiettt:v w4 taailb) Lots.
For InStLn1aticOUS gas list ivied input enJ mcm cr% of ricioncies.
Including Thermal Maxs.(therntat rniiss type. cowritq; thickness. and description)
COMPLIANCE STATEMENT
This certificate ot` cunipliamc line Ow buil0ty twww and p riomwi%x to comply with Tint: 24, Pads t and 6 of
thv Culilornin codi• omcgulations, and lige udmini.trath c regalations tr+ Implement them. This tentiicate has been signed by the
individual Willi (tevtoll desien respomibilit; , NV lien lit Ig certificate M 4nmpli atev is subrnintd for a single building plan to be Molt in
multiple Prirntuliorm any sltadittp fvnuuv that.is.ari.'(1 i., indiailcd in the Sineiul VenturalRcmarkssection,.
Designer or Owner (prr Biisines4 and 1'rufevtinnt Code) Docutne"Int o Author
Name isPQafzt111 tp1-h'`Y L�'2 Namr: 29 Q P T i1 =EfL
Title Firriv CAtI=t• Lt,QJIL I ulJOyA
Address; POITY— V MS -RI Le�%L[ LLT' �'cddreos. -
Tolrnhone` clepltort.
Lie. !':
-Ju
�o
(;ignatun:) (d:uct (aipnatnr"41 (date)
Enforcement Atenev
Name. �Q
Title:
Agcnc�•:.
Telephone:
(sf� nature %siartcp) tem -5
31tl%- 1, 1V9) wy
TAJ;aNO- I'M5
ALTERNA27YE COMPONENT PACKAGESS
FOR CLIMATEZONE IS
PACKAGE]
B
C
COMPONENT h
A
BUILDING. ENVELOPE
Insulation A inimwns2
R9d
R38
R49
R19
R29
t aCeiling
R21 R.',kWIgoprR� 3
Wood Fame Walls
Rl9
(RS.S)
(R4.5)
NA
(R4.76) R 25,
"Heavy Mass" Walls
jR7XI
[R6.Oj
NA
NA
"Light Mass" Walls
NA
NA
NA
Below Grade Walls
R7
R7
_
NR
Slab Floor Perimeter
__r.
— R21
R19
Raised FloorsNA
R19
_ ..�B19
NA
R4
Concrete Raised Floors
GLA?.►NG
Maximum ELvalue3
0 NS
0,63
0.40
0.6S
NA
16%
1695
1695
Maximum Total Area
NR
NR
NR
Maximum Total Nonsouth Facing Asea
9.
NR
NR
Minimum South Facing Area
6.445 4%
NR
SOLAR HEAT GAIN CQEFFICIENT I
South Facing Glazing
0.
15
0.15
0.40
0.40
0.40
040 �,••- `
•
West. Fazing G1=09
O.IS
0.13
NR
0.40
1140
East Facing Glazing
NR
)i1R
NR
NR
1VR •
North Facing Glazing
REQ
NR
REQ
NR
THERMAL MASS5
INFILTRATION CONMOL
•REQ
NR
NR
Continuous Harrier
NR
NR
REQ
NR
.
NR
Air -to -Air Hew Exchanger
SPACE HEATING SYVE1v16
yES7
NO
Electric Rsistant Allowed
NO
NO.
78 96
7895
MIN
' if Oas, AFUE _
7895
8
tfHeat Pump.
stem HSPF6 =
Split Sy
6.8
6.6
6.8
MIN
Single Package System HSPF =
6:6
6.6
6:6
M1N
SPACE COOLING SYSTEM
10.0
10.0
MIN
If Split System A/C, SEER =
10.0
9.7
9.7
MINIf
Single Package A/C, SEERS =
9:7
DOMESTIC `WATER REA77NG'TYPE
ANY
ANY9
ANY
System must meet budget, see
ANY
151(b)1 and 131 (9)
LEGEND: NR — Not,R lied; NA — No Applicable; Ri Q ¢ Required~ MIN = Min "
SEE NOTES FOLLOW TABLE NO,
Z16
r,
July 11 '1999
t esidentlat Manual
342
Alf
Additions of fass.then t, 000 square feet meet the
requirements of package D for the applicable
climate tone with the following exceptions: walls
meet only the mandatory insulation level of R-13
In a wood frame; glass area Is limited to the
percentage allowed by 0 e''package plus any
glass removed because of the addition:
Additions of 1,000.squm feet or more meet all of
the requirements of packsge'D.
akk)tit/11
xr�*
Dual•Glazed Skylights and Dual -Glazed
Greenhouse Windows
Due4lazed skylights or dual -glazed greenhouse
windows are treated as though they have the U-
valde required for prescriptive•compiiance.
Dus4tazed skylights and dual -glazed
greenhouse windows, should be included in
compliance calculations, as a fenestration product
with a U -value equivalent to the Package D
requirement for the appropriate dknate zone (or
0.75 for additions of less than 500 square feet).
1. This approach does not allow credit for glass removed. Compliance with the requirements for
additions of less than 500 square feet is allowed, In which case credit for glaxing'removed Is allowed.
2. Meet the component prescriptive requirement for Package D (see Chapter 3) and all mandatory
requirements.
3. ~Heavy a .ass" and "Light Mass" walls may meet the Package D requirements for rnesa wall insulation
instead of R-13 ,(see Chapter 3).
4. For addition and alteration compliance only, uai-glued greenhouse. windows and dual -glazed
skylights are assumed to meet this requirement.
Z. The Package D fenestration area plus the area of ny glazing removed becau _ of the addition.
6. All applicable mandatory measures must be met ( e Chaptet 2).
7. No electric resistance soacelh�atina may be Install . 11
Sri
Additions and
Table 71: Prescriptive Compliance of Additions -
Summary of Section 152(a)1 Requirements of the Standards
> 600 but
COMPONENT
< 100 eta')
500 fe
.7000 itz
y1;oo0.f�
Insulation
Ceiling
R=19
Package
Package
Package
Wa113
R-13
1113
R-13
Package
Floor
Mandatory' .
Package
Package
Package
Fenestration
Max. U -value
0.75
0.75
Package
Package
% of CFA
S 50 f
Pk®. + Remove&
Pkg. + Removed'
Package
Shading
NIA
Package
Package
Package
Space Heating'
MandatoW
Package
Package
Package
8 Cooling
(No electric)
(No electric)
(No electric)
(No etectrto)
Water Heatine
Replacement
WA
NIA
NWA.
NIA
Increase
See Table 7-2
See Table 72
See Table 7-2
See Table 7-2
1. This approach does not allow credit for glass removed. Compliance with the requirements for
additions of less than 500 square feet is allowed, In which case credit for glaxing'removed Is allowed.
2. Meet the component prescriptive requirement for Package D (see Chapter 3) and all mandatory
requirements.
3. ~Heavy a .ass" and "Light Mass" walls may meet the Package D requirements for rnesa wall insulation
instead of R-13 ,(see Chapter 3).
4. For addition and alteration compliance only, uai-glued greenhouse. windows and dual -glazed
skylights are assumed to meet this requirement.
Z. The Package D fenestration area plus the area of ny glazing removed becau _ of the addition.
6. All applicable mandatory measures must be met ( e Chaptet 2).
7. No electric resistance soacelh�atina may be Install . 11
Sri
Additions and