04296 (SFD)T44
,t44Q"
Address
Address 52580 Eisenhower
Owner
Patricia Swanson
Mailing
Address
City Zip
Contractor
M. Masson.
Box 1499
City Zip
Palm Springs; 92263
State Lic.
& Classif. 1498210
Arch., Engr.,
Designer
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
04296
BUILDING:' TYPE CONST. OCC. GRP.
A.P. Number. 773-301-004
el,
Legal Description
. .
Project Description single FaMily DWallinq
Tel. {AJ yqyq, }//y(��� /•r
.340-9584 _
City
Lic. # 932
Tel.
Sq. Ft. 1722No. No. Dw.
Size _ " " " Stories' Units
New O Add ❑ Alter O Repair ❑ Demolition ❑
CityZip 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. .i Jr ,l r 1�.1 4
SIGNATURE r 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, after, Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile 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).
❑ 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, 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
onstruct 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 df consent to -self -insure, or a certificate of
Worker's Compensation Insurance, or a certified`copyahereof:j(Sec. 3800,11-aborCode.) r"'3
Policy No.Companyy
❑ Copy is filed with the city. O 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 ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS
0($J 1 Z 10
2 l:fsiff i t1Y(ril 2 �iyr),�7t3
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 7,11/$8Permit
Validated by:
f
Validation:
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE; HARD COPY - FILE
>timated Valuation
$89o763
PERMIT
AMOUNT
Plan Chk. Dep.
$250.00
Plan Chk. Bal.
. 9 W A U
Const.
4fJ 3 . UV
Mech. ',
$% • Cf C�
Electrical
Plumbing
103.00
Grading
20.00
Driveway Enc.
20.00
Infrastructure
ia.
TOTAL
V w 0 V -Pia 40
' 't16 `. i
REMARKS
0($J 1 Z 10
2 l:fsiff i t1Y(ril 2 �iyr),�7t3
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 7,11/$8Permit
Validated by:
f
Validation:
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE; HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO F1 y $
UNITS
�SIAB GRADE
41
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2N0 FL SO FT. a
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT at
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT.
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. I SO FT. a
FINAL INSP.
WALL SO. FT. rd
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus x$ _ $
LUMBER GR..
URINAL
SO. FT. 0
I FRAMINGO
y GGG
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
ROOFING
WATER PIPING
NOTE Not to be used as property tax valuation
VENTILATION
FLOOR DRAIN
MECHANICAL FEES
FIRE ZONE ROOFING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTOYDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID g t v. c
SEWAGE DISPOSAL
SO.FT.GAAer VAc
HOUSE SEWER
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 8 AIR COND. SOLAR
CeSETBACK t
ROUND PLUMBIN -�
UNDERGROUND
A.C. UNIT
COLL. AREA
�SIAB GRADE
41
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF,
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
/
4`CREINF. STEEL Cil►l ` �
CCC
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$ _ $
LUMBER GR..
FINAL INSP.
I FRAMINGO
y GGG
FINAL INSP.
ROOFING
l O�� �Q C.L./`,IJ
�J`JS�J/�% �- p Az
G/✓U f+ I "�/ : n I'�
('I%lp' � (v (( t4
7s �G
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR-
GAR. FIREWALL
THING / —
/
MESH
ASULATIONISOUND/) J6 'FjFINISH
GRADINGC�
FINAL INSPECTION
CERT. OCC.
FENCE FINAL'
INSPECTOR'S SIGNATURESANITIALS ,
GARDEN WAIL FINAL
11 .1 fl -e --,I, f_ F
�ef'0 - �E Pl",J FR C3, �����? I_j T__ &Q -7- 1���� �����
JOHN -H. HACKER, CIVIL ENGINEER, PALM SPRINGS 327-4565
LATITUDE 33.0 WINTER TEMP. 31 DEG SUMMER TEMP. 110 DEG
NAME ------- RON KOSTELECKY
ADDRESS ---- 52580 LISENHOWER
/CITY ------- LA QUINTA / CALIF.
REF.CAL.ENERGY CONSERVATION DESIGN MANUAL, FORM 2, HEATING LOSSES
[MANUAL J FOR COOLING LOSSES
AREA BLDG 1722 SQ. FT.
PERIMETER 191.3333 SQ. FT.
� INSULATION R VALUES.FLOOR 0 ..CEILING 38 ..WALL 19
AREA NORTH WINDOWS 76.6 SQ.FT. PERCENT OF AREA 4.448316
AREA EAST WINDOWS 0 SQ.FT. PERCENT OF AREA 0
AREA SOUTH WINDOWS 60 SQ.FT. PERCENT OF AREA 3.484321
AREA WEST WINDOWS 0 SQ.FT. PERCENT OF AREA 0
AREA SKYLIGHTS 0 SQ.FT. PERCENT OF AREA 0
|TOTAL WINDOW AREA 136.6 SQ.FT. PERCENT OF AREA 7.932637
`
THE U VALUE OF THE WINDOWS IS .65 DUAL PANE
.THIS BLDG USES DRAPES & FLAT SHADING DEVICES* ON WINDOWS
(*mini -blinds, rollar shades, ven!etian blinds or vertical blinds)
�'THE TOTAL S.C. OF THE WINDOWS IS 0.30
SOUTH OVERHANG LENGTH 2
INTERIOR THERMAL MASS AREA = 344 SQ. FT. '
ATTIC AREA = 1722 SQ FT
| INFILTRATION (STD 0.010, MED 0.014, TIGHT 0.012) = .014
HEATING LOSSES
FOOTING LOSSES... 8357.441 BTU
CEILING LOSSES... 1700.203 BTU
WINDOW LOSSES..' 3462.81 BTU
WALL LOSSES;... 2652.127 BTU
INFILTRATION LOSSES... 7521.696 BTU
TOTAL HEAT LOSSES BTU/HR.. 23694.28
� GAS FURNANCE SIZE 48022.56 BTU OR 45,000 BTU
COOLING LOSSES
INFILTRATION LOSSES... 7714.56 BTU
^^^ ^
| FOOTING LOSSES 8571 733 �BTU
|
CEILING LOSSES... 1743.798 BTU �
WINDOW LOSSES... 8954 BTU
WALL LOSSES.... 27k6.228 BTU
INFILTRATION LOSSES... 7714.56 BTU
� NO. OF PEOPLE, 5 COOLING LOSSES... 2000
KITCHEN... 1500 BTU .
DUCT LOSSES INCLUDED IN TOTAL
'TOTAL COOLING LOSSES 33200.32 BTU
`
U
COMPLIANCE CHECK LIST PER DESIGN DATA'
SLAB OR FLOOR.,
WALL INSULATION,
CEILING INSULATION,
ATTIC,
NORTH WINDOWS GLAZING
EAST WINDOWS GLAZING
SOUTH WINDOWS GLAZING
WEST WINDOWS GLAZING
SKYLIGHT GLAZING
EAST SHADING COEFFICIENT
SOUTH I SHAD I I' G COEFFICIENT
WEST SHADING COEFFICIENT
NORTH SHADING COEFF I CENT
SKYLIGHT SHADING COEFFICIENT
INFILTRATION
THERMAL MASS SS 344 SO. FT.
SOUTH OVERHAND ^ FT.
GAS FURNANCE 71 SE AND REFRIGERATION COOLING
THE EER OF THE COOLING SYSTEM IS 8.7
'COOLING
—4 POINTS
0 POINTE;
0 POINTS
4 POINTS
- POINTS
4 POINTS
0 POINTS
10 � POI NTS
_> POINTS
0 POINTS
—1 -POINTS
0 POINTS
POINTS
0 POINTS
.-1. POINTS
6 POINTS
0 POINTS
6 POINTS
THE ALLOWABLE POINTS PER AD 1 63 IS —4 FOR AREA 15
THE TOTAL POINTS ARE 23
THE FOLLOWING MANDATORY FEATURES/DEVICES ARE REQUIRED PERCAC TITLE 24
ELECTRIC RESISTANCE WATER HEATING NOT PERMITTED
INSULATION AS SPECIFIED: PER MANUFACTURES L(.',bL E:
J:NF I LTRATR I ON CONTROL. DOORS, WINDOWS FULLY WEA'THE:RSTR I PPE:.D
OPENINGS CAULKED AND SEALED AROUND JOINTS IN WINDOW AND WALL SOLE PLATES AND
ELECTRICAL OUTLET PLATE BASKETS
MANUFACTURED RED DOORS SHALL MEET APPLICABLE STANDARDS
BACK DRAFT DAMPERS ON EXHAUST FAN
FIREPLACES MUST HAVE TIGHT FITTING, CL_OSE:.6-`iBLE:: DOORS COVERING FIREBOX
PROVIDE C01`'USTIOIC! AIR INTAKE DUCTS (6 SQ. IN.) WITH TIGHT FITTING DAMPER
DUCTS; BUILT PER CHAPTER 1.0 U.M.C.
GAS FURNANCE SIZED TO 1.3 DESIGN LOSS+10 BTUH PER SQ.FT.OR 45,000 DTi.J
SETBACK THERMOSTATS ATS SHALL HAVE AUTOMATIC SE_TI::sACK CAPAB T L._ I TY /2 PERIODS PER .24
WATER HEATER TO HAVE R-12 INSULATION WRAP=PING , AND R—.T ON FIRST ' ' OF PIPE
NAT. GAS'STOVES SHALL- NOT HAVE CONT. I:URNINO PILOTS
LIGHT IN KITCHEN AND BATH TO BE FL._Oi_1RECENT , EXCEPT BATH MIRROR KIT SINK, TAT::;,.._i:..:
CERTIFIED BY
�i�' P.___------------------___--..
����E.7 -4.
��
FEE IT: �-3 i
`
��N E.. q -T I.J R..
.
.
ewl -77 1:_Z]7�44`41
97'Z FEE.-.. ACh
JOHN H.
HACKER,
CIVIL
ENGINEER, PALM
SPRINGS 327-4565
LATITUDE
33.0
WINTER
TEMP. 31 DEG
SUMMER TEMP.
110 DEG
/NAME ------- RON KOSTELECKY
ADDRESS ---- 52580 LISENHOWER
�CITY ------- LA QUINTA / CALIF.
�REF.CAL.ENERGY CONSERVATION DESIGN MANUAL, FORM 2, HEATING LOSSES
iMANUAL J FOR COOLING LOSSES
AREA BLDG 1722 SQ. FT.
PERIMETER 191.3333 SQ. FT.
�INSULATION R VALUES' .FLOOR 0 ..CEILING -38 ..WALL 19
AREA NORTH WINDOWS 76.6 SO.FT. PERCENT OF AREA 4.448316
AREA EAST WINDOWS 0 SQ.FT. PERCENT OF AREA 0
AREA SOUTH WINDOWS 60 SQ.FT. PERCENT OF AREA 3.484311
AREA WEST WINDOWS 0 SQ.FT. PERCENT OF AREA 0
AREA SKYLIGHTS 0 SQ.FT. PERCENT OF AREA 0
|TOTAL WINDOW AREA 136.6 SQ.FT. PERCENT OF AREA 7.932637
`
THE U VALUE OF THE WINDOWS IS .65 DUAL PANE
THIS BLDG USES DRAPES & FLAT SHADING DEVICES* ON WINDOWS
(*mini -blinds, rollyr shades, venetian blinds or vertical blinds)
|'THE TOTAL S.C. OF THE WINDOWS IS 0.30
SOUTH OVERHANG LENGTH 2
INTERIOR THERMAL MASS AREA = 344 SQ. FT. '
ATTIC AREA = 1722 SQ FT
| INFILTRATION (STD 0.018, MED 0.014, TIGHT 0.012) = .014
HEATING LOSSES
FOOTING LOSSES... 8357.441 BTU
CEILING LOSSES... 1700.203 BTU
WINDOW LOSSES..' 3462.81 BTU
WALL LOSSES...` 2652.127 BTU
INFILTRATION LOSSES... 7521.696 BTU
TOTAL HEAT LOSSES BTU/HR.. 23694.28
| GAS FURNANCE SIZE 48022.56 BTU OR 45,000 BTU
COOLING LOSSES
INFILTRATION LOSSES... 7714.56 BTU
FOOTING LOSSES... 8571.733 BTU `
CEILING LOSSES... 1743.798 BTU �
| WINDOW LOSSES... 8954 BTU
WALL LOSSES.... 27k6.228 BTU
INFILTRATION LOSSES... 77�14.56 BTU
NO. OF PEOPLE...5 COOLING LOSSES... 2000
KITCHEN... 1500 BTU
DUCT LOSSES INCLUDED IN TOTAL
|,TOTAL COOLING LOSSES 33200.32 BTU
I COMPLIANCE CHECK LIST PER DESIGN DATA'
SLAB OR FLOOR ,
.WALL INSULATION,
CEILING INSULATION,
� ATTIC,
NORTH WINDOWS GLAZING
EAST WINDOWS GLAZING
SOUTH WINDOWS GLAZING
'WEST WINDOWS GLAZING
| SKYLIGHT GLAZING
| EAST SHADING COEFFICIENT
�
' SOUTH SHADING COEFFICIENT
| WEST SHADING COEFFICIENT
' NORTH SHADING COEFFICENT
|
� SKYLIGHT SHADING COEFFICIENT
INFILTRATION
THERMAL MASS 344 SQ.FT.
| SOUTH OVERHAND 2 FT.
-4 POINTS
0 POINTS
0 POINTS
4 POINTS
-2 POINTS
4 POINTS
0 POINTS
' 10 POINTS
0 PJINTS
P GAS FURNANCE 71 SE AND REFRIGERATION COOLING
0 POINTS
-1 9OINTS
0 POINTS
3 POINTS
0 POINTS
-1 POINTS
6 POINTS
0 POINTS
'THE EER OF THE COOLING SYSTEM IS 8.7
� COOLING 6 POINTS
THE ALLOWABLE POINTS PER AB163 IS -4 FOR AREA 15
�THE TOTAL POINTS ARE 25
I THE FOLLOWING MANDATORY FEATURES/DEVICES ARE REQUIRED PERCAC TITLE 24
ELECTRIC RESISTANCE WATER HEATING NOT PERMITTED
INSULATION AS SPECIFIED: PER MANUFACTURES LABLE
INFILTRATRION CONTROL. DOORS, WINDOWS FULLY WEATHERSTRIPPED
OPENINGS CAULKED AND SEALED AROUND JOINTS IN WINDOW AND WALL SOLE PLATES AND
ELECTRICAL OUTLET PLATE GASKETS
MANUFACTURED DOORS SHALL MEET APPLICABLE STANDARDS
BACK DRAFT DAMPERS ON EXHAUST FAN
FIREPLACES MUST HAVE TIGHT FITTING, CLOSEABLE DOORS COVERING FIREBOX
PROVIDE COMUSTION AIR INTAKE DUCTS (6 SQ.IN.) WITH TIGHT FITTING DAMPER
DUCTS; BUILT PER CHAPTER 10 U.M.C.
GAS FURNANCE SIZED TO 1.3 DESIGN LOSS+10 BTUH PER SQ.FT.OR45,000 BTU
SETBACK THERMOSTATS SHALL HAVE AUTOMATIC SETBACK CAPABILITY /2 PERIODS PER 24
WATER HEATER TO HAVE R-12 INSULATION WRAPPING, AND R-3 ON FIRST 5' OF PIPE
NAT. GAS-STbVES SHALL NOT HAVE CONT. BURNING PILOTS
| LIGHT IN KITCHEN AND BATH TO BE FLOURECENT, EXCEPT BATH MIRROR KIT SINK, TABLE
�
CERTIFIED BY __ ___�___ _________________________-