06-1497 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
06-00001497
48140 VIA VALLARTA
649-381-027- -
PLUMBING
LOW DENSITY RESIDENTIAL
500
Architect or Engineer:
0 JIB
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT .
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/12/06
--------------------------------------------------
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 C : Q 6 Lice se lo.: 828264
ate: Contractor:
ILDER DECLARATION
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 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 I am exempt under Sec. , BAP.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:
LQPERNM
------------------
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 STATE FUND Policy Number 1576840
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
/ 3790 of the Labor Code, I shall foghwiliK-co-itply with those provisions.
WARNING: FAILURE TO SECURE WORKER9.QO PENSATION 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 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 count toerJ��er upon the above-mentioned property for inspe tion p se
��5' ature (Applicant or Agent):
Owner:
MARTI STATTIN
48140 VIA VALLART
QUINTA, CA 92253
_____LA
n
o
Contractor:
' FOY, SCOTT A.
l 43579 MAIN STREET
---
INDIO, CA 92201
(760)775-9405
Lic. No.: 828264
--------------------------------------------------
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 C : Q 6 Lice se lo.: 828264
ate: Contractor:
ILDER DECLARATION
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 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 I am exempt under Sec. , BAP.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:
LQPERNM
------------------
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 STATE FUND Policy Number 1576840
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
/ 3790 of the Labor Code, I shall foghwiliK-co-itply with those provisions.
WARNING: FAILURE TO SECURE WORKER9.QO PENSATION 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 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 count toerJ��er upon the above-mentioned property for inspe tion p se
��5' ature (Applicant or Agent):
Application Number . . . . 06-00001497
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 22.50
Plan Check
Fee
5.63
Issue Date
Valuation
. .
.
0
Expiration Date 10/09/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB WATER
HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and Comments
REMOVE & REPLACE NATURAL GAS WATER
HEATER.CF1-R APPROVED.
Fee summary Charged Paid Credited
---------- --
Due
-----------------
Permit Fee Total 22.50
.00-
.00
22.50
Plan Check Total 5.63
.00
.00
5.63
Grand Total 28.13
.00
.00
28.13
LQPERNM
Bin tf
T
Permit A
oG .• 1�t97
Project Address: f-) g I Lro V
A. P. Number.
Contracurr. .�.
Address S7 ma
Cirv,ST,Zip. C1,
f Telephone:
State Lic. 9
Arlt., Ergr.. Designer:
Address:
City; ST. Zip:
Telephone:
Statc Lic.::
Name of Contact Person:
Telephone p of Conrad Person:
.9
Submittal ittal A d
Plao Sets
Strecwml C01cs.
Truss Cales.
Title 24 talcs.
Flood plain plan
Grnding plan
saltrenTaetor List
Grant Deed
11.0-A. Approval
1N HOUSE: -
Planning Approval
Pub. In, Appr
School Fees
City of L? Quinta
Btatdfitg 67 Safety DWaft
P.O Box 1504, 78-495 C29P Tamplao
La QWMI, C. 92253 - (760) 777-7012
Building Permit AD11HOdon and Tracf&wr Sheer
Q
(��
Owner's Niow.1 "1a.✓T % Si
Add-- LI$1,L40
City, ST Trp: ' S.
O
Telephone: . - ut W��A
Xr
'n
ProjedDescription:
.,r ,r da eMen
City Lic. 4:
'
_
ion TY'P. Ot cupmcy:
Ptojxt tree (arde one). New Add'n (titer epair Demo
SQ. FL:
41 Stories:
4 Unita
Fsthnned Value of P10'r
APPLICMtT:
DO NOT VME BELOW THIS LLE
Reed
TRACMG
PERAIW FEES
PlanCheek submitted
Ioror
Amovw
_"-,k ready for cwredions
Plan Cheek Deposit
Called C ontacrPerson
Plan Check Satanee
P18as picked up
Consuaetion
Plans resubmitted
Mecbaniul
"° Review, ready for cotreetioymime
Electrical
Called Contact Person
Plumbing
Pians picked up
5 a1.1.
Plans resubmitted
Crnding
Review. ready fur eorreedowrMae
Developer Impact Fee
Called Coutnet Person
A.Li! P.
Date of permit issue
Total Permit Few
CERTIFICATE OF COMPLIANCE: RESIDENTIAL. (Pat=e 1 of 4) CF -1R
rrojecr Haaress
1,113
Documentation Author ' "- t' A • -.1; ^" ` '~' J_ - . ` Telenhone - -
i I . - I 'I ffA7,=
K.�tmm
wrnpuance iviemoa krrescnpuve)_ _ ;timate Lone .
- - �! i�=. "• 't - ., � .; .--Z2..i,: ' _ • �_? '�� _4 .--•... r.. ,., i- Enforcement Agency Use Only .
✓ ❑ Alternative Component Package Method:'(check one) _r C D D (Alternative) - +
Package C and Package D, choices require HERS rater field verification and/or diagnostic testing (see_ CF -1R page 3)
For Package D Alternative see Appendix B Table 151:C Footnotes 7-14
r GENERAL INFORMATION`,
Total Conditioned Floor Area (CFA) t-} x'fi2: Average Ceiling Height:
-- Makimum Allowed West Facing Fenestration Products Per.Table 151-B or.151-C — (5% X CFA) fe
Maximum Allowed Total Fenestration Products Per Table 151-B or 151-C " (200/oX CFA). g a
✓ O_ Building Type: (check one or'more) "1. Single Family ` `' Multifamily Addition Alteration ,
-1 L:...a s _ ..p �
' . - (If adding fenestration fill out WS -4R,- Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
- for Additions and 8.3.3 `for Alterations.)" - - , "
Number of Stories: }Number of Dwelling Units:
f Floor Construction Type: '= - Slab/Raised Floor (circle one or both) --•- ... _ Front
-
Front Orientation: = North/ South / East /.West / All Orientations (input front orientation in degrees from True
..amu i.: a....w^a.,.y.» ►}y..y.;=.r - �.-1 L 3 X* -;�..
L
North and circle one).'" `' ' � �- �► --•:, �;; �.:,� c a _a � , ,
�, ,, �F-- IVEti a,t t. ; r ,,*i.,rr.r iC1z'.. kt `tom-'_ �*^
0 RADIANT BARRIER (ieouired in climate zones 2.4,8-15)-. fi—
r
i— L' .r
l 5 _ L ,• iCi.:�l.. _ n.. c,._�•• . CC.rJ:y»
OPAQUE SURFACES INCLUDING OPAQUE DOORS' cz"= ,r ,,,1
t -- -
i'
Component
1 r , : r; l ty t�+; F , .
Assembly U=
Type (Wall,
Frame
: _ _
T factor (for Joint
Roof Radiant
Roof, Floor,
TypeCavity
Continuous
_InInsulation
wood, metal ' Appendix
Barrier -
Location/Comments
Slab Edge,
(Wood
Insulation
frame aid mass ' - IV - :"Installed "
(attic, garage,
Doors)
or Metal)
R-
R -Value
i assemblies ._ Refeience -
Yes or No
typical, etc.
*Value
1) See Joint Appendix IV in Section" IV.2,! IV.3 and IVA, which is the basis for the U -factor criterion.'0-factors cannot
t exceed prescriptive value to show equivalence to R -values
wt�or Cr7,,C ly k -=1 l �.. •.i E
L .....va lF �-.. CII (t'�#^ ±`.Y4wLi :�•i. =1 t3 �'y�di�. L-:"�Y,«_.a.'• f '�,,.� } ,.
�: _ t i r•:t 1 t . ..t ,.+ ar t 'Jy#.,. F,-rt—
V=
7't•`
r ; : V= V4 i s fh*� ». a
• x:+�r}? .. .-. -. l�ctt�m»,yi -. -, - ;:'t;;.�+;vxtl J�j2/s t ,
Residential Compliance. Forms March 2005
I
V 4�
d
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Pace 1 of 4) CF -1R
am
r VjCcl tiuurCSS C'—C D 1 '^ -I
j 30
Documentation Author Telephone
Compliance Method (Prescriptive)
Climate Zone
113ItfX.P
Date
Building Permit #
Plan Check / Date
Field Check / Date
Enforcement Agency Use Only
✓ ❑ Alternative Component Package Method: (check one) - C " D D (Alternative)
Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -1R page 3)
For Package D Alternative see Appendix B Table 151-C Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) Average Ceiling Height: ft
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C — (5% X CFA) ft
Maximum Allowed Total Fenestration Products Per Table 151-B or 151-C — (20% X CFA) ft
✓ ❑ Building Type: (check one or more) Single Family Multifamily Addition Alteration
(If adding fenestration fill out WS41?, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
Number of Stories: Number of Dwelling Units:
Floor Construction Type: Slab/Raised Floor (circle one or both)
Front Orientation: North / South / East / West / All Orientations (input front orientation in degrees from True
North and circle one).
✓ El RADIANT BARRIER freguired in climate zones 2.4,8-15)
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
or Metal)
Cavity Continuous
Insulation Insulation
R -Value R -Value
Assembly U -
factor (for
wood, metal
frame and mass
assemblies)'
Joint
Appendix
N
Reference
Roof Radiant
Barrier Location/Comments
Installed (attic, garage,
Yes or No ical etc.
�-'V w„II hppcuulx I v III auction i v .z, r v .j ana i v.w, wmcn is the basis for the U -tactor criterion. U -tactors can not
exceed prescriptive value to show equivalence to R -values.
Residential Compliance Forms
March 2005
d
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page' 3 of 4) C&M
SEALED DUCTS and TXVs (or Alternative Measures) .
A signed CF -411 Form must be provided to the building department for each home for which the following. are
required.
❑ IAltemahve to Sealed Ducts and Refrigerant Charge /IXXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
UU A TL•D IIT A T71►T! nv
Distribution Number
e in S stem
❑
Sealed Ducts all climate zones Installer testing and certification and HERS rater field verification required.)
❑
TXVs, readily accessible (climate zones 2 and 8-15 only)
(Installer testing and certification and HERS Rater field verificationrequired.)
❑
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification i- uired.
___2`
AD
❑ IAltemahve to Sealed Ducts and Refrigerant Charge /IXXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
UU A TL•D IIT A T71►T! nv
Water Heater
Type/Fuel T eT
Distribution Number
e in S stem
Rated
Input
(kW or
Bbi/hr
y�, vaa
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
Tank
External
Insulation
R -Value
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
not allowed.
❑
Check box when using Preapproved Alternative Water Heating table, Table 54 in Chapter 5 in the Residential
Manual. No water heating calculations are requirecL and the system complies automatically.
___2`
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump fora system serving multiple
units \
Water Heater
Type/Fuel T eT
Distribution Number
e in S stem
Rated
Input
(kW or
Bbi/hr
y�, vaa
Enemy
Tank Factor or
Capacity Thermal Standby'
ions Efficiency Loss /6
3-0
Tank
External
Insulation
R -Value
Svctam carvino .....rK..1.. A-_11!__
___2`
LY Y
RatedEner_y
Input Tank Factor or
Water Heater Distribution Number Ixw or Capacity Thermal
Type I Type I in Svstem I Ah,n,A lam--.
..,...
Tank
External
Standby' Insulation
Loss (%) R -Value
1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Pipe Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are %
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 6) 2 B.
Residential Compliance Forms
Mare
CERTIFICATE OF ' COMIA
PLNCE: RESIDENTIAL (Page 4 of 4) CF -IR
Project Title Date
SPECIAL FEATURES NOT REQUIRING HERS VERIFICATION (add extra sheets if necessary)
Indicate which special features are part of this project. The list below only represents special features relevant to the
✓
Feature
Required Forms if applicable)
Description
❑
Metal Framed Walls
CF -1R
Refri Brant Charge
❑
Radiant Barriers
CF -1R
CF -6R part 6 of 12
❑
Exterior Shades
WS -4R
N/A; Attach CRRC Label to
❑
Cool Roof
Forms.
Dedicated Hydronic Heating
Performance Calculation
❑
System
Required; Attach Run to Forms.
❑
Combined Hydronic System
Performance Calculation
Required; Attach Run to Forms.
❑
Gas Cooling
Performance Calculation
Required.
❑
Buried Ducts
N/A; Indicate on building plans.
❑
Kitchen Pipe Insulation
See Section 5.6.2 Distribution
Systems in Residential Manual.
Multiple Water Heaters Per
See Table 5-13 or use
❑
Performance Calculation and
Dwelling Unit
attach Run to Forms.
❑
Central Water Heating System
Performance Calculation and
Serving Multiple Dwellings
attach Run to Forms.
❑
Non-NAECA Large Water
CF -1R
Heater
See Table 5-13 or use
❑
Indirect Water Heater
Performance Calculation and
attach Run to Fors
See Table 5-13 or use
❑
Instantaneous Gas Water Heater
Performance Calculation and
attach Run to Forms
See Table 5-13 or use
❑
Solar Water Heating System
Performance Calculation and .
attach Run to Forms
❑
Wood Stove Boiler
Performance Calculation and .
attach Run to Fors
SPECIAL FEATURES REOUHUNG HERS RATER VERIFICATION
(add extra sheets if necessary) Indicate to the HERS Rater which credits are part of this project and need
verificatinn-
✓
Feature
Required Forms if applicable) Description
❑
Duct Sealing
CF -6R part 4 of 12
❑
Refri Brant Charge
CF -6R part 5 of 12
❑
Thermostatic Expansion Valve
CF -6R part 6 of 12
Residential Compliance Fors March 2005