09-1207 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 7 09-00001207
Property Address: 78244 LAGO LA QUINTA DR
APN: 646 -200 -014 -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 700
Tiht 4 4 0".
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
CHADWICK FRED
78244 LAGO LA QUINTA DR.
LA QUINTA, CA 92253
(
Contractor:
Applicant: Architect or Engineer: ALVAREZ, JORGE A.
IA-A� PO BOX 984
THERMAL, CA 92274
(760)777-3613
Lic. No.: 880103
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.
LicenseClass: C36 1 License No.: 880103
Data: 112r1 -al Contract.: T
OWNER -BUILDER TION
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).:
(_) 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 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.).
(_ 1 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
( 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:
LQPERA11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/24/09
U q
NOV C FL24 ?Dog
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 EXEMPT Policy Number EXEMPT
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, 1 shall forthwitl ply with those provisions.
::Oate:-2 N-0'?' Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COV LAWFUL, 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 county to enter upon the above-mentioned propert='nspet'onses.Dater Signature (Applicant or AgeGnt))
�r�
f
LQPERMIT
Application Number
09-00001207
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . . 22.50
Plan Check Fee
5.63
Issue Date . . . .
Valuation . . .
. 0
Expiration -Date 5/23/10
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 7.5000 EA PLB
WATER HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and Comments
REPLCACE 50 GALLON WATER HEATER
NATURAL
GAS.
----------------------------------'------------------------------------------
Other Fees . . . . . . . . .
BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
Due
---------------------------
Permit Fee Total 22.50
------------------------------
.00 .00
22.50
Plan Check Total 5.63
.00 .00
5.63
Other Fee Total 1.00
.00 .00
1.00
Grand Total 29.x3
.00 .00
29.13
f
LQPERMIT
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Pane 3 of 4) ' , CF -IR
rpj� Zy �
roject Title
1�
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the following. are
required.
OR — --
Alternative to Sealed Ducts and Refrigerant Charge 1TXVs (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.
WATER HEATING SYSTEMS
Distribution
Type
❑,
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 verification required.)
❑
Refrigerant Charge (climate zones 2 and.8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
OR — --
Alternative to Sealed Ducts and Refrigerant Charge 1TXVs (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.
WATER HEATING SYSTEMS
Systems serving single d -we ling units
�Water,Heater
r.T-- %FtielTv e-
Distribution
Type
Number
in S stem
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
T -anti.. A
Capacity
t allons)
d%�elling unit. If the water heater is a storage. type, 50 gallons is the, maximum -capacity and _recirculation system is
Tank
External
Insulation
R -Value
not allowed.
0
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
a, oo)
Manual. No water heating calculations are required, and the system complies automatically.
e
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.
0
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Systems serving single d -we ling units
�Water,Heater
r.T-- %FtielTv e-
Distribution
Type
Number
in S stem
Rated
dri ut1"'�
t(kP or �,
Bi -Ar) l `
T -anti.. A
Capacity
t allons)
Energy !
YFactor or,
Tlierrnal Standby'
Effictencv Loss %)
Tank
External
Insulation
R -Value
a, oo)
e
A5
system serving multiple dwelliniz units
Water Heater
T e
Distribution
Type
Number
in S stem
Rated
Input,
(k%i, or
Btu/hr
Tank
Capacity
(.gallons)
Energy
Factor or
Thermal
Efficiency
Tank
External
. Standby Insulation
Loss % R -Value
I . 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
Btuihr), 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 > 314 inches) All hot water pipes from the heating source to the kitchen fixtures that are '/4
inches or greater in diameter shall be thennally insulated as specified by Section 150 (j) 2 A or 150 (j) 2 B.
Residential Compliance Forms March 2005
Z
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page,I of 4) CF -1R
Project Title
Project Address
Documentation Author
Telephone
Date
Building Permit 9
Plan Check / Date
Field Check 1 Date
Compliance Method (Prescriptive) Climate ZoneEnforcement 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 -IR page 3)
For Package D Alternative see Appendix B Table 15I -C Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) ft' Average Ceiling Height: ft
Maximum Allowed West Facing Fenestration Products Per Table 15I -B or 151-C ---- (5% X CFA) ftZ
Maximum Allowed Total Fenestration Product 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 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:
Floor Construction Type: Slab Raised* Floor (circle one or both)
Front Orientation: North Pot of th /East / West / All Orientations (input front orientation in degrees from True
North and circle one).
✓ ❑ RAD [ANT BARRIER (required in climate zones 2,4. 8-15)
OPAQUE SURFACES INCLUDING OPAOUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type Cavity
(Wood Insulation
or Meta) R -Value
Assembly U -
factor (for
Continuous wood, metal
Insulation frame and mass
R-Valtte assemblies)'
Joint
Appendix
IV
Reference
Roof Radiant
Barrier Location/Comments
Installed (attic, garage,
Yes or No t teal, etc.
Il SeT Inint Ar, ra Iv c .,
- -- - "' • -1111--l- • - „I 1 v .-, t v ., and ► v A, which is the basis for the U -tactor criterion. U -factors can not
exceed prescriptive value to show equivalence to R -values.
Residential Compliance Forms March 200
Bin #
City of La Quinta
Building & Safety Division
Permit #
P.O. Box 1 SO4, 78-495 Calle Tampico
La
Quinta, CA 92253 - (760) 777-7012
Building
Permit Application and Tracking Sheet
ProjectAddress: "7 Owner's_Name:I
A. P. Number:
Addles:-"? 2 y i,G. 8
Legal Description: City; $T'Zip:Lo, aWcL C -A 9 253
0nfr4cfor: 2 Ium ! Jo►' A`N)rA-re.i. Telephone: _
Address: Project>:DescrpEon:
0.0 SO G
City, ST, ZiQnna= -CA p: Q Z Z
Telephone:
State Lic. # : no 10 3 City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: C
onType: Occupancy:
State Lic. #: ect type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Ft.. #Stories: # Units:
Telephone # ofContact Person: Estimated Value of Project: 4 aQ
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING. PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Energy Calcs.
Pians ticked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2i° Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review, ready for corrections/usne
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Ll
Total Permit Fees