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9912-109 (AR)LICENSED CONTRACTOR DECLARATION I J;ereby affrcM, under penalty,of perjury that I am licensed under provisions of 9hapter'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 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). T I am exempt under Section B&P.C. for'thi -reason Date / f 3. Signature of Owner. ��t� ZJI 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. (This section need not be completed'if the permit valuation is for $100.00 or less). ()rt Icertify 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, I shall forthwith comply withthose pisi r#'s. 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 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 State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspectionn purposes:, Signature (Owner/Agent) • PERMIT# BUILDING .PERMIT 991 2-J.1119 DATE f VALUATION %.5e72.5 50 LOT TRACT �n � JOB SITE//'y ADDRESS? 7867 VIf' MTAD R.�iT APN ! OWNER CONTRACTOR/DESIGNER/ENGINEER RDl3 ;`dt C;i-fER,YL NOALL 0XVNERIBUJI:.DEA. •I8-675 VI:irLFTA .DRIVE LA QUINTA CA 922.5; USE OF PERMIT �V 1l��SS�ljj T �if.+ � E'u'tZ / a:l:Ply tJl 1 l:At( �SF1i2.1�4�J✓ Tx�rl'Cj ©1'1' ll�)'3 - . 430, FUS 14'5.00 SF F's -4 im�tnrl :`ice"p or, ,7 .s IRKRNI r'"e"►�y,�'e�t tl. r'i�r 3t� � 13F �� t ••U+{1f)-� i �-!)On 3�3l.utf , NZIC)'WRICAL F931 101 �tGCt-Ai-Ott) 8"t'.K0N0Y'M'(J110.N EEE - RE -31D 1014)0-24.1-M 3,57 f."3 SUM -iYYTs1i . C0 S'fti i!" i'i0_i 7t1�i it['ik-(��'_ 1•BL �).- -= CiV[[ FEES T(YfAL PERMIT FEES DUE ]NOW $134.22 t RECEIPT DATL ( [[ / BY J DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap ri F.A.U. Framing .'25 Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath l l • 'VtC _ Final _ Final C� BLOCKWALL APPROVALS _ POOLS -SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I Gas Piping PLUMBING APPROVALS 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) ELECTRICAL 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: Q� —Fp� v�.stST.p ¢j;ftr�J —♦� Gly 12 $t� Ci of� La Qu inta tY . t - Buildi' W Safety Di4ision . ,,, P.O Boz 1504 •. ,..:. 1?.ettrtit # " "' ,:;:: ., , .. . �; 78-495 Calle Tampico ' : i '/'7i r ., La� Quinta; .CA 92253 , _ B1ailding.Permit Application and Tracking Sheet .`'>:<:` Project'Address IR -78 � Xr- yr //t {w J, . Owner's Name: ,.�k,� -'' ��jes� ,.. /1� d /� �� y A. P. Number.' ' _ , . _ Address: %1� �7.5":(/:Y/e .0'A- . . Leal Description: - " • '.. ' ` . -. : , / . . Ciry,ST, Zip: ,[o- Q, 1,, /I . ' • - - _ Contractor: cs�- t.� C/L U Q� w� t: 7 y Tele hone. 5/ . P m.*,Project 1. Address: Descri tion:. f�, J P C ori ��: �,, + S — 73 Cit -,-.ST, Zip: '+� - . .. , .. ... . �, ° v ./'.%' �' . ., f �7� Tele P lio ne: .. . Stale Lic.'# Ciry, Lic: #: i. ,ry' • d y Arch . Enur:. Designer: .. 4t r . '5' ^� ) Address . . -.. . . ) 2 . Cit.'"ST. zip - ' L = .,2 (� 23 . ,Construction- le Telephone: _ Te P T . e:.. . Occu anc : . 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I � - - . - . .114..'' - , . � . - I 1 . . � I . . Desert Sands Unified School. District 47-950 Dune Palms Road Notice: La Qninta; CA 92253 _• Document Cannot Be Duplicated 760-771-8515 r - CERTIFICATE OF COMPLIANCE Date 12/13/99 APN # 604-144-001 No. 19754Jurisdiction La Quints Owner NameRobert & Cheryl NoallIa- Permit # No. 78-675 Street Villeta Drive Log # City La Quinta Zip 92253- Study Area Tract # Lot # . Square Footage Type of Development ResidentialAddition No. of Units Comments Conversion of a portion of 3 car garage %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: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of . 0.00' X 165 or $ 0.00• 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 N/A Telephone,,,.77,24956 Name on the check'- .lkr By, .. Dr. Doris Wilsoni � V ''- -Superintendent Fee collected /exempted by Ellen Patino Exempt . " $0:00; Check No.' N/A,'" Signature NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or another public entity authorized to collect them on the District('s)(s') behalf, whichever is earlier. 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 1 OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "Owner/ Builder" you are the responsible party -of record on such a permit. Building permits are not required to be signed by property owners. unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. J Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the_following information for your benefit and,protection: If you employ, or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the -State and Federal Government as an employefand'you are subject to several obligations including. State and Federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to, worker's compensation insurance. For more specific information about your obligations under: Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under State Law, contact the'.Department of Benefit Payments and the Division of Industrial, Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a, licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be,contractors is to secure an "Owner/ Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building :permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed'contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico - --La.Quinta,;CA-92253- •- (760) 777-7012 �• ,.. _. - _ :., _ _ . . FAX (7 77011 , OWNER'S SIGNATURE/ DATE 1 PROPERTY ADDRESS F PERMIT NUMBER(;)' �o16►ts= • r*� eta (• a 36 . Q) 4 00 �� � .! n�• h -�. Sx t J � � �,Y fifty`' � �. , •J 4. 3 q k 'j -. U, i,• °� Q .Q �:�. Ln its J Z0 Q '� �► v 1 . r Q ;5t Lu n e ¢.� N h tD W) CL CL "Z�- p Q L'C a 2 I C C a .c r6.S C C: LL: to c ( , -� �- - J OLu too Cal 71 LI 5 + �ti .. .- ..... A_ ,_ .. ..a .� M . ..ww.--...wM.way.KJ.,•-x.r+mak . M � ��r ..wsn. �......w. - .ac�� - w�-.!t•:-•.Yi•3.i.r. r.c�•a•�sa ra• �vn t.+�f.w�3 Spf .3 Additions of less than 11000 square feet' meet the Dual -Glazed Skylights and 'Dual -Glazed requirements of package D for the applicable Greenhouse Windows. climate zone with the following exceptions: walls meet only the mandatory insulation level of R-13 Dual -glazed skylights or dual -glazed greenhouse in a wood frame; glass area is limited to the windows are treated as though they have the U - percentage allowed by the' package plus any value required for prescriptive compliance. glass removed because of the addition. Dual -glazed , .' skylights and dual -glazed Additions of 1,000 square feet or more*meet all of greenhouse windows should be included in .the requirements of package D. compliance calculations as a fenestration product r with a U -value. equivalent .to the. Package D requirement for the appropriate climate 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 glazing removed is -allowed. 2. Meet the component prescriptive requirement for Package D (see Chapter 3) and all mandatory requirements. 3. "Heavy Mass" and "Light Mass" walls rr;:�jy meet the Package D requirements for mass walEinsulation instead of R-13 (see Chapter 3). 4. for addition and alteration compliance only, dual -glazed greenhouse windows and dual -glazed skylights are assumed to meet this requirement. 5. The Package D.fenestration area plus the area of any glazing removed because of the additions 6. All applicable mandatory measures must be met (see Chapter 2). 7. No electric resistance space heating may installed. Additions and Alterations July 1, 1999 7-7 w Table 7-1: Prescriptive Compliance of Additions - Summary of Section 152(a)1 Requirements of the Standards 0 > 500 but . COMPONENT < 100 ft2(1) < ft" <1000 ft, >1;000 fe Insulation Ceiling R-19 PackageZ Package Package Walla R-13 R-13 R-13 Package Floor Mandatory' Package Package Package Fenestration , Max. U-Value 0.75 0.75 Package Package % of CFA < 50 ft, Pkg. + R'E' moved5 Pkg. + Removed Package . Shading N/A Package Package Package Space Heating' Mandatory' Package Package Package' , & Cooling (No electric) (No electric) (No electric) _ (No electric) Water Heating' Replacement N/A N/A N/A N/A Increase See Table 7-2 See Table 7-2 : 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 glazing removed is -allowed. 2. Meet the component prescriptive requirement for Package D (see Chapter 3) and all mandatory requirements. 3. "Heavy Mass" and "Light Mass" walls rr;:�jy meet the Package D requirements for mass walEinsulation instead of R-13 (see Chapter 3). 4. for addition and alteration compliance only, dual -glazed greenhouse windows and dual -glazed skylights are assumed to meet this requirement. 5. The Package D.fenestration area plus the area of any glazing removed because of the additions 6. All applicable mandatory measures must be met (see Chapter 2). 7. No electric resistance space heating may installed. Additions and Alterations July 1, 1999 7-7 w 3 11 C'e 1 Insulation Minimums2 TABLE NO. 1-Z1 S . ALTERNATIVE COMPONENT PACKAGES FOR CLIMATE ZONE 1 S- PACKAGEI COMPONENT!" A B C BUILDING ENVELOPE 1 Insulation Minimums2 Ceiling R30 ' R38 R49 R38 Wood Frame Walls R19 R19 R29 CR2/ "Heavy Mass" Walls(R5. S) (R4. S) NA (R4, 76) �NA 'Light Mass"Walls [R7.0] [R6.01 NA Below Grade Walls NA NA NA IRO{ Slab Floor Perimeter R7 R7. R7 NR Raised Floors R19 R19 R21 R19 Concrete Raised Floors NA NA NA IR4 . GLAZING { Maximum. U-value3 , 0.65 0.65 0.40 0.65 Maximum Total Area NR 16% 16% 16% Maximum Total Nonsouth Facing Area 9.6% NR _ NR NR NR Minimum South Facing Area Minimum 6.4% NR NR 3 SOLAR HEAT GAIN COEFFICIENT4 I . South Facing Glazing 0.15 0.15 0.40 . 0.40 West Facing Glazing 0.15 0. I S . 0.40 0.40 East Facing Glazing NR NR 0.40 0.40 North Facing Glazing NR NR NR NR THERMAL MASS5 REQ NR REQ NR, INFILTRATION CONTROL Continuous Barrier NR REQ NR NR, Air -to -Air Heat Exchanger NR REQ NR NRI SPACE HEATING SYSTEIN6 ` s - Electric. Rsistant Allowed NO. NO YES7 NO If Gas, AFUE = 78% 78% 78% MIN l If Heat Pump, Split System HSPF8 = 6.8 6.8' 6.8 AfIN� Single Package System HSPF = 6.6 6.6 6.6 MIN SPACE'COOLING SYSTEM i If Split System A/C, SEER = 10.0 :10.0 10.0 MIN IjSingle Package A/C,' SEERS = 9.7 9.7 9.7 DOMESTIC WATER HEATING TYPE. System must,meet budget, see ANY ANY ANi'9 ANY 151(b)1 and 151(n (9) LEGEND: NR = Not Required; NA = Not Applicable; REQ = Required, • MIN ="Minimum SEE NOTES FOLLOWING TABLE NO. I -Z16 . 3-42 July 1, 1999 Residential Manual CERTIFICATE OF COMPLIANCE: RESIDENTIAL _ (Page 1 of 2) ' CF -1R r Project Title Date Protect Address Building permit d Documentation Author ,� Telephone Plan Check /Dace Field Check / Date Compliance Method (Package or Computer). Climate Zone Enforcement Agency Use Only GENERAL INFORMATION, _ Total Conditioned Floor Area ft' " Average Ceiling Height: $ ft Conditioned Slab Floor Area ft -Building Type: Single Family �:' Addition (check one or more) . Multi -Family Existing -Plus -Addition Front Orientation: V _Rh / South / East /,West / All Orientations / (input front orientation in degrees from True North and circle one) Number of Stories . t Number of Dwelling Units: Floor Construction Type: (!la Raised Floor (circle one or both)' . BUILDING SHELL INSULATION ; Component' Type Frame Type wd = wood stl = steel Cavity Sheathing Total R- Assembly Insulation Insulation Value' ` U -Value' R -Value R -Value Location/Comments (attic, garage, typical, etc.) ' Wall et- 9 /3 ,�'rrro �;r tmr Wall Standard Rear Standard Roof ~ �/l 3 >� �.o- A ><..,t_ Roof ' Standard Skylight Standard Floor Standard Floor Slab Edge FENESTRATION Shading Devices Fenestration Orien- #/Type/Pos. tation - Area Fenestration • Fenestration Interior Exterior Overhangs (ftl) U -Value SHGC Shading Shading Att. /Fins Att.' Front Standard Front- Standard Left 90 . 2 0 -ff AF iS' Standard Left Standard Rear Standard Rear Standard .Right Standard Right,.. Standard Skylight Standard Skylight Standard ' For prescriptive compliance, Total R -Value and Assembly U -Value are not required for a wood -framed wall that meets cavity R -value insulation requirement for the Prescriptive Package., ' For prescriptive compliance, there are no credits for any interior shading except the default or Standard" drapery. 'These default interior shading devices (draperies) need not be installed for compliance purposes. 'July 1;1999 ` 1 CERTIFICATE OFCOMPLIANCE:RESIDENTIAL (Page 2 of 2) CF -1R Project Title "Date HVAC SYSTF,i11S - Note: Input h�dfonic o: ul:dvi 1'r::;:: Il a!iff, SYsf_•r.u. e?:cent Ihsi_•n Ile:uing Load �. L)I;tributlon Heating Fquipment Minimum Tvpe and Duct•or Heat Pump' Type (furnace. lied: Efficiency Location Pipin!u Thermostat Configuration pump. et .) (AFUG of IISIT) Iduct>: attic, etc.) R-ValUC`T vpe (split or package) Cooling Equipment Nlinimtun- --- Duct - _ Heat Pump Type(aircondhioner. 'Effic.ienc% Looation Duct Thermostat Configuration - heat pump. evap. cooling) (SElat) (anic. Cie.) R -Value Type (split or.package) WATER HEATING SYSTEMS Energy' External Rated' Tank Factor or Tank ' 'Water Heater Distribution Number Input (k\\' Capacity Recovery Standby' Insulation Type -I \ pc in S%'stem of Bitv'lfr) ' (gallons) Efficiency Loss (°o) R -Value �/L4 lei. -r , 1. For small gas siora^_e- eater hcaters (rritcd inputs of les; than of equal to 7>.00(I Blu/hr). elecfric resistance, and heat pump -water heaters, list Energy Factor. For larce g;fc storage water hratcfs (rated inpet of greater than 75.006 litu/h!): list Rated Input. Recovery Efficiency and Standby Loss.". ' For instantaneous gas water hcatcrs, list fated input and rccoverN cfliciencies. � SPECIAL FEATURES antl MODEI_,ING ASSUMPTIONS (Add extra sheets if necessary) Including TherntaLMass (thermal mass typ:, covering, thickness. and description) COMPLIANCE STATLAI N1' This eertificate of compliance lists I!i:• buildings fcalwc: and perforfrta;:ce specifications needed to comply with Title 24, Parts I and 6 of the California Code.(if Regulations, and the ad.n inistrativc regulations Ii, implentcni them. This certificate has been signed by the , individual.with overall design res110115ibility. \Vllcn this certificate of compliance is submitted fora single building plan to be built in multiple orientations. am' shadif!' failure that is \ of i;(f is indi.ated in Ihr Special hcatures / Rc•nmrks section. Designer or Otv to/t' (per Business and Professiow; Cade) Documentation Author Name: ��S en� /�. /�e�/di� — - — Name. Tillehinn: _ "_ _ "I itic/Finn: ' Address:;',ddress: - `~Telephone: 760'" 722: "fclephunr.• — Lic. 9: (signature) (date) + (si^_nature! (date) Enforcement Agency Name:. - Name: Title. Agency: - �' ' Telephone: — - -- ---- (signature / stamp) Idatc) . • ----- -- July 1, 1999 � .. a