BPLB2016-0012,G�` I IIIIII IIIII (III (III
06
�arw
VOICE (760) 777-7125
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/21/2016
Application Number: .
BPLB2016-0012
Owner:
Property Address:
78269 HACIENDA AVE
NANCY SHUMA
APN:
646280020
78269 HACIENDA —/-
Application Description:
SHUMA /WATER HEATER (2)
LA QUINTA, CA 9225
�+-
Property Zoning:--�.—�--ti
Application Valuation:
$9,260.75
Applicant:
Contractor: CITY0FLAW
A R S AMERICAN RESIDENTIAL SERVICES OF C
A R S AMERICAN REER., EiNTIAle+SEj2IEESX_,ARVdENT
965 RIDGE LAKE BLVD SUITE
201
965 RIDGE LAKE BLVD`S
MEMPHIS, TN 38120
MEMPHIS, TN 38120
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 Professions Code,
and my License is in full force and effect.
License Class: C36. C10. C20 License No.: 765074
Date: /�// Contractor: '? /"- �"of) r'Crc
OWNER -BUILDER DECLARATION
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 & 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.).
(_) 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
Lender's
(951)276-9744
Llc. No.: 765074
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
iSection 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are:
Carrier: _ Policy Number: _
_ 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, I shall forthwith
comply with those provisions. -
Date: Applicant: 6,6/ =ill vL 0'ti r�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 Building Official 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 city to enter upon the
above-mentioned property for inspection purposes.
Date: �l "Signature (Applicant or Agent):
N, rp FINANCIAL INFORMATION
DESCRIPTION i ACCOUNT.
QTY: AMOUNT _ .. PAID
PAID DATE
BSAS SB1473 FEE 101-0000-20306
0 $1.00 $1.00
1/21/16
PAID BY METHOD.
RECEIPT # CHECK #
CLTD BY
ARCHON ENERGY SOLUTIONS CHECK
R12258 1330
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: ' $1.00 $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT :.
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
1/21/16
PAID BY
METHOD•
RECEIPT #
,CHECK #
CLTD BY
ARCHON ENERGY SOLUTIONS
CHECK
R12258
1330
RSE
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE.
WATER HEATER/VENT
101-0000-42401
0
•$24.18
$24.18
1/21/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
ARCHON ENERGY SOLUTIONS
CHECK
R12258
1330
RSE
DESCRIPTION'
.ACCOUNT
QTY
AMOUNT
PAID •
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$14.50
$14.50
1/21/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
ARCHON ENERGY SOLUTIONS
CHECK
R12258
1330
RSE
Total Paid for PLUMBING FEES: $38.68 $38.68
Description: SHUMA / WATER HEATER (2)
Type: PLUMBING Subtype: Status: APPROVED
Applied: 1/21/2016 RSE
Approved: 1/21/2016 RSE
Parcel No: 646280020 Site Address: 78269 HACIENDA AVE LA QUINTA,CA 92253
Subdivision: TR 8792 & INT IN COMMON AREAS Block: Lot: 9
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $9,260.75 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NAME
Details: WATER HEATER CHANGE OUT - 2- 50 GALLON/GAS CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
__j Applied to Approved
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
A R S AMERICAN RESIDENTIAL
SERVICES OF C
965 RIDGE LAKE BLVD
SUITE 201
MEMPHIS TN
• 38120
CONTRACTOR
A R S AMERICAN RESIDENTIAL
SERVICES OF C
965 RIDGE LAKE BLVD
SUITE 201
MEMPHIS TN
38120
OWNER
NANCY SHUMA
78269 HACIENDA
LA QUINTA CA
92253
Printed: Thursday, January 21, 2016 10:30:40 AM 1 of 2
17777 SYSTEMS
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, January 21, 2016 10:30:40 AM 2 of 2 >.
SYS7Eh1S
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE _
RECEIPT #
CHECK.#
METHOD
PAID BY
$Y
BSAS SB14'73 FEE
101-0000-20306
0
$1.00
$1.00
1/21/16
R12258
1330
CHECK
ARCHON ENERGY.
RSE
SOLUTIONS
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:'
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
1/21/16
R12258
1330
CHECK
ARCHON ENERGY
RSE
SOLUTIONS
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
WATER HEATER/VENT
101-0000-42401
0
$24.18
$24.18
1/21/16
R12258
1330
CHECK
ARCHON ENERGY
RSE
SOLUTIONS
WATER HEATER/VENT
101-0000-42600
0
$14.50
$14.50
1/21/16
R12258
1330
CHECK
ARCHON ENERGY.
RSE
PC
SOLUTIONS
Total Paid for PLUMBING FEES: $38.68 $38.68
TOTALS: $131-53 $131.S3
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, January 21, 2016 10:30:40 AM 2 of 2 >.
SYS7Eh1S
STATE OF.� ALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 -
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations
Project Name: 7,y 2 J6 91 #06 /P/1 4110 k
CALIFORNIA ENERGY COMMISSION
CF1R-ALT-01-E
(Page 1 of 4)
%t a vfQ C % 53 1 Date Prepared: )12_17f 6 6
A. GENERAL INFORMATION
01
ASK
01
Project Name:
02
Date Prepared:
03
Project Location:
04
Building Front, orier%taton'(deg or cardinal):
05
CA City:.
06
Number of Alte�ed<Qwelling Units: IV,&
07
Zip Code:
08
Fuel Type: ,.
09
Climate Zone:
10
total,C.oriditio ed Floor=A�ea (ft2)
11
1 Building Type
12
1SIab;A�ea(ft2)��-
13
Project Scope:
i
K .Y V, "Vi.
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)
01
02
03
04
05
06 ' Q*67 I 08,-fIMP9.
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
Frame
Spacing
(inches)
P,r_oposed
Required
Comments
v,
Tk'
' Continuous
Cavityg Insulation
R -value, R -value
; U,factor
Appendix JA4
Reference
. U -Factor
Table,, Cell
o
.
Compliance
Pitch
Exceptions�11umber
,P ct Type ,
ulat
Reflectance Reflectance Emittance (Optional) Reflectance Erriittance (Optional)
k1WI
C. ROOF REPLACEMENT (Prescriptive Alteration, Se&i'on 1 0.2(b)1H)
'
01
02
03
04 Y
05
P 06
'0;7 08 09 10 11 12 13
Method of
Roof
CRftC odD
R -value
DKe k;
'+� Propos d Minimum Required
nitial Solar Aged Solar Thermal SRI: Aged Solar Thermal SRI.
o
.
Compliance
Pitch
Exceptions�11umber
,P ct Type ,
ulat
Reflectance Reflectance Emittance (Optional) Reflectance Erriittance (Optional)
k1WI
`
--7
a
t w
NOTES q '• +
• Roof area covered y.bldin�gyintegrated phtovoai panels and solar thermal panels are exempt from the above Cool Roof requirements.
field from 110.8(i)4.
• Liquid applied?coabngsmust comply withristallation criteria section
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
HERS Provider:
June 2014
r
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION `
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E
Prescriptive Residential Alterations (Page 2 of 4)
Project Name: Date Prepared:
D. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.2(b)1)
01 02
04 V
03
Alteration Type Orientation
Maximum Allowed ft2 Comments._
i�.+ A.
05
06
07
08
E. FENESTRATION/GLAZING PROPOSED AREAS AND EFFICIENCIES (Section 150.2(b)1) -
01
02
03
04
05
06
07
08
Vol,
10'V1,1#,11
,'
� 11
12
13
14
15
Combined
Orientation
Area
Area q
N
Maximu'fn
,V.
Exterior
SHGC
Tag/
Fenestration
Frame
Dynamic
N, S, W, E, or
Removed
Added
Added
Alldwei
Shading
from
ID
Type
Type
Glazing
Roof
ft2
ft2
Area ft2
fac or
U -factor
Source
SHGC
Source
Device
CFIR-ENV 03
3
a
Net Added West�aci g nestratio e
�A
b
Existing + Added West -facing Fenestration Area
c
Maximum Allo eclWest-facing,•Ferie t�ation Area
#r Six v 91.
d
Is West facing Fenestration Area < Maximum Allowed West facing Fenestrations
e
..< x ¢ n
,� CNet Added F en�estrakationtit Area (all or<'etations)
f
' estration Area (all�oiien�tations)
,,Existing+Ad,deZFe
g
Maximum<A�IIQwed Fenestration Area (all orientations)
h
+"A- Is Existing + Ad-ded-Fenestration Area �Maximum Allowed Fenestration Area (all
10; orientations)
Registration Number:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time:
HERS Provider:
June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E (Revised 06/14)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations
Project Name: I p,0a Lot
CALIFORNIA ENERGY COMMISSION ?;
CFIR-ALT-01-E
(Page 3 of 4)
Date Prepared: 2/ /�
F. SPACE CONDITION ING(SC) SYSTEMS - HEATING/COOLING (Prescriptive section 150.2(b)) A 1%
01 02 03
;s
Dwelling Unit Name Dwelling Unit CFA (Ft2) Comments .
G. W TER HEATING SYSTEMS (Section 150.2(b)iG)
Ol
02
03
04
05
06 .
07
08
U9;
_ 10
,1f1
3 12
13
14
15
•
Water Heating
Alteration to the Space
of
Water
5. r Name �
Identification or Name
Conditioning System(s)?
N
r:
Back -Up
Water
Heater
"HeatingHeatin
3
System
Water
Water
Heaters
Storage
Rated
Rated
Exterior
Solar.
Dwelling Unit DHW
Identification or
Heating
Heater
in
Volume
Fuel
Input
Input"'
Efficiency a
Efficiency
Standby
Insul.
Savings
. Central DHW System
System
Name
Type
yp
Type
yp
system
y
(gal).
Type
T•,pe
�, Value
Type'��
' � V,alue
Loss,(%)
R -Value
Fraction
Type
Distribution Type
-System
s
0,
�.
,f
2 .
*fie
CDistribution
d
�dx&-A
H. SPACE CONDITIONING SYSTEMS AND WATER HHEAT 'G SYSTEMS I ULTIFAMILY DWELLING UNITS
01
02
, 03
640
05
06
CentraLVVater Heating
P Dwelling Unit
Dwelling Unit:
Dwelling �lJni>Total-CFA
g �
System Identification or �
y
ater�Heatin System
g Y
Alteration to the Space
Dwelling Unit Name
(ft2)
5. r Name �
Identification or Name
Conditioning System(s)?
Comments
<eo
Registration Number': Registration Date/Time:- HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential.Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY -COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 4 of 4)
Project Name: Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT.
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: '
Company:
Signature Date:
Address: .t � L
U 7
CEA/ HERS Certification dentificationl(if applicable): y
City/State/Zip:
Phone:
RESPONSIBLE PERSON'S DECLARATION STATE ENT
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information on this Certificate Compliance is true and correct.
provided of
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibll ty,�for the building desi- n or system design identified on this Certificate of Compliance (responsible
designer).
'�s-,for
3. That the energy features and performance specifications, materials, compose its; and'manufacturrei dL-vi' the building design or system design identified on this Certificate of
Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of,Regul tions
1%4 `* . :.
4. The building design features or system design features identified on this Certificate of Compliance<bre consistent.it the Information provided on other applicable compliance documents,
of pprovaI wilding
worksheets, calculations, plans and specifications submitted to thye cement agency for with this permit application.
5. 1 will ensure that a registered copy of this Certificate of Comyphin�ce:shall be made,availab►e with the building permlt(s) issued for the building, and made available to the enforcement agency
for all applicable inspections. I understand that a registered copy'of this Certificate?o�f Compliance is required to be included with the documentation the builder provides to the building
owner at occupancy. W,
Responsible Designer Name: ) /
Riiipdnsible Designer Signature: XIA-/
10
Company : "� t `
Date Signed: A�.
Address: � ��. �' +`�j ,_ „y '�+,
License:
s6
/�X76
City/State/Zip: ` O / aw �%
Phone: -3 / 3q
For assistance or=questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
0
E7
G3
Bin ## e •
.0ty of La Quina
Building Si' Safety Division
Permit ## 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
gPL ZQ I (�U' Building Permit Application and Tracking Sheet
Project Address: 7 9 2zq f-)"t,t Qnc2d ',Q (3�u Nvler'sName:
A. P. Number:
Address: 2 C1 4e L
Lc4l Description:
nn
Contractor: 1`
City, ST, Zip:
Telephone: .S 6�-
-F � `tom. C--� P 7 O ........................................:.:.
Address: �O �j Q i •e..lrs S w T'roject Description: /,-to n
City, ST, Zip:
�t s 6��, C Z -�7 Gt7'
T
cic P hone:f9i
D Ic
tate%Lic. '1126 S O -79 City Lic.
Arch., )✓ngr., Designer: Q
5 _'-
Address:
City, ST, Zip:
Telephone: one:
Lic.
Name of Contact Person:
`Ucuu
Co truct' n Type: e• U Pan cY
P
<
Repairair Demo
ProJecttYPecit (circle
cS J Sq. Ft.: # Stories: # Units:
Telephone # of Contact ASS? 263— 3 qstimated Value of Project: 2desQ.. S
APPLICANT: DO NOT WRITE BELOW THIS LINE
M
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact.Pcrson
Plan Check -Balance.
Title 24 Calcs.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN I10USE:-
'rd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. \Vks. Appr
Date of permit issue
School Fees,
rota) Permit Fees