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9902-158 (AR)LICENSED CONTRACTOR 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 # Lic. Class Exp. Date 'Date w i f ` Signature of Contractor" / J t OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) ..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 & Professionals Code). ( ' ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). I 1 ' () I am exempt under Section , B&P.C. for this reason Date Signature of Owner 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). ( )�I certify that in the performance of the work for which this permit is issued, I 9hall 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 Coe; l shall forthwith comply with°those provisions. D tes '7A 6 /l.(. Applicant 4* t- V' Warning:. Failure to secureMorkers' 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 tabor 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 4. 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, acid State laws relating to the building constP - ction, and hereby authorize representatives of this City to enter upon the Bove -mentioned property for inspection purposes. '.a'/ ps' `y 'k r� _ Date.X., h /Signature (Owner/Agent) —7— PERMIT # BUILDING PERMIT„ DATE a VALUATION 59042'4." LOT TRACT JOB SITE ADDRESSrr ERN•ESS APN 769-431-032 OWNER CONTRACTOR / DESIGNER / ENGINEER PAUL S1:i1Z.GLRS J & I CONI M2iJL`T ON .`.G 1857 INVERNESS 1i I' Y 45651 PME0 coltpN'.IV00 LA QUINT CA 92253 INDIAN WELLS, LS• CA, 92210 iC/60)' 33-1108 C.BL# ` USE OF PERMIT Eti'1i�RT t r IvCi.uSti► 1,A1�:ty 3'iez' 1u� + C31 iT. - �tii°iia l�k l uialT�x [dsS a€aHLL 4WAR4 OPEN AND NUJil,E USED F'CR PA S11NC",. ID rra 26 1999 US'1 V C NSTIZUCTION 121.00 S.F. 11Y ® Es. T-1 awl Eill) MIT OF CO NISTAR11 U CTIONT P.1 MOT VEE SUIMIARV PLAN O"'}• 9CX FEE 101 -OW -439-318 $76JIS CONS`f ROC'fON > 1014000-'419-000 V 170l MMMM1C;AL F^ - 101-000-421-0()0 521.50 E.L"CT CT AL fid%. X01-000420-000 S 19 24 -1'1.iJiLfl3INQ FEF 10.1-000-419- 0 $25.50 3IRON 0 !0TION FW, -11.F610 101-000-741-000 SUB -'i OTAlN CON:�TAU(MON AND PLAN CM CK $260.21 LESS Pii-F;TAI1r7FEE S x,0.00 TMAI, PUMUff FE&S 01) F. NOW S26013 RECEIPT DATE BY DATE FI ED INSPSC TOR 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 0. K. to Wrap F.A.U. Framing Compressor Insulation 717 z Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath 3 Final Final BLOCKWALL APPROV S POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final 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 Fbdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 2/26/99 No. 18393 CERTIFICATE OF COMPLIANCE APN # 769-431-032 Jurisdiction La Quinta Owner NamePaul Bergers No.54857 Street Inverness City La Quinta. zip 92253 Permit # Log # Study Area Tract # Lot # Square Footage 121 Type of Development Residential Addition No. of Units 1 Comments 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 amoiuit of N 0.00 X 121 or $ 0.00 the property listed above and that building's"G, permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued' Fees Paid By n/a Telephone 779-0879 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Adriana Gauto Exempt $0.00 Check No. n/a Signature NOTICE: Pursuant of Assembly Bill 3081AtHAP 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 to 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 CUNIPLIANCE ANALYSIS ()F AN ADDITION ALONE Any addition —;hat is. the sum of all new ,:ond►tionca soaccs and assoctatcd new exterior wails. cc►linim and floors within the building — ,nav nc snowr :o meet the cncrLy budLct as a -tcparatc cnan. Iles prvccaurc docs not involve the ex►sune structure, except when caicuiaune the water heating energy use for any addition in which the total numlxr of water heaters in the hutldinz incrcascs. Thc analvsts may he pcnormca using either a special presenpttve package accordtne to the size of the addition or with the point systcm or any approved computer pcnormance meunoa. Table 7-1: Prescriptive Compliance of Additions-, Summary of Section 152(2)1 Re encs of the Standards COMPONENT � 1(N) ft" 1011-.199 ft" 500-999 ft" >_ 10(1) ft' Insulation Ceiling R-19 Packager Package Packagc Wall` R-13 - R-13 R-13 Packagc .Floor R-13 Packagc Packagc Packagc Fenestration U -Value i % of CFA 0.75 , <_ 50 ft" 0.75 Pkg + Removedi Packagc Pkg +Removed Packagc Packagc �. Shading Na Packagc Packagc Packagc Thermal Mass Na Packagc Packagc Packagc . Space Heating Mandatorvs Packs g a Package. g Pa k c agc & Cooling (NO electric') (NO electnc) (NO electric) (NO electric) Water Heating - No Increase & No Change Na Na Na Na Replacement: No Increase Standard Standard Standard Standard Increase A.Uowcd w/Calculations -flowed Allowed Allowed w/Calculation w/Calculation w/Calculation L Meet the component prescnpuve requirement for Package D for slab -on -grade construction or Package E for raised floor construction (see Chapter 3). '_. "Heavy" and "Light Mass" mass walls may meet the Package D or E requtmmcnts for mass wall insulation instead of R- 13 (see Chapter 3). 3. For compliance of additions and alterations only, dual glazed "greenhouse'' windows and skylights may be assumed to meet this requirement. 4. The Package D or E fenestration area plus the area of any glazing removed because of the addition. 5. All mandatory measures for HVAC:ivstcros must be met (sce Chapter 2). 6. No eiectnc resistance space heaung may be installed. 7• A standard water heaung system is explained in Section 6.6. S. If the total number of water heaters increases in the residence, then the entire existing plus addition system must meet the water heating energy budget (see Chapter 6). Table 3-4 lists water hcaung ,Nstem combinations which have been pre -calculated to comply. with the water heating budget. 7-4 Revised January 1992 Residential Manual Table 3-Z15: Prescriptive Packages for Climate Zone 15 - Package Package Component A B Package e i t (Package D Package E BUILDING ENVELOPE Insulation Minimums: Ceiling R-30 R-38 R-49 R-38 R-38 WaUI R-19 R-19 R-29 R-21 R-21 "Heavy" Wall (R-5.5) (R-4.5) N/A (R-4.76) (R-4.76) "Light Mass" Wall (R-7.01 (R-6.01 N/A N/A N/A Slab Floor Perimeter R-7 R-7 R-7 NR NR2 Raised Floor R-19 R-19 R-21 R-193 R- 19 FENESTRATION Maximum U-Value2 0.65 0.65 0.40 0.65 0.65 Maximum Total Area NR 16% 16% 16% 16% Maximum Total Nonsouth Facing Area 9.6% NR NR NR NR Mitumum South Facing Area 6.4% NR NR NR NR SHADING COEF-FICIFN74 South Facing Glazutg 0.15 0.15 0.40 0.40 0.40 West Facing Glazing 0.15 0.15 0.40 -0.40 0.40 East Facing Glazing NR NR 0.40 0.40 0.40 North Facing Glazing NR NR 0.66 0.66 0.66 THERMAL MASSS REQ NR REQ 20% 5% 04MTRATION CONTROL Continuous Barrier NR REQ NR NR NR 'Air -to -Air Heat Exchanger NR REQ NR NR NR SPACE HEATING SYSTEM6 Electric Resitance AUowed NO NO YES NO NO If Gas. AFUFr 78% 78% 78% 7896 78% If Heat Pump. Split System HSPO- = 6.8 6.8 6.8 6.8 6.8. Single Package System HSPF = . 6.6 6.6 6.6 6.6 6.6 SPACE COOLING SYSTEM If Split System AIC. SEER = 10.0 10.0 10.0 - 10.0 10.0 If Single Package A/C. SEERS = 9.7 9.7 9.7 9.7 9.7 DOMESTIC WATER HEATING TYPE System mustmeet.budget. Meets Meets Meets!! Meets Meets see §151(b) and 151([)(8) Budget Budget Budget Budget Budget LEGEND: NR = Not Required: N/A = Not Applicable: REQ = Required See notes following Table 3-Z16. Presc�ptiVe- PaCkag@S Revised January 1992 3-35 :RiYicaze of comaiiancr: Residential Pace I OT ') CF -1 R 'oject Tltlt7 q�- d "--� -- i1f�S Climate Zone 1ENERAL INFORMATION otal Conditioned Floor Area: tt2 'Wilding Type: 105 -Single Family Addition :heck one or morel Muni -Family Existing -Plus -Addition =ront Orientation: North / East / South / West / All Orientations (Input orientation in degrees and circle one.) Vumber of Dwelling Units: -loor Construction Type: I / Raised Floor (circle one or both) 3UILDING SHELL INSULATION Construction :;omponent Insulation Assembly LocatjorvComments Type R -value U -Value (attic. to garage. tyotcal. etc. Wall .........:.... -CA-3 Wall ......... .... ._`. Root ............. �.--3 Root ............. Floor ............. w Stab Edge .... «e_1 — Date Building Permit s Plan ChecK, Date Field Check i Date enforcement Agency use Only ,mptlanes ethod 1 Package. Point System or Computer) -�Y t) Ca Z — rFENESTRATION Shading Devices Fenestration Area Fenestration Interior Exterior Overhang Framing Type (shadescreen. etc.) !ves/noj (meta Orientation SO U -Value (roller blind. etc.) l/woodNtnyl) Front..... ( ) Front..... ( ) Lett ....... ( ) Lett ....... ( ) Rear ..... ( ) Rear ..... (. ) Right..... ( ) Right.....( ) --� ,s .k_T2: MTc, Skylight .1t. 7— hHTS Skylight ....... THERMAL MASS Type/Covering Area Thickness slab/exoosed. tile. etc. (St) (inches Location/ Description kitchen, batn. etc.) L�ic�JSi) st41.,t.a7 AM V 76 ItaMmW Janutiry 1992 .4mv.y. s Certificate of Compliance: Residential (`-I- / X14(1 09(CY Zr--vr,o (Page 2 of 2) CF -1 R - Date HVAC SYSTEMS Note input hyamic or combined hydropic data under Water Heating Systems, except Design Heating Load. Distribution Heating Equipment Minimum Type ana Duct or Type (furnace, heat Efficiency Location Piping Thermostat Pump. etc.) (AFUE/HSPF) iductsrattrc etc 1 R -Value Type I oe- 1 To 'i2t: V-^, 0" 6 t J Cooling Equipment Minimum Duct Type (air conditioner. Efficiency Location Duct Thermostat heat Bump. evao. cooling) rSEER) (attic. etc.I R -Value Tyne WATER HEATING SYSTEMS Cont iguration (sold or oackz Energy' External Rated' Tank Factor or Tank Water Heater Distribution Number Input (kW Capacity Recovery Standby' Insulation Type Type in System or Btu/hr1 (gallons) Efficiency. Loss (%) R Value For small gas storage (rated input s 75.000 BIUM0. electric resistance and hew pump water heaters, list Energy Factor. For large gas storage water nesters Crated input a 75.00013wft). list Rated Input. Recovery Effiaency and Standby Loss. For Instantaneous gas water heaters. fist Rated input and Recovery Efficiency. SPECIAL FEATUREVREMARKS (Add extra sheets if necessary) COMPLIANCE STATEMENT This certificate of compliance lists the budding features and pertormance specification needed to comply with Title 24, Parts t and 6, of the Califomia Code of Regulations, and Me.admtrnstmove regulations to implement them. This certificate has been signed by the individual with overall design resoonit)i6ty.- When true certificate of compliance is submilted for a single building plan to be built in muidpb orientations, any shading feature that is vaned is indicated in the Special FeatureslRemarks section. Designer or Owner (per eusineaa a Professions code) Nance: ` Tids/Firm: Address: Telephone: Lie. a. (signature► (dam) Enforcement Agency Name: Tide: Agency: Telephone: (taprtatury:tamp) (�) Documenlon Author Name: ( pa -s °� #),3 So ij Tide/Firm: C it ,� -r (C f> C_iD IL Address: U.<— �i t�cgzF n ©20 i.�j Telephone: 9. C. l 7 4— o 8 7 `P nature). (�1