06-4246 (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:
(-06-00004246 -7
54901 INVERNESS
775-131-016- - -
PLUMBING
LOW DENSITY RESIDENTIAL.
500 '
Td4t
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
�' p
------------------
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 Licenseis in full force and effect.
License Class: C36 Lice lt: 828264 _
l
,Il
te,/_ontractor:
Oyff ER -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).:
(_ 1 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.).
(_) 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 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:
LQPERAUT
Owner:
RON NOLTE
54901 INVERNESS
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/11/06
Contractor: "FI_NANCE
FOY, SCOTT A. 43579 MAIN STREET
INDIO, CA 92201
(760)775-9405 Lic. No.: 828264
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 1 should become subject to the workers' compensation provisions of Section
73700 of the abor Code, I shall forthwith com ly with those provisions.
at/ licant:
WARNING: FAILURE TO SECURE WORKERS' C PENSA N 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 Ouinta, 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. ands to laws relating to building construction, and hereby authorize representatives
of this cou to enter upon t above-mentioned property for inspection poses.
D Si lure (Applicant or Agentl:
Application Number . . . . . 06-00004246
Permit PLUMBING
Additional desc .
Permit Fee 22.50
Plan Check
Fee
5.63
Issue Date . . . .
Valuation
. . .
.
0 ,
Expiration Date 6/09/07
'
'
Qty Unit Charge Per
4
Extension
.
BASE
FEE
15.00
1.00 7.5000 EA PLB
WATER HEATER/VENT
7.50
-----------------------------------------------------------------------------
Special Notes and Comments
WATER HEATER REPLACEMENT
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
LQPLRMIT
Dill it
City (ai b
Building 8r Safay DWIDO
PM. 111 ft P.O. Box, 1504, 79-495 Calle Tampico
La Quinn, CA 92253 - (760) 777-7012
Building 13'emit Appficadon and Tracking Sheet
~Project Address:
LOwncesNa='.
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A. P. Number:
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Lt.-Lpl Description: L
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AnJi., Engr, Designer:
Addi-cm.:
City: S'1-, lip:
Tolephono; .... .....
Construction
occupmcy:
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EmbMted VWUC of Projt Y
APPLICANT; DO NOT VIMTE BELOW THIS LINE
Req'd Reed TRACMG
11120 Sets Plan Chect submitted Frew
Ainnunt
Nircetuml 021a.. Plan Cbeck Deposit
Tnm Coles. 1 QJIed Cow2rr Person
Plan Cheek Sulu=
riffe 24 Q21cs. I Mas picked up
consmetion
Mood plain Pinn rr Mons resubmi(ted
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Girtiding pItz
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Subruntacior List Called Contnef Person
Graw Dccd "Inns piefted tip
11.0-,L Approval resollmilled
Crading
IN HOUSE:- Pevfcv, read -v for correctloval'issue Developer tmpa'ct Re
1112noing Approsml Called Contact Person
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Pub. W6. Appr [j-Dnte ofpermit issue
School recs
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Total Permit Fem
' CERTIFICATE OF CON&LIA NCE: RESIDENTUL (Page'3 of 4) CF -IR
Date
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -4R Fort must be provided to the building department for each home for which the following. are
required.
VK
❑ Alternative to Sealed Ducts and Refrigerant Charge frXVs (See Package D Alternative Package Features
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
aces shall meet the requirements of Section 150 m and duct insulation requirements of Package D.
♦r 11r, XMA 111Vis J It O 1141v1J
Distribution
Type
0
Scaled Ducts all cliutate zones installer testing and certification and HERS rater field verificationrequired.)
❑
TXVs, readily accessible (climate zones 2 and 8-15 only)
Installer testing and certification and HERS Rater field verification requited.
D
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification ' ' uired.
VK
❑ Alternative to Sealed Ducts and Refrigerant Charge frXVs (See Package D Alternative Package Features
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
aces shall meet the requirements of Section 150 m and duct insulation requirements of Package D.
♦r 11r, XMA 111Vis J It O 1141v1J
stexims ares-v,n sin re u
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Tank
External
Standby' Insulation
Loss % R Value
not allowed.
❑
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required,and the system complies automatically.
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 for a system serving multiple
units \
stexims ares-v,n sin re u
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Rated
Input'
(kW or
Btu/hr
Tank
Capacity
lona
Energy
Factor' or
Thermal
Efficiency
Tank
External
Standby' Insulation
Loss % R Value
System serving mulhnle dwellmr► units
Water Heater
Type
Distribution
Type
Number
in Sstem
Input
(kW or
BW/hr(gallons)
Eney
Tank Factor or
Capacity Thermal
Efficiency
Tank
External
Standby' Insulation
Loss M R -Value
o...u.. 6a' ILUMIg = wntcr m -4=S traced 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
Bhdhr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Pine Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are S/
inehos or greater in diameter shall be thermally insulated as specified by Section 150 6) 2 A or 150 6) 2 B.
Residential Compliance Forms March 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 41CF-IR
Documentation Author
Compliance Method (Prescriptive)
Telephone
Climate Zone
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 -IR page 3)
For Package D Alternative see Appendix B Table 151-0 Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CEA) Average Ceiling Height: ft
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C — (5% X CFA) ft2
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 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 / South / East / West / All Orientations (input front orientation in degrees from True
North and circle one). '.
v ❑ RADIANT BARRIER (required in climate zones 2A.8-15)
8-15)
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Wall,
Roof; Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
or Metal)
Cavity
Insulation
R -Value
Assembly U -
factor (for
Continuous wood, metal
Insulation frame and mass
R Value assemblies)'
Joint
Appendix
IV
Reference
Roof Radiant
Barrier Location/Comments
Installed (attic, garage,
Yes or No typical, etc.
1) See Joint Appendix IV in Section IV.2, IV.3 and IVA, which is the basis for the U -factor criterion. U -factors can not
exceed prescriptive value to show equivalence to R -values.
Residential Compliance Forms
March 2005
SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION
Gadd exL-A sheets if neck
Indicate to the HERS Rater which credits are part of this project and need
CF -6R art 4 of 12
CF -6R alt 5 of 12
Valve
CF-6R part 6 of 12
March 2005
Residential Compliance Forms
�CF-IR
`, (Page 4 of 4)
OF�COWLIANCE: RESIDENTIAL (�
- � CERTIFICATE
/
Date
Projcwl Titic
FEATURES NOT RE UUUNG HE RIFICATION add extra sheets if nee
SPECIAL TE ial features relevant to the
spec
Indicate which special features are part of this project. The list below only represents
reser live method.
R uired Forms if a livable Descri tion
✓ Feature
❑ Metal Framed Walls
CF -1R
❑ Radiant Barriers
CF -IR
❑ Exterior Shades
WAR
N/A; Attach CRRC Label to
❑ Cool Roof
Forms.
Performance Calculation
_ Dedicated Hydronic Heating
❑
R uired- Attach Run to Forms.
S stem
Performance Calculation
❑ Combined Hydronic System
Re uired; Attach Run to Forms.
Performance Calculation
❑ Gas Cooling
R uired.
❑ Buried Ducts
N/A; Indicate on buildin lans.
See Section 5.6.2 Distribution
❑ Kitchen Pipe insulation
S stems in Residential Manual.
See Table 5-13 or use
Multiple Water Heaters Per
Performance Calculation and
❑ Dwelling Unit
attach Run to Forms.
Central Water Heating System
Performance Calculation and
0 Servin Multi le Dwellin
attach Run to Forms.
Non-NAECA Large Water
CF -1R
❑ Heater
See Table 5-13 or use
❑ Indirect Water Heater
Performance Calculation and
attach to Forms
See Table 5-13 or use
❑ Instantaneous Gas Water Heater
Pr rinance Calculation and
attach to
See Table 5-13 or use
❑ Solar Water Heating System
Performance Calculation and
attach Run to Forms
Performance Calculation and
❑ Wood Stove Boiler
attach Run to Forms
SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION
Gadd exL-A sheets if neck
Indicate to the HERS Rater which credits are part of this project and need
CF -6R art 4 of 12
CF -6R alt 5 of 12
Valve
CF-6R part 6 of 12
March 2005
Residential Compliance Forms