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BRES2017-003578-495 CALLE TAMPICO Ct 0(iNMCl/ 4: •, LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT - Application Number: BRES2017-0035 Property Address: 79715 DESERT WILLOW ST APN: 600320041 Application Description: RUDISILL/ FIRE DAMAGE REMODEL Property Zoning: Application Valuation: $80,000.00 Applicant: KP FORHIM INC DBA NIX PROFESSIONAL RESTO P O'BOX 993 . CALIMESA, CA 92320 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: B License No.: 923111 "J _YADate: ' s / %Contractors �� t',p 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).: (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.). ( ) 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 Na Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: JOSEPH RUDISILL 79715 DESERT WILLOW LA QUINTA, CA 92253 Contractor: KP FORHIM INC DBA Nlk P 0 BOX 993 CALIMESA, CA 92320 (909)792-1360 Llc. No.: 923111 Date: 5/5/2017 -----------=-- ------- ----------------- 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: BENCHMARK INSURANCE COMPANY Policy Number: CST5008853 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:' 3 --1 Applicants 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. • � q i �y Date: S 1/ Signature (Applicant or Agent): , Date: 5/5/2017 Application Number.: BRES2017-0035 Owner: Property Address: '-'79715;DESERT WILLOW ST JOSEPH RUDISILL APN: 600320041 79715 DESERT WILLOW Application Description: RUDISILL / FIRE DAMAGE REMODEL LA QUINTA, CA 92253 Property Zoning: Application Valuation: $80,000.00 Applicant: Contractor: KP FORHIM INC DBA NIX PROFESSIONAL RESTO KP FORHIM INC DBA NIX PROFESSIONAL RESTO P 0 BOX 993 P 0 BOX 993 CALIMESA, CA 92320 CALIMESA, CA 92320 (909)792-1360 Llc. No.: 923111 Detail: REPAIR ROOF DAMAGE BY FIRE, TRUSS REPAIR; REPLACE MINOR ELECTRICAL - OUTLETS, SWITCH, CAN LIGHT, EXHAUST FAN, REPAIR DRYWALL AND REPLACE HVAC. PER 2016 CALIFORNIA BUILDING CODE • 1 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $4.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $4.00 DESCRIPTION ACCOUNT QTY AMOUNT Credit Card Fee 101-0000-43505 0 $10.97 Total Paid for Credit Card Fee: $10.97 DESCRIPTION ACCOUNT QTY AMOUNT APPLIANCES, RES #01-0000-42403 0 $25.34 DESCRIPTION ACCOUNT QTY AMOUNT APPLIANCES, RES PC 101-0000-42600 0 $25.34 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $25.33 Total Paid for ELECTRICAL: $101.34 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $38.00 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE 101-0000-42402 0 $38.00. DESCRIPTION ACCOUNT QTY AMOUNT FURNACE PC 101-0000-42600 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $5.07 Total Paid for MECHANICAL: $144.40 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $12.67 Total Paid for PLUMBING FEES: $25.34 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, FIRST 100 SF 101-0000-42400 0 $51.68 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, FIRST 500 SF PC 101-0000-42600 0 $141.36 Total Paid for REMODEL: $193.04 DESCRIPTION ACCOUNT QTY. AMOUNT REPLACEMENT INSPECTION CARD 101-0000-42600 1 $38.00 Total Paid for REPLACEMENT OF PLANS/JOB CARD: $38.00 DESCRIPTION ACCOUNT QTY AMOUNT SMI -RESIDENTIAL 101-0000-20308 0 $10.40 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $10.40 DESCRIPTION. ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE ' 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 DESCRIPTION ACCOUNT QTY AMOUNT DOOR/WINDOW, RETRO/REPAIR, FIRST 7 101-0000-42400 0 $63.84 DESCRIPTION ACCOUNT QTY AMOUNT DOOR/WINDOW, RETRO/REPAIR, FIRST 7 PC 101-0000-42600 0 $62.32 Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $126.16 . TOTALS: $658.65 i � � N r' t I Bin i`f . City of La � C� uin t.a �—.. Building 8z: Safety Division 78-495 Calle Tampico Permit 9f , M La Quinta, CA 92253 - (760) 777-701,2 ' '�1� Building Permit Application and Tracking.'sheet Project Address: " a �SrIQf LG �'"~— Owner's Name: J' t i✓�%i✓ r/ J' LL' A. P. Number: Address: Legal Description: SIA164.6L' W��jrr( City, ST, Zip: Qd I. Contractor: ' / Telephone: Address: �/� D �( Project Description: P,� • �}-�►I,q 4p City, ST, Zip: el ne: T eh o P s so y r State Lic. # : / City Lic. #:. I-AceN,� ''L ; Od Arch., Engr., Designer:W ,)( Address City, ST, Zip: ne: Telephone: d : Occupancy: onstracti n Type: ancY Lic,. Add' n Alter Demo Project type �circle one) New Name of Contact Person: Sq. Ft.:.2,39? Stories: # Units: r Telephone # of Contact Person: Estimated Value of Project: to B 0,0 . 00 ►-� APPLICANT: DO. NOT WRITE BELOW THIS LINE 9 Submittal Req'd Rec'd TRACKrNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'd 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 ROUSE:- ` Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. r ' Pub. Wks. Appr Dale of permit issue School Fees, Total Permit Fees Plan Submittal g (1 &-uq Ova r Building Permit Number. Project Description: Fire Restoration Exempt: 0 (Materials may contain hazardous wastes and are not subject to recycling provisions) Construction Debris Management Plan 4/6/2017 Job Sita Addressi 79715 Desert Willow Owner's Name Number, Street,. or PO Box City, State, Postal Code Owner's Phone Number Owner's E -Mall Address Project Manager's Project Manager's Phone N Project Manager's E-mail A Builder / Conta Number, Street or PO Cly, State, Postal C Project Square City Approval By Date of City Approval To Be Discarded: Product Trash Asphalt Brick/Black Cardboard Commingled Concrete Drywall Donated / Reuse* 'Describe Items Shannon Rudisill 79715 Desert Willow Le Quints, CA. 92253 Kurt Nix 909-792-1360 0=55611vahoo,coM Nix Professional Restoration P.O. Box 993 Calimesa, CA. 92320 2,179 square feet I Renado Douldlock-DEC:/Surrtec Waste Tons r ls: Recycle Trash 4.3 2.3 ble Product Masonry (broken) Plaster Scrap Metal Tile (floor) Tile (roof) Wood Landscape Debris Projected Diversion• • 65.49% I understand 5 is the property owners responsibility to submit copies of weight tickets or recelpls to the District Environmental Coordinator as these hauls occur. I hereby certify that completion, implementation and adherence of the Debris Management Plan (DMP) for the above named project shall guarantee that at least 66% of the Jobsite waste is diverted from landftiting. The remaining material will be recycled or reused. l will divert, for recycling or re -use, remaining materials generated from the fist day of the project through the completion of the project in accordance with this plan. This DMP is issued in the name of the property owner(s) and shall remain their property throughout the construction and/or demolition project. A contractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP Is still Issued in the name of the property owner(s) and the owner retains legal responsibility for ensuring that the provisions of the DMP are adhered to. The property owner(s) and general contractor shall be kept informed of the diversion progress through bl-monthly reports. If setf-hauling, all refuse material from this project site must be taken to an approved recycler or transfer Owner/ Developer/ Project Manager/ Superintendent Date "Restoring Hope... Rebuilding Families" April 10, 2017 To Whom It May Concern, The following subcontractors will be performing work at: 79715 Desert Willow La Quinta, CA 92253 1. Mark Lewis Roofing 2. Erkies Electrical Heating and Air Respectfully, Rachel Alarcon Office Manager Nix Professional Restoration RECEIVED APR 10 2017 CITY OF LA QUINTA COMMUNITY DEVELOPMENT 1091-7 th St. Ste. E, Calimesa, CA 92320, CA License 923111 • 909.792.1360 • 1.888.725.7867 • 760-835-9655 •951.682.1312 0 Fax 909-792-4042 "Restoring Hope... Rebuilding Families" To Whom It May Concern, The following is a list of items needing building approval. Please note attached building diagram which shows location on the following items: 1. Truss Repairs 2. Electrical Outlets (3) 3. Electrical Switches (2) 4. Ventilation Fan (1) 5. Reassessed Lighting (2) 6. Roof Sheathing 7. Roofing Felt 8. HVAC Installation with Ducting Respectfully, Kurt Nix President Nix Professional Restoration 1091-7 th St. Ste. E, Calimesa, CA 92320, CA License 923111 • 909.792.1360 • 1.888.725.7867 • 760-835-9655 • 951.682.1312 • Fax 909-792-4042 STATE OF CALIFORNIA 'ALTERATIONS - HVAC CEC-CF1 R -ALT -04-E (Revised 011161 ERTIFICATE OF COMPLIANCE .CFIR-ALT-04-E Alterations - HVAC CZ 2, and 8-15 (Page l of 1) Site Address.' Enforcement Agency: Date Prepared: Permit#: Equipment Type Equipment Efficiency New Ducting or Lineset: Conditioned Thermostat Required R -value Floor Area (ft) 13 Packaged 13 Evaporator Coil System 13 Condensing Unit13 AFUE _Cop 13R-6 (CZ 1-10, 12&13) Ducts Served by system 11 Setback 13 Split System ❑ Compressor SEER HSPF R-81 (CZ 11,14-16) Ducts ftz (if not already 1 Mini Split ❑Lineset � ClC2 R-2.8 Lineset° present, must ❑ Furnace 13 TXV EER be installed) HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site. ❑ 1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: All Equipment, CFIR-ALT-02-E Condenser Unit, Evaporator Coil, CF2R-MCH-01-E, MCH -20-H, MCH -(23 or 24)'-H, MCH -25-H2 Compressor, TXV, Lineset, CF3R-MCH-20-H, MCH -(23 or 24)-H', MCH -25-H' Air Handler/Furnace' (Can include new ducting) . Installer Requirement: Duct leakage (<15%, or 110% to outside, or seal all accessible leaks), Air Flow z 300 CFM/ton, Refrigerant Charge. Exempted from duct leakage testing if: ❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building ❑ 2. New HVAC System ' Required Compliance Documents to be left ori site for Final: All new equipment and All New Ducts' CF111-ALT-02-E including Mini Split CF2R-MCH-01-E,'MCH-20-H, MCH -22-H, MCH -(23 or 24)-H', MCH -25-H' CF3R-MCH-20-H, MCH -22-H, MCH -(23 or 24)-H2, MCH -25-H' Mini Splits require CFIR-ALT-02-E, CF2R-MCH-01-E, and (CF2R-CF3R) MCH -25-H Installer Requirement: Duct leakage < 5%, Fan Efficacy (0.58W CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge ❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final: All New Ducts3 and one or more of the following CF111-ALT-02-E replaced: Condenser Unit, Evaporator Coil, CF2R-MCH-01-E, MCH -20-H, MCH -(23 or 24)-H, MCH -25-H Compressor, TXV, Lineset, Furnace' CF3R-MCH-20-H, MCH -(23 or 24)-H, MCH -25-H Installer Requirement: Duct leakage:5 5%, Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final: New ducting but less than All New Ducts3 CFIR-ALT-02-E, CF211-MCH-20-11, CF3R-MCH-20-H Installer Required to: Duct leakage (:g_15% or, 610% to outside or, or seal all accessible leaks) ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. ' All new ducting requires R-8 insulation when more than 40 ft installed in CZs 11 & 14-16 and R-6 in CZs 1-10,12 &13, and R-6 insulation when less than 40 ft installed. This includes in walls, between floors etc. ' Heating only systems and Air Handler/Furnace changes do not require Air Flow MCH -(23 or 24), or Refrigerant Charge verification MCH -25 3 All New Ducts is when at least 75%of the duct system is new duct material, and up to 25%may consist of reused parts from the dwelling unit's existing dud system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material) R-2.8 (1" thick insulation) for linesets 1" and less. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division3 of the California Business and Professions Code to accept responsibility for the information on this document. 3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR). 4. That the energy features and performance specifications, materials, components, and manufactured devices for 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 CCR. S. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Responsible Designer Name: Responsible Designer Signature: Date Signed: licence: Company: Address: City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300 e N -22'- 21' 22'- 21' 4' Re '(A1) Regi00 i( tc 12' s'1 A 0-0 6 2" —, iVD v ppi tit Njc Z �-- Vj �® \,j 02 g ) lU Main Level M e,Av1 L-ft'-- Se(AlON '�, CA/ 04 2.- 0 L.r S"'t 2016-08-01-1435 22' 21' 4" N Kitchen O0 �L �•��/ C,�L Sud/T C6�`,. Vel&71-A-770A/ i2 ,4 S 1,16 3 F-7ElT s 5° M main Level 3/7/2017 Page:1 ° NAME ON lx�-&('� ADDRESS CITY,�.� all�i-,4 Zip X5'3 66J1OesteirAng Hope... RebufflAng lFam Pies" CLAIM # CAUSE OF LOSS i/ i2c ONOO FANS 0 DEHUMIDIFIERS _ , + 4. j �. �{G��j,��i, ...�- -�. � __. _ i � - � ...! ' _i. ..i .._7 ."I (� ! f f -• - -j .. i, i � i ..'.. .!_,_ i i _. .i G' f _ _ 1