BRES2018-0338C 0 4P
ZIt1 RAJ
78-495 CALLE TAMPICO D
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: BUILDING RESIDENTIAL/REMODEL
Application Number: BRES2018-0338
Property Address: 54489 SOUTHERN HILLS
APN: 775101056
Application Description: CURRIER / NEW DOOR ON GARAGE
Property Zoning:
Application Valuation: $1,300.00 ^
Applicant. P
L�
CAROLYN CURRIER
54489 SOUTHERN HILLS OCT 2 2 2018
LA QUINTA, CA 92253
CITY OF LA QUINTA DD
DESIGN & DEVELOPMENT DEPARTMENT
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.
LicenseClass:- LicenseNo.:_
Date:
Contractor:
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
eged exemption. Any violation of Section 7031.5 by any applicant for a permit
leas the applicant to a clviI penalty of not more than five hundred doiIars ($500).:
as owner of the property, or my empioyees.with wages as their sole
compensation, will do the work, and the structure is not intended or offered fpr 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
ithin aneyear Of completion, the owner -builder will havetite8urden of proving that he
s e did not build or Improve for the purpose of sale.).
I, as owner of the property, am exclusively contracting with licensed contractors to
s ct 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,
d who contracts for the projects with a contractor(s) licensed pursuant to the
C n ra .tors' State License Law.).
( exempt under Sec. , B.&P.C. for this reason,
Date: Z Owner
CONSTRUCTION LEND NG 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 Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/22/2018
Owner:
CAROLYN CURRIER
54489 SOUTHERN HILLS
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No.:
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:
Carn 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.
J
Date: o/2Z pplicant:
WARNING: FAILURE TO SECURE WORKERS' COIVIPEN ION COVERAGE 15 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 ardinances and state laws reiating to building
construction, and hereby authorize representatives of this city to enter upon the above -
mentioned pro erty or inspection purposes. f
Date: igrtaLure (Applicant or Age
Date: 10/22/2018
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
CAROLYN CURRIER
54489 SOUTHERN HILLS
LA QUINTA, CA 92253
BRES2018-0338
54489 SOUTHERN HILLS
775101056
CURRIER / NEW DOOR ON GARAGE
$1,300.00
Owner:
CAROLYN CURRIER
54489 SOUTHERN HILLS
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No.:
Detail: REMOVE EXISITNG WINDOW AND ADD DOOR OF SAME WIDTH NO FRAMING TO BE ALTERED EXCEPT REMOVING STUDS AND SILL BELOW
WINDOW. HEADER TO REMAIN AND FIELD VERIFICATION OF SHEER WALL.GLASS ON DOOR TO BE TEMPERED. PER 2016 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7
101-0000-42400
0
$65.54
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7 PC
101-0000-42600
0
$63.98
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $129.52
t p e
CG
PERMIT #
PLAN LOCATION:
ProjectAddress: 'D �C�S( c� c 0 vq ��,� 1
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
e-'A,loVL- '5T1 6arq •
4pplicant Name: 4 (_U I V r(j Q
1 Wow' r e CA
�s
Address: A � Ll 9<1 J � cJ _ rA-) 1
^, l
1�-�
�ity, ST, Zip: LA +6 �1
Telephone:
mC,
ail: Kro C0 t
w rr��'
Valuation of Project $ / do
:ontractor Name:
New SFD Construction:
address:
Conditioned -Space SF
:ity, St, Zip
Garage SF
'elephone:
Patio/Porch SF
:mail:
Fire Sprinklers SF
late Lic: City Bus Lic:
.rich/Eng Name:
Construction Type: Occupancy:
.ddress:
Grading:
ity, St, Zip
elephone:
Bedrooms: Stories:
# Units:
mail:
.ate Lic: City Bus Lic:
roperty Owner's Name: 0 I Ni`r0 r
New Commercial / Tenant Improvements:
ddress: Ll ['� �� i 5
Total Building SF
Ay, ST, Zipca
Construction Type: Occupancy:
:lephone: I 0 ljv ] % — 11 (
nail: SEA e q �C�o ►/,�_
78495 CALLE TAMP ICO
LA QUINTA, CA 92253'
760-777-7000
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
�F �wa�rw
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760)777-7012
FAX (760) 777-701 1
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IMPORTANT! NOTICE. TO PROPERTY OWNER
Dear Property Owner;
An application for a building permit has been submitted in your na listing Yourselfi aV the builder of the property
improvements specified at
We are providing you with an Owner -Builder ACknowl dgment and Information Verification arm 64FAC you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OIVNER'S ACKNOW1EllGM11;NT AND VERIFICATION OF I7VFORMATION
RECTIDNS: Bead and initial each sratenrent below to signify you understand or verify this information,
1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I ant willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
Amyproperty.
I understand building permits are not required to be signed by property owners unless they are responsible for the
TZtruction and are not hiring a Iicensed Contractor to assume this responsibility.
I understand as an "Owner -Builder"
er I am the responsible party of record on the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
N<)--4.�
1understand Contractors are required by law to be licensed and bonded in California and to list their lice nse numbers on
(95.
iEs and contracts.
I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
xmr
y construction is at least five hundred dollars (S50Q), including labor and materials, I may be considered an "employer"
Gstate and federal law.
'. I understand if I am considered an "employer" under state and fcderal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
rnpensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
ri k.
I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
CITY OF LA QUINTA SUB-CONT'R-ACTOR.LIST
JOB ADDRESS
PERMIT NUMBER OWNER, _- - ,_ _ wBUILDEi
Timis form shall tLe nosteci art #!Jc Jolt v_v-i.tlt the BUildillig
_ _
ITISI)ection Cad -s all tirT�e in a corisliici�ocrs pf�e. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. —
Tr:�L€� 1,Cih$Sl(ECAil011 , :..:...-Ca..it[rclor
5tat4;Cortitiator's Lipci>Sc..,.•. ►(tila;iccrs Coirtiperi.,afion litis►iran.c
-- _— Cif f:li5iiiC$$ (_sC�il$G'. ,�--
Company Name
Classification licy Number Exp. Date License Number Exp: Date
License Number Exp. Date Carrier Name :(Format
-
(e.g. A, B, C 8) (xxxxxx) (xxlxx/xx) (e.g. State Fund, CalComp) Varies) (xxlxxlxx) (xxxx) (xxlxxlxx)
FARTHWDRK (G4.2).
— -----
FRAMING (C. ' //�i@r �, e•
STRUM. -STEEL (C-5 )'•.
MASC]NRY (C-29)
PLUMB-ING IC-36j.
LATH, PLASTER.{C=35) ,.
DRYWALL (C-:J)
HVAC (C-20)
-- —
ELECTRICAL (C=1D)
no-OFING (C-31)
SHEET META(_ (C-4-3).
f L.0'GRING (C-151
_GL/AZiNG (L'-17)•
INSULATION (G••2}'
SEWAGE DISP. (C-42)
PAiNnmG (t-33).
_r
CERAMIC TILE, (C-a4)
CABINETS (C-6)
FENCING (C.-13)
—.- —
LANDSCAPING (C-27)
� --
STAT= LIFORNIA
Pr��criptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CF1 R-ALT-05-E (Revised 04116)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Ve
Pm iName:
This compliance document is only applicable to simple alterations that dd&trequit
with a HERS Provider Data Registry.
cation
verification for compliance. When HERS
vssloN •
1R-ALT-05-E
Page 1 of 4
a CF1 R-ALT- 01 shall first be
Alterations to Space Conditioning Systems that are exemptfrom HERS verification requirements may use the CFIR-ALT-05 and CF2R-ALT-05 Compliance Documents. Possible exemptions from duct
leakage testing include: less than 40 ft of ducts were added or replaced, or the existing duct system was insulated with asbestos, or the existing ductsystem was previously tested and passed by a
HERS Rater. If space conditioning systems are altered and are not exempt from HERS verification, then a CF1R-ALT-02 must be completed and registered with a HERS Provider Data Registry.
Alterations that utilize close Cell Spray Polyurethane Foam (ccSPF) with a density of 1.5 to less than 2.5 pounds per cubic foot having an R-value other than 5.8 per inch, or Open Cell Spray
Polyurethane Foam (ocSPF) with a density of 0.4 to less than 1.5 pounds per cubic foot having an R-value of 3.6 per inch, shall complete and register a CF1R-ALT-01 with a HERS Provider Data
Registry.
If more than one person has responsibility for installation of the items on this certificate, each person shall prepare and sign a certificate applicable to the portion of construction for which they are
responsible. Alternatively, the person with chief responsibility for construction shall prepare and sign this certificate for the entire construction. All applicable Mandatory Measures shall be met.
Temporary labels shall not be removed before verification by the building inspector.
A. General Information
01
Project Name:
1r� �r - 02 Date Prepared:
03
Project Location:
r,4;� ' �0'
(T ^� 04 Building Front Orientation (deg or cardinal):
05
1 CA City:
06 Number of Altered Dwelling Units:
07
Zip Code:
Vi-2 �;;3—
08 Fuel Type:
09
Climate Zone: S
10 Total Conditioned Floor Area (ft2):
11
Building Type-
12 Slab Area (ft)
13
Project Scope (Select all that apP4
❑ B. Insulation ❑✓ D.
& E. Fenestration/Glazing - ADD
❑ G. Space Conditioning System (Heating, Cooling, Duct system) ❑ Lighting
❑ C. Roof Replacement
❑ D. & F. Fenestration/Glazing -
REPLACE ❑ H. Water Heating System ❑ Include Mandatory Measures?
'CA Building Energy Efficiency Standards - 2016 Residential Compliance April 2016
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STATE, %LiFORNIA
Pr-.;�, ,ptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CFI R-ALT-WE (Revised 04116)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
Projea
25 Required Fenestration SHGC (Windows)
26 Compliance Statement
27 Proposed Fenestration U-factor (Skylights)
28 Required Fenestration U-factor (Skylights)
29 Compliance Statement
30 Proposed Fenestration SHGC (Skylights)
31 Required Fenestration SHGC (Skylights)
32 Compliance Statement
Proposed Fenestration SHGC 5 Required Fenestration SHGC
Proposed Fenestration U-factor <_ Required Fenestration U-factor
Proposed Fenestration SHGC <_ Required Fenestration SHGC
ENERGY COMMISSION
CFIR-ALT-05-E
Page 3 of 4
Yes (` No
No
CA' Building Energy Efficiency Standards - 2016 Residential Compliance April 2016
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
C EC:-CF1 R-ALT-05-E (Revised 04116)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
pmjeo
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
ENERGY
MMISSION-a
CF1R-ALT-'05-E
Page 4 of 4
:vmpany: signature Date: Z
Yddress: _ _ CEN H E n certification Identiifcation;irapplica6Eel:
4---
Gc/t
�ityls[atgllip: � /f Plrone:
RESPONSIBLE PERSON'S DECLARATION STAT MENT
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 Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible
deslgnerl.
3. 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 California Code of Regulations.
4. The building design features of 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.
S. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permNsj issued for the building,.and made available to the enforcement agency
for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building
owner at occupancy.
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
April 2016
CA Building Energy Efficiency Standards - 2016 Residential Compliance
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13UILDING & SAFETY DEPT
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