BRES2019-013178-495 CALLE TAMPICO c&t!t
D �P Q"
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: BUILDING RESIDENTIAL/REMODEL
Application Number: BRES2019-0131
Property Address: 53400 AVENIDA VELASCO
APN: 774085008
Application Description: THOENE / 9 WINDOW CHANGEOUT / RETROFITS
Property Zoning:
Application Valuation: $7,800.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
SHARI THOENE
53400 AVENIDA VELASCO
LA QUINTA, CA 92253
Applicant:jj��'�� Contractor:
SHARI THOENE UZa�,OWNER BUILDER
53400 AVENIDA VELASCO
LA QUINTA, CA 92253 APR 2 6 2019
CITY OF LA QUINTA Llc. No.:
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.
License Class: License No.:
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 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
1, as owner of the property, or my employees with wages as their $ole
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
h or he did not build or improve For the purpose of sale.).
I, as owner of the property, am exclusively contracting with licensed contractors
,y
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
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 Add
Date: 4/26/2019
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: PolIcy Number:_
1 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. f
Date: _ 41 — -Z (.1 —' ApIpl#cant;
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. _ _ _R
Date: Signature (Applicant or Agent)I
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
SHARITHOENE
53400 AVENIDA VELASCO
LA QUINTA, CA 92253
BRES2019-0131
53400 AVENIDA VELASCO
774085008
THOENE / 9 WINDOW CHANGEOUT / RETROFITS
$7,800.00
Owner:
SHARITHOENE
53400 AVENIDA VELASCO
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
LIc. I4o.:
Date: 4/26/2019
--------------------- --------- --------- - - - r - - -- - - - - - --------- - - --`- -- --- - --
Detail: 9 WINDOW CHANGEOUTS - 2 AT NORTH SIDE OF PROPERTY, 3 AT EAST SIDE OF PROPERTY, AND 4AT WEST SIDE OF PROPERTY. THIS PERMIT DOES
NOT INCLUDE ANY OTHER WORK BEYOND THE SCOPE OF THIS PERMIT. PER 2016 CALIFORNIA ENERGY CODE
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid
for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$1.01
Total Paid for STRONG MOTION INSTRUMENTATION SMI:
$1.01
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, EA ADDITION 5
101-0000-42400
0
$11.21
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7
101-0000-42400
0
$67.24
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7 PC
101-0000-42600
0
$65.64
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION:
$144.09
eca Qa�tra
Project Address: 5,3 2/p D ClXu
t`�L c, �4
APN #:
Applicant Name: S -TN O1, N E
Address: 5 3 0 0 V--eiw-,t c
City, ST, Zip::'��
Telephone: "7� 0 ( )q- Sq is -CA
Email: q�y qok I C-0�
Contractor Name: W �
Address: it
City, St, Zip
Telephone: q 15 13
Email:
State Lic: 1 (fSo b r] City Bus Lic:
Architect/Engineer Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic: City Bus Lic:
Property Owner's Name: oEwtF
Address: 3 t� 0 0
City, ST, Zip 3
Telephone: r 0 0 _ c -
E
I ail: A_ r . _ _ A, .. l -E? .,
PERMIT #. 14 j ;AX! W — b 1;
Project Description:
Valuation of Project $ '7 OO. oo
New SFD Construction:
Conditioned Space SF
Garage SF
Patio/Porch SF
Fire Sprinklers SF
Construction Occupancy:
Grading:
Bedrooms: I Stories: I # Units:
New Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
# Submittal Required Received
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
TW9�1 4 4 a"
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760)777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IMPORTAIM NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as
[be builder of the property
improvements specified at. y'3_ QOa6&nj&t, 1/P�rlx/C LJ
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make 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.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
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 am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on my property.
I understand building permits are not required to be signed by property owners unless they are responsible for the
ruction and are not hiring a licensed Contractor to assume this responsibility.
I understand as an "Owner -Builder" 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
own.
I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
p mats and contracts.
--P• I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
I understand if I am considered an "employer" under state and federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
risk.
_; I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
'I$! I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
�9. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California
Division of Industrial Accidents. l also understand I may contact the California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
�10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible for proposed constructionactivity at the following address:
1,-z i, n - sn .. . o _ i Ai. ! / kza- (6 i , I, /-tI -`-snL
l 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner -Builders as well as employers.
-l2.1I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also
-u to understand that if an ,!nlicensed Contractor or emnlnvee of that individual or firm is injured while workingy.,..
on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors,
you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or
other verification acceptable to the agency is required to be presented when the permit is issued to verify the property
owner's signature. +
Signature of property owner t Date;, ] ,
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which l understand is my personal responsibility, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that l am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature.
Property Owner's Signature: I Date:
Permit Floor Plan
Window Existing
Number Window Type
/ A�um,n�m
Existing
Window Size
�lum,ncc.m
New Window New Window
Type Size
Notes
1/�n J 1�
q_
top �A
yg1g u 1/
�'/� )'
-lox _7q //,�t
tl
APP
OVED
3
Y91 YM 14.
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y
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-70u`7q
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-+ems b _—_ +crnfYj A 611 a(
OF IA
QUINT
--BUILDING &
APP
OVED
R CON
T_RUCTia
13-
DATE
ul r-act�-4= I I I 4-A�tr _-
07
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CECCF1R-ALJ-0.«F. LROv4ed 07111)
TE OF COMPLIANCE
Prescriptive Resi
Thoene
This compliance dacument is only applicable
with a HERS Provider Data Registry.
Nol Require HERS Field Verification
not require HERS vedflCorion for compflanc4. When HERS verification
""d 4/23/19
R-ALT•05-E
Page 1 of 4
Alterations to Space Conditioning Systems that ore exempt from HERS verification requiremen is may use the CF1 R -ALT -05 and CF2R-ALT-05 Compliance Documents. Possible exemptions from duct
leakage testing include: less than 40 ft ofducts were added or replaced; or the existing duct system was insulated with asbestos; or the existing duct system was previously tested and passed by a
HERS Rater- If space conditioning systems are altered and ore not exempt from HERS verification, then a CFIR-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 on R -value other than 5.8 per inch, or Open Cell Spray
Polyurethane Foam (ocSPF) with a density cf 0.4 to less than 1.5 pounds per cubic foot having an R -value of 3.6 per inch, shalt complete and register a CF1R-ALT-01 with a HERS Provider Data
Registry.
If more than one person hos responsibilil y 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 meL
Temporary labels shall not be removed before verlficatlan by the building inspector.
A. General Information
01
Project Name:
Thoene
02
Date Prepared:
4/23/19
03
Project Location;
53400 Avenida Velasco
04
Building Front orientation (deg orcardinal):
West
05
CA City:
La Quinta
06
Number of Altered Dwelling Units:
07
Zip Code:
92253
OB
Fuel Type:
Electricity
09
Climate Zone:
15
10
Total Conditioned Floor Area (£t'):
11
Building Type:
Single Family
12
Slab Area (ft')
13
Project Scope (Select all that apply):
�] B. Insulation ❑ D. & E. Fenestration/Glazing - ADD
❑ C. Roof Replacement 0 D. & F. Fenestration/Glazing -
❑ G. Space Conditioning System (Heating, Cooling, Duct system) [] Lighting
REPLACE ❑ H. Water Heating System ❑ Include Mandatory Measures?
CA Bullding Energy Efficiency Standards - 2016 Residential Compliance
CITY OF L.A.QUINTA
BUILDING & SAFETY DEPT
APPROVI D
FOR CONSTRUCTION
DATELl EY
July 2017
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
COr,CF IR:M.r415-E JRSIAMd 0711 D
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations Titin 13o No Require HERS Field Verification T
CALWORNIA
Page 2 of 4
F. Fenestration/Glazing Proposed Areas and Efficiencies - Replace (Section 1S0.2(b)IB)
01
02
03
04
05
06
07
08
09
10
11
12
13
14
Area
Area
Net
Combined
Fenestration
Dynamic
Orientation
Removed
Added
Added
Exterior
SHGCfrom
Tagt(D
Typo
Frame Type
Glazing
IN, S, W, E)
(W)
(fill
Area (W)
LI -factor
Source
SHGC
Source
Shading Device
CFIR-ENV-03
1
Operable
Non-metal
West
0
0
0
30
NFRC
.Z2
NFRC
2
Operable
Non-metal
West
0
0
0
.30
NFRC
.22
NFRC
3
Operable
Non-metal
East
0
0
0
.30
NFRC
.22
NFRC
4
Operable
Non-metal
East
0
0
0
.30
NFRC
.22
NFRC
5
Operable
Non-metal
North
0
0
0
.30
NFRC
.22
NFRC
6
Operable
Non-metal
North
0
0
0
.30
NFRC
.22
NFRC
pol
Operable
Non-metal
North
0
0
0
.Z9
NFRC
.23
NFRC
pd2
Operable
Non-metal
East
0
0
0
29
NFRC
.23
NFRC
pd3
Operable
Non-metal
South
0
0
0
.29
NFRC
.23
NFRC
Add Row
Ueleie Roth
15 Net Added West -facing Fenestration Ares
lfi T Is Net Added Fenestration Area <_ for west -facing fenestration? 10 yes
CA Building Energy Efficiency Standards - 2016 Residential Compliance July 2017
CITY OF LA QUINTA
BUILDING & SAFETY DEPT:
APPROVIED
FOR CONSTRUCTION
DATE Gi BY
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CERTIFICATE OF
Pr reseriotive Residential All era tiorts that Do Not Require HERS Field Verification Page 3 of 4 I
r.�.ni•�rn•s ....-1 wn..wr.a 4/23/19
Thoene
17
Net Added Fenestration Area (all orientations{
1$
Is Net Added Fenestration Area 5 0 for all orientations?
N Yes f No
19
Proposed Fenestration U -factor (Windows)
20
Required Fenestration LI -factor (Windows)
21
Is the proposed Fenestration U -factor 5 the Required Fenestration U -factor?
10 Yes IF No
22
Proposed Fenestration SHGC (Windows)
23
Required Fenestration SHGC (Windows)
24
Is the Proposed Fenestration SHGC:g the Required Fenestration S1,160
• Yes f No
2S
Propped Fenestration U -factor (Skylights]
26
Required Fenestration LI -factor (Skylights)
27
Is the proposed Fenestration U -factor 5 the Required Fenestration U -factor?
/ Yes r No
28
Proposed Fenestration SHGC
29
Required Fenestration SHGC
30
Is the Proposed Fenestration SHGC 5 the Required Fenestration SHGC?
0 Yes r. No
CITY OF U� QUINT ►
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
CA Building Energy Efficiency Standards - 2016 Residential Compliance July 2017
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
bFC.CFIR-RLT-QfrE Revirsd Q7n
CERTI HCA IE OF CUMPLIAREE — — — CJVUFtiRulAE�aERGrcolfMlsstoN
Prescriptive Residential Alterations That Do Not Require HE Reid Veriilcatiyn MR -ALT -05-E
Thoene — --- —...._ . _ �ge4
4/23/19
DOCUMENTATION AUTHOR'$ DECLARATION STATEMENT "---— ----
1, lceftify?hat this Ceftificateof Compliance doctrmentatfon ss accurate and complete.
weymrnreiionnether N'" ueenmenuk nurhyr aRnaixra:
Charlotte Das — -'
CamganV• h#gnatYrY fiat:
Windmk World of Riverside County 4123/19
gdrl,elf:
11671 Sterling Avenue Unit DrIA10ER5Lertil kai,nnyG iranPnlifaAritic t: ---- —
c,v iia=°1ap'Riverside, CA 92503 °''° °
951-354-2723
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I Certify the following under penalty or perjury, under aws a $tete of Catifomfd;
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
designer).
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 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,
5 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency
I'm all applicable inspections. L 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.
!1°fpoml We DV JRryr N♦Irne: Ibr°unulHn nevyn er S VRIOCx
Charlotte Das
Window World of Riverside County e'6hQ"`
4123/19
� c�eir
11671 Sterling Avenue, Unit D `1°°"`
1018007
riysin TrP: i
Riverside. CA 92503 ce•951-354-2723
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-300-772-3300.
cv. awimng energy Etticiency Standards - 2016 Re;fdentlal Compliance
AaOF—L:- UI1 V Q A
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE �L�I--'BY
July 2017