BRES2019-032378-495 CALLE TAMPICO
LA QUINTA, CALIFORN)A 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
A BERUMEN CONSTRUCTION
68120 MARINA ROAD
CATHEDRAL CITY, CA 92234
ce4ht 4 4 Qu!K&
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BUILDING RESIDENTIAL/
BRES2019-0323 Rtmeact
53100 AVENIDA MADERO
774032022
HARN / (3)DOORS AND (9)WINDOWS CHANGEOUT
$12,000.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
WENDY R. HARN
53100 AVENIDA MADERO
LA QUINTA, CA 92253
0
D
Contractor:
/�-4� A BERUMEN CONSTRUCTION
a 68120 MARINA ROAD
SEP 3 0 2019 CATHEDRAL CITY, CA 92234
CITY 4F LAQUIN A (951)545-7352
DES1GN & DEVELOP'N'IENT 0E.RI . UIMENT Llc. No.: 920968
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 Professions Code, and
my License is in full force and effect.
License Class: B License No.: 920969 Li
Date: ^ �a — 1 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 ($500).:
(_) 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
Lender's
Date: 9/27/2019
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'
c m 'ion, as provided for by Section 3700 of the Labor Code, for the performance
of k for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Se t n 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 COMPENSATION INSURANCE FUND Policy Number: 9115052
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 Se 'on 3700 of the Labor Code4 , I shall forthwith
comply wi tha a provisions.
36
Date: � Applicant:
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 thatthe above information is correct.
I agree to comply with all city and county ordinances and tate laws relating to building
construction, and hereby authorize representatives of thi ity t nter upon the above -
mentioned property for inspection purposes. jIf
Date: .6 0 _ l 5 Signature (Applicant or Agent)
Date: 9/27/2019
Application Number:
BRES2019-0323
Property Address:
53100 AVENIDA MADERO
APN:
774032022
Application Description
HARN / (3)DOORS AND (9)WINDOWS CHANGEOUT
Property Zoning:
Application Valuation:
$12,000.00
Applicant:
A BERUMEN CONSTRUCTION
68120 MARINA ROAD
CATHEDRAL CITY, CA 92234
Owner:
WENDY R. HARN
53100 AVENIDA MADERO
LA QUINTA, CA 92253
Contractor:
A BERUMEN CONSTRUCTION
68120 MARINA ROAD
CATHEDRAL CITY, CA 92234
(951)545-7352
Llc. No.: 920968
Detail: [9] WINDOW RETROFIT CHANGEOUTS AND [3] DOORS LIKE FOR LIKE TO BE INSTALLED IN PRIOR WINDOW AND DOOR LOCATIONS TO BE FIELD
VERIFIED. PER 2016 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
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
RECORDS MANAGEMENT FEE 101‐0000‐42416 0 $10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION ACCOUNT QTY AMOUNT
SMI ‐ RESIDENTIAL 101‐0000‐20308 0 $1.56
DESCRIPTION ACCOUNT QTY AMOUNT
SMI ‐ RESIDENTIAL 101‐0000‐20308 0 $1.56
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $3.12
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 $11.27
DESCRIPTION ACCOUNT QTY AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7 101‐0000‐42400 0 $67.62
DESCRIPTION ACCOUNT QTY AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7 PC 101‐0000‐42600 0 $66.01
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION 2019: $144.90
TOTALS:$164.02
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
A BERUMEN CONSTRUCTION
68120 MARINA ROAD
CATHEDRAL CITY, CA 92234
Titw4.lw4u;,rw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BUILDING RESIDENTIAL/DWELLING - SINGLE FAMILY DETACHED
BRES2019-0323
53100 AVENIDA MADERO
774032022
HARN / (3)DOORS AND (9)WINDOWS CHANGEOUT
$12,000.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
WENDY R. HARN
53100 AVENIDA MADERO
LA QUINTA, CA 92253
Contractor:
A BERUMEN CONSTRUCTION
68120 MARINA ROAD
0 D
S 0 2019 CATHEDRAL CITY, CA 92234
zE AP3 �'CITY OF LAQUNTA 0 (951)545-7352
DESI 1J & DEVELGRA"ENT DJEPARTIVIIENT Llc. No.: 920968
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: Li
B License No.:
Date: 1 ^ SD — I 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 ($500).:
(_) 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 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.).
(_) 1, 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.).
Date: 9/27/2019
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'
c m tlan, as provided for by Section 3700 of the Labor Code, for the performance
of for which this permit is issued.
t have and will maintain workers' compensation insurance, as required by
Set n 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 COMPENSATON INSURANCE FUND Policy Number: 9115052
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 Se Ian 3700 of the Labor Code, I shall forthwith
comply wi the a provisions.
Date: '�6 Applicant:
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 tate laws relating to building
construction, and hereby authorize representatives of thi ity tWenter upon the above -
mentioned property for inspection purposes. j
Lender's Name: -� D _
Date: Signature (Applicant or Agent)
Lender's Address:
Date: 9/27/2019
Application Number:
BRES2019-0323
Property Address:
53100 AVENIDA MADERO
APN:
774032022
Application Description
HARN / (3)DOORS AND (9)WINDOWS CHANGEOUT
Property Zoning:
Application Valuation:
$12,000.00
Applicant:
A BERUMEN CONSTRUCTION
68120 MARINA ROAD
CATHEDRAL CITY, CA 92234
Owner:
WENDY R. HARN
53100 AVENIDA MADERO
LA QUINTA, CA 92253
Contractor:
A BERUMEN CONSTRUCTION
68120 MARINA ROAD
CATHEDRAL CITY, CA 92234
(951)545-7352
Llc. No.: 920968
Detail: [9] WINDOW RETROFIT CHANGEOUTS AND [3] DOORS LIKE FOR LIKE TO BE INSTALLED IN PRIOR WINDOW AND DOOR LOCATIONS TO BE FIELD
VERIFIED. PER 2016 CALIFORNIA BUILDING CODES.
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
RECORDS MANAGEMENT FEE - MAJOR
101-0000-42416
0 $21.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $21.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$1.56
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$1.56
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $3.12
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, NEW/ALT, EA ADDITION 1 PC
101-0000-42600
0
$12.88
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, EA ADDITION 5
101-0000-42400
0
$11.27
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7
101-0000-42400
0
$67.62
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7 PC
101-0000-42600
0
$66.01
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION 2019: $157.78
ta Qw�fra
"Al 114A NAA
Project Address• s-,Ibo
�3 5 z01
PERMIT #
-2-
d
PLAN LOCATION:
, roject Description:
APN #:
Applicant Name:�fl ire,S
Address: z-6
City, ST, Zip: ( %
Telephone: 6-1 -6Ll9 —7 357--
Email:at/ldybetctM?�r71 �+Sw1��L.CbN�
Project Valuation $
Contractor Name: �V Q,,I5ra r
New Construction:
Address:61ZI2,6 k
Conditioned Space SF
City, St, Zip r�� G 9 22 3
Garage SF
Telephone: -5-q ,5, _ 7 *3 6 Z
Patio/Porch _ SF
FEmail:
Fire Sprinklers SF
State Lic: L7&)9/, ?� City Bus Lic:
Architect/Engineer Name:
Construction Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: WgW bV �
New Commercial / Tenant Improvements:
Address: 53 100 ro
Total Building SF
City, ST, Zip r# I 22dr
Construction Type: Occupancy:
Telephone: .5,6
Email.
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
# Submittal
Required
Received
Plan Sets
Structural Calcs
Truss Calks
Title 24 Calcs
CVWD Fire Flow Letter
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
f
Grant Deed
J
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
f
Fire approval
City Business License
STA: E OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
;EC-CF1R-ALT-05-E (Revised 07117) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E
Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 1 of 4
Arpige knm : I
� f [7re �mna»c C
This compliance document is only applicable to simple alterations that do not require HERS verification for compliance. When HERS verif Cation is required, a CF1R-ALT- 01 shall first
with a HERS Provider Data Registry.
Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CF1R-ALT-0S 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 duct system 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 on 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
f Project Name:
W 61 ^
nl
r] �`Y
02
Date Prepared: G�
I C
03
Project Location:
2 /� A J r 1 `d /1
U f�
04
06
Building Front Orientation (deg or cardinal):
Number of Altered Dwelling Units:
05
CA City:
LP U i Y /GT/T�
6
07
Zip Code'
ZZ�?.>
08
Fuel Type:
09
Climate Zone:
10
Total Conditioned Floor Area (ft):
11
Building Type:
12
Slab Area (ft)
13 Project Scope (Select all that apply):
❑ 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 July 2017
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
;EC-CF1 R-ALT-05-E (Revised 07117) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E
Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 2 of 4
Project Name: Date Prowed:
LP
Fenestration/Glazing
Allowed Areas
and Efficiencies
(Section 150.2(b)1)
Existing
04
05
01
02
03
Maximum
Maximum
Allowed
Allowed
Fenestration
Existing
Maximum
Maximum
Fenestration
West -Facing
for All
West -Facing
Allowed
Allowed
Alteration
for All
Fenestration I
Orientations
Fenestration
U-Factor
U-Factor
Type
Orientations (ftz)
Area Only (ftZ)
(ftz)
Area (ftz)
i (Windows)
(Skylights)
06 07
Maximum Maximum
Allowed Allowed
SHGC SHGC
(Windows) (Skylights)
Comments
F. Fenestration/Glazing Proposed Areas and Efficiencies - Replace (Section 150.2(b)16)
01
02
03
04
05
06
07
08
09
10
11
12
13 14
Tag/ID
Fenestration
Type
Frame Type
Dynamic
Glazing
Orientation
(N, S, W, E)
Area
Removed
(ftz)
Area
Added
(ftZ)
Net
Added
Area (ftz)
U-factor
Source
SHGC
Source
Exterior
Shading Device
Combined
SHGC from
CF1R-ENV-03
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STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CF1R-ALT-05-E (RevkW 07117) CALIFORNIAENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E
Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 4 of 4
i
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1.- 1 certify that this
Dowtat- Author Nan
3:nK.reS
W
'Id/- let
is accurate and
S Teci c 7 tG
Documentation Author Signature:
Signature
n
applicable)
Date
ury�oc—Uj� p. Phone:
IT _G -2 Z 7 � � Z-
RESPONSIBLE PERSON'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 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.
S. I 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
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.
Rcsponsible Designer NaResponsible Disignev�natu�: /
License:
Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
CA Building Energy Efficiency Standards - 2016 Residential Compliance
July 2017
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