BRES2019-044878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
NELSON T. & KATHYN GOFF
43582 MESSINA COURT
LA QUINTA, CA 92253
T+y au 6,wC2"
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BUILDING RESIDENTIAL/REMODEL
BRES2019-0448
43582 MESSINA CT
609552021
GOFF / KITCHEN REMODEL+ NEW BATHROOM AND DEN
$50,000.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/17/2020
Owner:
NELSON T. & KATHYN GOFF
43582 MESSINA COURT
LA QUINTA, CA 92253
DPContractor:
OWNER BUILDER - NELSON T GOFF
43582 MESSINA COURT
JAN 17 2020 LA QUINTA, CA 92253
D
CITY OF LA QUINTA (
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.::CONV:140528101254114852
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.:;CONVA40528101254114852
'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
lcts the applicant to a civil penalty of not more than five hundred dollars ($500).:
s, s owner of the property, or my employees with wages as their sole
m ensation, 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
wi in one year of completion, the owner -builder will have the burden of proving that he
e did not build or improve for the purpose of sale.).
s owner of the property, am exclusively contracting with licensed contractors to
c st ct the project. (Sec. 7044, Business and Professions Code: The C ractors' State
License Law does not apply to an owner of property who builds or i rov s thereon,
and who contracts for the projects with a contractor(s) license rsugpeto the
Contractors' State License Law.).
(_) I am exempt under Sec. B.&P.CAr this re
i
Date: l ��2' Owner:
CONSTRUCTION G ENCY
I hereby affirm under penalty of perjury that the is a an cti a Ing envy for
the performance of the work for which this per it is issued (Sec 09 C.).
Lender's Name:
Lender's Address:
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:
Ca ri Policy Number:
I certify that in the performance of the work for which this rfPlit is issued, I
sha Ioy any person in any manner so as to become sub- to the workers'
compensation laws of California, and a e that, if I shout me U •eet to the
workers' compensation provisions of S 'on 3700 of t o e, Is all f hwith
comply with those revisions.
Date: , c7 Applicant:
WARNING: FAILURE TO SECURE WORKERS' CO PEN SA 10 IC GE I UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIE CIV MES UP TO
ONE HUNDRED THOUSAND DOLLARS ($I00, 0). IN ADDT N T THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FO SECTIO 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 informa ' correct.
I agree to comply with all city and county ordinances and state laws ing wilding
construction, and hereby authorize representatives of is cit ter upon above -
mentioned property for inspection purposes. 7
Date: nature (Applicant or Agent]'
Date: 1/17/2020
Application Number:
BRES2019-0448
Property Address:
43582 MESSINA CT
APN:
609552021
Application Description-
GOFF/ KITCHEN REMODEL+ NEW BATHROOM AND DEN
Property Zoning:
Application Valuation:
$50,000.00
Applicant:
NELSON T. & KATHYN GOFF
43582 MESSINA COURT
LA QUINTA, CA 92253
Owner:
NELSON T. & KATHYN GOFF
43582 MESSINA COURT
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER - NELSON T GOFF
43582 MESSINA COURT
LA QUINTA, CA 92253
(
Llc. No.::CONV:140528101254114852
Detail: GOFF / INTERIOR REMODEL - REMODEL KITCHEN, RELOCATE KITCHEN SINK AND APPLIANCES, CREATE NEW ISLAND, REPLACE (1) WINDOW AND
CONSTRUCT NEW NON -BEARING PARTITION WALLS TO CREATE NEW POWDER ROOM AND DEN. THIS PERMIT DOES NOT INCLUDE THE ALTERATION OF
ANY LOAD -BEARING OR LATERAL -RESISTING CONSTRUCTION NOR ALTERATIONS TO OTHER AREAS OF THE DWELLING. 2016 CALIFORNIA BUILDING
CODES.
FINANCIAL
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $2.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
Credit Card Fee
101-0000-43505
0
$2.25
Total Paid for Credit Card Fee: $2.25
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($24.18)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($13.40)
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$26.83
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$26.83
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL
101-0000-42403
0
$29.42
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL
101-0000-42403
0
$24.18
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL PC
101-0000-42600
0
$13.40
Total Paid for ELECTRICAL 2019: $83.08
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($9.59)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($40.25)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($13.42)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($5.37)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($13.42)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($5.37)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
EXHAUST HOOD
101-0000-42402
0
$13.42
DESCRIPTION
ACCOUNT
QTY
AMOUNT
EXHAUST HOOD PC
101-0000-42600
0
$5.37
DESCRIPTION
ACCOUNT
QTY
AMOUNT
OTHER MECHANICAL EQUIPMENT
101-0000-42402
0
$30.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
OTHER MECHANICAL EQUIPMENT
101-0000-42402
0
$9.59
DESCRIPTION
ACCOUNT
QTY
AMOUNT
OTHER MECHANICAL EQUIPMENT PC
101-0000-42600
0
$40.25
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN
101-0000-42402
0
$13.42
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN PC
101-0000-42600
0
$5.37
I Total Paid for MECHANICAL 2019: $30.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PLAN CHECK DEPOSIT - ADDITION/REMODEL
101-0000-42600
1
$125.00
i Total Paid for PLAN CHECK DEPOSIT - ADDITION/REMODEL: $125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$53.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$53.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$13.42
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$26.83
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$13.42
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$13.42
Total Paid for PLUMBING 2019: $174.45
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE - MAJOR
101-0000-42416
0
$21.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $21.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500SF
101-0000-42400
0
$24.15
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500SF PC
101-0000-42600
0
$19.32
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 100SF
101-0000-42400
0
$54.74
DESCRIPTION
ACCOUNT
QTY
I AMOUNT
REMODEL, FIRST 100SF PC
101-0000-42600
0
$149.73
I Total Paid for REMODEL 2019: $247.94
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$6.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $6.50
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $697.88
a 94 fa
CALIFORNIA
Project Address:
APN #:
Applicant Name:
Address:
City, ST, Zip: `
Telephoner
Email: -
�_ r
Arch/Eng Name: Construction Type: Occupancy:
Address: Grading:
City, St, Zip
Telephone: Bedrooms: Stories: # Units:
Email:
State Lie: City Bus Lic:
/8495 CALLE TAMPICO LA QUINTA, CA 92253 (760)777-7125
WWW.LAQUINTACA.GOV
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC•CFIR-ALT-a5-E (Revised 07117) CALIFORNIA ENERGY COMMISSION
Is
CERTIFICATE OF COMPLIANCE CFIR-ALT-05-
Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 1 of 5
Pro,e4Name: GOFF KITCHEN REMODEL - Date Prepared:
11-27-19
This compliance document is only applicable to simple alterations that do not require HERS verification for compliance. When HERS verification is required, a CF1R-ALT- 01 shall first be registered
with a HERS Provider Data Registry.
Alterations to Space Conditioning Systems that are exempt from 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 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 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 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 f 3.6 per inch, shall cam ie a and register a CFIR-ALT-01 with a HERS Provider Data
Registry.
If more than one person has responsibility for installation of the items on this certificate, each p rsvn shall prepare and-sigmgreg�pplieab to the portion of construction for which they are
responsible. Alternatively, the person with chief responsibility for construction shall prepare and sign this raft" Wart!
entire rurtran. AlaPP Mandatory applicable Mandato Measures shall be met.
{
I i�� � Temporary labels shall not be removed before verification by the building inspector. _ _
A. General Information
01 Project Name:
03 Project Location:
05 CA City: I
07 Zip Code:
09 Climate Zone:
11 j Building Type:
13 Project Scope (Select all that apply):
COMPLIANCE
aFf �IC.€
GOFF KITCHEN REMODEL
VL
r d�f —j
11-27-19
43582 MESSINA CT
04
Building Front Orientation (deg or cardinal):
SOUTH
LA QUINTA
06
Number of Altered Dwelling Units:
1
92253
08
Fuel Type:
Natural Gas
15
10
Total Conditioned Floor Area (ft):
2025
Single Family
12
Slab Area (ft)
2025
❑ B. Insulation ❑ D. & E. Fenestration/Glazing - ADD ❑ G. Space Conditioning System (Heating, Cooling, Duct system) ❑ Lighting
❑ r7pf(e! ERV
0 D. & F. Fenestration/Glazing - REPLACE ❑ H. Water Heating System ✓❑ Include Mandatory Measures?
.. E D-
DEC 0 5 2019
CM OF LA QUINTA
DESIGN A2 DEVELOPMENT DEPARTMENT
CA Building Energy Efficiency Standards - 2016 Residential Compliance July 2017'�
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CF1 R-ALT-05-E (Revised 07/17)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
Project Narna: GOFF KITCHEN REMODEL
Fenestration/Glazing Allowed Areas and Efficiencies (Section 150.2(b)1)
FORNIA ENERGY
Date Prepared: 11-27-19
01
02
03
04
05
06
Maximum
Maximum
Existing
Allowed
Allowed
Fenestration
Existing
Maximum
Maximum
Maximum
Maximum
Fenestration
West -Facing
for All
West -Facing
Allowed
Allowed
Allowed
Allowed
Alteration
for All
Fenestration
Orientations
Fenestration
U-Factor
U-Factor
SHGC
SHGC
Type
Orientations (ft2)
Area Only (ftz)
(ft2)
Area (ft2)
(Windows)
(Skylights)
(Windows)
(Skylights)
Replacing fenestration
20%
i
I 101.25SF
I 47 SF
F. Fenestration/Glazing
Proposed Areas
and Efficiencies - Replace (Section 150.2(b)113)
01
02
03
04 05 06
07 08
Area
Area Net
Fenestration
Dynamic Orientation Removed
Added Added
Tag/ID
Type
Frame Type
Glazing (N, S, W, E) (ft2)
(ft2) Area (ft2)
KITCHEN
Operable
f Metal thermal
break
NO West 47
15 -32
Add Row
Delete Row
15
Net
Added West -facing Fenestration Area
16
Is Net Added Fenestration Area <_ for west -facing fenestration?
■ Yes r No
17
Net Added Fenestration Area (all orientations)
-32
18
Is Net Added Fenestration Area 5 0 for all orientations?
4 Yes r No
19
Proposed Fenestration U-factor (Windows)
.32
20
Required Fenestration U-factor (Windows)
.32
21
Is the proposed Fenestration U-factor 5 the Required Fenestration U-factor?
■ Yes r No
22
Proposed Fenestration SHGC (Windows)
.25
23
Required Fenestration SHGC (Windows)
.25
24
Is the Proposed Fenestration SHGC15 the Required Fenestration SHGC?
r Yes r No
25
Proposed Fenestration U-factor (Skylights)
26
Required Fenestration U-factor (Skylights)
27
Is the proposed Fenestration U-factor <_ the Required Fenestration U-factor?
r Yes ■ No
09 1 10 1 11
12
U-factor I Source I SHGC I Source
.32 1 NFRC 1 .25 1 CFRC
MMISSION
CF1R-ALT-05-E
Page 2 of 5
07
Comments
13 14
Combined
Exterior SHGC from
ding Device CF1R-ENV-03
NO
CA Building Energy Efficiency Standards - 2016 Residential Compliance July 2017
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CF1 R-ALT-05-E Revised 07117) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E
f Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 3 of 5 1
"°'—.— GOFF KITCHEN REMODEL
a e repave 11-27-19
28
Proposed Fenestration SHGC
29
Required Fenestration SHGC
30
Is the Proposed Fenestration SHGC <_ the Required Fenestration SHGC?I (`. yes (` No
CA Building Energy Efficiency Standards - 2016 Residential Compliance July 2017
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CFI 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 4 of 5
I r'"" """m' GOFF KITCHEN REMODEL f oaeevrepared: 11-27-19
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: BRIAN DIEBOLT
Documentation Author Signature.-
�-P��
Company:
DESIGN CONCEPTS
Signature Date:
11-29-19
Address: 57445 29 PALMS HWY, SUITE 304
CEA/ HERS Certification Identification (if applltable):
City15[atenp: 7760-365-8742
YUCCA VALLEY CA 92284
RESPONSIBLE PERSON'S DECLARATION STATEMENT
f 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.
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
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.
Responsible Designer Name: Responsible Designer Signature:
BRIAN DIEBOLT
company. Date Signed:
DESIGN CONCEPTS 11-29-19
Address: License:
57445 29 PALMS HWY, SUITE 304
City/State/hx Phone:
YUCCA VALLEY CA 92284 760-365-8742
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
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CF1 R-ALT-05-E (Revised 07117) CALIFORNIA ENERGY COMMISSIOk
CERTIFICATE OF COMPLIANCE CF1R-ALT-05-El
Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 5 of 5
I `"""a GOFF KITCHEN REMODEL DateFrepared= 11-27-19
Building Envelope Measures:
§ 110.6(a)1:
Air Leakage. Manufactured fenestration, exterior doors, and exterior pet doors must limit air leakage to 0.3 cfm/ftx or less when tested per NFRC-400 or ASTM E283 or AAMA/
WDMA/CSA 101/I.S.2/A440-2011.
§ 110.6(a)5:
Labeling. Fenestration products must have a label meeting the requirements of § 10-111(a).
§ 110.6(b):
Field fabricated exterior doors and fenestration products must use U-factors and solar heat gain coefficient (SHGC) values from TABLES 110.6-A and 110.6-B for compliance and
must be caulked and/or weatherstripped.
§ 110.7:
Air Leakage. All joints, penetrations, and other openings in the building envelope that are potential sources of air leakage must be caulked, gasketed, or weather stripped.
§ 110.8(a):
Insulation Certification by Manufacturers. Insulation specified or installed must meet Standards for Insulating Material.
§ 110.8(g):
Insulation Requirements for Heated Slab Floors. Heated slab floors must be insulated per the requirements of § 110.8(g).
§ 110.8(i):
Roofing Products Solar Reflectance and Thermal Emittance. The thermal emittance and aged solar reflectance values of the roofing material must meet the requirements of
§ 110.8(i) when the installation of a cool roof is specified on the CF1R.
§ 110.8(j):
Radiant Barrier. A radiant barrier must have an emittance of 0.05 or less and be certified to the Department of Consumer Affairs.
Ceiling and Rafter Roof Insulation. Minimum R-22 insulation in wood -frame ceiling; or the weighted average U-factor must not exceed 0.043. Minimum R-19 or weighted average
§ 150.0(a):
U-factor of 0.054 or less in a rafter roof alteration. Attic access doors must have permanently attached insulation using adhesive or mechanical fasteners. The attic access must be
gasketed to prevent air leakage. Insulation must be installed in direct contact with a continuous roof or ceiling which is sealed to limit infiltration and exfiltration as specified in
§ 110.7, including but not limited to placing insulation either above or below the roof deck or on top of a drywall ceiling.
§ 150.0(b):
Loose -fill Insulation. Loose fill insulation must meet the manufacturer's required density for the labeled R-value.
§ 150.0(c):
Wall Insulation. Minimum R-13 insulation in 2x4 inch wood framing wall or have a U-factor of 0.102 or less (R-19 in 2x6 or U-factor of 0.074 or less). Opaque non -Framed
assemblies must have an overall assembly U-factor not exceeding 0.102, equivalent to an installed value of R-13 in a wood framed assembly.
§ 150.0(d):
Raised -floor Insulation. Minimum R-19 insulation in raised wood framed floor or 0.037 maximum U-factor.
Slab Edge Insulation. Slab edge insulation must meet all of the following; have a water absorption rate, for the insulation material alone without facings, no greater than 0.3%;
§ 150.0(f):
have a water vapor permeance no greater than 2.0 perm/inch; be protected from physical damage and UV light deterioration; and, when installed as part of a heated slab floor,
meet the requirements of § 110.8(g).
§ 150.0(g)1:
Vapor Retarder, In Climate Zones 1-16, the earth floor of unvented crawl space must be covered with a Class I or Class II vapor retarder. This requirement also applies to
controlled ventilation crawl space for buildings complying with the exception to § 150.0(d).
§ 150.0(g)2:
Vapor Retarder, In Climate Zones 14 and 16, a Class I or C#ass II vapor retarder must be installed on the conditioned space side of all insulation in all exterior walls, vented attics,
and unvented attics with air -permeable insulation.
§ 150.0 (q)'
Fenestration Products. Fenestration, including skylights, separating conditioned space from unconditioned space or outdoors must have a maximum U-factor of 0.58; or the
weighted average U-factor of all fenestration must not exceed 0.58.
CA Building Energy Efficiency Standards - 2016 Residential Compliance July 2017
Titv/ 4 4QuGAa
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
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified at z_V-
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.
UK.NOWLEDGMENT AND VERIFICATION OF INFORMATION
Read and initial each statement below to signify you understand or verb this information.
I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
4b it g permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as
an weer -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and is or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injure I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
c nWproperty.
nderstand building permits are not required to be signed by property owners unless they are responsible for the
Fis ruction and are not hiring a licensed Contractor to assume this responsibility.
understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
om potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
-understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
and contracts.
derstand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of }+ onstruction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
�tde st a and federal law.
:rstand if I am considered an "employer" under state and federal law, I must register with the state and federal
withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
i for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
ure of legally build them with the intent to offer them for sale, unless all work is performed by licensed
sub nntractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
unde ontract with a licensed general building Contractor.
understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
ship or materials.
J understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
, the United States Small Business Administration, the California Department of Benefit Payments, and the California
n of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
1-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
-1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
legally and financially responsible for proposed construction activity at the following address:
1. l agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
laws and requirements that govern Owner -Builders as well as employers.
2. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
som a 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
important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working
on your property, you may be held liable for damages. If you obtain a pen -nit 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, t orm m completed and signed by the property owner and returned to
the agency responsible for iss ing.the i . Not . A co of the property owner's driver's license, form notarization, or
other verification acceptable to the n is uired to e p ented when the permit is issued to verify the property
owner's signature.
Signature of property owner Date: !
Note: The following Authorization Form is re4dired 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 I 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: Tel No
Address of Authorized Agent:
I declare under penalty of perjury that I 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: Date:
CITY OF LA QUINTA SUB -CONTRACTOR LIS !
JOB ADDRESS' 35�'� JSr Caur��404PERMIT NUMBER OWNER _T DL
�• IS /c
BUILDER 1 ,
_ a
This fa m shall be posted on the iob with the Buildin g Ins p ection Cad at all times in a cons i_cuou-s place. 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.
Trade. l Classifications Cpn.fracta..r . ..� _ State Contract:or's License Workers-Compensat)vn..l.nsu..rance City Business. Licenso
_
_
. ,; ...
Carrier Name
Policy Number
Exp. Date
License Number
Exp. Date
Company Name
Classification
License Number
Exp. Date
(e.g. A, B, C-8)
(xxxxxx)
(xx/�.x/xx)
(e.g. State Fund, CalComp)
(Format Varies)
(xx/xx/xx)
(xxxx)
(xx/xx/xx)
EARTHWORK (;C=12)
CONCRETE (C=8)
FRAMING- (C-5)
CIS / r c'
STRt GT. STEEL (C=51`)
MA. S 0 NRY :(C-29)
PLUMBING (C-36)
LATH, PLASTER
DRYWALL (C-9.).
:HVAC :(.C=20):
ELECTRICAL (C-10.)
HOOFING (C,39:)
SHEET :METAL. (C-.43)
FLO:GRIN:G '(:C:-115)
GLAZING (:C-17)
INSULATION (C-2)
SEWAGE DISP. (•C-42)
PA.INTI GAC:=33:)
—
—
CERAMIC TILE (-C-54)41
CAB.INETs (C-6)•.
FENCING .(C-13)
LANDSCAPING (0-27•)
`
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