BRES2020-002078 495 CALLE TAMPICO ceit,/ D� VOICE (760) 777-7125 4-u
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Permit Type/Subtype:
BUILDING RESIDENTIAL/REMODEL
Owner:
Application Number:
BRES2020-0020
MARIO HERNANDEZ
Property Address:
51540 AVENIDA MENDOZA
51540 AVE MENDOZA
APN:
773143003
LA QUINTA, CA 92253
Application Description:
HERNANDEZ / [61 WINDOW CHANGEOUT
Property Zoning:
Application Valuation:
Applicant:
Zk,
U
Contractor:
MARIO HERNANDEZ
D
OWNER BUILDER
51540 AVE MENDOZA
LA QUINTA, CA 92253
FEB 0 5 2020
CITY Orr [A QUINTA
DESIGN & DEVELOPMENT DEPARTMENT
Llc. No.;
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
aI, 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 r she did not build or improve for the purpose of sale.).
(, 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
thtractors' State License Law.).
(
Wm exempt under Sec. B...&P.C. for this reaso
Dated Owner] �2C
CONSTRUCT( N 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 Address:
Date: 2/5/2020
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:
Caryl 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 sub ct to the
workers' compensation provisions of Section 3700 of the Labor Cade, shall Forthwith
campty wlt those provisions.
Date �yApplicant:
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 b ding
construction, and hereby authorize representatives of this city to ter upon th
above -men lone property for inspection purposes. n
Dat �19b Signature (Applicant or Agent)
Date: 2/5/2020
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
MARIO HERNANDEZ
51540 AVE MENDOZA
LA QUINTA, CA 92253
BRES2020-0020
51540 AVENIDA MENDOZA
773143003
HERNANDEZ / [6] WINDOW CHANGEOUT
Owner:
MARIO HERNANDEZ
51540 AVE MENDOZA
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No.:
Detail: [6] WINDOW CHANEGOUTS RETROFIT LIKE FOR LIKE ON 4 SIDES OF DWELLING. NO ALTERATIONS TO OPENINGS. PER 2019 CALIFORNIA BUILDING
CODES.
FINANCIAL
DESCRIPTION
INFORMATION
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
SMI - RESIDENTIAL
101-0000-20308 1 0
$0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50
DESCRIPTION ACCOUNT
QTY
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
$67.62
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST PC
101-0000-42600
0
$66.01
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION 2019: $133.63
Za Quf�tra
Project Address:
APN #:
PERMIT # r I '" OO2,QI
PLAN LOCATION:
'�?l/�f. Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
Applicant Name:
Address:.S/,�Yd
City, ST, Zip:
Telephone: %;D ,5G4co7'��C7�
Email:�j�IJ�r�f
Contractor Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic:
Arch/Eng Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic:
Property Owner's Name:
Address:
City, ST, Zip
Telephone:
Email:
City Bus Lic:
City Bus Lic:
Valuation of Project
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction Type:
Grading:
Bedrooms: I Stories:
SF
SF
SF
SF
Occupancy:
# Units:
New Commercial / Tenant Improvements:
Total Building SF
Construction Type Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
Address:
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CITY OF LA QUINTA ()
BUILDING & SAFETY i EPT
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Customer Name:
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5
Window
Number
Existing
Window Type
Existing Window
Size
New Window
Type
New Window)
Size
N es
L3 , =)r-7
W
v x FT'�
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X
WINDOW SHGC: 6 •,�
WINDOW U-FACTOR: �r
PATIO DOOR CTOR:
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SUVO A OF 41EP&)ZA
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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 buildin permit has en su4mitted �y!'ou name zling?�� eif as the Ilder of the property
improvements specified at , s � 6� �/�!� 1 � '' r/,?-
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 verb this information.
/W-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 am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
�o�npmy property.
t it 2. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
/�g
I G 3. 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.
0�/ 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
/Ifr5. 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.
P � 6. 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.
%{,�_17. 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.
W8. 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. I 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. I also understand I may contact the California Contractors' State License Board (CSLB) at I-
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 construction activity at the following address:
11. 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.
(it 12. I 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
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 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 reed to be presented when the permit is issued to verify the property
owner's signature.
Signature of property q /ner,
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 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:
Address of Authorized Agent:
Tel No
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:
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CALIFORNIA ENERGY COMNf1551ON
CEC-CFIR-ALT-05-E Revised OV20}
CERTIFICATE OF COMPLIANCE CF1
Prescriptive Residential Alterations That Do Not Require HERS Field Verification Paagege 1 ooff 4
4
"ece Name: HERNANDEZ D'e p"P d; 2/5/2020
This compliance document is only applicable to simple alterations that do not require HERS verification for compliance. When HERS verification is required, a CFIR-ALT-01 shall first be registerea
with a HERS Provider Data Registry.
Alterations to Space Conditioning Systems that are exempEjrom Hi RS verification-regainerrtenmmay fsse-the CF104L-T-054Ad-CF2R-ALT415Cornpliv�WcumON Possible zxemptions frorr 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 greater 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 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 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.
r ..,.,—,,, rnhoic chnll nnr hp romnved hefore verification by the building inspector,
A. General Information
01 Project Name:
03 Project Location:
05 CA City:
07 Zip Code: 1
09 Climate Zone:
11 Building Type:
HERNANDEZ
51540 AVENIDA MENDOZA
LA QU I NTA
92253
15
SINGLE FAMILY
02 1 Date Prepared:
04 1 Building Front Orientation (deg or cardinal)
06 1 Number of Altered Dwelling Units:
08 1 Fuel Type:
10 `Total Conditioned Floor Area (ft2):
12 I Slab Area (ft)
2/5/2020
WEST
1
ELECTRICITY
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 FV� D. & F. Fenestration/Glazing - REPLACE ❑ H. Water Heating System ❑ Include Mandatory Measures?
January 2020
CA Building Energy Efficiency Standards - 2019 Residential Compliance
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-UlR•ALT-05-E Revised oirm
CERTIFICATE OF COMPLIANCE
Prescriutive Residential Alterations That Do Not Require HERS Field Verification
HERNANDEZ
. Fenestration/Glazing
--- --Or - ---
Allowed Areas
---�}
and Efficiencies
--- --03 -�
(Section 150.2(b)1)
04
Existing
Maximum
Maximum
Allowed
Allowed
Fenestration Existing
Fenestration
West -Facing
for All West -Facing
Alteration
for All
Fenestration
Orientations Fenestration
Type
Orientations (ft2)
Area Only (ft2)
(ft2) Area (ft2)
2/5/2020
05 06 07
Maximum
Maximum
Maximum
Maximum
Allowed
Allowed
Allowed
Allowed
U-Factor
U-Factor
SHGC
SHGC
(Windows)
(Skylights)
(Windows)
- (Skylights)
Comments
Page 2 of 4
F. Fenestration/Glazing
Proposed Areas
and Efficiencies
- Replace
(Section 150.2(b)16)
Note: Doors
with greater than
or equal to 25
percent glazed
area are considered
glazed
doors and
are treated
as fenestration products.
01
02
03
04
05
06
07
08
09 10 11
12 13
14
Area
Area
Net
Proposed
Proposed
Combined
Fenestration
Dynamic
Orientation
Removed
Added
Added
Proposed U-factor Proposed
SHGC Exterior
Source Shading Device
SHGC from
CF1R-ENV-03
Tag/1D
Type
Frame Type
Glazing
(N, S, W, E)
West
North
East
(ft2)
0
0
0
(ft2)
0
0
0
Area (ftz)
0
0
0
U-factor Source SHGC
.28 NFRC .21
.28 NFRC .21
.28 NFRC .21
NFRC
NFRC
NFRC
1
Operable
Non-metal
2
Operable
Non-metal
3
Operable
Non-metal
4
Operable
Non-metal
South
South
North
0
0
0
0
0
0
0
0
0
.28 NFRC .21
.28 NFRC .21
.28 NFRC .21
NFRC
NFRC
NFRC
5
Operable
i
j Non-metal
1
6
Operable
Non-metal
15 Net Added West -facing Fenestration Area
16 Is Net Added Fenestration Area <_ for west -facing fenestration? Yes G No
17 Net Added Fenestration Area (all orientations)
18 Is Net Added Fenestration Area 50 for all orientations? %Yes No
19 Proposed Fenestration U-factor (Windows)
CA Building Energy Efficiency Standards - 2019 Residential Compliance January 2020
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CF7R-ALT-05-E RevLmd Ot126
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
HERNANDEZ
20
21
22—_
Required Fenestration U-factor (Windows)
Is the proposed Fenestration U-factor 5 the Required Fenestration U-factor?
Proposed Fenestration SHGC (Windows)
Required Fenestration SHGC (Windows)
6 Yes C No
23
24
Is the Proposed Fenestration SHGC 5 the Required Fenestration SHGC?
/ Yes C No
25
Proposed Fenestration U-factor (Skylights)
26
Required Fenestration U-factor (Skylights)
27
Is the proposed Fenestration U-factor 5 the Required Fenestration U-factor?
■ Yes No
28
Proposed Fenestration SHGC
29
Required Fenestration SHGC
30
Is the Proposed Fenestration SHGC 5 the Required Fenestration SHGC?
/ Yes C No
CA Building Energy Efficiency Standards - 2019 Residential Compliance
2/5/2020
R-ALT-05-I
Page 3 of 4
January 2020
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CFC-CFI R-ALT-05-E (Revised 01120)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require H
P-* " -': HERNANDEZ
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1
is accurate a
DOW WORLD OF RIVERSIDE COUNTY
11671 STERLING AVE #D
IVERSIDE CA 92503 1 951-354-2723
RESPONSIBLE PERSON'S DECLARATION STATEMENT
2/5/2020
s
Page 4of4
I certify the fallowing 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 S 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 forthe 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.
Designer looms:
CHARLOTTE DAS
WINDOW WORLD OF RIVERSIDE COUNTY I 2/5/2020
11671 STERLING AVE #D 1 1018007
RIVERSIDE CA 92503 I 951-354-2723
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at:1-800-772-3300.
CA Building Energy Efficiency Standards - 2019 Residential Compliance January 2020