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BPLB2020-002078-495 CALLE TAMPICO D eCrw LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: PLUMBING/ Application Number: BPLB2020-0020 Property Address: 78423 TERRA COTTA CT APN: 604022063 Application Description: REA / 50 GALLON WATER HEATER CHANGEOUT Property Zoning: Application Valuation: $1,400.00 Applicant: P a Rea Ronald H / Rea Janice M 78423 TERRA COTTA COURT MAR 11 2020 LA QUINTA, CA 92253 CITY OF LA QUINTA 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 su t e Ilcant to a civil penalty of not more than five hundred dollars ($500).: 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 AQt build or improve for the purpose of sale.). s caner of the property, am exclusively contracting with licensed contractors to construe[ 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 State License Law.). e mpt under Sec. . B.&P.C. for this reason t n 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 Name: Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-71S3 Date: 3/11/2020 Owner: Rea Ronald H / Rea Janice M 78423 TERRA COTTA COURT LA QUINTA, CA 92253 Contractor: OWNER BUILDER Llc. No.: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Car r: Policy Number:_ if that in the performance of the work for which this permit is issued, I sh 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. y� [38T - Iw 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. 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. (Applicant or Agent) ~ r Date: 3/11/2020 Application Number: BPLB2020-0020 Property Address: 78423 TERRA COTTA CT APN: 604022063 Application Description: REA / 50 GALLON WATER HEATER CHANGEOUT Property Zoning: Application Valuation: $1,400.00 Applicant: Rea Ronald H / Rea Janice M 78423 TERRA COTTA COURT LA QUINTA, CA 92253 Owner: Rea Ronald H / Rea Janice M 78423 TERRA COTTA COURT LA QUINTA, CA 92253 Contractor: OWNER BUILDER Llc. No.: ------------------------------------*t-------------------------------------- ---------- - - - - - - Detail: REPLACE 50 GAL ELECTRIC WATER HEATER LIKE FOR LIKE. PER 2019 CALIFORNIA BUILDING CODES Krc . 00V -- GEMof,)w DESERT I•-W a,k PERMIT # PLAN LOCATION: Project Ad • �'e_ ! Q v Project DescripAW: Pool, Remodel, Add't, Elect, Plumb, Mech OWW- APN #: .AppumatAum �J _ Address: 7 a C iz City, ST, Zip: Telephone: Email: Valuation of Project $_ Contractor Name: New SFD Construction: Address: Conditioned Space SF City, St, Zip Garage SF Telephone: Patio/Porch SF Email: Fire Sprinklers SF State Lie: City Bus Lie: Arch/Eng Name: Construction Type: Occupancy: Address: Grading: City, St, Zip Telephone: Bedrooms: Stories: # Units: Email: State Lie: City Bus Lie: Property Owner's Name: New Commercial / Tenant Improvements: Address: Total Building SF City, ST, Zip Construction Type: Occupancy: Telephone: Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 t(V Qaiar(v CALIFORNIA Disclosures & Forms for Owner -Builders Applying for Construction Permits MWIPTAAITI PJnTIr_F Tr) PPnDr- PTV nWNP0 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 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 UNIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- uilder" 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 'rconstruction and are not hiring a licensed Contractor to assume this responsibility. 4mI understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I 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. c_ *umbers I understand Contractors are required by law to be licensed and bonded in California and to list their license on permits and contracts. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and 6)t—'h"etot'al 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. 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. Page 3 of 4 '4I 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 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. f I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand 'thaWl the party legally and financially responsible for proposed construction activity at the following address: 9 V 1. 1 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. YJ'i 4.12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the - 'in armation 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 required to be presented when the permit is issued to verify the property owner's signature. Signature of Property Owner: r Date: �l 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 AG E NT TO A9T ON PROP ERTY OWN ER'5 BE HALF 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: one: 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. Signature of Property Owner: Date: Page 4 of 4 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CFiR-ALT-05-E (Rt)nsea I)Ir2a) CERTIFICATE OF COMPLIANCE -- Prescriptive Residential Alterations That Do Not Require HERS Field Verification b.Acc. Vano — -- This compliance document is only applicable to with a HERS Provider Data Registry. not require HERS MMISSION CF1R-ALT-05-E Page 1 of 3 �• ©-1— n HER5 verifico1,or is required a CF1R-ALT-01 shall first be registered Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CF1R-ALT-05 and CF2R-ALT-05 Compliance Documents. Possible exemptions from duct leakage testing include. less than 40 ft of duets 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 spare conditioning systems are altered and are not exempt from HERS verification, then a CF1 R 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 I.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 (acSPF) 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 Aata 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 responsibilityfor construction shall prepare and sign this certificate for the entire construction. All applicable Mandatory Measures shall be met. Temporary labels shall not be removed before verification by the building inspector. A. General Information 01 Project Name: y�j A , - /_� rl _ �tf 02 Date Prepared: 3-7 03 I Project Location: i70q r-- - u 04 Building Front Orientation (deg or cardinal): 05 I CA City: j`' n r 06 Number of Altered Dwelling Units: 07 Zip Code: G. 08 Fuel Type: 09 � Climate Zone: ! z 10 Total Conditioned Floor Area (ft ): 11 Building Type: 12 Slab Area (ft2) 13 Project Scope (Select all that apply): FIB. 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? ICA Building Energy Efficiency Standards - 2019 Residential Compliance c January 2020 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC•CF1 R-ALT-0S-E 1Rev+sea 01120) _ _ _ CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E Prescriptive Residential Alterations That Doi Not Require HERS Field Verification Page 2 of 3 Date Pr � rr[} H. Water Heating Systems (Section 150.2(b)1H) 01 02 _ 03 04 05 06 07 08 09 10 11 12 13 14 15� Water Water Water # of Heater Back -Up Heating Heating System Water Storage Rated Rated Heating Exterior Solar Dwelling System Location or Water Heating Water Heaters Volume Fuel Input Input Heating Efficiency Standby Insulation Savings UnitName IDor Name Area Served System Type Heater Type in System (gal) 1 Type Type I Value Efficiency Type Value Loss (%L R-Value Fraction // L 1 Add Row Delete Row CA Building Energy Efficiency Standards - 2019 Residential Compliance f January 2020 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC•CFIR-ALTO E {R!eY,12 01120) _ CERTIFICATE OF COMPLIANCE — — — - - - ve Kesidential Alterations That Do Not Require HERS Field Verification DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I. I certify that this Certificate of Compliance documentation is accurate an Dotumentai-on Author Name: ?ri4Noel` 14' . Av MPWW MORM CALFORNIA ENERGY COMMISS€ON Aim CF1R-ALT-05-E ' Page 3 of 3 � ?r Coy uv MtKs k LemncaNdn id" f?ntian (if appaC&b*I L'f, GivlStaref�p= /-7 IA- Mane: - RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State df 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 5 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Complance 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. 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. Respon^y��sit'l-e Designer Name; Respdnsib'.a Des-gne, Signature: Company ate gneE: - Address License: Ciiyl3ta[eJlip: - — - - PTone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. CA Building Energy Effitiency Standards - 2019 Residential Compliance January 2020