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10-1332 (PLBG)P.O. BOX 1504' 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00001332 • Property Address: 54766 OAK TREE APN: 775-081-070-. - Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 10.50 c&t�v4.-4Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: GEORGE STOBAUGH 54-766 OAK TREE LA QUINTA, CA 92253 Contractor: Architect or Engineer: CALIFORNIA DELTA MECHNICAL I 6052 E. BASELINE RD, #155 MESA, AZ 85206 (866)692-5273 Lic. No.: 811114 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 1© Date:. 12/07/10 L1"17 0 3 2010 . ,.-,,J TJ`7 i0B L -------------------------------------------------------------------=------------------------ - - - - - — 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 an Professionals Code, and my License is in full force and effect. Lice�ss:B-ClO-C_6 ' nse No.: 811114 atetractor: Ud 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 (5500): (_ 1 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.). (_ 1 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.). ( 1 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 Name: Lender's Address: LQPERMIT WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1697823 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 t at, if I should become subject to the workers' compensation provisions of Section V a Labor Code, I allall'fortth .th ccompI with those provisions. W�ARNIN? ant: 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 Director of Building and Safety 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 pd county ordinance and state laws relating to build' 9. construction, and hereby authorize representatives of this cou tt(py t enter on the above-mentioned prope for inspe do S. Date : lJ I ✓ ignature (Applicant or Agent): Application Number . . . . . 10-00001332 Permit PLUMBING Additional desc ... Permit Fee 22.50 Plan Check Fee 5.63 Issue Date . . . . Valuation 0 Expiration Date 6/05/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 -------------------------------7-------------------------------------------- Special Notes and Comments. REPLACE 40 GALLON GAS WATER HEATER. 2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited ---------- ---------- Due ----------------- Permit Fee Total -------------------- 22.50 ..00 .00 22.50 Plan Check Total 5.63 .00 .00 5_.63 Other Fee Total 1.00 .00 .00 1.00 Grand Total 29.13 .00 .00 29.13 LQPERMIT D 7. .2 01 () 10 6 AM DELTA MECHANICAL ...N.-,. 4017 S P. 9 --tij.j Ca te (?f C CC 0 frija ijWZ ilate Zone .. 15 'd for r1hol atin dd [nlvIfSL 17 or a It EE 7 iN —CG,' and boijarrf,)j- both d"n'll-stlic hot water heaters mid hydro?IiC sp -0P PHR ace. heating. -V! i P' -qne fired, cmd 'naY 7lot atr-eed S0 gallo;,, 'Hot W010,1"Pip, bidhiiduol diveiiin.:- 04 all w? deegrmrnd hot waterpipas 11 1Lqmi1,d in,all Co '?Ln"OtiOn f70172 thL, J)B'gt -!?n 71 hearet. .PonewPac roga�, in 071 climwe zones. .Distribution IyppEucrgy Number of Capacity ctor —(Standard T11111, System Teal at 1 tandard Clfmcv r)P, etc) S67*ng —hOe dwal);)7 of' shell meet the 7-scirculation requjr,,,,,U reci),culq#�Yer h',�n� i'iw r XIE?Lf qf 150(n). DY Drain )1eteeiPejxhall ba jwijjln�dt —,meet the requirient, a 0 1 f cm m P. (Itati oll A.UtJa or1g [Rewpoja a iiD— a1e]Deslane eclaratillj3 Stale !!:T, eliRJbi- under Division 3 Complifmar. documentation is ac Of th-j Caamij accurate =4 oqmplctt:. 11titi:+ Ce-tifi:zte of Com Buli],Qsa gnd ?lOfE*.qiO_ Code to accept rgp 'lance. 'bility fLr the bio Nint lilt energy felibmu an ding dosip a PerfOrmomce apeciLcatimls ideliitfiec :; j"UtalentS of Title 24, P" I end 6 of Iffie C,lifonlia forth; building desig, id 1):idd;!j dds-ig�u .features idmtifirA (m t r jEr CO(k Of PXPIAtions. Mtifled OR VX'S CUIMCat8 of CqMpjiaZ, 11b �� Ate of J�,. 6-si.In on the other applicable Gampl, III- finnz, woCr0kmheynHcation "Ua=CQ4m cotl9ist=t WM the ftff, calculations, -PL rove! �,b mation with tlli& bug to dDc=eht ts C=& ed to the mvarctmiev. Signature: % California Delta Mechanica D Datc atc 1 15B E. Baseline Rd., #155 7A d l Mesa, AZ 85206 x11114 7 777=-- :-- Z�W �01 I C717C 2 FOt'117S Iva/ -c/7 —20 T, .4 Dec. 1. 2010.10:56AM DELTA MECHANICAL Bin # No. 4011 P. 8 CRY of.La Chita Building 8i Safety Divirlon Permit # ^ P.O. Box 1504, 78-495 Calle Tampico O 1� La Quinta, CA 92253 - (760) 777.7012 Building Permlt Application s�and T'racking� Sheet Project Addiess: Owner's Name: lJ Y g, ' D A. P_ Number. Address: Legal Description: City, ST, Zip• C4 G' Z Z� Contractor. q Tolepbone: Address: 6DS6 'yt2 f ,� escriti iammm City,ST.Zp: /uZ ?G�6 au- 40 Telephone: X66 - 2 _','L , StateLic.#: fill �� Arch, Engr., Designer. - Address: City., ST, Zip: - Telephone: Cnn=ction Typo: Occupancy: State Lia #: Project type (circle opo): Navr Add'n Alt ' ' 'epait Deo Name of Contact person: Sq. Ft: # Stories: ' q # ll'nite: Tcicphone # of Contact Poison: p 66"6 q Z—•J-Z 3 , c- $atimaiPd Valua of Project- JO APPLICANT! 00 NOT WRrrt BELOW THIS IMF # submittal R 'd Bac'.d TRACIQI.IG Plan Sets Plan Ckeck anbmltted Structural Calm Reviewed, ready for corrections Trans Calcs• Colied CoutactPeraon Mmtriegi Plumping Title 24 Calm Plana picked up S_M.L Grading Developer impact Fee Flood plain plan Plans resubmitted A.I.P.Y. Crading plan a'�Revlw, ready for corrections/issuo SubcontacforUi t CalledContaetPeraon Total Permit T+'ees Grant Decd Plane Ofeked up HOA- Approval Plan resubmitted IN)IOUBT;. '"' RSvlew, ready for correction&hssue Planning Approval Called Cont sct Persop Pub. Wks, Appr Date of permit Issue School Fees MMIT BEES Item Amount Plan Check Deposit Plan Check Balance Construction XechanicA Mmtriegi Plumping S_M.L Grading Developer impact Fee A.I.P.Y. Total Permit T+'ees I L y�f INSTALLA.'i'10N CERTIFICATE Domestic Hot W2ter� (DHW) � Site Address: 1. \VATF.R 1-3F+'.9'AYNId--' QVQ-rVRAQ. iorcernent Agency CF-6R-AIECSI-01 (a age 1 of 21 Term t 1N'urnber: Fleatcr Type CEC Certified Mfr Nante &'Model Number Distribution Type (Std, Point -of- Use, etc) If Recirculation, Control T e ;# of Identical Systems Y Rated Input (kw or Btu/hr t ) Tank Volume (gallons) Efficiency (EF,1tE )t . Standby Loss o wore j: ror smau gas storage (rated input less than or equal to 75, 000 Btulhr), electric resistance and heat pump water heaters, list Energy Factor (EF). For large gas storage water heaters (rated input ofgreater than 75,000 Btztlhr), list Recovery Efficiency (RE), Thennal Efficiency, Standby Loss and Rated Input. For instantaneous gas water heaters, list the Thermal Efficiency and Rated Input. 2. Mandatory Measures TO COMPLY - ALL BOXES MUST BE CH ECIIMD , —§ 110-§ 113: Water heaters, showerhead and faucets are certified by the California Energy Commission. /§ 1500):' Water System Pipe and Tank Insulation. And Cooling Line Insulation 1. Storage tank insulation. )LI, A. Storage gas wafer heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with insulation having an installed thermal resistance of R-12 or greater; and B. Unfired storage tanks or other- indirect hot water tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the tank. 2. Water piping and cooling system line insulation thickness and conductivity 0 Fust 5 feet of hot and cold water pipes.closest to water heater tank, non -recirculating systems, and entire length of recirculating sections of hot water pipes are insulated per Standards Table 150-B; and Pipe insulation for stearn hydropic heating systems or hot water systems >15 psi, meets the requirements of Standards Table 123-A. Insulation is protected from. damage, including that due to sunlight, moisture,'equipment mainfenance,,and wind. 151(08D: If indicated on the CF -1R, all hot water piping that runs from the hot water source to the kitchen fixtures is, insulated per Standards Table 150-B. 2008 Residential Compliance Fonns August 2009 1 �J e ' INSTALLATION CERT) 16V1 _E__ � ���-61'�=1llr CIS-tJ3. J. Site Addre Domestic Iiot Nater- (DIiZi') ,ar.� e v. -- ��� -(Page 2 of "J/ Ejiforcement A -enc,y: • Permit Number: 3. Central !Yater Heating in )Buildings with Multiple 1Dswelling Units (required for prescriptive) O COMPLY - ALL BOXES MUST BE CHECKED All hot water piping in main circulating loop is insulated to requirements of 51500) Central hot water systems serving six or fewer dwelling units which have (1) less than 25' of distribution piping outdoors; (2) zero distribution piping underground; (3) no recirculation pump; and (4) insulation on distribution piping that meets the requirements of Sectiou 1500) Central hot water systems serving more than 6 dwelling units - presence of either a time control or a time/temperature control I DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. 9 I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person resp6nsible for construction (responsible person). 4 I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. I reviewed a copy of the Certificate of Compliance (CF -IR) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. C I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. 1 -understand that a signed copy of this IInstaUation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Responsible 19 rson's Name: Responsible Pers Sigi tu`re: _ CSLB License: Date Si e¢ Position With Company (Title): 2008 Residential Compliance Forms August 2009