09-0015 (PLBG)Al
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4iyl 4 4 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
09-00000015
Property Address:
05.4938—OAK TREE
APN:
775-081-057- - -
Application description: PLUMBING
Property Zoning:
LOW. DENSITY RESIDENTIAL
Application valuation:
500
Applicant: Architect or Engineer:
\ I
P,
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 Professionals Code, and my License is in full farce and effect.
LicenseClbss: C36 LicenseNo.: 828264
atentractor:
(" �ER-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 7031.6 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.). -
(_) 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 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
Owner:
MARGARETE VIGRA
54938 OAK TREE
LA QUINTA, CA 92253
Contractor:
FOY, SCOTT A.
43579 MAIN STREET
INDIO, CA 92201
(760)775-9405
Lic. No.: 828264
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/07/09
-----------------------------------------------
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 FIRST COMP INS Policy Number WS1004457
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 1 should become subject to the workers' compensation provisions of Section
3700 ofabor Code shall fo wi h comply with those provisions.
Dpi€: Applicant: r /
WARNING: FAILURE TO SECURE WORKERS' CO NSATION CO AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 shalldefend, 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 applic 'on and state that the above information is correct. I agree to comply with all
city and county ordinances an ate laws relating to building construction, and h reby honze representati s
of this counWto enter up he above-mentioned property for inspection pyrpAges
(Applicant or Agent):
LQPERMIT
Application Number,
09-00000015
Permit . . . PLUMBING
Additional desc .
Permit Fee. 22.50
Plan Check Fee
5.63
Issue Date
Valuation
0
Expiration Date .' 7/06/09
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 7.5000 EA PLB
WATER HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and Comments
REMOVE & REPLACE 40 GALLON GAS
WATER
HEATER.
-------------------------- ----------------
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
CERTIFICATE OF COMPLIANCE: RESIDENTIAL e 3 of 4 CF -IR
r cwovi ;GAS � � 2 O
Project Title
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the fdlloMng. are
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Proiect Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-14.
For additions and alterations, duct systems that are not documented to have been previously
0 sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the uiretnents of Section 150(m) and duct insulation requirements of Package D. !
wA'rVD 9WAI'FNC cVQrrPUc
Distribution
Type
0
Sealed Ducts all climate zones(Installer testing and certification and HERS rater field verification required.
Tank
Capacity
Ions
TXVs, readily accessible (climate zones 2 and•8-15 only)
Standby
Loss %
staller testis and - +;lr-c tion and HERS Rater field verificationrequired.)
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
0
verificationrequired.)
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Proiect Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-14.
For additions and alterations, duct systems that are not documented to have been previously
0 sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the uiretnents of Section 150(m) and duct insulation requirements of Package D. !
wA'rVD 9WAI'FNC cVQrrPUc
V ViVfYv w
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
Tank
Capacity
Ions
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Standby
Loss %
not allowed.
Check box when [sing Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the system complies automatically.
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
0
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
Tank actor or
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
0
units
V ViVfYv w
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Inpud
(►W or
Buoy)
Tank
Capacity
Ions
ERatne
Fact7or
Thermal
Efficient •
Standby
Loss %
Tank
External
Insulation
R -Value
ner�y
Tank actor or
External
Water Heater
i
Number
n
or
Capacity a1
Standby
Insulation
Type
Type
in System
LuOu
a SICU AGI van=WW cc a.A
.,,..w
Tank
ner�y
Tank actor or
External
Water Heater
Distribution
Number
n
or
Capacity a1
Standby
Insulation
Type
Type
in System
LuOu
tons Efficient
Loss %
R -Value
1. For small gas storagewater treaters (rated inputs or less utan or v4u4i to .J,uw •1 ,
pump water heaters, list Energy Factor. For large gas storage water -heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous. gas water
heaters, list Rated Input and Thermal Efficiencies.
Pipe ImaktioB (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/e
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005
Birr #
Pptmft #P.O.
Ot - \�
Project Adatess.T
A- P. Number.'
City Of La Quinta
Btu 8t Safety DMsfon
Box 1504, 7&495 Cale Twom
U Qlama, CA 92253 - (760) 777-7012
BUH&W Permit Application and Tracking Sheet
Owner's Name:
"93 Oa K 4-tv -
Legal 'p°on
Co°Uacmr��
Address
/ ' f
city, sr, zip:q ;n c ZZ S'3
Telephone: %(pO — I %
Project Description:
City, ST, zip:. T—
7Cfi�C� -711s
Tekphone:7
State Lie. # :
CityLic. ii57 7
l l j n
'C
Arch., Eug.. Design:
Address:
City., ST. Zip:
Tdcph0°e:
Slide Lk
Constr=on Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. FL:
S Stories:
# Units:
Telephone fi of Contact Pers:
Estimated Value of Project fj
APPLICANT: DO NOT WRITE BELOW THIS UNE
Sabsaitdl
Req'd
Reed
TRACKING
PERBUT FEES
Pin Seb
Phe Geek submitted
Item
Ansoant
Gdes.
BsvkRed, ready for earsatiem
Phu Check Deposit
Trap Cala.
Called Coofaet Person
Plan Check Baiance
Ti@e 24 Cala.
Plans picked up
Coasb-octiou
Fwd plain pin
Plans resubmitted
Mechanical
Grading plan
2'! Review, ready for correctionstipne
FJxbical
Sobeoistactor Lst
Called Contact Person
Plumbing
Grant Dad
Plans picked ap
S.M.I.
ELOA. Ap{uoval
Phos resubmitted
Grading
IN SOUSE:-
'"' Review, ready for eorreetionwissnc
Devdoper Impact F«
Plaadbg Approval
Called CoaUtet Person
A.U.P.
Pub. Wks. Appr
Date of pa =ft isme
School Fees
Total Permit Fea