12-0586 (PLBG)P.O. BOX 1504"
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht. 4 - XP Q"
Application Number: 12-OQ.00.0.5.86y
Property Address: 80595 OAK TREE
APN: 775-082-019- - -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 750
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 force and effect.
License Class: C36 License No.: 880103
Date: ��-IZ ontractor:
WNER-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 ($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 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: tA
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
- FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date
Owner:
EVA VALDEZ'
80595 OAK TREE
LA QUINTA, CA 92253
Contractor: D
ALVAREZ, JORGE A. �J
P.O. BOX 984
THERMAL, CA 92274 1%j4� ` A
(760)777-3613 `t
Lic. No.: 880103 Cl OP
FINgA► AQU
5/24/12
zo,� lD
--------------------------------------=---- ------
WORKER'S COMPENSATION DECLARATION
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 XEMPT Policy Number EXEMPT
"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 of the Labor Code, I all forthwith_ comply with those provisions.
,61
ate: ' Z y-1pplicant:
WARNING: FAILURE TO SECURE WORKER COMPENSATION COVERAGES
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. _
I . 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 building construction, and hereby authorize representatives -
of this county to enter. up n the above-mentioned property for in a tion purposes..
pefe: 5.1411 ignature (Applicant or Agent):
LQPERMIT
Application Number . . . . .
12-00000586
Permit ... . PLUMBING•
Additional desc .
Permit Fee . . . . 22.50
Plan Check
Fee
5.63
Issue Date . . . .
Valuation
0
Expiration Date.. 11/20/12
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 50 GALLON GAS
WATER
HEATER. 2010 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
prescriptive. CeEtificate of Compliance: Residential CF- IR -ALT -IDU W
Residential AlterationPap I of 2
Project Name: Climate Zone: Permit #:
General lnformatioit
Site Address: 5`15 Enforcement: A ` m:: Lw V\
Building e: in le Family D Mufti Family Project e: lacement or Chan a Out of.Water Heater
WATER HEATING
List neii-h installed Crater heaters and boilers for both domestic hot titter heaters (DWH) and lndronle apace hearing. Newly installed
DW11 heaters and bolters must be gas., pro ne, or use the exis(ingficel live.
External Tank
pistributionTyQe rBy.. ,or
(Staadatxii . Number la Tank Epr
Type � LSystem Capadly isan 'thermal Effidency
Insulation
TyOd�rel Type" Itet:iradaCn
g_vakd
rut ---
Z1.
1. Indicate Type {Storage Gas, Heft P;ar, Insrantageo".
2. Recirrtdaling systems serving mctlrlple dwelling uniia shall. ateet the reeimdatipn tequlrrenrents of 91S0(n).
The Prescriptive
nequirethen6 do not allow lite iltstailation of a recirculating water heat{ng system forsingle dwelJittg ntlits.
A The external water heatin tank and i es shall be insulated to aieet die requirements of §150U).
Contractor. or Homeowner (Documentation Authoes/Responsible Building Des%ner.'s Declaratloa Statemeat)
a I certify that this Certificate of Compliance dceuinentation isAccxtrate and complete.
• 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibil iii for the building design
identified on this Certificate of Compliance.
P i certify that the energy features and performance speciftcidlims. for• the building design identified on this CertiPteate of Compliance
conform to the requirements of 1`itle 24. Part t and 6 of the California Code of Regulations.
Elie Nuilding dcsi.,r, features idenilned on this eertificateaFt7otnpliance are consistem with the information provided to.document this
building design on the othei applicable compliance forms. worksheets, calculations. plans and specifications submitted to the
entoreerrent atufor approval trovri wii8 this building permit a licatinn. _—
Name: SI at
n,ce:.
C. ovairtay:
Address: t (cense:
citylstatr/zip: Phone:
MO -1 C A__ �t 22`� y U - -t -7 -7
GAnril 701!
Bln #
City. Of La (�..ui tj
�C
Building 8r Safety Divirlgn
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA .92253 . (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
�(
'�-
Project Address: SO 5S
Owner's Name:
A. P. Number:
Address: G
Legal Description:
City, ST, Zip: -
Contractor:`� �U
Address:
Telephone:
Project Description:
City, ST, MaA u\ CoZ -,�
C
Telephone: -1WTY) - kS
.
State Lic. # : 3 City Lie. #--
Arch.,
:Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: —7 O �
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd .
Rec'd
TRACENG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Cheek Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'' Review, ready for corrections/Issue
Electrical
Subeontactor List
Called Contact person
Plumbing
Grant Deed
Plans picked up
SMI.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correctionsluisue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees