08-0460 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 4 0 "-
BUILDING
& SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
0.8<0'0000460
Property Address:
'1153=884 AVENIDA OBREGON
APN:
773-164-025-8 -000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
750
Applicant: Architect or Engineer:
AV -
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 force and effect.
LicenseClass: C36 License No.: 828264
Date: C- rAtra=or: i
• OWNER-BUI Z ER. DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'sState 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 aiiy 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
Lic•enseLaw (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
thathe-or-she is exempt"therefrom and the basis. for the alleged exemption. Any violation of Section 7031.5 by
any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
I _ 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 Profession stoae: 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.).
( I 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.).
(_) 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:
LQPER IIT
Owner:
STEVEN SAFT
51884 AVENIDA
LA QUINTA, CA
(213)448-3825
Contractor:
FOY, SCOTT
43579 MAIN
INDIO, CA 9
(760)775-94
Lic. No.: 8
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
OBREGON
92253
A
S "T
2 1
0 MAR 14 2000
2 1264
CITY OP UA QUINYA
FINANCE DEPT.
Date: 3/14/08
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 ACE INC Policy Number 045040239
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
. " person in any mannerso 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.
c
■D`atez� � - Applicant:
WDA NIG : ,FAILURE TO -SECURE WORKERS' OMPENSATI COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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 ms a result of this apptiCation,
the owner, and the applicant, each agrees to, and shall defend, indemnify nd hold harmless the City
of LaQuinta,.its officers, agents and employees for any act or omission rel ted 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 w k is not commenced
within 180 days from date of issuance of such permit, or cessation of wor for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state that the above information is correct. agree to comply with all
city and county ordinances and state laws relating to building construction, and her horize representatives
of this county to enter upon the above-mentioned property for inspection aurpgWs
L�
Application Number . . . . . 08-00000460
Permit . . . . . PLUMBING
Additional desc .
Permit Fee22.50
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date . .' 9/10/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB WATER
HEATER/VENT
.7.50
-----------------------------------------------------
Special Notes and Comments
----------------------
REPLACE WATER HEATER WITH TANKLESS GAS
UNIT
Fee summary Charged Paid
Credited
----------
Due
-------------------------------------
Permit Fee Total 22.50
.00
----------
.00
22.50
Plan Check Total .00
.00
.00
.00
Grand Total 22.50
.00
.00
22.50
LQPERAIIT
City Of La Quinta
BuUft 8T Safety DMsion
P.O. Box 1504; 78495 Cage Tampko
La Qttinta, CA 92253 - (760).777-7012
Building Permit Application and Tracking Sheet
Pem* g
Project Address: y",
Owner's Name:fit ✓l SA
A. P. Number:
Address: 541P17,} • 6
Legal Description:
City, ST, zip:
Contractor. C�
Address: 5
Telephone: u
Project Description: lA ;
City, ST, Zip: T �r _ . , .. _ ....... _ :
. LU. G ,7 F S 55 Gi f Y
Telephone:
Stale Lic. # : City Lic. #; 5 Cl
Arch., EW., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Oxupancy:
State Lic. #:
Project.type (circle one): New Add'n Alta Repair Demo
Name of Contact Person: "e W
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person: Zis
Estimated_ Value, of Project
APPLICANT: Do' NOT WRITE BELOW THIS UNE
it
Submittal
Req'd
Beed
TgtACIMG
PBRAM FEES
Plan Sets
Pian Check submitted
item.
Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit
Truss Calc.
Called Contact Person
Plan Cheek Balance
Trtte 24 Cates.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
x
Mechanical
Grading plan
2" Review, ready for correctionstissue
Electrical
Sabcoutactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correetlonsrmue
Developer Impact Fee
Planning Approval
Called Contact Person
A".P.
Pub. Wks. Appr
Date of permit sae
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -1R
Project Title Date.
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -411 Form must be provided to the building department for each home for which the following. are
OR
❑ IAlternative to Sealed Ducts and Refrigerant Charge /TXV.s (See Package,D Alternative Package Features for
Proiect Climate Zone in the RM Appendix B Table 1.51-C, Footnotes 7-14.
nn
For additions and alterations; duct systems that are not documented to have been previously
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.LeRuirements of Section 150(m) and duct insulation requirements of Package D.
VU A TCD XYV A q YMf`_ .QVQ1-VX4Q
Distribution
Type
❑
Sealed Ducts all climate zones).(Installer testing and certification and HERS rater field verificationrequired.)
❑
TXVs, readily accessible (climate zones 2 and8=15,:only)
❑
nstaller testin and, certification and HERS_Rater field verification required.)
Refrigerant Charge (climate zones 2 and 8=15 only) (Installer. testing and certification and HERS Rater field
❑
verificationrequired.)
OR
❑ IAlternative to Sealed Ducts and Refrigerant Charge /TXV.s (See Package,D Alternative Package Features for
Proiect Climate Zone in the RM Appendix B Table 1.51-C, Footnotes 7-14.
nn
For additions and alterations; duct systems that are not documented to have been previously
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.LeRuirements of Section 150(m) and duct insulation requirements of Package D.
VU A TCD XYV A q YMf`_ .QVQ1-VX4Q
Svstems servinvAnale dfwelling units
- - -
Water Heater
Type/Fuel Type
Distribution
Type
Number .
in S'stem
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑
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 using Preapproved Alternative Water Heating table, Table 54 in -Chapter 5 in the Residential
Manual. No water heating calculations are uired,:and the system complies. automaticall.
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
13
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
box to verify that time control is required' for a recirculating system pump for a'system serving multiple
13
units
units
Svstems servinvAnale dfwelling units
- - -
Water Heater
Type/Fuel Type
Distribution
Type
Number .
in S'stem
Rated
Input'
(kW or
BuAr)
Tank
Capacity
Ions
Enety
Factor? -or
Thermal
Efficienc
Standby
Loss %
Tank
External
Insulation
R -Value
System serving multiple dlwellin :.units
Water Heater
Type
Distribution
Type
Number
in System
Rated
Ips
(kW or
Btu/hr
Energy
Tank Factor or
Capacity Thermal
Ions Efficiency
Standby
Loss %
Tank
External
Insulation
R -Value
1. For small gas storage water heaters (rated, inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
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 Insulation (kitchen lines >_ 3/4 inches) AII. hot water pipes from the heating source to the kitchen fixtures that are 3/a
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