10-1330 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
10-00001330 - '
Property Address:
54100 RIVIERA
APN:
775 -031 -046 -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL.
Application valuation:
1050
Tit!t 4 4 a"
Applicant: Architect or Engineer:
�JA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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.
Lic se CI s: -C10-C 6 License No.: 811114
Date/ ontractor:
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 ($500).:
(_ I 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 _ 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.).
(_) 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:
PATTY KURK
54-100 RIVIERA
LA QUINTA, CA 92253 -
Contractor:
CALIFORNIA DELTA MECHNICAL
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
Date: 12/07/10
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
1 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 I should become subject to the workers' compensation provisions of Section
/33700 of he Labor Code, I forthw' h comply with those provisions.
/e: r Applicant:
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 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 and county ordinances and state laws relating to buildin onstr�andauthorize representatives
of this cou ty o�enter upo the above-mentioned propert t i sp
ate: W ignature (Applicant or Agent):
LQPERMIT
Application Number 10-0000133.0
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
Special Notes and Comments.
REPLACE 50 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
Permit-Fe
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
Dec, 1.' 2010 10:31AM DELTA. MECHANICAL
No. 4015 P. 5
Prescriptive Certificate of Coma fiance: Residential Water Heating CF-1R�c�LT-V4�H
General Information
Site Address: (105 K)7ve.R� climate Zone: bate:
NOTE: This form is only used for alteration of addirinp, nfw opr Gong— —0—..
WATER HEATING
List water heaters and boilers for both domestic hot water (DH139 heaters and hydronic space hea ft Individual dwelling DHW
heaters must be gas or propane fired, and miry not exceed 50 gallons. Hot water pipe insulatdon from the LL'HW heater to the
kitchens) and on all underground hot waterpt es is required in all componentpacka es in all c1hnatezones.
Energy Factor or
Water Heater Type / Distribution I pe Nutnber of Tank Capacity Thermal External Tank
Fuel e' Standard) ) Eflicioncy tionR-Value
�1, 5 standard 170��►/b d 7h.
I. Indicate Type porW Ga,. ReaaPamip, Instarucmeaus et(-) .
2. Recirculating systems sMtrtq multiple dwAng units shall meet the reciraulatton reg+Qrements o1150(h). rho Fraser4y4ky LQ ttirementa do
not anew the installation of a Tecimitlatiuig avatar heatin,-sastem for slnela dwelline units
3. The water heating tank and piper shall be insulated to meet the requirements of150(1).
Contractor (Documer<tatiott Author's /R onsible Designer's beclaration Statement)
• I ccr fy that this Certificate of Compliance documentation is accurate amid complete.
• I am e.Ugible under Division I of the California Business and professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• I certify that the energy feat= and perfnce specifications forth* building design identified on this Certificate of Compliance conform
to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The building design features identified on this Ccrtif cote of Compliance arc consistent with the information piuvided to doeummt this
building design on the other applicable compliatrcc forms, worksheets, calculations, plans and specifications submitted to the enforcement
W11-GY for aP=Val
�with this bUildin etmit Mlicatio&
Namc:l14 L Jam/ i Signattrro:
Company:California Delta Mechanical Date: 1 Z
r�
A '8058 E. Baseline Rd., #155 Liecnse:811,14
City/State/Zip:Mesa, AZ 85206 Phone:866-692-5273
J
2008 Residential Compliance Farms
411
U�
Dec, 7. 2010 10:37AM DELTA MECHANICAL
Bin 71
No. 4015 P. 4
City of.' La QuInta
SWOng 6E Safety Dftlon
Permit # (�� P.O. Box 1504, 78-495 Cage Tampico
La QUM4 CA 92253 . (760) 777.7012
Buflding Permit Application and Traddng Sheet
Project Addn 6%limG R ✓fzti _ Owner's Name: k
u
A. P. Number;:
D�
Legal Dc ri tion: CYtY. ST, zip; 4,4 V
Contractor CcW1201,f
G �
Telephone: %
Address: CO -5-6- �. 60,aei611�1@� �.p�, IS.5—
�ojwtDwa *j don:
City, Sr, Zip. / tg Z
g5lv�
s-6
Telephone; 6 'gl%z _ s2-71
Glit.
V
Statc Lia # : fillCSty
Lia 4. Inti d�
Arch,, EW., Designer:
Address:
'
City„ ST, Zip;
Telephone:
Constnretion
Occupancy;
State Lac #
Project" (elrcle one): New Add'n AI a0pair Demo
Name of Contact Person:
t)t
Sq. Ft:
# StatiZs: # Tlnits;
Telephone # of Contact Parson: 966-6q7- 2 3
Valu of Project(; % � .13
APPLICANT: DO NOT YVMn 13ELOW THIS LINE
M mnw
Req'd
Reeld
TRACKVG
P)i;RMYT �
Plan Sefa
Plan Checknbmltted
item
Amount
Struetuml Cafes.
Reviewed, ready for corrections
Plsu Check Deponit
Truss Cabs.
Called Cnatact Perm
Plan Check Balance.
Mile 24 Cale&.
Plans piekid up
Coaytrnctlon
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2 j Rcvtew, ready lbr eorrectioneisgue
Electrical
Subcontactor Llat
Called Con tactPmson
Plumbing
Orant Deed
Plana pfded up
g -
IIA A. Approval
Plans reagbmitted
Grading
IN HOUSE:-
Review, ready for correedonahmae
Developer Impact Fee
Planning Approval
Called ContactPeraon
A.U.P.
Pub• Wks• APpr
Date of permit issue
School Fees
Total Permit Pees
t�Y
Dec. 1. 2010 10:37AM DELTA MECHANICAL No. 4015 P. 5
Freseri five Certificate of Compliance; Residential 'Water Heating
CF -IR -ALT -
General Information
Site Address: X105 Kt >✓arv� "Climate Zone:
NOTE: This fOTM is only used for alteration or addition of water headntr systems.
Contractor (Documentation Author's /R onsible Deftnerss Declaration Statement)
• I certify that this Certificate of Compliance docmenffitkatt is accurate and complete
• I am 44bla Mxter Division 3 of the California Business and professions Code toaccept responsibility for the building design identified oa
this Certificate of Compliance.
I certify that the energy feahurs and performance specifications for the building design identified an this Cutif tate of Compliance conform
to the requi ments of Title 24, parts I and 6 of the Califomia Code of Regulations.
• The building design feataree identified on this Ccrtificate of Complianee arc consistent with the information provided to document this
building design on the other applicable conrpliaacc forms, worksheets, calculations, pians and specifications submitted to the enforcement
aglDGY for approval With this buildine nermit armlimanm
Naoxzqfir% lignatum.
ComPw''.Californla Delta Mechanleal Date. 1 Z
Add "'%056 E. Baseline Rd., #155 License:811114 ( U
Crty/3tatetZrp-Mesa, /Z 85206 Phone:
866,692-5273
2008 Residential Compliance Forms � � March 2010
INSTALLATION CERT rICATL
Domestic Ilot Water (DHW)
Site Addresses"b
F 'I S-�QO O�i Vi�lbl.
1. NAIATF.R 11RA'A YNTP-- 42v0nrtcnmc.
j;i�forcenrent AQ rtcy:
Cf-6R-A1EC71..01.
(l�a�e 1 0,' 2j
yerrnit Number:
CEC
Certified Mfr Name & Model
FleateType
T e . Numbber
n-rx/1
Distribution
Type
(Std, Point -of-
Use, etc)
If
Recirculation,
Control Type
4 of
Identical
Systems
Rated
Input (k,Al
of
Bm/6r)'
Tank
Volume
(gallons)
Standby
Efficiency Loss
(EF, RE)t ("o)t
6-67'j/v/'
/yore j: ror smau gas storage (rated input less than or equal to 75, 000 Btu/Izr), electric resistance and heat pump water heaters, list
Energy Factor (EF). For large gas storage water heaters (rated input ofgreater than 75,000 Btu/hr), listRecoveiy Efficiency (RE),
Thermal 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 CHECKED
//–§.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
,0— A. Storage gas water 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
Unfired B. 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
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 150-13; and
Pipe insulation for steam 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 maintenance, and
` wind.
/ 8151(f)8D: 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.
7005 Residential Compliance F01777s
August 2009
' INSTALLATION CERTIFICATE
-- y— CF-6R-AIECH-03
Dojnestic H,A Water (Page 2 m`r'
Site Address:
o a /P-,'
' - Enforcement—A—zency: ,Permst Number:
..
3. Centn•al Water Heating in Buildings with Multiple Dwellitng Units (ne aired foi• prescriptive)
O 'COMPLY - ALL, BOXES MUST BE CHECKED
All hot water piping in main circulating loop is insulated to requirements of §1500)
Centrall 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 Section 1500)
Central hot water systems serving more than 6 dwelling units - presence of either a time control or a
time/temperature control
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.
I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized
representative of the person responsible for construction (responsible person).
Y 1 certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) r
conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the
enforcement agency.
6 1 reviewed a copy of the Certificate of Compliance (CF -1R) 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.
Y I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made availablewith the building
permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand
that a signed copy of this )Installation Certificate is required to be included with the documentation the'builder provides to
the building owner at occupancy.
Com any Name: (Installing Subcontractor or General Contractor or Builder/Owner)
_ Cali-�10rte-,'e _ C.t ;'/A ct' i c �
Respon ble P rson's Name: Responsi le Perso ' sialture:�'
CSLB License: Date Signed: Position With Company (Title):
p -e t -n-i i Te c.•lL. i C�'c��r�
2008 Residential Compliance Foams August 2009