14-0571 (PLBG)�4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
14-00000571
54655 RIVIERA
775-031-014- - -
PLUMBING
LOW DENSITY RESIDENTIAL
800
T-iht 4 4 "
BUILDING & SAFETY DEPARTMENT.
BUILDING PERMIT
Architect or Engineer
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.
Li''c1eennseClass: C36 Le �No.: 812894
DSte: NContractor:
W -BUILDER DECLARATION
I hereby affirm and o rtury that -I am exempt rom th`e'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
I,irense 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 viuladon 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.).
(_) 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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
HENDRICK, THOMAS
54655 RIVIERA
LA QUINTA, CA 92253
(
Contractor:
ALL STAR WATER HEATERS
30300 PUERTO VALLARTA
MENIFEE, CA 92584
(951)301-0067
Lic. No.: 812894
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/05/14
------------------------------------
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 [his 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 OAK RIVER INS Policy Number 2200062086121
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 s orkers' compensation laws of California,
and agree that, ifl should b u ject to the ompen revisions of Section
/ 3700 of the Labor d , 1 shall forthw' p y provisions.
� Appli nt:
WARNING: FAILURE TO SECUR KERS' COMP UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE UNDRED 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 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 thea correct. I agree to comply with all
city and county, ordinances and state laws reta '�—1 sentatives
this county to enter u I the a���z�
D ignature(Ap ca or A
Z_.
LQPERMIT
Application Number . . . . . 14-00000571
Permit . . . PLUMBING 2013
Additional desc .
Permit Fee . . . . 11.92
Plan Check -Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 11/01/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA PLBG WATER
HEATER/VENT
11.92
----------------------------------------------------------------------------
Special•Notes and Comments
PLUMBING - WATER HEATER CHANGEOUT - 40
GALLON. VERIFY SEISMIC STRAPS ARE IN
PLACE. 2013 CPC 2010 ENERGY CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT'ISSUANCE
M/P/E
90.57
PLAN CHECK, PLUMBING
7.15
Fee summary Charged Paid
-----------------
Credited
Due
---------- ----------
Permit Fee Total 11.92 -
-7 -------- ----------
.00 .00
11.92
Plan Check Total .00
.00 .00
.00
Other Fee Total 98.72
.00 .00
98.72
Grand Total 110.64
.00 .00
110.64
wA
1M 111M
K wrta► Ilrfle' C iil0tst I1r a gpaa rO ajr
hearenr amts h las @rprgmj x4 axd arty xot.quwad J0: jd 1sw, -Xikw orp me lharLt aofmx the AllMwwr N dot Uicho(s)
ar) an & U all ta.au. 1~#
later. Heater oWbutior( Type Wiftr In . Tank Intra►• Postbr or External Tan
Type/fuel Types (3tpndprd,' Systo .. Gpsity (pl) Thermal Efficiency Insulation R -Value'
Raairsulati )'
STORAGE
.62 -
6
P2.
intirnoj e.ulatieq:.-value is �i 01"ted an the exterior of the tank:
110(j)2' First 5 feet of het 4A0.cald.ratxr Aipeo elesest to water heater tank, non-recireubting systess, and
1. I eet #*so so• ,ate,
Redimlatlsl owcw m6W amhok AwMA4 *xO skelt Meet Me rrdMwWOR, modm"01, of f1560). The Plrsc*t w
Hrgsinarwxw ata xw 4&w stye hweftdon q/s rednadatimg w er Aarlk, for+bgk it aft salts.
3..Nirextxixal water h t rAell be ixmkwst as namoos• .. " ,
DaeumeAtstion Author's ant
WOW1 442n7.1at arm Manda MeamW
1 (0-'J 113: later heaters. gwoortified by the Envyom ssiom
113(4 5: star hsstini''res reulation loops servinj w -t ple dvelling.units and High-Riaop residential
oacup hoioo not the air.,rolaase valva, backflow prevention, pump isolation valve, and ro'circulgttoa.
lee .sonneatieh is�rtts-ai. i133(s$i,
lis0 lA: Storage see rater hatira rated with do nsrgy cater no trsster than the federal sinfaal slandud
are ex• #rnsll !Wed. on installed thermal resistance of 1-11 er ater.
Ib0'(j)18: Unfired storage tanks. such as stor'op tsnks.or backup tanks for solar rater- esting eyatex, or:
other indirect hot rater tanks have R-11~ asternal insulation or R-16 internal insulation Theme the. '
intirnoj e.ulatieq:.-value is �i 01"ted an the exterior of the tank:
110(j)2' First 5 feet of het 4A0.cald.ratxr Aipeo elesest to water heater tank, non-recireubting systess, and
entire length of recirculating seat an of het voter i are insulated .standards Tab) 150-9.
150 2: Cool ng System piping °(suction, chill. w tar. a vin. linea ,add piping 'insulated betwNn heating
source and indirect het esti tank shell be. insalated to able. 15"... and ties IWA.
150(j)2: Pipe insulation for steam hydronie heeting syeteus or hot eater eyetow >15. i, soots the
requirements of Standards Table 123+4
150Q) 3A: Insulation is protected frqq d rue: to qualight, moisture, e4uirmik
PAIntenonss, and wind,
DaeumeAtstion Author's ant
e I ;ti'tt fJrb CsAtJLifaatt et ioc.Msmtttlas ip asapaia mend
Waal: KEN BLOCK 1•�.' Q!!71e� th liutborise agent Id Conts•etos
31p�atur
C�OIpanY ALL STAR WATER HEATERS
Co clot I ioeas•
Address: 30300 PUERTO VALLARTA WAY
Phone: 951-345-4083
City/state Zip: MENIFEE CA 92584
Date: _; dl
uuu�u.
_4F / It - Aj
CITY OF LA QUINTA.
BUILDING & SAFETY DEFT.
..APPROVED
FOR CONSTRUCTIO
5'yt Cos' tip
s rtaitl _
Bin #
City of La Quinta
Building 8t Safety Division
P.O. Box 1SO4, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: j yep ��C �J �rezl
Owner's Name:
A. P. Number:
Legal Description:
Contractor:
Address: J�030d er761Piz.
n --- _ -
City, ST, Zip:W`I1�e, L1% 9l�25?V
Telephone: ": r•.•-,
p 9s�0067:>...::�:ti:�tiy'.:
ll
Address: sy�Ss iViPj�
City, ST, Zip: ir �/� 922-e-,-3
G •� rftv:.
Tephone:
Project Description: e ex/s it
--
State Lic. # : �/� d g 7
City Lic. C
Arch., Engr., Designer.
Address:
-
City, ST, Zip:
Telephone:
.. _
<.: • ?;>,::
:>%" ;"`ata"Y`
.�,��.�: €.'r%:�cW'.�.x �•:t:SAs cair'.'. ;;:,i 1..C:.. r,. �:.:.:,cma:;y t
{' •%°';>D� �' "<
nstruction TYPe: Occupancy:
-:
Ptoject type (circle one): New Add'n Alter Repair Demo
State Lic. #
Name of Contact Person: o ;,�
Sq; Vit.;
- -
# Stories:
#Units:
Telephone # of Contact Personr/ l.__.._.
_-
$stimated Value of Project: OO
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Seta
Plan Check submitted
Item
Amount
Structural CalaReviewed,
ready for corrections
Plan Check Deposit
Truss Cala.
Cailed Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctio /issue
Electrical
Subcoutaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
&M;i,
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSES-
"' Review, ready for correcdons/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A:LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
total Permit Fees
l