13-0494 (PLBG)"w P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Titit 4�VOICE (760)'777-7012
�./ FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
13-00000494
54892 .RIVIERA
775 -153 -088 -
PLUMBING
LOW DENSITY RESIDENTIAL*
1063
Applicant: Architect or ngineer:
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.
License class: C10 C20_C3�, License No.: 811114
1
r ?
Date: _
Contractor: '
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).:
1 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 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.). .
(_) 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:
LQPERN11T
Owner:
WILLIAMS ANDREA
54892 •RIVIERA :DRIVE
LA QUINTA, CA 92253
(
Contractor:
CALIFORNIA DELTA
6056 E. BASELINE
MESA, AZ 85206
(866)692-5273
LiC. No.: 811114
Date: 4/19/13
-----------------------------------------------
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 1697823-11
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 I should become subjt to the workers' compensation provisions of Section
' ) 3700 of the Labor Code, 1 s�rthw4 comply with those provisions.
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 ($100,0001. 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 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.
1 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 thiss-cou ty enter upon -the -above-mentioned property f nspection purposes:
t
Date: ti Signature IAppv nt_oAgent):
t.
LQPERMIT
Application Number . . . . 13-00000494
Permit . . .
PLUMBING
Additional desc .
Permit Fee-
22.50 Plan Check
Fee
5.63
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
10/16/13
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 FROM
' SAME LOCATION GARAGE.
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
APR/18/2013"MU 10:28 AM DELTA MECHANICAL—NV FA.i.No,702-369-9578 P. 003/003
rescrintive Certificate of Compliance: Residential Water Heating CF -IR -ALT -WH
General Information
Site Address:5 iverioL r Climate Lone: Date: 4 la 1
:YOTE. Titin form is only used for alteration.or addition of water heating systenrs.
NATER RErATnG
List water heaters and boilers fiir both domestic hot water (Dffw) heaters and hydronic space heating. Individual dwelling DH6V
heaters must be gas or propane fired, and may not exceed SD gallons. Hot water pipe insulation from the DH6V heater to the
kitchen(sl and on all underground hot water i es is required in all component pack -ages in all climate ones.
Energy Factuc or
-410 1 - 50 0•60 1 a.•8
1. Indicate Type (Storage itIfS. HeLT1 Pump, lnstantaneo(ts.-ete.J
?..Recirculatingsystems serving multiple duelling units shall tweet the recirculation requirements
-of 15001). The ,Prescriptive requirements
da Lot
allow the instahatiyn of a reeireul4tins' water lizatin� system dor single dsvelli Z units
J. I'le N V.re, . w r. c r , ."Cl PLPCIJ j1hill Ve r n rc t ")-")-ef ill- r r 3 of t
Contractor (Documentation Autaoir's trtespousivte liesxgner-s MCCRII.MUVAS
• I ccttify that this Certificate of Compliance documentation.is accurate and complete.
• 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• I certify that the encrgv Matures and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 2-• Paas l and 6 of the California Code of Regulations.
• The building design features identified. on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and specificntio submitted to the
enforcement agency for a nrova with this buildins permit a lira ' n.
tvame: Signature:
Company: (/ "ak
Delta Mechanical Inc 1.2/1,3
a /
r License: 81 114
Address:
6056 E Baseline Rd 9 155
P
Citv!StateiZip: hone: b - _-J J
Mesa/AZ/8206
APR/18/2013/THU 10:27 AM DELTA MECHANICAL -NV FAX No•702-369-9578 P•002/003
r
Bin #
City, �f La Quihta
Bupoing ez Safety Division
P.O. Box 1504,78-495 Calle Tampico
1.a.Quinta, CA 92253 -:(760) 777-7012
Building Permit' Application and Tracking Sheet
Permit #
Project.Addms: 5q'942 R i eria. dr
Owner's Name:. i
A. P.N.umber
Address:5-4-812 gtrtG. air
Legal Description
City, ST, Zip: La j2ue A 4*,. c F1q 7.15,3
Contractor. I
Telephone:
Address:
ProjeetDesoriptiion:'SQ $4216
City, ST, lap.: C,
Telephone: 52" 3
State Lia # : I I I y GSty Lic- f.161 ba
Ardi, Fag, Designer.
Address:
City, ST, Trp:
Telephone:
State Lia #:
Construction `type:. Oacupat<cy:
Prgject type (circle one): New Add'n Alter a a' Ileolo
'Name of contact Person:
Sq_ FL;
#Storiis: #Units:
Telephone # of Contact Pemon: 73Estimated
Valine of PtojecE O 3- 13
APPLICANT- DO NOT WRITE BELOW THIS UNE
d
tdnbmittal
ReWd,
Reed
TRACKING
VERMIR FM
Plan Sets
Plan Check submitted.
Item Amount
StrueturaI Calcv.
Reviewed, ready for corrections
Plan Check Deposit, .
Truss Cal".
Called Contact Person
Plan Check Balance
Title U Calci.
Plans piekcd up
Catistrndlan' '
Flood plain plan
Plans resubmitted '
Mechsriiral
Grading plan
2`i Re new, ready for correc@onarusuc
Flectlical
SubcontactorLiat
Called Coat¢ctpcnon
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. ,Approval
Plans resubmitted
Grading
Ilk DOUSE:-
' 1 W%,icw; ready fo:r correctlonsAme
Developer Impaet Fee
Planning Approval.
Called Contact Person
A.T P.>? -
Pub. Wks. Appr "
Date of permit Issue
School Fets
Total Permit Fees