11-1367 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-i&t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1.2/30/11
Application Number: �11000a0136.7 -,
Owner:
Property Address: 54-92.4__RIVIERP;J
KANYR ANN
APN- 775-153-084- - -
54924 RIVIERA
Application description: PLUMBING
LA QUINTA, CA 92253
D
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i
Property Zoning: LOW DENSITY RESIDENTIAL
(
;
Application valuation: 850
t
DEC 3 0 2011yq
t
Contractor.
Applicant: Architect or Engineer:
ALVAREZ, JORGE A.
CITY. OF LA QUINTA
P.O. BOX 984
THERMAL, CA 92274.
FINANCE VEPT.
(760)777-3613
Lic. No.: 880103
--------------
' LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C36 License No.: 880103
for by Section 3700 of the Labor Code', for the performance of the work for which this permit is
issued.
Date: G 1- Contractor:, -
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
LJ
Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are: -
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier EXEMPT - Policy Number EXEMPT
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if Isho ecome subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Cod I s II rthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by-.D_`�
-
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Date: .1 .1—Applicant:,
( 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 oroffered for sale (Sec. 7044, Business and Professions Code: The '
WARNING: FAILURE TO SECURE WORKER COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT. AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE.HUNDRED THOUSAND -
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE -COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. -
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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the '
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. • Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.)•
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnity and hold harmless the City
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
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 jaws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned prop s action purposes.
Dateo�,�0� Signature.fgpplicantorAgenil:_
Application Number . . . 11-00001367
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 22.50 Plan Check Fee
5.63
Issue Date Valuation . . .
. 0
Expiration Date 6/27/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
.7.50
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE 50 GALLON GAS WATER HEATER.
-----------------------------------------------
-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
Prescriptive. Certificate of Com fiance: Residential . --.--;CF-IR-ALT-DHW
* -, , -4-
Residential Alterailoils — Page I of 2
Proj&tName:
,I Climate Line: Permit #:
!Sw-k�; krAir\�4r,
General Information i
Site Address:
TEnforcement A enc LitLL i r\+ c, Tpat
'04ilding Type:;KSingle Family 0 Multi Fami
Iteplacernent.or Change Out ofWater Heater
WATER MATING
List newly installed water heaters and boilers for both dontestir hot water heaters (OWH) and hvdronkspace fieati ig. Newly installed
MH heaterscand boilers must be gux propane, or use the existingfid' I type.
Distribution Type -EX(CmalTank
Water Heater:- Number -In Tank EmiigyFaFtorur i'i; Insulation
."S'andird.', i C (gal) 11termal Elfficicac y
Typeffittel Type� System N a pacity
Reckulafingt,'— R -Value.'
GK
2-
_77
L Indicate 7:%,#e, (storage Gaj. Hod( Puinp., instantaneous. etc.)
neet req:rculatio requirements of §150(n), ne. Prescriptive
Z. Recirculating systeim'-'serving,multiple dwelling units'�shall'# the" n
.
requirements do not allow the installation of a recirculatingdwelling units. water heating system single d
V J. The emernal water heating tank and pipei shall be insulated to Meet the req u i r -en ie n Is jo I
Contractor or Hoineowner (Documentation Author's/Responsible'Buildifig Designer's Declaration Statentent)
I certify that this Cerlificam of Compliance documentation is accurate and complete.
0,1'am eligible under Division 3 of the California Business and Professions Code to accept responsibility foe thebuilding design
identified on this Certiricat"ecof;Oian-ie.
I certify that the enerigy"features'and 'performance specifications, for the building design identified on this'Certificate of I Compliance
conform to the requiremints of Title 24. Part I and 6 of the California Code of Regulations.
'fie haildi ig design features identified on this Certificate C-ompliancc.are consistent with the inf&iiiiaiion provided to document this
in - " . "
h�uildinj design on the other applicable compliance forms, worksheets, calculations. plans and specifications submitted to the
t
enfurcerne it a fit* ton.
Name' 11 Signature --
Date:
comip-any.
Lidense:
Addre�zs:
-C)
0-7-7-7-3(el
QAnril min
Stora a Water Heater is defined as:
2009 Appliance Efficibncy Aegulatlon8 far Small. Water Heatt;er>�
Small Water Heater is defined as:
Type
input
Gas Storage
75,000 Btu/hr or less
Oil Storage
105,000 Btu/hr or less
Electric Storage
12 kW or less
Gas Instant
200,000 Btu/hr or less
Oil Instant
210 000 Btu/hr or less
Electric Instant
12 kW or less
Heat Pump
24 amps or less
Stora a Water Heater is defined as:
Max Btu/hr Galion 30 Gallon 40 Gallon 50 Gallon
•4,000 120,000 160,000 200,000
If rated Energy Factor does not EXCEED minimum
Federal Minimum
Values Below, an External Insulating Blanket (R-12,
Energy Factor
minimum shah be Installed'
Water Heater Fuel Type
Effective Jan 20 2004
30 Gallon
40 Gallon
50 Gallon
Gas-fired storage -type water
0.62 — (0.0019 x• V)
0.563
0.544
0.525
heaters
0.59 — (0.0019 x V)
0.533
0.514
0.495
Oil -fired water heaters
(storage and Instantaneous
Electric storage water heaters
(excluding tabletop water
0.93 — (0.00132 x V)
0.890
0.877
0.884
heaters
Electric tabletop water
0.93 — (0.00132 x V)
0.890
0.877
0.864
heaters
Gas-fired Instantaneous water
0.62 — (0.0019 x V) _
0.563
0.544
0.525
heaters
Electric Instantaneous water
heaters (excluding tabletop
0.93 — (0.00132 x V)
0.890
0.877
0.864
water heaters
0.93 — 0.00132 x
0.890
0.877
0'864
Heat um water heaters
if -..i..A .a.I
Ift in nallnne
v — ,cs►vv .v,.....v —
1. Per Section 1500) of the 2008 Energy Efficiency Standards.
SAnr;l 2010
in #
( Permit #
1,13 J
Projeet.;ddress: J:::;L
A. 11. Number. —�—
Legal Description:
= t'ontractor: ��
d
Gly Of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
QUiiding Permit Application and Tracking Sheet
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Zip:
\�) awe Z Telcphoq�;_R
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Address:
Pt oJcct rxsci0io,:
ti City S'S 'r.S
C P q 227 Lf
TeleIp) hone:-�
-tA
State Lic. i! . �� (03 3`
Cih' Lic.
�'
Arch., l:ngr., Designer:
l
�f Address:
�I City, ST, Zip:
Telephone: #-. _",1Z r zi
zP Y -� ,
Construction T ype. Occupancy.
State Lic. It: Project type (circle cine): .Ne% n Add'Alter Itepair Demo
�^ —
Name of C:nntact Person: i! Sq. l't.: it Stories: It, Uri its:
Telephone A of Contact. Person: � 1�_Estimated Value of Project:
APPLICANT: DO NOT WRITE
BELOW THIS LINE
�i 11
Submittal Rcq'd
Iicc d TRACT ENG 11E12MiT ilG1S
�
1'tan Sets { �
:i `; Plan Check submitted
_
iE Win Amount!
Structural Calcs.
f Reviewed, ready for corrections Plan Check Deposit
r
HTvuss
Catcs.
t f:alleA (;ootact 1'erson
li flan Check Balance
Etter C:nles.
g7 _
Vi
l'laus picked up
k
� i Cuustrucfion li
`I
Flood plaint plan
t'iaus resubmitted
a
ji Mechanical
Grading plan
y 2"d Review, ready for corrections�ssue '' Electrical
4
Subcontactor List
; 1 (;abed Contact Person
'� I'luntbing
�j
Grant Deed
}Tans picked up
S.M.I.
i,
tt.O.A. Approval
% ?! flans resubmitted
Grading
!i
IN HOUSE: -Review,
fns--------• �„<�
— i �'' ready for corrcctiuns/issac ,qtr i� Developer Impact Fee —
Planning Approval
Called Contact Person
Pub. Wks. Appr
1 D 11 Date �f permit issue
School Fees
'
—
!
(
�i Total Permit ices