12-0703 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00000703
Property Address: 78295 SCARLET CT
APN: 604-025-031- -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 862
c&t�v - 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby-atfiirti•under pen'a t of perjury that I am licensed under provisions of Chapter 9 (commencing with
t, Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicenseClass: /C/1%0 ,CC20 C3 License No.: 811114
/Date:a/X/H.Z' Contractor:
Iill��77 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, 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.).
(_ 1 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: Al
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/25/12
Owner:
ANFUSO JOSEPH & JENNIFER TRUST
5333 ST ANDREWS DR
STOCKTON, CA 95219
Contractor:
CALIFORNIA DELTA MECHNICAL INC
6052 E. BASELINE RD, #155'
MESA, AZ 85206
(866)692-5273
LiC. No.: 811114
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION '
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 1 should become subject to the workers' compensation provisions of Section
7�3�700 of the Labor Code, I o�rt�hwpiyth�omply 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 ($100,000). 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 building construction, and hereby authorize representatives
o/f its county to enter upon the above-mentioned property f p tion urposes.
Date:69�S/" attire (Applicant or Agent): ! ,
Application Number . . . 12-00000703
Permit . .
. PLUMBING
Additional desc .
Permit.Fee
22.50
Plan Check Fee
5.63
Issue Date
Valuation . . .
. 0
Expiration Date
12/22/12
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 40 GALLON
ELECTRIC WATER
HEATER.
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
0
LQPERMIT
JUN/25/2012/MON 02:16 PM DELTA MECHANICAL—NV
PAX No.702-369-9578 P,005/009
a
aJd—..!n ii,l I
'"!,;l:c:.!_
�._ y; .,!.,,r.'
�•::` l �r.'. i�:L.�) moi: RL2L. C N:
NijilLe. :r.
1
•••'. c :ie:Gr ,r
?, •7j -_- `'L�nnlaJi���
oAsrt">�� ✓''
r.'i lwC•_ Luc, ..
!F )f Sviril:s
G':rcril 1 ^t"urtnuren a
_�+���LIY I Cn`' rc�mCt ����• Data:
�: i:Ci%_ 7: `l: Ji aic �::tr:�: � ��•r::i �;;, 1 �• .•
7y.-,=: ;_. r- ?.i[2r1L"C 15 1'ntt'^t CL
. i��`- ._-'?Cal ii .i11,^••.!� �Ui ��i.:'.C: i?1�.1.^,,. C:18't :J .b l::.
v1�T�• T;s.: err, is rig; ; i•: (rsc,r rJr �;�:1.!•I � r
C::r:rr:rc•A:l �:rtlr!i,!,++; 7r:IJ:iir iu
WATER H,EATTSC
:.i.r( .1:rrer:r:;ncr, I�r7rli/er:c 'nl Jn:ir ;f;:,a»r: d; :,ul ,rarr: ;'r:i!:v; %frarcr:ulyr atirnni :n+r(= :I:::::;r;, incl:'Irnrl yru;lirr %Ij:Y;ltr!•_r.• :ru:;
is wwer;ipeln.aflc:inlr; lniu dr» :w:V ;n iter fit Ito .ii::!l.q;s; 11r:(
4 _ :!!f» rl JBl C:trlrnr;rnl,! •.(: Cn':?4°: %r, 71: C!il,:(i: _^ =7112:.
Contracrarrs, TDCUM..Crt]ijor, kuL'hcz'I-/Respansiblc Buiia,-Il D�i�re: aiD'•? 1
I:C'C'Si:�lec.gratl0[IJCatCITlCilt
0 7(:1 Bate:CP_
2:1 raS Swine;3 9,^.rl ;�Si�CC,: SCC'_ °.G CC- �reC.S::.t.:"I .'7i :'•'S �t:'!r:,l�= .
]f!•= it::3G71a�
are-
:7t:"'
^C
_ . �r tie Ca :.:ria Cern R.z�:a::�r•r.
.... '.�,!i:. r•ii ria.?:: :—wirpJ +t�..�::.,P� •. �:� r,.tiC,.
y'4";;
'L.• 'yl: •,t _: ._ .. , .,. .• . .t__.r, �I r:: cir:1'C� 2:� .r r: Ji:r�.., '.'i::� [::� cr. :1^�1: �.:': :': :V�� .�
a J.: -- - - .1:1'_:,r,�..;_c: r�r,, Isar..e .`�r-�.:•�:r �. c: a!:cry. siami asz.eai-cr:c.-,s
. C+ i;r 9^CfJ•rl' 'v:: .ti:� 4�:1�!ra (;n�•,.i, 21'5::3nt. i
C•: -CC^.;,' r� 1 , is/:+'%r'S,///ii• /�`
.14
iq�'1 �1
r
y!fsULui0�
•3:anc:'�. !
•�
NijilLe. :r.
1
•••'. c :ie:Gr ,r
R�=ir^�!''-n,:
/jII�// ^� i .,ii.._.
t.. '.
`. Irl,•.%C::C Yl:e i�ICr_:gr sae, ;C:(f .':rnlr7, Iq.u[Nfrrrl:7rlL', lrc;,
.:7ae/lLi' :Cr>;lh ,IY.r((llll." f!rg(:flh :1/1tf.; nIIL'li :hN^I !%IC ::g?^!•tll�l)nn ^ f
nGr !lrnP 112 :rl.S:La!:r!rl!"!:I
,, ; I,'. . •IC /�rL:(•r:/Jfif't
r3q. uir:ne:;G: dcl
r,::::n�:rc(L:Uc il:��,!rfcn(,r r:in,le YII•:!;rr, Jnic_
'. 771C ^_ v/ q,^
:l::fli - . Comm Jir.-, .rin,jl .:n.cl_. ;;,
nrr_. dre 1•e:nlir,�"len:.; rfa! :ri..
Contracrarrs, TDCUM..Crt]ijor, kuL'hcz'I-/Respansiblc Buiia,-Il D�i�re: aiD'•? 1
I:C'C'Si:�lec.gratl0[IJCatCITlCilt
0 7(:1 Bate:CP_
2:1 raS Swine;3 9,^.rl ;�Si�CC,: SCC'_ °.G CC- �reC.S::.t.:"I .'7i :'•'S �t:'!r:,l�= .
]f!•= it::3G71a�
are-
:7t:"'
^C
_ . �r tie Ca :.:ria Cern R.z�:a::�r•r.
.... '.�,!i:. r•ii ria.?:: :—wirpJ +t�..�::.,P� •. �:� r,.tiC,.
y'4";;
'L.• 'yl: •,t _: ._ .. , .,. .• . .t__.r, �I r:: cir:1'C� 2:� .r r: Ji:r�.., '.'i::� [::� cr. :1^�1: �.:': :': :V�� .�
a J.: -- - - .1:1'_:,r,�..;_c: r�r,, Isar..e .`�r-�.:•�:r �. c: a!:cry. siami asz.eai-cr:c.-,s
. C+ i;r 9^CfJ•rl' 'v:: .ti:� 4�:1�!ra (;n�•,.i, 21'5::3nt. i
C•: -CC^.;,' r� 1 , is/:+'%r'S,///ii• /�`
.14
iq�'1 �1
r
JUN/25/2012/MON 02:16 PM DELTA MECHANICAL -NV FAX No,702-369-9578
Fftrirllit
-
Citli of La QuInta
Suildin9 K Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Qcdnts, CA 9225-T - (76o) 777-7012
\ Building Permit Application and Tracking Sheet
Project Address: i
Owner's Name: '1 I ��Qh �/✓�
A- P. riumber: Address: •��� � S'G o, r%' f
LcgoJ Description: City, ST, Zipp;
Address: 6 0S6
City, ST, Zip:
Construction Type:
Telephone:. a66 _�q2
State l,ic. # : LOB—
City Lie. #: to Z{GQ y
Arch., Rngn, Designer:
"
Address:
City, ST, Zip:
Plan Check 1321ance•
Telephone:
State Lie. #;
Caustructlon
Mechanical
i
' rlQnae I f Cotuact Person: M
V`
Telephone # of Conraet person:
APPLICANT; DO NOT V
# Submittal Req'd
Plumbing
Ree'.d
TZ>�
Xlau Sets
S.1M.I. .
plan Check submitted
Structural CNcs.
Grading
Developer Impact Fee
Revi-Pd, ready for car
Truax Calfs.
A.I-P.P..
•
Called Confixurrrsou
Title 24 Cal e9.
Eats picked up
Flood pWn plan
To fal Yermlt P tea
1
plans resabnrltied
Grading plan
2^! Rev[ev{, ready for to,
SubcantaetorList
Called Contaetperson
Grant Dced
Pleas picked up
g.O.A. Approval
plans resubmitted
IN SiOli3E:-
J- $eYtr-w, ready for corf
Planning Approval
Called Contact Persou
Pub. Wks, A.ppr
Date aFpermit issue
501001 Fees
Project
P. 004/009
P0# �ta� �(��►Z
Construction Type:
Occupancy;
project type (circle one): New Add'n Al ,epair Demo
Sq. Ft: # stories: # CJtlits:
Estimated Value of Project 4.9 3
IRITE OF -LOW THIS LINT;
CTfIIVG PERUM Fla
Item Amount
sections
Plan Check Deposit
Plan Check 1321ance•
Caustructlon
Mechanical
rections/Issue
Electrical
Plumbing
S.1M.I. .
ections/issue
Grading
Developer Impact Fee
A.I-P.P..
•
To fal Yermlt P tea
1
P0# �ta� �(��►Z