PLBG (13-0350)78815 Lowe Dr
13-0350
P.O. 30X 1_`04
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000350
Property Address:
78815 LOWE DR
APN:
604-233-007-176 -23268 -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
700
Ta9v 4 4 Q"
Applicant: Architect or Engineer:
-------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Bu ass and Professionals Code, and my License is in full force and effect.
Lice Class: C36 License No.: 936147
Date 0 Contra tor:
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 (5500),:
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.).
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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
JOE KING
78815 LOWE DR.
LA QUINTA, CA 92253
(310)938-5530
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
is- Date: 3/25/13
Contractor: D }
STATEWIDE SERVICES INC U
40244 CATANIA CT
BERMUDA DUNES, CA 92203 p
(760) 636-0315 f - 201qq
3
Lic. No.: 936147
!9E_DEPT.
--------------- - - -
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
sued.
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 1948371
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner s s to become subject to the workers' compensation laws of California,
and agree that, if I s ul become subject to the workers' compensation provisions of Section
S00 of the Labo od , I shall forthwith comply with those provisions.
Dat,: Appli nt:
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 l have read this application and state that the ve information is correct. I agree to comply with all
city and county ordinances and state laws relating to buil _9
construction, and hereby authorize representatives
of this county to enter upon the above-mentioned prop ty i s ctiioo'nn purposes.
Dates. n T / Signature (Applicant or Agent). G I
Application Number . . . . . 13-00000350
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . . 25.50 Plan Check Fee
6.38
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 9/21/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
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Special Notes and Comments
WATER HEATER CHANGE -OUT 50 GALLONS [2008
ENERGY]. CARBON MONOXIDE ALARM(S) TO BE
INSTALLED PRIOR TO FINAL INSPECTION.
2010 CALIFORNIA BUILDING CODES.
-----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 25.50 .00 ..00
25.50
Plan Check Total 6.38 .00 .00
6.38
Other Fee Total 1.00 .00 .00
1.00
Grand Total 32.88 .00 .00
32.88
B
LQPERMIT
-Pcescri tiye Cerfificiite of Compliance; Residential..
• CF=IR-ALT-DHW
Residential Alterations Ngc t °('-
Proiect.Name:'j
Climate zcxte: Permit #:
General Information
Site Address. .Enforcement enc' : Date:
Buildine Type"VSin ale Family ❑ Multi Family I Proiect Tvoe: VReolacement or Change Out of Water Heater
WATER HEATING
List neu4r installed %voter heaters and boilers for bbdt danestic hot water heaters-(OWH) and ltpdronic space hearing.
Newly installed
DIVH Treaters aW boilers must be as, p or use the a eistirt eI n .
Water titer t
Typts/Fuei Type
OisuibWw Type
(Statdud .
.
Number Fn . Took TBY Factor or _
System Capacity (gal) Ittertrui E(Ficic7icy
Extemal Tuck
• Insulation '
R -Values
1. Indicate Type (Storage Gas. Heat Plump. Instantaneous. etc.)
2. Recireulating systems serving multiple dwelling units shall 'titer the recirculation requirements of §150(n).
Thr Prescriptive.
requirements do not allow the installation of a recirculating uaoterheatnng system for single dwelling utnits.
J. The e:vernal eater heating tank and pipes shall be insulated to meet the requirements off 1
Contractor or Homeowner (Documentation Author'sMesponsibie Building Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is arcuate and complete.
• I am eligible under Division 3 of the Califamia Business and Professions Code to accept responsibility for the building design
identified on this Certificate of Compliance_
• l certify that the energy features and performance specifications for the building design identifted on this Certificate of Compliance
conform to the mquimn=ts of Title 24. Part I and 6 of the California Code of Regulations.
. features building design featuidentified on this Catificate of Compliance are consistent with the information provided to document this
building design an the cubs applicabk.complianee forms, wotitsbeets. Taitons plans and specificairau submitted to the
enforcemem agony for approval with this building perm' lication-
Name Signa"Mm
may:
C4a 6,) I amu. 3
CityP= (,,o 3 (p—
► , .lel- : S
#
Pe it #
'7 2
Project Address:'
City. of La Quin
Building a Safety Division '
P.O. Box 1504,78-495 Calle Tampico
14.Quinta, C4,92253 - (760) 777-7012
Building Permit 'Applicatio nd Tracking Sheet
S �� Owner's Name:
A P. Number.7
Address
Legal Description:
Contractor.
W
`(
City, ST, Zip:La Ca 1 tl
Telephone:f�'
�. .T �•J.w iib: —:.. :.S.,ca:
Address: L4 Owl"
' k-)-�C4 �
Project Description: 2
City, ST, Zip:.
, -
n
Telephone &0 03 k1_03)
State Lic. # . 3
Arch, Engr., Designer-
esignerAddress:
{��: y Q�., R3 tea;'
City Lic #;
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
,? � »; r
l..! t l67
lt(/GvO
Construction Type: _ Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories:
#Units:
Telephone # of Contact Person: ` 3 i
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
S"ctueal Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calci.
Called Contact Person
Plan Check Balance.
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted -
Mechanical
Grading plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for correctionViissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Tota! Permit Fees
1%
C_= 1 'i• x Ur- LA U I NTA
Contractor cXFCc/4-iu1—a- Address '62 --?:,35 (x-?dksk-t t�OQ-E-
Owner rz-C Jfr 1 5c,f_ e C_ _ Job Address I S �— e ,—Z �z_ 1\,� v::L,
This form shall be posted on the job with the Building Inspection Card at all times in a
conspicuous place. It is the responsibility of the General Contractor or the owner/Builder
to monitor the sub -contractors that are an this list are the same persons performing the
work. Any changes of this list must be approved by the City of La Quinta Department of
Building and Safety prior to work being performed by a changed sub -contractor. Failure to
comply will result in a stoppage of work and/or the voidance of building permit.
TRADE
SUB -CONTRACTOR NAME
CONTRACTOR'S
LICENSE NO.
WORKMAN COMP.
NO. ON FILE
CITY BUSINESS
LICENSE NO.
GRADE/
EXCAVATE
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