13-0467 (PLBG)"? :OX
1504
787495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
13-00000467
57037 MERION
762-031-007- - -
PLUMBING
LOW DENSITY RESIDENTIAL
1554
•4.4 QUM&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: 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 Pro essionals Code,. and my License is in full force and effect.
License CI sss: 10 C20 C3 Li en 811114
Date: IW 1> Contractor: -
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 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 _) 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.).
( ) Iam exempt under Sec. , B.&P.C. for this reason
t
Date: Owner:
CONSTRUCTION LENDING AGENCY
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:
LQPERAI IT ,
Owner:
JOHN PFAFFL
57037 MERION
LA QUINTA, CA 92253
(
VOICE(760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/16/13
APR 16 2013
Contractor:
A.
CALIFORNIA DELTA
MEC IC L
6056 E. BASELINE
RD,
MESA, AZ 85206
CITY OFIAQUIN7A
FINANCEAEPT,
(866) 692-5273
LiC. No.: 811114
15
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
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 subject to the workers' compensation provisions of Section
0 of the Labor Co I shall fo thwith comply with those provisions.
Date:,y41/;,
Applicant:
WARNING: FAILURE T0SECURE 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 es 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 permitJssued 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. -
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 this cou ty to nter upon the above-mentioned property for in p ion purpo es.
Date: �3Signature (Applicant or Agent):
C -
Application Number . . . . . 13-00000467
Permit . . . PLUMBING
Additional desc .
Permit Fee 22.5,0 Plan Check Fee
5.63
Issue Date Valuation
0
Expiration Date 10/13/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
----- --- --
SpEcial Notes and Comments
WATER HEATER CHANGE -OUT 50 GALLON GAS
WATER HEATER [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 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
LQPERMIT
..
. r
APR/04/2013/THU 04:42,PM . DELTA MECHANICAL -NV .FAX No, 702.369 9.57$_ -,4L i, P,-003-
Prescriptive
03 Prescri tive Certificate of Compliance: Residential. Water Heating CF -IR -ALT -WH
General Information
Site Address: Climate Zone: rj Date:
NOTE. This form is only used for alteration or addition of water heating systems.
NATER REATENG `
List water heaters and boilers for both domestic hot water (DHW) hearers and hydronic space heating, Individual dwelling DHW
heaters must be' gas or propane fired, and may not exceed 50 gallons. ,Hot water pipe insulation from the DHW,heater to the
kitchens) and on all underground hot water pipes is required fn all compo entpackages in all climate zones,
• I certify that the energy features and performance specifications for the building dcsigz identified on this Certificate of Compliance conform
to the requirements of Title 24, Parts l and 6 of the California Code of Regulations.
Energy Factor or.
WRter T4enter Tvne/Distribution J=e.
Number of L111 rqnqrifv
Thermal Fytemil janic
Fuel T et Standard
v tem
v Isulation R-Value3
GASiD
0-V1O
0. AbR
1. Indicate Type (Storage Gas, Heat Pump, ,Instantaneous, etc.)
Z. Recirculating systems serving multiple dwelling units shill meet the recirculation reguirenrents of 150(1). The Prescriptive requirements do Mt
allow the installation of a reeireulatine water heating system for single dwelling. unirs
.�. . r o as.w cu...� .........,.. N•t+w �r ..� ...o...a..c.a.... o,w. • � c �.... �...�,..� v,/ �..V�.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
• I 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 energy features and performance specifications for the building dcsigz identified on this Certificate of Compliance conform
to the requirements of Title 24, Parts 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 aiid specification ubmitted to the
enforcement aec cv for arorproval with this buildingpen-nit applicatign.
Name:
Signature:
SantosJohn
Company: ..
`c
pate: -
q13/11
c
Address:
License: 811114
6056 E Baseline Rd # 155
-
City/State/Zip:
`
Phone:
'KA—/ A 7/91;1(14
APR/04/2013/THU 04:42 PM DELTA MECHANICAL—NV FAX No,702-369-9578
P. 002
Bltt #
: _ • ' ; Ciiy of La Quint
Buiidmg a Safety Division
P.O. Box f 504, •TB -49S Cali,- Tampleo
4.Quirrtd, CA. 92253 - (760) 777-7012
Building Permit ',Application and Tracking Sheet
Pefinit #
1�
ProjeccAadress: eeion .
Owner's Name:. SOIIn pro -IM.
A. P. Number.
Address: V03 tje �•
Legg Description:
City, ST, Zip: L4 a -Ai n
Teieghvnc:
PmojectDescription: R, ac
Contractor: De1 1
Address:
City, ST, Zip: L 5•ai
Talcpbone: a •5x73
State Lic. # 4City Lic.1k- dg00
ArcfL, Ettgr„ Deelper,
Address:
City., Sr, Zip:
Telephone:
State Lic. #:
Construction Type: , C dccapancy:
Project typo (circle one): New Add'n Alter 69DDemo
• Sq. FL: # Stories: #Units
Name of Captaet Person: j
Telephone # of Contact Person; '% Estimated Value of Project: !�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
submittal
Req'd
Reed
TRACMG
PERMIT FEES.
plan 3c�
Plan Check submitted
Item Amount
Sergct"al Coles_
Revlewed, ready for corrections
Plan Check Deposit. .
TMN tics•
Called Contact person
P'hn Cheek Balance.
TWO 20 Coles.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted'
1►Iechatikal
GtadinY Plaq
7! Review, ready for correttiot riaue
Electrical
Subcontactor list
CapeQ Contact Person
Plumbing
Grant need
Plans plcked up
SALL
FLO,A. Approval
Plans resubmitted
Grading
DY HOUSE:-
" Rexlews ready for correctlonsllsme
Developer Impact Fee
Planning 4proval.
Caned Contact Person
Adp.P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fee;