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BPLB2015-008378-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2015-0083 Owner: Property Address: 43642 MESSINA CT DAVID DUFAULT APN: 609552023 43642 MESSINA'CT Application Description: DE FAULT / WATER HEATER CHANGE OUT - 40GALLON/G4S LA QUINTA, CA 922 Property Zoning: Application Valuation: $850.00 Applicant: JORGE A ALVAREZ PO BOX 984 THERMAL, CA 92274 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 Professions Code, and my License is in full force and effect. License Class: C36 c— License No.: 880103 Contractor: OWNER -BUILDER DECLA ATION 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.). ( 11, 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 Lender's Address: Contractor: JORGE A ALVAREZ PO BOX 984 THERMAL, CA 92274 (760)698-8975 Llc. No.: 880103 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/17/2015 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: Policy Number: _ 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 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:- to- 1 - I Applicant: WARNING: FAILURE TO SECURE WORKERS' CO PENSATION 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 Building Official 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 of this city to enter upon the above• mentioned property for inspection purposes. Date l �� Signature (Applicant or Agent):.-- e. FINANCIAL INFORMATION •' 'DESCRIPTION "` ACCOUNT ' QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $91.85 $0.00 'DESCRIPTION ` ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 _PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT" PAID PAID DATE WATER HEATER/VENT PC 101-0000-42600 0 $7.25 $0.00 PAID BY, METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $19.34 $0.00 TOTALS:00 Description: DE FAULT / WATER HEATER CHANGE OUT - 40GALLON/GAS Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 6/17/2015 SKH Approved: Parcel No: 609552023 Site Address: 43642 MESSINA CT LA QUINTA,CA 92253 Subdivision: TR 28458-1 Block: Lot: 42 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $850.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: U No. Unites: 0 Details: WATER HEATER CHANGE OUT - 40GALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. Printed: Wednesday, June 17, 2015 1:20:05 PM 1 of 2 ' SYSTEMS CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT JORGE A ALVAREZ PO BOX 984 THERMAL CA 92274 CONTRACTOR JORGE A ALVAREZ PO BOX 984 THERMAL CA 92274 OWNER DAVID DUFAULT 43642 MESSINA CT LA QUINTA CA 92253 Printed: Wednesday, June 17, 2015 1:20:05 PM 1 of 2 ' SYSTEMS Printed: Wednesday, June 17, 2015 1:20:05 PM 2 of 2 RWYSTEMS INSPECTIONS SEQID; ,:i,'INSPECTION-TYPE "INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT ., REMARKS ` NOTES'' PLUMBING FINAL" BLD CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid forPERMIT ISSUANCE: $91.85 $0.00 WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 WATER HEATER/VENT 101-0000-42600 0 $7.25 $0.00 PC Total Paid for PLUMBING FEES: $19.34 $0.00 TOTALS:• •• Printed: Wednesday, June 17, 2015 1:20:05 PM 2 of 2 RWYSTEMS INSPECTIONS SEQID; ,:i,'INSPECTION-TYPE "INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT ., REMARKS ` NOTES'' PLUMBING FINAL" BLD Printed: Wednesday, June 17, 2015 1:20:05 PM 2 of 2 RWYSTEMS STATE OF CALFOPJ44 RESIDENTIAL ALTERATIONS — WATER HEATER CEGGFI14-ALT-01-E (ReVbW MM4) CAUFORNIA ENERGY COAA6R91SION CERTIFICATE OF COMPUANa MR -ALT -01-E WATER HEATER Prfscriptive Residential Akerations for Water, Heater jPage i of 2 A. GENERAL INFORMATION Sit address: Builth 3 X12 t ria ng T J>OingieYPe� Family Dweirmg ❑ Muni Family Dwellings Cit1►. Zip Code: C-AC1'Z C imate Zone: G. WATER HEAVING SYSTE141S on. 15o.2(b)IG) 01 02 03 04 03 06 07 08 09 10 11 12 13 14 is Water Water Water liof Water Fuel Rated Rated Heating Heating Standby Exterior Bads -Up Central Dwell n% HeatNg System kieftdftcwJon or Name Heating System Type Heater Type Water Heaters in system Heater Storage Volume (4aq Type input Type Input Value Efficiency Type Efficiency Value Lost I%i InsuL R -Value Solar Savings Fraction DHW SWCdn Distribution Type unit DHw System Distirlbtition Type C-.4 3�1> 11 t �0 �►QS WAM HFAT(NGSYST®V1S Water heating compliancefor an alteradon Is described in Section 150.2(b)lG. For single. dwelling'a gas or propane water beater, wJtb a storage tank:of 60 gallons ma:dmum or Instantaneous (tankless) can be used. Dwelling:unit distribution systems are limited to Standard.trunk and branch or, demand recirculation fcr.gas gr propane water heater. Demand recirculation -is not allonred for elediic water heater. if`thereis no natural gas connected to .the bu.pdin&,an electric water heater maybe replaced Ah another electric water heater. However, chan&Wfrom gas to electricJs not allowed. Multi-family-ceMral systems must use certified equipment as defined under Section 110:1 and 1103. NOTE: if the proposed installation does not meet the requirements allowed specifically for akerations, use form MR -NCB -01 to document the water -heater alteraftri, las—,hy-Oions for sections with column numbers are Given below: 1 Water HeaftSystem Identification -or Name: enter a unique name for the Water Heating System. 2- Water heatingsystem type: DomeSticHot Water(DHW),.Hydronic, Combined Hydronfc, or Central-DHW.(s for domestic hot,water, hydropic is a water heating system used for space heating -6W,, combined hydronk i4wfien'the water heaterwi will provide both space eonditioning:and domestic hot water. 3• Water heater hype For non -central systems only Small Storage or Small Instantaneous.are allowed. For central: systems pick from Large Storage, Small Storage, Heat Pump, Boller, Large Instantaneous, Small Instantaneous or Indirect. CERTIFICATE OF COMPUANCE Preriptive Residential Alterations for Water Neater MR -ALT -01-E WATER 2 of 4. Number Of Water heaters:hnsysterrc M single4amily and- mutt rnily with water heaters in each dwelling units the Wlue.is L For multi -family central sMems serving muftfpfe,dweifirtg units enter the total:number of water heaters. 5- Water heater Yom (Safi tank c2fadtY Ingallons. For individual.water heaters for a dwelling unit this will be. 60 gallons or less, if instantaneous, enter n/a. For multf-famfty central systems enter the total storage volume. 6. Fud Type Gas, Propane, Electric (only if natural gas is not available) , 7- Rated Input Type: Enter the equipment input rating type, for gas or n� 8. Rated Input Value: Eller the numeric value of rated input. propane. fired units are Btuh, for electric fired system the units are kW. Heating.ffWency'TYIM Enefgy-.Factor,•AFUE;.orTherrnal Effidericy. From product literature or a,Ufffomia Ere, 10. hleatf 1Rfld rgy Commission directory. n6 . , encyValue: Enterthevalue*.om,producf-i teratutear a California Energy Commitsion•.directory 11. Standby t mts(Perceiity spokes only to latge storage water heaters, Enter n/a for-srnall"storagg or Instantaneous water heaters. 1Z Exterforhisulallon ft-Vatue: Enter the R-Value%if exterior Insulation on the storage tank is installed 13- Back-up solar SmATgs fraction: If compliance requires a back-up solar system, indicate the:solar contribution a 03Q� External plculationsare required. 14. Central DihiN DlsbibiRion System; For multi-fami bvfldf (�� h ngs-with using a central distribution system a:demand rearculationsystem with at teasttwo distr(butfon loops must be installed. This. requirement applies to any building wulth eight -or more.units. if the systerrr is non ientraI or project: is1ndhiidual•units enter n/a., 15. DareflingUntt p}iyyl) uNon Type: For a Central DHW this field shall be Standard. If non -central then pick from Control, Demand. Recirculation — Sensor Control. if non-central•electric water heater this must be Standard,, no recirculation • Demand 11 Reci rculation Calle .Manual system shall be iraWlled. MENTATION AUTHOR'S DECLARATION STATEMENT 'certify that this CWMkMW of Compliance documentation Is a=rate and counplete. Name: aOwner o Authorized agent aContractor g Signature: Company : Address: Contractor license Phone: City/'state/Zip: Date: For mance or qui regarding the Energy Standards, contact the Energy Hotline at: i-8110.772-3380. N Submittal PLN'd City ofLa QuInia - ••� . ...u. c oea.W VV l nla URt TRACMG DWpn P.O. Box I SO4, La • .•777-7012 Pian Check submitted Builaung Permit APP11cation and Tracidng Sheet Item Amount A. P. Structural Caks. Number •' I 1 , RIP V • Plan Check Deposit %., U � Asa Caged Contact Person Plan Check Balance Tide 24 Cales. 1 •. • K p r Address: Construction 1 1 • 1 /!7� / i:l ��Jif J �. �• ��,'. �jlj/ ?ifs:, //1 i??+i:• `F PrOJeCt tYPe (circle one): New Add'n Alter Repair 11 1 I 1 1',V •1 I i IO , Telephone 1 111:person:,IDIOM 2' Review, ready for eorrections&me N Submittal PLN'd Rec'd - ••� . ...u. c oea.W VV l nla URt TRACMG PERMIT FEES Plan Sets Pian Check submitted Item Amount Structural Caks. Reviewed, ready for comedons Plan Check Deposit Truss Cates. Caged Contact Person Plan Check Balance Tide 24 Cales. Plans picked up Construction Flood plain plan Pians resubmitted Mechanical Grading plan 2' Review, ready for eorrections&me Metrical Subcontactor Ust Called Contact Person Plumbing Grant Deed Plans picked up 3.M.L Ti.O.A. Approval Pians resubmitted Grading IN HOUSE:- 3" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permlt issue School Fen Total Permit Fees