PLBG (14-0558)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000558
Property Address:
79616 MISSION DR E-
APN:
"649=650-011- - -
Application description:
PLUMBING
Property Zoning:
LOW . DENSITY RESIDENTIAL
Application valuation:
2450
Applicant: Architect or Engineer:
r
LICENSED CONTRACTOR'S DECLARATION
4
u�itr
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70 1 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Licens ass: A C36 11C42 License No.: 765155
D te: I / l �' CoR ractor:
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 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 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. , BAP.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:
LQPERDI IT
Owner:
JOYCE DIFFAR
79616�MISSION=DR. E.
LA QUINTA, CA 92253
(760) 518 - 2683
Contractor:
RESCUE ROOTER
1520 W. LINDEN STREET
RIVERSIDE, CA 92507
(951)341-9371
LiC. No.: 765155
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/01/14
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 LIBERTY INS Policy Number WC7631508631
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
V/ 3700 of the Labor Code, I shall hwit comply�with �those provisions.
Date: I / 1 _( Applicant:
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
of this c unty to enter upon bove-mentioned property for inspe n p dyes.
/</«��
D te: Signature (Applicant or Agent):
LQPEPNI IT
Application Number . . . . . .14-00000558
Permit . . . . PLUMBING 2013
Additional desc .'.
Permit Fee 11.92 Plan Check Fee
.00
Issue Date Valuation
0
Expiration Date 10/28/14
Qty: `Unit Charge "Per
Extension
1.00'. 11.9200.EA . PLBG WATER HEATER/VENT
11.92
Special Notes and Comments
PLUMBING - CHANGE OUT EXISTING WATER
HEATER WITH 75 GALLON WATER HEATER. 2013
CALIFORNIA BUILDING CODES.
-- - - - - - - - -- - -----------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473)
-------- - - - - -- _
1.00
_. PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, PLUMBING
7.15
Fee summary Charged, Paid Credited
Due.
--- --------- - -- ----------
Permit Fee Total 11.92 .00 .00
11.92
Plan Check 'Total .00 .00 ..00
.00
Other Fee Total 98.72 .00 ..00.
98.72
Grand Total 110.64 .00 .00
110.64
r
•
Din #
City Of >a Q uIn to
Building 8l: Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 --(760) 777-7012
Building' Permit Application and Tracking Sheet
Permit #
j
Project Address: _GIG 5 d
Owner's Name: G —
A. P. Number:
Address: alp �7 d
Legal Description:
City, ST, Zip: Lw .—
it�i�— c-4 ctZ2� �j
Contractor. rG��L%t' e c SC"L
Telephone: `ZGO� �I _2
s:>,::>:v,<>•<:::»:.<.>;:%.>>><;<:#::
Address: t: to ` J T n
Project Description:
City, ST, Zip: `(2; t .l i� C - 2507
FY_.11_ V
Telephone: u�
..
State Lic. # : 7G 515 S
City Lie. #•:
u.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
' "
>>- ' :>'``>>;•::::::.:.: •::<:;:•:::.•::
Construction T Occu anc
Type: P Y
State Lic. #:
Project type (circle one): Add'n Alter Repair Demo
AM
Name of Contact Person: 16 V\ U Z
Sq. Ft.:#Stories:
# Units:
Telephone #,of Contact Person: s) ._ cl3 7 j
Estimated Value of Project:
APPLICANT: DO NOT WRITE 13ELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Revicived, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up •
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.1.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
'
Total Permit Fees
q
Prescri tiVe;Certificate of Compliance: Residential. .
Residential Alterations
project Name: ,w r4. ems. r Ikcr o r...I'-t Climate Zone:
♦ 1
�J
CF-IR-ALT-DHW
Page 1 of 2
Permit 11:
General Information
Site Address: (6, l -d y-, ,J.Y ,� Enforcement Agency: Date: t (I t
Buildin T Sin le Family 0 Multi Family Project Type- (34ire-lacement or Change out of Water Heater
WATER HEA'L'ING
List ne%44v installed water heaters and boilers for both domestic hot w-ater heaters (DWH) and hWronic space hearing.
NeKfi• installed.
D.WH heaters and boilers ertust be gas. propane, or use the existing el Are.
Water Heater
�� type Number In Tank E—By Factor
External Tank
Insulation
Typc/Fucl Type
System System Capacity (gal) Thermal Efficiency
R-Vakie3
-7 5 -
CJ
1. Indicate T.)pe (Storage Gas. Heat Ptunp: Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of f lAn).
The Prescriptive
requircmemis do not allow the installmion of a recirculating water heating system for single dwelling units.
3. The ever= water heating rank andpipes shall be insulated to meet (he requirements o 1
Contractor or Homeowner (Documentation Author'stResponsibk Building 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 design identified on this Certificate of Cotttplianee
conform to the requirements of Title 24. Part I 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 forts, wort sbeas, calculations. plans and specifications submitped to the
enforccmast -far approval with this building rtlication-
Name: Signanrx: I
Company: Dew:
ell
OCA
city/SuRdLip: Phone'