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PLBG (13-0144)4 44 a P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 2/08/13 Application Number:13-00000144%x:.+- Owner: Property Address: T9864iMORRIS AVE EMERY DAVID S APN: 604-512-001-7 -24197 - 79864 MORR VE. Application description: PLUMBING LAQUINTA, Property Zoning: LOW DENSITY RESIDENTIAL (760) 360-6 Application valuation: 700 1 1 Contractor: OF LL UAA A Applicant: Architect or Engineer:. STATEWIDE SE VICES1��Tj�l 40244 CATANI V.p+ BERMUDA DUNES, 1.92203 / (760)•636-0315 Lic. No.: 936147 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C36 LicenseNo.: 936147 Da LL'- Contractor 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 permiVsubjects 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-builderwill have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 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.). 1 _ 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: Address: ' LQPERMIT WORKER'S COMPENSATION DECLARATION I hereby i m under penalty of perjury one of the following declarations: 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. 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 L1_ I certify that, in the performance of the work for which this permit is issued, I shalt not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, 41shuld become subject to the workers' compensation provisions of.Section ////�qq��3700 of�the.Lae, I shall fo�rth�w7ith comply with those provisions. Data /'/�App�T licanp `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 buildin construction, and hereby authorize representatives of this county to enter upon the above-mentioned property r inspection purposes. -Dii�k � i = l ,Signature,_1Applicant or AgentP ` ` Application Number . . . . 13-00000144 Permit . . . . PLUMBING Additional desc . Permit Fee' . . . . 22.50 Plan Check Fee 5.63 Issue Date Valuation . . . . 0 _ Expiration Date 8/07/13 Qty Unit Charge Per Extension' BASE FEE _ 15.00 1:00 7.5000 EA PLB WATER HEATER/VENT 7.50 Special Notes and Comments REMOVE AND REPLACE 4.0 GALLON NIG 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 LQPERMIT '. .. - .. �^ . ~----� Qty.ofb- Who P.O. Box 1504,78-495 Calle Tampico 14.Quinta, CA 92253 -:(760) 777-7012 Building Permit -Application'and Tracking Sheet Pemuft # Legal Description:a4v— z4o. 014- City, ST, Zip: LA -6 LLyj4-q Contracto IAV -W 11A.0 Telephone:-Roo-AD—lo/q,5 WIN Address: Project Descri tiGn: Telephon City Lic. State Lic. Project type (circle one): New Add'n. Alter Repair Demo Sq.'FL; A Stories: Name of Contact Person: V- I Telephone # of C ontact Person: Estimated Value of ProjecL2 DO . APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Reqld 'Rec'd TRACKING PERMIT FEES - Plan Sets Plan Check submitted item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. Truss Cates. Called Can tart Person Plan Check Balance, Title 24 Calcs. Plans picked up Cons"cdoa Flood plain plan' Plans resubmitted.'. Mechanical Grading plan X'! Rtvltw, ready for correctionstissue Electri.cal Subcontactor List Called Contact Person Plambing Grant Deed Plans picked up S.M.L H.O_A_ Approval Plans resubmitted Grading IN ROUSE:- Review, ready for correctio'ns/issuc Developer Impapt Fee Planning 4proval. Called Contact Person AJ.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees R;=r:e��T,L���.�3ti C�:�CI1.tlltj3l� �" stic dpi Water (DHS) f i. IZI_�'fER HEaZL� G S1 S l EELS: Enforcement AaeLey: ff r+ i_ia- C�-6R IIECH-1 EPaae I of PerrFat'umber: I FZflt:•1 1 j j Bi.-=b1l�oa 121 ; j.: •� , 1. j y- ` H. -we r I. Cem5_d. 1'!s S 3II3' fi. tOLI !.I (DEQ. Attu-!i{ii- 11 1f Number , ; ii tip. ercj ,f � t RIE } f II it Enforcement AaeLey: ff r+ i_ia- C�-6R IIECH-1 EPaae I of PerrFat'umber: I FZflt:•1 1 _ _ lnt`aI j 121 ; j.: •� , 1. j Vchime }q D j �rndbp biLIcieaev o ._r �.-, � roti• rvW . 1 ,`ate 1: For.smr11 gas S16rQ�e Ira 12J. IT*a-i jle'ss ihar- Or _q -,til i0 7-,000 %3 iL'fr;. e'terWC reSSIQ1IC2 r), It Ree, ;e;:. it'Qier heaters. list •. �lIeF'?i' i actor (cr}c For l�r�a,�as star';Qge :CCtei� hiw-vers hale inpw Oi grearer rilar, J. 009 B11i' 1Vii. 1£sl i?'C0`•'ei LifICfPIiC:T r�G,). i Thermal El�ciercy, Standby Loss old Ra eco lapin. For lnstantarlEOUS QCs 't'Q-Er21PrS. list the �!!:r�a? Gj+iC12FiCl ^>i`1 +2ai'��IT)7[il' i 2. ylandatar}' Measures ; TO Co li -OL-Y - ALL BO�-S A—TUST BE C�C=t-- C3 1 1 Q-§ 1 13: Wacer hzaeer_ shote erhaad and Elueel� --re cera ed b o3c Cal-zo ;iia ire�r Coi Ii�TcFss10n. { § 15060: Water System Pipe 4nd TAek lnst:3d Gcaiiag Lille ins atioh l . otaae tank insulation i A. StOraae ga5 �i?atcr 11i;aIer5 ralAd v ah an 1"�Br y I actor no �eaier 112:1 :112 doral mini -mal Standard are 1 t c:: a (� externally wrapped with insulation_ ha:'Ina an 1rsall.Q Ehe_i�cal to istance o- R -l- or irat= and !.1 t _ I-, i --oma ns gt r B- UnIffred:toiage taAks Or o -her incl to L 1'vcae �� have R-1_ eitett.'1 iu_I. ton C_ R -i5 Llt2i?lal insulation Where the in' te! ns! insUladon R -value Is i ti1C?t�L er -tie for Q water piping and Cooling Svster? line- 1rlitllayoh !?iCiCheti and conLSI Cti'vity �-s _r heater -Lank- nor-recircula7nQ systems: and -,ntlre wS first 5 cct Cif•hot and c6l :`rai�r pipes closes: to :Y ., _ i -. a_r! i:t!laC.t'i uZr �tanda rdss I able 1 �a-B; arid_, length of reci4cuiadda 5cctlons-of ntat wafer P,- 1 ' i Pipe iil3ulatloi? fi}r3i�c�L i`�;'CiJniC il=aiinQ 5l:_€C? �S er uo_ ltiat2l ��'�e: e'n5>i� 7�I, iT1�2rs ilio reCluir�m8n`u or Standards Tele 123' _-k { . +r= equipment �I L In_ularon 15 proteCi2d from damage+ mcluding that due to .isi!ll ct, ii!oiSLi i1.aint2nanC2; an yy•--77 1 Ll y 1-5-1 f SD: If indicated oh the ba IR- all i?o= -water piping, tri,{ t -an; -pri th `clot :Vater sUrce i0 the it!tCCieh ;Zstiires L' insulated perSia_ndards Table'ISQ-B. 7008 Residevlial Compliance FonnS , i1 it Just2009 ;w.