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09-1170 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09-00001170 Property Address: 51300 AVENIDA CARRANZA APN: 773-082-003-22 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 500 c&t!t 4 Xfo Q" Architect or Engineer: alp BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -------------------------------------------------- LICENSED --------------------------------------------------LICENSED CONTRACTOR'S DECLARATION Ihereby 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 Professionals Code, and my License is in full force and effect. License Ips: 36 License No.: 618140 at ntractor: r 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 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).: (_) 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.). (_ 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/04/09 Owner: JULIE VAN DER KALLEN 51300 AVENIDA CARRANZA LA QUINTA, CA 92253 Contractor: CAMPESINOS UNIDOS, INC. P.O. BOX 39 � 04 BRAWLEY, CA 92227 (760)344-4500 Cfi)'ff�dF Lic. No.. 618140f`f`Jtdi�� ----------------------------------------------- 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 569-0000490 _ 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. plicant: WARNING: FAILURE TO RE WORKERS' C ATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL -PE ALTIES 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 �CC county ordinances and state laws relating to building construction, and hereby authorize representatives of t�hi oursty to enter upon the above-mentioned grope r ins tion purposes. Ddt6: (%U 'nature IAppli�ant o Application Number 09-00001170 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 22.50 Plan Check Fee.. 5.63 Issue Date . . . . Valuation . . 0 Expiration Date 5/03/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 ---------------------------------------------------------------------------- Special Notes and Comments - INSTALL 40'GALLON GAS WATER HEATER. 2007 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 CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -1R Project Title Date SEALED DUCTS and TXVs (or Alternative Measures) A signed CF -411 Form must be provided to the building department for each home for which the following. are -e aired. OR — — ❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for Proiect Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14. OR For additions and alterations, duct systems that are not documented to have been previously ❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D. WATER HEATING SYSTEMS Distribution Type ❑ Sealed Ducts (all climate zones) (installer testing and certification and HERS rater field verification required.) ❑ TXVs, readily accessible (climate zones 2 and 8-15 only) Standby Loss (%) (Installer testing and certification and HERS Rater field verification required.) ❑ Refrigerant Charge (climate zones 2 and 8-15.only) (Installer testing and certification and HERS Rater field verification required.) OR — — ❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for Proiect Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14. OR For additions and alterations, duct systems that are not documented to have been previously ❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D. WATER HEATING SYSTEMS Systems serving single dwelling units Water Heater Tye/Fuel T e Distribution Type Number. in System Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per ❑ dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is Standby Loss (%) not allowed. ❑ Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential Manual. No.water heating calculations are required, and the system complies automatically. Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved ❑ Alternative Water Heating table. In this.case, the Performance Method must be used and must be included in the Submittal. ❑ Check box to verify that a time control is required for a recirculating system pump for a system serving multiple units Systems serving single dwelling units Water Heater Tye/Fuel T e Distribution Type Number. in System Rated Energy Input' Tank Factor' or (kw or Capacity Thermal Standby Bhdhr) (gallons) Efficient Loss (%) Tank External Insulation R -Value bs Standby Loss (%) Tank External Insulation R -Value oLta Lt, System serving multiple dwelling units Water Heater Type Distribution Type Number in System Rated Input' (kw or Btu/fir) Tank Capacity (gallons) Energy Factor.' or Thermal Efficient Standby Loss (%) Tank External Insulation R -Value 1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat pump water heatersjist Energy Factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe Insulation (kitchen lilies > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are' /a inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 (j) 2 B. Residential Compliance Forms March 2005 Bin # Qty of La Quinta Building u Safety Division Box 1501, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #\ ,l 0 ok - 0 __- Project Address: Avrkk4C,,'c3'A Owner's Name: — Va' A. P. Number: Address: S1300 AV",Y\IAN Legal Description: City, ST, Zip '�4 Contractor: Telephone: Address: l z d S SA Project Description: City, ST, Zip: Y-C, P�k CA Telephone: Ltso Z3 . . . . . . . . . . . . LAP State Lic. L1 City Lic. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lie. 4: Project type (circle one): Now Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: l !o 0 APPLICANT: DO NOT WRITE BELOW THIS LINE it Submittal Req'd Rec!d TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural CaIcs. Reviewed, ready for corrections Plan Check Deposit Truss Caics. Called Contact Person Plan Check Balance. Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanic -at Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees