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14-0249 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 14-00000249 Property Address: 51470 AVENIDA CARRANZA APN: 773-082-011-14 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 800 Applicant: Architect r BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the B iness and Professionals Code, and my License is in full force and effect. License Class: C 6 License No.: 936147 X / Da Contrac 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, 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. , 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: LQPERMIT Owner: PAULETTE ALCALA 51470 AVE. CARRANZA LA QUINTA, CA 92253 Contractor: STATEWIDE SERVICES I 83780 CORTE SOLIS COACHELLA, CA 92236 (760)984-0126 Lic. No.: 936147 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/10/14 � 0 2a1a h1aR '� CIN ! LA 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 MART EL INS CO Policy Number MWC0044634-03 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner o as to become subject to the workers' compensation laws of California, and agree that, if I o Id become subject to the workers' compensation provisions of Section � yy 3700 of the Lab Co e, I shall forthwith comply wi those provisions. D:� Applic�� _ 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 (5100,0001. 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 issuaAte mit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and statinformation is correct. I agree to comply with all cit and county ordinances and state laws relatinnstruction, and hereby authorize representatives o t s c u ty t n r upon the above-mentioneaction purp s. Date: Signature (Applicant or Age Application Number . . . . . 14-00000249 Permit . . . PLUMBING 2013 Additional desc . . Permit Fee . . . . 11.92 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/06/14 Qty Unit Charge Per Extension 1.00 11.9200 EA PLBG WATER HEATER/VENT 11.92 ------------------------------------- --------------------------------------- Special Notes and Comments WATER HEATER CHANGE OUT - 40GALLON/GAS [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CBC ---------------------------------------------------------------------------- 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 LQPERMIT Pemlit # City of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Permit Application and Tracking Sheet ect Address. Vi Owner's Name: . Number: FA. I Address:al Description: , City, ST, Zip: Contractor: jd (� I Telephone: Address: Lt K h v Project Description: fe City, ST, Zip: Telephone:: WON State Lic. # . City Lie. Arch., Engr., Designer. Address: i City., ST, Zip: I . Telephone: Stat c. #: % : h s. _ .�. Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo .Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: `� L I Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd ' TRACKING PERMIT FEES Pian Sets Plan Check submitted Item Amount structural Caics. Reviewed, toady for corrcctloaa Plan Check Deposit Truss Cabs. Called,Contact Person Plan Check Balance. Title 24 Calcs Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan Z°' Review, ready for correctionsliissue Electrical Subcontactor List CalledlContact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`a Revl'ew, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Tota] Permit Fees -Prescriptive. Certificate of Compliance-, Residential. • CF -IR -ALT. DHw- Residential Alterano is Page l of 2 Project Name: a ne: Permit #: General Information Site Address: Enforcement Agency: Date: Building T in le Family 0 .Multi Family Project T Re lacert>ent or Change Out of Water Heater WATER HEATING r installed water heaters and boilers for bush domestic hot ureter heaters- (D WH) and lritlronic space heating. Ne%4hy installed List neu4 m MH hea►ers and boil' rs must be gas. propanc, or use the existing el type. p�� Type Water her Numtxx In Tank E11eTBY Factor or TYPOT—q Type, R ( System Capacity (gal) T wnnal Efficiency External Tank Insulation R-Vatue' 01 building design on the other applicable eomplianoe fortes, worksheets, calculat' plans and specifications submitted to the enforcement for approval with this buildingit ikmdon. Name: t� _ (/ vt Sibnaruae: convoiy: i Date: 1. Indicate Type (Storage Gas. Heat Pump: Instantaneous. etc.) 2. Recitrularing systems serving multiple dwrlting units shall meet the recirculation requirrtnents of §lAn). requirements do not allow the insralixion of a mcirrWating water heating .system for single dwelling units. 3_ The etternal water heating tank and pipes shall be insulated to meet the re uiretnents of J 150(j) - The Prescriptive. Contractor or Hoaaeowner (Documentation Author'stResponsible Building Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Catifu=e of Compliance. • I certify the the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of T-tdc 24, Part t 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 documeru this building design on the other applicable eomplianoe fortes, worksheets, calculat' plans and specifications submitted to the enforcement for approval with this buildingit ikmdon. Name: t� _ (/ vt Sibnaruae: convoiy: i Date: CirylStatorGp: Phone: .. � Os/OGGy ^,' ` U