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BPLB2014-100778-495 CALLE TAMPICO LA QUINfA, CALFORNIA 92253 T4tr44Qumrw COMMUNITY DEVELOPMENT DEPARTMENT . BUILDING PERMIT Application Number: BPLB2014-1007 Property Address: 52875 AVENIDA CARRANZA APN: 773321006 Application Description: WATER HEATER CHANGE OUT Property Zoning: Application Valuation: $0.00 Applicant: D Q STATEWIDE SERVICES INC DBA STA 73804 DINAH SHORE DRIVE l(l ,.. PALM DESERT, CA 92211 CITY OF LA OU19TA nr.uw�NCiY DEVELOPMENT D EPARTMENI 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: _ License No.: 936147 Date: - ( C.. e`Contractgr: 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 Profession! 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.). (_) 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/29/2014 Owner: MARIA ARZAGA 52875 AVENISDA CARRANZA LA QUINTA, CA 92253 Contractor: STATEWIDE SERVICES INC DBA STA 73804 DINAH SHORE DRIVE PALM DESERT, CA 92211 (760)393-6115 Llc. No.: 936147 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: CarriN._ 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 !,4t, if I should become subject to the workers' compensation provisions of Sec ' n 3 00 of the Labor Code, I shall forthwith comply with those provisions. Date: O Applican . 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 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 ci to enter upon the above- mentioned property for inspection purposes. Date: / ignature (Applicant or Ag DESCRIPTION CITY AMOUNT PAID PAID DATE FINANCIAL INFORMATION ACCOUNT PERMIT ISSUANCE 101-0000-42404 0 $90.57 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $90.57 $0.00 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE WATER HEATER/VENT 101-0000-42401 0 $11.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE WATER HEATER/VENT PC 101-0000-42600 0 $7.15 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $19.07 $0.00 TOTALS:$109.64 $0.00 ----------.'--- - --- --- J . 2014-07.-25 08:59 Installed -Sales #208 7603934062 >> P 1/2 Bin #I. City of b Quffito - AWK of Division Burldrng 8z ety Permit i P.O. Box 1504, 8-495 Calle Tampico La Quinta, CA 922 3 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: 5 Q V tt7 Owner's Name: fflv1 , A. P. Number: Address: a.734V y. cyl�1 Legal Description: City, ST,V* &,,t&Liyx4q Contractor: Lc_ y 'x. -«mss Address: v LL 10 -.I. -a Project Description: 12 City, ST, Zip: 6 rIA1- G Telephone - U�"`EM State Lie. # : CityLic. R: I Arch., Engr., Designer: g Address: City., ST, Zip: �� I Telephone: :,: �n2 .. ;�s< CAastructionType: Occupancy: Project 4pe (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. FL: ( # Stories: 9 Units: Telephone # of Contact Person: P �� �� � 0� Estimate Value of Project; (' - APPLICANT: DO NOT WRITE BELOW THIS LINE d Submittal Req'd Rec'd TRACKING I PERMIT FEES Plan Sets Plan Check submitted I Item Amount Structural Cates. Rcvitwcd, ready for correctioas I Plan Cbeelt Deposit Truss Caics. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted I Mechanical Grading plan 2°" Review, ready for correctionstivue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans pick -ed up S.M.T. H.O.A. Approval Plans resubmittedI Grading IN HOUSE: - Review, ready for correctlonsris�a Developer Impact Fee Planning Approval Called ContaetPerson I A.I.P.P. Pub. Wks. Appr Date of permit issue I School Fees Total Permit Fees 2014-07-25 09:00 Installed Sales #208 7603934062 >i> P 212 •Prescried . Residential, Pmiect Flame: Site � Build of Compliance. Residential. SCF-IR-ALT-DHW - � Page t of z CrRate Zane: Permit #: I 1t9 e. u' v'CU? . ' Enforcement A 4nc : Date: ily Multi Family . Proiect Type: Replaces of or change Out of Water Heater WATER HEATING .1 1 List newly installed water heater and boilers for both domestic hot seater ieatrrr(DWH) and htdronic space heating. Newf.v installed O1VH heaters and boilers mutt be as e, or use the existirt of nat Tank Water Hutt Disitrtwtan T� Numtxx n MIM orsulation T.ypdT iType' (Standard. Systan -Vatcte� Rec' I_ indieae 6Pe (storage Cos. Heat Piww Instantaneous. etc.) 2. Recirculating systems serving multiple dwelling units shall meet tiquirements recirculation requirements of VA11). The Prescriptive requirements do not allow the installation of a recirculating water heatinnwem for single duTtling runits. 3. The eaernal water heads tank and pipes shalt be insulated to meet the o Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Dechration htatement) • I certify that this Certificate of Compliance documentation is acwratI complete. • 1 am eligible under Division 3 of the California Business and Profions Code to accept responsibility for the building design identified on this Certifx=c of Cwnpliance_ • I certify that the cmgy features and performance specifications for building design identified on this Cc ificate of Coinpliatici at conform to the requirements of Title 24. Parti and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Conipliart�t are consistent with the information provided to document this building design on the other applicable coTpliance fomu, t+vo calcutattorm plans and specifications submitted to the emforccmeit agency for royal with this building it appli Na Stsnlaaua I r &41C i Y: Dat ` e• )' a City/Su�q ( RPhone: