13-0499 (PLBG)P. dOX 15N
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
13-00000499
53781 AVENIDA CARRANZA
774-155-014-4 -000000-
PLUMBING
COVE RESIDENTIAL
700
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Bu ess and Professionals Code, and my License is in full force and effect.
License Class: C36 License No.: 936147
Dateq 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 1, 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 contractnrs 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:
LQPERn11T
Owner:
JOHN BRITSCHGI
53781 AVENIDA
LA QUINTA, CA
(
Contractor:
STATEWIDE SERV
40244 CATANIA
BERMUDA DUNES, CA
(760)636-0315
Lic. No.: 936147
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Date: 4/22/13
92203
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 1948371
.) 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
p��I 3700 of the Labo�del l forthwith comply with those provisions.
Date: Z) dr' App
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. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned prop ty for inspection purposes.
J
Signature (Applicant or Agent):
Application Number . . . . . 13-00000499
Permit _ . . . . . PLUMBING
Additional desc . .
Permit Fee . . . . 22.50 Plan Check
Fee
5.63
Issue Date . . . . Valuation
. . .
. 0
Expiration Date 10/19/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA- PLB WATER HEATER/'VENT
7.50
------------------------------------------------ ---------------------------
Special Notes and Comments
WATER HEATER.CHANGE-OUT - 50 GALLON
ELECTRIC WATER HEATER [2008 ENERGY]
CARBON MONOXIDE, ALARMS) TO BE•INSTALLED
PRIOR TO FINAL INSPECTION. 2010
CALIFORNIA BUILDING 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
LOPER1171T
•Prescri five Certificate of Com lianee; Re'sidentiae. CF-IR-ALT-ALT:.4..
Residential Alterations Page t of a
Pm'ect.Name: Climate Zone:
General information
Site Address:. nforcement e ,
Buildin T Sin le Family ❑ Multi"Pamily Project T e lacerrnent or Change Out of Water Heater
WATER HEATING
List newlr installed water heaters and boilers for both domestic hot nater heaters•(DWH) and h�+dronic space heating. Ne%44Y installed
DWH heaters and boilirs roust be as. e. or tae the existingel h .
Water d ata � ��
Typdr"ef Type, Rec
Numba In Tank E gy Factor a
System Capacity (gal) thermal Efficiency
vTo
Extemal Tank
Insulation
R-VaksO
W
0 MTIA
1. Indicate Type (Storage Gas. Heat Ptutrp. Instantaneous. etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of f l An).
requirements do not allow the installation of a recirculating water heating systene for single dwelling units.
3. The evernal Kier heating tank and pipes shall be insulated to meet the requirements of 115OU11.
The Prescriptive.
Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement)
• 1 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 Cetifumte of Cor*iarnce.
• 1 certify that the energy features and performance specifications for the building design identified on this Ceniftcate. of Compliance
conform to the requitemarts 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 cont oiance fortes, wotkshoem calculations. plans and specifications submitted to the
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s r I I AOA i
.ice, ._ IrMM
W01. 011i 11M.
W
0 MTIA
A? L
T.zTIIGN CERTIRCA
-Domestic Hot Water (DHW)
7-u
Enfb rcem en -' A-zen, cy.,
CF-6111-I'VIE-CH-01
'Page i of 2)
Permit 'N'umber:
Moie j: Fors'FludIgal star4ga 6-arad ikuu:`Iess [---'saw or emial x 7.re.)0 slecrdc :�E:ZuAairn� ond hect Du.-Y.D water heaters. !ZFt
Reca-ven 4ff"':ienj;'v ORE .
n -I -gt7C!O;- fEr-I -jaq ssfom -c rha, s �rwzd ljmr of greaferh��.- ils- I
;. Foi �aga- ' gre ;t ue, - - Pers --u- . .75� 0,9e. BI_
7-hermal Efflxienq� Standire Lois and.;Q-ele li-m-niz, -F-O;- invan.-c-r-i-r—t- as heaie?s' HS.- ij'.z 11'en-a-
�jtlC:3iti :'and R,,., --d- Inrini.
TO COA-Pl LY -.ALL BOX.E-S A-1-ILTS] BJf-CHECI=I'
I I 0-§.l 13; War., heaters-, ah sra ceirti4
-d =d
I 550(j): Water System Pipe and T� I hk,lasulaz-ionn. -4-?CLoling Line
1. -Starage rank ing-dation
tai A. Storage psvvaieef- Bede s- rai-ed vv`nh an, Fn-czor --110 +.0-i:he feder?l sm-ndard am
externatly xvreapped with ins-uhrion -havin-c a.m. :r--�Lnadldd -e_ofra-zis= f"R, !2 or zreare;- ILM-C
El 3- Unfired s..'orage mnks or olh-er indirecir hol I-varer maks ha -,-V= a ex:remiai :2---ula60n or R -I 6 htemaj
c -l-
Aar aaa .c - and conducr,iry
OiLuz S:'V5z';e-:'n 'Me in:,L-d
-- r, GF -hot and co'!d -wa. 'i3es closes.- to war rnns, and eaure
irZa- ; I -- vI- _e_ -Y-
ie
icne o--r,-c um u.; a LW z Stenon e f ha-, wa«r ar= i -n sul ar"d ner v• aada-Lc -1- h-- e i 0-3: -ad
Pipe insuiation f-ar hoy ndc szvsremus or h-13-1 VfE;[Crs'Vz-I-MS >1-5 psl
Standa-L ds 71 a-ble j 23�-A.l
F"culabon isLected f-rom darna2:e. In-clu"mi- thE�- eme E0 nnoisbure. equnpimenE niamien
rjro�- auce, and
§ 15 11 t)SD: Tfindicued on th z -R- aLl hio� waier �-;:Piaiz I'mr.- d.-, hot 'Vater source 'o 1he :Kftchen Ifi-xtures is
ecc -7
insulated per Sit-ndards Table '11 5512-B.
'008 Reside7ifi-q! GoinvErame Fomli
Aua"2009
T-ce
I F
is T
i
Hzale;
Ceniad �tvtl�
Rucu -.-
i;,-! I
Lo
TIW
I 'NEGfeel-
1 US i -C)
Tyne
iEBEL-=-)
f
Moie j: Fors'FludIgal star4ga 6-arad ikuu:`Iess [---'saw or emial x 7.re.)0 slecrdc :�E:ZuAairn� ond hect Du.-Y.D water heaters. !ZFt
Reca-ven 4ff"':ienj;'v ORE .
n -I -gt7C!O;- fEr-I -jaq ssfom -c rha, s �rwzd ljmr of greaferh��.- ils- I
;. Foi �aga- ' gre ;t ue, - - Pers --u- . .75� 0,9e. BI_
7-hermal Efflxienq� Standire Lois and.;Q-ele li-m-niz, -F-O;- invan.-c-r-i-r—t- as heaie?s' HS.- ij'.z 11'en-a-
�jtlC:3iti :'and R,,., --d- Inrini.
TO COA-Pl LY -.ALL BOX.E-S A-1-ILTS] BJf-CHECI=I'
I I 0-§.l 13; War., heaters-, ah sra ceirti4
-d =d
I 550(j): Water System Pipe and T� I hk,lasulaz-ionn. -4-?CLoling Line
1. -Starage rank ing-dation
tai A. Storage psvvaieef- Bede s- rai-ed vv`nh an, Fn-czor --110 +.0-i:he feder?l sm-ndard am
externatly xvreapped with ins-uhrion -havin-c a.m. :r--�Lnadldd -e_ofra-zis= f"R, !2 or zreare;- ILM-C
El 3- Unfired s..'orage mnks or olh-er indirecir hol I-varer maks ha -,-V= a ex:remiai :2---ula60n or R -I 6 htemaj
c -l-
Aar aaa .c - and conducr,iry
OiLuz S:'V5z';e-:'n 'Me in:,L-d
-- r, GF -hot and co'!d -wa. 'i3es closes.- to war rnns, and eaure
irZa- ; I -- vI- _e_ -Y-
ie
icne o--r,-c um u.; a LW z Stenon e f ha-, wa«r ar= i -n sul ar"d ner v• aada-Lc -1- h-- e i 0-3: -ad
Pipe insuiation f-ar hoy ndc szvsremus or h-13-1 VfE;[Crs'Vz-I-MS >1-5 psl
Standa-L ds 71 a-ble j 23�-A.l
F"culabon isLected f-rom darna2:e. In-clu"mi- thE�- eme E0 nnoisbure. equnpimenE niamien
rjro�- auce, and
§ 15 11 t)SD: Tfindicued on th z -R- aLl hio� waier �-;:Piaiz I'mr.- d.-, hot 'Vater source 'o 1he :Kftchen Ifi-xtures is
ecc -7
insulated per Sit-ndards Table '11 5512-B.
'008 Reside7ifi-q! GoinvErame Fomli
Aua"2009
Bin #
_
City. of La Quinta
Butlding SL Safety Division
P.O. Box 1504,'78-495 Calle Tampico
Ca.Quinta, CA 92253 - (760) 777-7012
Building Permit Application' and Tracking Sheet
Permit #
l
ProjectAddcess6_.Ownu'sName:.
A. P. Number.
Address: 45 .1 5 1 r
Legal Description:
City, ST, Zip: Lou n4c,
Contracto . (C
V i " .e S
Telephone: —
Address:
( o
Project Description:
City, ST, Zip:
Telephon4, 3 -6
I S0110.71,1a=
State Lie. 47.3
City Lic. #;
Arch, Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Y" `
7
'�'
:„'
Construction Type: . Occupancy:.
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES-
Plan Sets
Pian Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss C21cs.
Called Contact Person
Plan Check Balance.
Title 24 Calci.
Plans picked up
Construction'
Flood plain plan
Plans resubmitted '
Mechanical
Grading plan
V Review, ready for corrections/'issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.KL
iLO.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'n° Review; ready for correctionsrmue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I-P.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees