09-0605 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: e09=000006055
Property Address: 49920 LAGO DR
APN: 658-270-024-24 -3941. -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1435
Applicant:
Cf /
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 Business and Professionals Code, and my License is in full force and effect.
LicenseClla�ss: C36 ` License No.: 880269
ontractor: , v
O ER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am pt 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 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.).
(_) 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:
HART PATT B
P O BOX 914
LA QUINTA, CA 92253
Contractor:
BENJAMIN FRANKLIN PLUMB
2712 E. LA CADENA DRIVE
RIVERSIDE, CA 92507
(951)276-9744 1
Lic. No.: 880269
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/09/09
JUN 0 9 2009
r OF LA Q1jINrq
'JNAp- r
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 NTL FIRE INS Policy Number WC6506596
_ 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 %Zqde, I shall forthwith com with those provisions.
Dat licant:'
WARNING: FAILURE TO SECURE WORKER CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN'A 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 building construction, and hereby authorize representatives
of this county tto1 eenntt�er upon
the bove-mentioned pr arty for inspection pu ses.
Date: v 'S' ature (Applicant or Agent).
` Application Number . . . 09-00000605
Permit . . PLUMBING
Additional desc'.
--Permit Fee 22.50 Plan Check Fee
5.63
Issue Date . . Valuation . . .
. 0
Expiration Date 12/06/09
Qty Unit Charge -Per
Extension
- BASE FEE
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
----------------------------------------------------------------------------
7.50-
Special Notes and Comments
REPLACE 40 GALLON GAS WATER HEATER
LOCATED IN GARAGE. 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
Bin #'
City of La Quinta
Building & Safety Division
P.O. Box 15.04, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Dq,10"
Project Address: L4qT)o 7 Q T)'i' 1 V '�,
A. P. Number:
Owners Name: pa iQ�
Address: L"\R-�-o �� lV
City, ST, Zip: 0. 9 as z4 -j
Legal Description:
Contractor: Q \,,
�C \\Jj61 '\
Telephone: " y1 "3j%%' .�•;:::>.% 5, .).; ,F
Address: 6 1
�r l
City, ST, Zip: Q aVa
ivk'•f?'.•iys%�vTelephone: :nf>sr »{:>Ifq:>?'4:•x<{.j'j,i<f: ti>�
Project Description: !Ao
r- LE"
W
V
State Lic. # : C
City Lie. #;
Arch., Engr., Designer:
Address: --�
City, ST, Zip:
-- `:1..v4'•y.l� 4yy 'v •�.., ... 4}:•:k11 t'ri.:4 v
Telephone: v.N;,�{. �4.•�, 4�•.��Y?C•`{4f
,•<
State Lic. #c — . `% a%f % `�s o $6J
Name of Contact- Person:
-
Construction Te: Occupancy.
Project type circle one): New- Add'n Alter Repair Demo
) '
Sq, FL:
#-Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: (o
APPLICANT:
DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Plan Sets
Req'd
Recd
TRACING
Plan Check submitted
PERMIT FEES
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cale s.0
Called Contact Person
Plan Check Balance,
Title 24 Calcs.
Plans picked no
--
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up.
S.M.1.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review,.ready for correctionsfissue
Developer Impact Fee
PlanningApproval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School. Fees
Total Permit Fees
CERTTExCt� 'E OF COMPLIANCE-. ZZESZD WTZA,L
T) (Pa e l of 4 CI+'-IZZ
Project Title
Date
oJCO Address
Building Permit I
Docum: tibnAuthor �`�b�Y� Tel ^ P1anCtxek/Date
. v cphonc
Cotinplianoo Methal (Prrsaiptive) Fidel Chock1 Daly.
ate Zone .
Fn m"o C g Agency Use only
{ D Altereative Component Package Method: (dtXk one
• )
Package C and P- C D D (Alternative) .
ackage D choices r ire HF,RS rater field verification and/or d'
Foe Padkage D Altemativ� see A Rgnostic testing (see CF-1 R page 3)"
Ppendix.8Trble-151-CFobtnotcs 7=14
GENEIZ" Mop MA TALON
Total Conditioned Fioot/+,tea /
(CFA) " > Aycrage Cb-li . Height;. ft
Maximum Allowed WastFacing Febc�tmdon• --
Maximu m AUowcd 1`otal F Pei Table I5I-B of I51-C �-. (SiG X CFA) .
a'cs'rat" Products Pet Tabk 1514§ or 151-0 (p�/ X 5% X - ft
f Q Dw1 ' •
Wyk (chock one or more) Single Fatnil
. of adding fatestration fill-out WS-q . .F y ' MulGfamt7y Addition Altrration
for Additions and 8;33 fol Alterations. ettesstraattoa Maxitnuin / Bow cd Arra •Wocksltoct and sec Sodion 832 -
- Number of Stories` .
Number of Dwelling unity
.P
Boor
conse"°" 7*- S1aWRaised Floor (crrcic Q. a of both)
Noe& and circk•oae)-
Nor' / South / Fast/ West /All OcieataGoas.Cmput tib ocientatioa in dcgt,ccs from Trus
0. RADIANT 13ARMR
kedin climate zones 4 8-1
OPAQUE SVRRACES INCLUDING np
. AOLJE DOORS
Component .
(H'all, Frame Assembly U-
Roo4 F19ot, factor (for joint. Roof Radiant
Srab'I?d Cavity Continuous, iwod. metal
gti (Wood Ins<tlatioa .Insulation tininze and mass $Q�Cotntinatts
Doors otM R-Value IY Installed (attiC6p aM
R Valera. assunblie$ t Refarnce Yes orNo ical, etc. .
1) See loint.AppendixdY in Section IV-2„- IV-3 ,and IVA. Which Is the basis for the U-factor criterion, U-faders can not
axcccd prescriptive. value to show equivalence to R•values:.
t
CERTIFICATE OF COMPLIANCr:
RESIDENT
} IAL
far
Project�i le U -A
-�
Date .
SEALEDpU . nd TXVs or Alternative Measuires
A signed (�.4R Fonn must be- provided to the building d
7v
uired, g eparhnent for each home for which the following are
❑ ' Sealed Duds all climate zones Installer testis
TXVs readily. certification and HERS rater.field verification aired.
❑' Y alible (dimate. zones 2 and 8-15 only) .
11ristaller-testing and oertifigtion and HERS Rater field verification fired:
. Refrigerant Charge (climate zones 2 and 8-15 only).(Installer
veri5ration fired.
testing and rectification and HERS Rater field
oft
b . Atternativeto Sealed Duds and Refri
Pi'o'ect climate Zone in the RM g dix Charge /T7CVsFoot Package D Alternative Package Features for
OR " dix B Table 151: Footnotes y-14.
For additions and alterations, ductsystems that are not d
❑ . sealed as confirmed through field verification and di ocumented to. have been previously
Residential AC M Manual and dud . agnostic testing in accordance with procedures in the
shall meet the d systems with more than 40 linear feet in unconditioned
WATER HEATING SYSTEcMS on 15. m and dna insulation uiremeats of Package D.
`Checkbox if system meets criteria of a "Standard
dwelling unit. If the water heater isa „ system' Standard syr is one g s-5red water heater per
not allowed dome tYm SO gallons is the maximum Capacity and. recirculation system is
❑ Check box when using preapproved Alternative Water
}i Morand. No water h Calculations are HeatiBg table Table 5-4 in -Chapter 5 in the.Residential
Check box if system does not meet and the stem oo lies autornaticall .
Alternative Water H criteria of "Standard" sysAem, and does not o0
ming table. In this case, the Performahce M mPly with the roved
.submittal: ediod must be used and must be included in the
Check box to verify that:a time control is required bra.
units recirgrlating system pump for a system serving multiple
stems se in sin a dwe[lun :units
Rated Ea Tank
Water Heater Distribution Number. Input' Tank Factor' or F
ueI in (kW or Capacity. Themral Siartdby' Insulation
BAST . tons) Efficien Loss % R -Value
Rated
Water HeaterDistribution Number Inputs Tank
e.tem (kW er Capacity
in . s • Btulhr low
1. For small gas storage water heaters (rated inputs .of less than or
'
Factor or
Therrial '
Efficien
Standby'
Loss %
'Tank
External
Insulation
R -Value
P—p water heaters, list En F larg .g equal to 75,000 Btu/hr), electric resistance, and heat
eaterBhe), list Rated Input, Recovery Effie epcy, (rated'thermal Efficiency d Standby Losse For instantaneouut of greater thans gas water
5,000
heaters; list Rated Input and Thelma] Efficiencies.
Piac Insulation (kitchen lines> 3/4 inches) All hot water i
inches or greater in diameter shall be thenmally•insulated as s p from the heating source to the kitchen fixtures that are'/
pacified by Section 150 (j) 2 A or 150 (j) 2 B.
Residential Compliance Forms
Mareh 2005