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09-0074 (PLBG).01 ; P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: - 09-00000074 Property Address: 51895 AVENIDA RUBIO APN: 773-161-019-8 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 800 Applicant: Architect or Engineer: I� °f �wa�rw 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. License Class: 13 -C10 -C36 License No.: 811114 ate: 1►ru Jtractor. , 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.). 1 _ 1 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 orimprovesthereon, 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: AMMERMAN DENVER D 51895 AVENIDA RUBIO LA QUINTA,- CA 92253 Contractor: CALIFORNIA DELTA MECHAN JI 6052 E..BASELINE RD, #1 MESA, AZ 85206 (480)898-0007 Lic. No.: 811114 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/30/09 D JAN 3 0 2009 ,kL I&ITY OF LA QUINTA ----------------------------------------------- WORKER'S COMPENSATION DECLARATION - hereby affirm under penalty of perjury one of the following declarations: (,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 1697823 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 1 3700 of the Labor Code, hall fo with comply with those provisions. ate.- /plicant: 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 J$1 00,000). 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 to enter upon the above-mentioned property f insp�urposes. Jai ignature (Applicant or Agent): Application.Number. . . . . . 09-00000074 Permit . . . PLUMBING Additional desc . Permit Fee' 22.50 Plan Check Fee 5.63 Issue Date Valuation . . . . 0 Expiration Date 7/29/09 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 WITH LIKE UNIT ------------------------------------------- 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 California Delta Mechanical Inc. 1.235 Grand Ave, Spring Valley,CA 91977 Phone 61.9-307-0032 Fax 480-844-8844 Affidavit that Power of Attorney is in Full Force STATE OF CA, 1, TONY KITCHUKOV, President of California Delta Mechanical Inc being duly sworn, depose and say: 5. The Principal within did, in writing, appoint me as the Principal's`triie-and lawful ATTORNEY-IN-FACT in the within Power of Attorney. 6. I make this affidavit for the purpose of inducing : Svetoslav Eveeniev Pavlov to pull and process .the permits in the state of California SWORN /bw�eforre me this � day of 1 ) ) A NotaVy Public ) OFFICIAL SEAL LYNN A. LAWTON NOTARY PUBLIC - State of Arizona MARICOPA COUNTY My Comm. Wires May 24, 2011 ✓ V X/ �/" ! y Jan. 30. 2009 11; 33AM STEVE No. 3869 P. 3 la CERTIFICATE OF COMPLIANCE: RESIDENTIAL Pae 3 of 4 MIR SEALED DUCTS and (or Alternative Measures) A signed CF -411 Form must be provided to the building department for each home for which the following. are Pp,,,, mA ❑ Sealed Ducts all climate zones Installer testm an certification and HERS rater field verification re ui ❑ TXVs, readily accessible (climate zones 2 and 8-15 only) Installer tasting and certification and HERS Rater field verification r uired. ❑ Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater fit verification required,) OR Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features Project 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 s aces shall meet the requirements of Section 150(m) and duct insulation requirements of Packaee D. 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 not allowed. theck box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential anual. No water heatingcalculations are required, and the system complies automatically, heck box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved lternative Water Heating table. In this case, the Performance Method must be used and must be included in the bmittal. heck box to verify that a time control is required for a recirculating system pump for a system serving multiple nits Cviatama aarwlnm aCnftlo A-111-..- --I" Water Heater Type Distribution Tvpe Number in system Rated Tank External Standby' insulation Loss (%) R -Value Ener Tank _Efficiency Input, Tank Factor or External Water Heater Distribution Number (kw or Capacity Thermal Standby I Insulation Type/Fuel Type Type in System Btu/hr) aeons Efficiency Loss % R -Value G 4 Qp Water Heater Type Distribution Tvpe Number in system Rated Energy Input' Tank Factor or (kw or Capacity Thermal BiAr) (gaMons Tank External Standby' insulation Loss (%) R -Value _Efficiency ...• a»- ......6. .,µ.., „maav,a %lowu ,,,puts v, rose lrlttn or aqua, w n,uuu rsrwnr), eloctrtc resistance, and heat pump water heaters, list 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, PW* Insulation (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are % inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 Q) 2 B. Residential Compliance Forms March 2005 1 Jan,30. 2009 11:33AM STEVE 111h # Permit N Project Address; A. P. Number: Address: 6=4 ? City, ST, Zip: TOiepho wo 0 11 State Lic. N :-31111q Arch., Bngr., Deslpar. Address: City, ST, Zip: Telephone; State Lie. N: Name of Contact Person, Telephone M of Contact P Plan Sets Struetaral Calces, True CRlta. Title 24 Cale& Mood plain plan Grading plan Subcontactor Lilt Grant Deed HOA. Approval IN HOUM. Planning Approval Pub. Wks. Appr School Fees No, 3869 P. 2 City 0f'.a QuInta Building alt Safety DlvUlon P.O. Box 1504, 78.495 Calk Tampico U Wnta, CA 92253. (760) 777.7012 Building Permit Application and Tracking Sheet Owner's Name: Addross City, f, Zip: WTelephone: (lI✓ �� Project Description: Lia N: Total Permit Fees Constructlon Types Occupancy; Projeot We (cirole one): Now Add'n Alton Repair Demo Sq. Ft.: N Stories. N Units: Estimated Value of Project: APPLICANT- 00 NOT WHITE BELOW THIS LINE Recd TRACMG PSRMIT FEES Plao Check submitted Item Amount Reviewed, ready for eorrectlow Plan Check Deposit Called Contact Pe"06 I Plan Check Balance Pious picked up Comtructlon Plus resubmitted Mechanical '2" Review, ready for correctlom/iwue Metrical Called Contact Pamn Plumbing Pleas picked up S M L Plan resubmitted Grading Review, rea4y for earreetionelissue Developer Impact Fee Called Contact Person A.I.P.P, Date of permit issue Total Permit Fees