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08-1832 (PLBG)C P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253. Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: 4 BUILDING& SAFETY DEPARTMENT, BUILDING PERMIT 08-00001832 54825 AVENIDA RUBIO 774-291-016-4 -000000- PLUMBING COVE RESIDENTIAL 500 Applicant: Architect or Engineer: ----------------- 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: C36 License No.: 8282 Date: so Contractor ,;y 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 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 ISec. 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 herebyaffirm 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ' Date: 11/07/08 Owner: ALBERT TOLFE LEE 54825 AVENIDA RUBIO LA QUINTA, CA 92253 ( Contractor: D �"L! FOY, SCOTT A. 43579 MAIN STREET INDIO" CA 92201 NOY 07 2008 (760)775-9405 liU Lic. No.: 828264 ��F LA QUTAl4A WORKER'S CO MPENSATI ON, DECLARATION I 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. 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 FIRST COMP INS Policy Number ' WS1004457 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' c pensation provisions of Section 3700 of the Labo Code, I shall f hwith comply with t o e ovisions. 1, DatV/ Appljca t:` WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND HALL 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. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authonz a resentatives of this co my to enter upon the above-mentioned pr rt for inspect/lion purp9ges. Date�gnature (Applicant or Agentli Application Number . . . . . .08-00001832 Permit PLUMBING Additional desc . Permit Fee . . . 22.50, Plan Check•Fee 5.63. Issue Date . . . . Valuation . . 0 Expiration Date 5/06/09 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 WATER HEATER WITH NEW ELECTRIC 50 GALLON WATER HEATER. Fee summary Charged Paid Credited Due -- ---------- ---------- Permit Fee Total 22.50 ---------- .00 ---------- .00 22.50 Plan Check Total 5.63 .00 .00 5.63 Grand Total 28.13 .00 .00 28.13 CERTIFICATE OF COMPLIANCE: RESIDENTIAL .(Page 3 of 4) CF -IR Project Title Date SEALED DUCTS and TXVs (or Alternative Measures) A signed CF -4R Form must be provided to the building department for each home for which the following. are reauired. OR ❑ Alternative to Sealed Ducts and Refrigerant Charge /T'XVs (See Package D Ahernative Package Features for Project Climate Zone in the RM Appendix B Table 151-0, 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 sttaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D. Y :1 a Yh Y u Distribution Type ❑ Sealed Ducts all climate zones(Installer testing and certification and HERS rater field verification required. 1 TXVs, readily accessible (climate zones 2 and 8-15 only) Standby Loss % (Installer testing and certification and HERS Rater field verificationrequired.) Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field ❑ verificationrequired.) OR ❑ Alternative to Sealed Ducts and Refrigerant Charge /T'XVs (See Package D Ahernative Package Features for Project Climate Zone in the RM Appendix B Table 151-0, 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 sttaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D. Y :1 a Yh Y u epirving s' dw amts Water Heater Type/Fuel Type Distribution Type Number in System Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per Tank Capacity Ions dwelling unit. if the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is Standby Loss % not allowed. Check box when using Preapproved Alternative Water Heating table. Table 513 in Chapter 5 in the Residential ❑ Manual. No water heating calculations are required, and the system complies automatically. Tank Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved C3 Alternative Water Heating table. In this case, the Performance Method:must be used and must be included in the Water Heater submittal. Number Check box to verify that a time control is required for a recirculating system pump for a system serving multiple ❑ units epirving s' dw amts Water Heater Type/Fuel Type Distribution Type Number in System Input' (KW or EW") Tank Capacity Ions Energy Factor' or Thermal i Efficiency Standby Loss % Tank External insulation R -Value bbd Tank Factor' or External Water Heater Distribution Number (kut W or Capacity Thermal -Standby Insulation Type Type in System Bw/hr tons Efficient Loss % R -Value Q__*__ —wsinn mnl"Vaa AWAINISo nnitc 1. For small gas storage water heaters (rated inputs of less than or equal :to /5,000 t5nvnr), eiecu-ic restsrame, and nc-4i pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/ttr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe I>a u6tion (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/n inches or greater in diameter shall be dwrmally insulated as specified by Section 150 0) 2 A or 150 0) 2 B. Residential Compliance Forms March 2005 Enerp• Tank Rated i Tank Factor' or External Water Heater Distribution Number (kut W or Capacity Thermal -Standby Insulation Type Type in System Bw/hr tons Efficient Loss % R -Value .J L_ 1. For small gas storage water heaters (rated inputs of less than or equal :to /5,000 t5nvnr), eiecu-ic restsrame, and nc-4i pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/ttr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe I>a u6tion (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/n inches or greater in diameter shall be dwrmally insulated as specified by Section 150 0) 2 A or 150 0) 2 B. Residential Compliance Forms March 2005 Bar # City of La Who Burg 8i Safety Undon Pem* # �ZP.O. Box 1504, 78-495 caneTmwko dloo !a Qtdnta, G4 92253 - (760) 777-7012 BLd -Permit Applicadon and Tracking Sheet / Project Address. T _V,0 • KL09 l (� Owner's Nene: Q l aj A.P. Number Legal Dc=40m: con�e��c City, ST, ZipaaLA 4 5 Teicpbone: _ Address / '�' • Project Description: city, ST, Zip. `% , , / i Tdephone: J State Lie. #:r4�tloq I City Lic. #5LI7 Arch, EW., Dia. Address: City, ST, Zip: Tom' on Type: icy: �7: State Lk. #: e (circle one): New Add'n Atter Riepair Demo Name of Contact Person: Sq. FL: ffi Stories: Telephone # of Cont Person: Estimated Value of Project Q Q ' 0 APPLICANT: DO NOT V11M BF1.OW THIS LWE # Sabvimr Beq'd «Beed TRACKMPERBOT FM Pin Seb Pian Check sabntltted Item Amoaat StructmW Cara. I Reviewed, ready for corrections Pian Check Deposit Trans Cala. CREW CoasactTerson Plan CDedc Baiaea 716e 14 Calm Maas picked up Co:straction Flood plab om l Plans resubmitted p � pl- r! Review, ready for contttiooWiuoe Ekcbicai Subcoutactor List Caped Col pawn Plumbing Grant Dad Pisus picked up &POLL HAA- Approval Phm raaimmitted Grading IN HOUSE:- '"` Review, ready for mnvcdoa A=m Deveioper Impact Fee Planning An"wal Caw Coutaet Person AA -P -P. Pub. Wb- Appr Date of permit issue Sterol Fees Total Permit Fees C