11-0945 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-000.0.0945
Property Address:'
522054AVENIDA RAMIREZ
APN:
773-221-022-11 -000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENT -IAL
Application valuation:
1000
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LICENSED'CONTRACTOR'S DECLARATION
o`Cq QUINTA
-------:- .- FINS r €----- --- ---
WORKER'S COMPENSATION DECLARATION .
T-ihf 4 4v
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHERI JARROT
52205 AVENIDA RAMIREZ
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/01/11
LQPERMIT
Contractor:
Applicant: Architect or Engineer:.
STARRETT, DAVID D.
39.70.5 VIA CACHO D' 4
TEMECULA:, CA 92592
/
(951)514-9133
JI
�{
Lic . No.: 885220 201 .
-
cm'
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LICENSED'CONTRACTOR'S DECLARATION
o`Cq QUINTA
-------:- .- FINS r €----- --- ---
WORKER'S COMPENSATION DECLARATION .
I hereby affirm under penalty of perjury thk I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following: declarations: '
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B License No.: 885220
for by Section 3700 of the Labor. Code, for the performance of the work for which this permit is
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Date < tl ontractor: ' - •'
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. issued.
1 have and will 'maintain workers' compensation insurance, ;is required by Section 3700 of the Labor .
- ..x. i• , „
Code,. for the performance of .the work for which this permit is issued. My workers' compensation'
OWNER -BUILDER DECLARATION
insurance:carrier and policy number are:
. I hereby affirm under penalty of perjury that I am' exempt'rfrom the Contractor's State License Law for the
Carrier STATE 'FUND"c Policy Number 49.7
_
following reason (Sec. "7031.5, Business and Professions Codd Any city or county tha.vrequires a permit to
d certify that, in the performance of the work'for which this permit is issued, I shall not employ any
., construct, alter, improve, demolish; or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
•permit to file a signed statement that.he or she is licensed pursuant to the provisions of the Contractors State
and 'agree that, if I should b� _ Ie subject to the workers' compensation provisions of Section
License:Law-lChapter 9 (commencing with Section-7000)'of Division 3 of the Business and Professions Code) or
3700 of the Labor e, I hal forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any.violation of Section 7031.5 by
any a permit subjects the applicant -to a civil penalty of -not more than4ive hundred dollars ($500).:
te: �. 4WI cant - - - -
applicanPfor
1 1 I, as ownerof the property, ,or my employee's with wages as their sole.coiripensation, will do the work; and
_ •
. the structure is not intended or-offeredfor sale ISec. 7044, Business and Professions Code: The '
WARNING: FAILURE TO SECURE WO S' COMPENSATION COVERAGE is UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who buildsror:improves;thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO`ONE.HUNDRED THOUSAND
and who'doesthe work himself oi'herself through his or her own employees; provided that the,
- DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or`dffered for said. If; however, the building.or improvementis:sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. '
' —one year of completion, the owner -builder will have the. burden of proving that he orshe didnotbuild or
'
"improve for the;pu"rpose of sale.). ,. ';' r
APPLICANTACKNOWLEDGEMENT-
1 _) I, as owner 'of.tha property, am exclusively contracting with.licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044; Business,and-Professions Code: The Contractors' State License'Law does not apply to an owner of
conditions and restrictions set forth on this application. -
property who builds of improves thereon, and who contracts for the projects with a contractor(s) licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).whose
benefit work is performed under or pursuant to any permit issued as a result of this application,
I 1 I am exempt under Sec. B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, ihdimnify 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. ..
Date: Owner:
2. Any permit issued as 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
• CONSTRUCTION LENDING AGENCY
permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to building o struction, and hereby authorize representatives
of this co ty o enter upon the above-mentioned pr erty foli pection purposes.
Lender's Name:
�)
Si ure (Applicant or Agen
Lender's Address:
LQPERMIT
,+ a
Application Number . . . . . 11-00000945
Permit PLUMBING
Additional desc .
Permit Fee . . . . 22.50 Plan Check Fee
5.63
Issue Date . . . . Valuation . . .
. 0
Expiration Date 2/28/12
Qty Unit Charge Per
Extension
BASE.. FEE
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
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�:, :. . , Special,. Notes,• -and, Comments- .:..., _
INSTALL 50 -GALLON GAS WATER HEATER. 2010
CODES."
,
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Other :Eees' BLDG STDS.:ADMIN (SB1473)
1:00
Feed Charged Paid Credited.
-------------------
Due
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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
Prescriptive Certificate of Com liance: Re§idential CF-IR-ALT-DHW
Residential Alterations Page I of 2
Project Name: - 7-40S- GAN% a'Mi rCL• . Climate Zone: Permit #:
General Information
Site Address: CZ "(' nforcement A enc Date: i 9 t/
Buildin T Sin le Family❑ Multi FamilyPrdiect.T - Re• lacement or Change Out of Water Heater
WATER HEATING
• t certify that this Certificate of Compliance documentatiow is accurate and complete..
List newh• installed water heaters and boilers for both domestic hot ti-ater heaters (D WH) and h►�dronic space heating. Newh• installed
DIVH heaters and boilers must be gas. propane, or use the i.risting fiteI type.
• i certify that the energy features and perf'ormance.specifications for the building design identified on this Certificate of Compliance
Distribution Type*.:-
Water Heater Number In Tank Energy Factor of
(Standard,
Extemal Tank
Insulation
Type/Fuel TypeRecirndatin) z System Capacity (gal) Thermal Efficiency
R -Value 3
ro a^A-1/2
Signa
slid i✓ra /tJi �P'� /'L '�_
.
Company: Date:
7.
Address: License:
1� $g z2
1. indicate Type (Storage Gas, Heat Puanp. Instantaneous, etc.)
2. Recirculating systens serving muhiple dwelling -units shall sneer the recirculation requirements of §150(n).
The Prescriptive
requirements do not allow the installation of a recirculatin&vvater heating sistem for single dwelling ztnits.
3: The external water healingtank and pipes shall be insulated to meet the re uireuitents of § 150(j).
Contractor or Homeowner'(Documentation Author's/Responsible Building Designer's Declaration Statement)
• t certify that this Certificate of Compliance documentatiow is accurate and complete..
• 1 am eligible under Division 3.of the Califomia`Business and Professions Code -.to accept responsibility for the building design
identified on this Certificate of Compliance.
• i certify that the energy features and perf'ormance.specifications for the building design identified on this Certificate of Compliance
conform to the requirements of Title,24. Partl and 6'of the'Califomia Code'of.Regulations.
• The building design features identified on this Certificate•of Compliance are consisteni with the infoirtnation provided to document this
building. design on the other applicable compliance_ ; forms, worksheets:, calculations, plans and specifications submitted to the
enforcementagency for approval with this'buildin rmit appiication.
Name:
Signa
slid i✓ra /tJi �P'� /'L '�_
.
Company: Date:
7.
Address: License:
1� $g z2
City/State/Zip: Phone:
Bin #
Cityb ILd Qdint.9
.8&14ipgw Safety, Division .
PA.' Box 1504, 78495;Calle.Tampico "
La Quints, CA 92253` (760).777=7012
BUil 6Pe k Application and Tracking.•Shw
Permit #
�� V1
Project Address: 52_ "205 Ave_J GL
�� 40'I.I
Owners Name f' f0 T—
A. P. Number:
Address: S Z - L0 S ,,4,,/ e.. wi, j e-,Ic°g 'J t 2
Legal Description:
City, ST, Zip:, La u� •-,ra
Contractor: /� •--�
I .I S/6ri?�C BF• / Cow.&
Telephone: � &.Os �— 10l0�
mow: c tiQa
Address: OL ? (03(.a Nt 2..... L 7
Project Description: IRe.G 0 % w�a 'G
City, ST, Zip
Tele hone:I5l—dd .� M:>::x<:zr......y.�•Y'='
State Lic. # : a$ 5 2 Z O City
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
c,�
� }, � �,� :
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ConstructiodType: Occupancy:
.
State Lic. #:
Pro'et circle one): New Addn Alter Repair Demo
Jctype ( )' 'eP
Name of Contact Person:. r
A #q. Units:
Telephone # of Contact Person:
•Estimated: Valueo 'f Project:
t �
APPLICANT; DO NOT WRITE<BELOW THIS LINE
N
Submittal
Req'd
Rec'd
r TRACKING PERMIT FEES
Plan Sets
; Plan-Cbeck submitted
.Item Amount
Structural Cala.
Reviewed, ready for corrections
Plan Cheek Deposit
Truss Cala:
Called Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Constractiou
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
r!�Revicw, ready,for correctionaftsue'
EledHcal
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans'picked.up
S.M.I.
H.O.A. Approval
Plans resubmitted,.
Grading
IN HOUSE:-
Review, ready for correctionsflssue
Developer Impact Fee
Planning. Approval
Called Contact Person.
A.LP.P..
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
L_ ,