BPLB2016-0109VOICE (760) 777-7125
-J8-495 CALLE TAMPICO Td/w Q�i!'0 D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVECOPIVIENTDEPARTMENT
INSPECTIONS (760) 777-7153
BUILDIN&PERMIT.
' ---� ----� Date: 9/2/2016
Application Number: BPLB2016-0109? n. OWner:
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Property Address: 54275 AVENIDA.RAMIREZ —,IMARTIN DECLERCQ
APN: 774243013:. �5�i4, 5 AVENIDA RAMIREZ
.. Application Description: DE CLERCQ RESIDENCE / WATER;HEATER PE E i �' 2016 �LA�QUINTA, CA.92253
Property Zoning:
Application Valuation: $850.00 CITYOFLAQUINTA
COMMUNITY DEVELOPh7ENT DEPARTMENT
Applicant: Contractor:
JORGE.A ALVAREZ JORGEA ALVAREZ
PO BOX 984 PO BOX 984
THERMAL, CA 92274 'THERMAUCA 92274'
` (760)698-8975
•LIC. No.: 880103
LICENSED CONTRACTOR'S DECLARATION f WORKER'S'COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that.l am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions,Code;:. I have and will maintain a certificate of consent to self-insure for workers'
and my License is in full force and effect... compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: C36 license No.: 880103. of the work,for Which this permit is issued:
I. have and will maintain workers' compensation insurance, as required by
Date: 9'� 'Zntract 7, Section3700 of the Labor Code, for the performance of the work for which this permit
is:issbeH: My.workers' compensation insurarice carrier and policy number are: <
OWNER-BUILDEWDE LARATION . Carrier: EXEMPT Polity Number:
I hereby.affirm under penalty of perjury that I am exempt from the Contractor s.5tate I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec..7031;5, Business and Professidns Code:,Any shall notemploy any person, in any manner so as to become subject to the workers'
city or county that requires a permit to construct; elter,,improve; demolish;. or. repair compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also;requires the applicantfoi,the permii to file'a` workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she.is licensed pursuant to the provisions of the,:- comply with those provisions.
Contractor's State License Law (Chapte(9(commencing with Section 1000)'6f Division
3 of the Business and Professions Code) or that he or she. is exempt therefrom and the Date: - 2 - Oplicant:
basis for the alleged exemption. Any violation of 5'ection 7031.5 by any applicant:for a
permit subjects the applicant to a civil penalty of not more than five hundred. dollars WARNING: FAILURE TO SECURE WORKERS' CONeENSATION COVERAGE IS UNLAWFUL,
($500).: AND SHALL SUBJECT AN EMPLOYER TO•CRIMINAL PENALTIES AND CIVIL FINES UP TO
as owner of the property, or my employees with wages as their'sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure isnot, intended oroffered:for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF-THE LABOR CODE,
(Sec. 7044, Business and Professions.Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES..
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or•her owrcemployees; provided that the improvements APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however,,the building or improvement is sold IMPORTANT: Application�is-Hereby made to the Building Official for a permit subject to
within one year of,completion, the owner-builder will have.the burden of.proving.that the conditions.and restrictions setforth on this application.
he or she did not build or-improve for the:purpose of sale.). - 1.1;Each person,upon whose behalf this application is made, each person at whose
(_) I, as owner of the property, am exclusively. contracting with licensed contractorsrequest.and for whose benefit.work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and:Professions Code:.The Contractors' issued asa result-of:this application, the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of: property`who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or
the Contractors' State License Law.). followingissuance of this permit. .
(_) I am exempt under Sec. B.&P.C. for this reason. 2. Any'permit issu6d-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.
Date: Owner:. I
I certify that I have read this application and state that the above information is correct.
CONSTRUCTION LENDING'AGENCY I agree.to comply with all city and county ordinances and state laws relating to building
I hereby affirm under penalty of perjury•that,there is a construction lending agency for construction, and hereby authorize representatives of this city to enter upon the
the performance of the work for which this permit-is issued (Sec. 3097; Civ: C.). above-mentioned property for inspection purposes.
Lender's Name: ate: �� ' �% Sigipre (Applicant-or Agent):
Lender's Address:
_ r ,
` Date: 9/2/2016
Application Number: BPLB2016-0109 Owner:
Property Address: 54275 AVENIDA RAMIREZ MARTIN DECLERCQ
APN: 774243013 54275 AVENIDA RAM IREZ
Application Description: DE CLERCQ RESIDENCE / WATER HEATER LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $850.00
Applicant:
Contractor:
JORGE A ALVAREZ
JORGE A ALVAREZ
PO BOX 984
- PO BOX 984
THERMAL, CA 92274
THERMAL, CA 92274
(760)698-8975
Llc. No.: 880103'
---------------------------------------------------------------------------------------------
Deta'il., VATER HEATER CHANGE OUT - 40 GALLON/ELECTRIC [2008 ENERGY] CARBON MONOXIDE A[JIRM(S)TO BE INSTALLED PRIOR TO FINAL IN
2013 CALIFORNIA BUILDING CODES.
t
r..
DESCRIPTION�Y , ; ., • • r >_ ,ACCOUNT ..
^QTY
AMOUNT
BS'
AS SB1473 FEE
F`,? - 101=0000 20306
0
$1.00
'Total Paid for'BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
r
DESCRIPTION' "
"'`
A000UNTj.'D
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$91.85
w' Total Paid for PERMIT ISSUANCE:
$91.85
'DESCRIPTION •.`.;
'a
ACCOUNT.,
QTY
AMOUNT
-WATER HEATER/VENT
10170000-42401
0
$12.09
DESCRIPTION'
ACCOUNT.
KQTY
AMOUNT .
WATER HEATER/VENT PC
101-000042600
0
$7.25
^ TOfiI Paid'for PLUMBING FEES:.$19.34
`'
. �
Pemlit # .
city Of �:d�`Q[un
BOIng a Safety Olv[slon
P.O. Box,i504, 78-495 6&,Tamplco
La ;C to CA .92253 • (760) 777-7012
Permit Application and Tracking Sheet
Owner's Name: t
Address: M
City, S'T, Zip: ; ' C,
'telephone:
(Pr'^ojeJct Description: t .
1 Ae►a•�nw�err e...�.
COnSt[ndion Type: Ory:
Project type (circle one): New Add'n Alter Repair Demo
Sq. A: d Stories: # Units:
Estimated Value -of Project: S5 U f
q
Submittal
Req'd
Recd
a
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Clea
Reviewed, ready. tar e6ftecdons
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Cheek Balance
Title 14 Coles.
Pkiaa pleked ap T
Conatraetioa
Flood plain Plan
Plans resubmitted. -
Mechanical
Grading Plan
V Review, ready [or oorrectionslissve
Electrical
Subeontaetor List
Called Contact Person
Plumbing
Grant Dad
Plans' picked up
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
r'' Review, ready for correctlonsli sne
Developer Impact Fee
Planning Approval ,
Called ContaetPersoo
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS — WATER HEATER
CEC-CF1R-ALT-01-E (Revised 06114) CALIFORNIA ENERGY COMMI55ION
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E WATER HEATER
'Prescriptive Residential Alterations for Water Heater (Page 1 of,2)
A. GENERAL INFORMATION,'
Site address:
���-1� AV2ri�c�c� �ZC.Qr�n� t`e Z
Building Type:
la' Single Family Dwelling
1 05'
06::�
07
❑"Multi,Family Dwellings
City,Zip Code:
Low Cu.� c�
Climate Zone:
10
G'WATER HEATING -`SYSTEMS Section 15,0.2 b 1G
` Ol,
02
03
04
1 05'
06::�
07
08
09
.. 10.
11
:12 r
1.3
14
Water
Water
Water,
,# of
Water
Fue'I
Rated
Rated
Heating
Heating';.
Standby
Exterior
, Baclk;Up
Central
Dwelling
Heating
System
Heating
System
Heater
Type
Water
Heaters ,
Heater
• Storage
Type
Input
Type
Input_
Value
Efficiency
Type
'. Efficiency-
Value.
- Loss (°�)
Insul.
R'Value,,
Solar •
. ,Savings
DHW System
Distribution
Unit DHW
System
Identification
Type
in
Volume
Fraction
Type
Distribution
or
system
(gal)
Type
Name
l lC7
:1ec
WATER HEATING SYSTEMS
Water heating compliance for an alteration is described in Section.150.2(b)lG. For single dwelling a gas or propane;witer1heater, with a.sforage tank of 60 gallons maximum
or instantaneous (tankless).can be used. Dwelling Unit dist ribution„systems are limited to Standard trunk and branch or demand:recirculation for gas orpropane water
heater. Demand recirculation'is not allowed for electric water heater. If there is.no natural gas connected to the building, an electric water•heater may be replaced with
another electric water heater. However, changing from gas to electric is not allowed. Multi=family central systems must use certified equipment as defined under Section
110.1 and 110.3.
NOTE: If the proposed installation does not meet the requirements allowed specifically for alterations, use form CF1R-NCB-01 to document the water heater alteration.
Instructions for sections with column numbers are given below:
1. Water Heating System Identification or Name: enter a unique name for the Water Heating System.
2. Water heating system type: Domestic Hot Water (DHW), Hydronic, Combined Hydronic, or Central. DHW is for domestic hot-water, hydronic is a water heating
system used for space heating only; combined hydronic are when the water heater will provide both space conditioning and domestic hot water.
3. Water heater type: For non -central systems only Small Storage or Small Instantaneous are allowed. For central systems pick from Large Storage, Small Storage,
Heat Pump, Boiler, Large Instantaneous, Small Instantaneous or Indirect.
CERTIFICATE OF COMPLIANCE MR -ALT -014 WATER HEATER
Prescriptive Residential Alterations for Water Heater (Page 2 of 2)
4. Number of water heaters In system: In single-family and multi -family with water heaters in each dwelling units the value is 1. For multi -family central systems -
serving multiple dwelling units enter the total number of water heaters.
S. Water heater volume (gal): tank capacity in gallons. For'individual water heaters for a dwelling unit this will be 60 gallons or less. If instantaneous, enter n/a. For
multi-family'central systems enter the total storage volume.
6. .Fuel Type: Gas, Propane, Electric (Only if -natural gas is not available)
7. Rated,lnput Typec Enter the equipment input rating type, for gas or propane fired units are Btuh, for electric fired system the units are kW.
8. Rated'inputValue: Enter the numeric value of rated input:
9. Heating .Efficiency Type: Energy Factor-, AFUE, or Thermal Efficiency. From product literature or California Energy Commission directory.
10. Heating' Efficiency Value: Enter the value from product literature ora California Energy Commission directory .
11. Standby Loss (percent): Applies only to large`storage water heaters, Enter n/a forsmall.storage or instantaneous • water heaters.
12., Exterior•.Insulation R-Value:'Enter the.R-value if exterior,insulation on the storage tank is;installed
13. Back-up solar savings fraction: If compliance req uiresya"back-up solar system,.indicate the solarcontribution (e.g., 0.30). External calculations are required.
14. Central DHDistribution System: For multi. -family buildings with using,a central distribution`system a demand r 'dr'culationsystem with'at.1'east two distribution
loops must be installed. This requirement-applies.to any building with eight or more units. Ifthe system.is non; -central or:project is individual units enter n/a.
15. Dwellin 'Unit DHW Distribution Type: ype: For a Gentral;DHW this field shall be Standard. If non -central, then pick from Standard, Deman&Recirculation —Manual
Control, Demand, Recirculation — Sensor Control: If non -central electric water heater this must be. Standard; no recirculation system shall be installed.
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
• I certify that this Certificate of Compllance documentation is accurate and complete.
wner o
Name: oO. Authorized agent )<Conttactor
Signature:
_
Company: `�wm�� n .
Contractor license a&o ) pa
Address: z
Phone: 6. 984q�`S
City/State/Zip: q2Z,,
Date: 9 , Z.— Ks
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.