BPLB2015-0040•78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BPLB2015-0040
Property Address:
54625 AVENIDA BERMUDAS
APN:
774285018
Application Description:
WISH/WATER HEATER CHANGE OUT (1) 50 GALLON PROPANE GAS
Property Zoning:
Application Valuation:
$1,115.00
Applicant:
TOMMY ROOTER PLUMBING
INC
80975 INDIO BLVD #C3
INDIO, CA 92201
2 0
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 Professions Code,
and my License is in full force and effect.
License Class: C36 License No.: 930133
Dat"� _ l� )� Contractgt•
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).:
(- 11, 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 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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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 t1le work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Secti(;4A700 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: _ Polity Number: _
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 Code, I shall forthwith
comply with those provisions. A
Date:�1O-1S Applicant. /\
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 ($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 Building Official 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 city to enter upon the above-
mentioned property for inspection purposes.
Date:" ( D 1 I S' Signature (Applicant or Agentb-
Date: 3/10/2015
Owner:
DENNIS WISH
54625 AVENIDA BERMUDAS
w
LA QUINTA, CA 92253
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Contractor:
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TOMMY ROOTER PLUMBING
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80975 INDIO BLVD #C3
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INDIO, CA 92201
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(760)574-4444
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Llc. No.: 930133
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 t1le work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Secti(;4A700 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: _ Polity Number: _
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 Code, I shall forthwith
comply with those provisions. A
Date:�1O-1S Applicant. /\
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 ($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 Building Official 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 city to enter upon the above-
mentioned property for inspection purposes.
Date:" ( D 1 I S' Signature (Applicant or Agentb-
t,
Prescriptive Certificate of Compliance: Residential CF-IR-ALT-DHW
Residential Alterations Page i of 2
Project Name: t46a5 O.J Climate Zone: Permit #:
General Information _
Site Address: 5 2S Age . a Enforcement Agency: Date: 3— 1
S: -
Building Type: Single Family 0 Multi Family Project T e: Replacement or Change Out of Water Heater
WATER HEATING
a i certify that this Certificate of Compliance documentation is accurate and complete.
List newly installed water heaters and boilers for both domestic hot water heaters (DWH) and hydronic space heating. Newly installed
DIM heaters and boilers must be as propa or use the existing tel type.
Water Heater
Type/Fuel Type
Distribution Type Number In
(Standard, System
Recirculatin)
Tank
Capacity (gal)
Energy Factor or
Thermal Efficiency
building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the
Extemal Tank
Insulation
R -Value
Na e:
F-1 5.
Company:
Date:
3 -M -is
Address: I
g DOO S
License:
qt 3 0 G3
City/Stateflip: .
Phone:
\
1. Indicate Type (Storage Gas: Heat Pump, instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n).
requirements do not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank and pipes shall be insulated to meet the requirements 9f §150U).
The Prescriptive
Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement)
a i certify that this Certificate of Compliance documentation is accurate and complete.
m i am eligible under Division 3 of the California, Business and Professions Code to accept responsibility for the building design
identified on this Certificate of Compliance.
o I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance
conform to the requirements of Title 24. Parti and 6 of the California Code of Regulations.
o The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the
enforcement agency for approval with this building permit application.
Na e:
tures
Company:
Date:
3 -M -is
Address: I
g DOO S
License:
qt 3 0 G3
City/Stateflip: .
Phone:
\
kr -+-r t v f I kA Jv'N
PLUMBING WORK
ORDER/INVOICE
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TOMMY ROOTER 19397
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HELPING THE DESERT }-
ONE FRIEND AT A TIME Co.
•ITEM • - PART
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Plumbing, Drain Cleaning & letter Specialist Inv.#
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80975 Indio Blvd., #B9 //✓
Indio, CA 92201 Auth.#Q 7 13 l
760-574-444 ,500 In ,
Fax D
760-444-2717
WWW.TOMMYROOTER.CQN � D
"All Clear!"
CA LIC. #930133 ' 3C)
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NAME n DSCHEDULED
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STREET PHOSI� 2
CITYS E ZIP ❑ WARRANTY
❑ CONTRACT
MAKE
MODEL SERIAL NUMBER ❑ SERVICE CONTRACT
❑ NORMAL
TOTAL MATERIALS
RES. ❑ COMM.
❑ NOT C] COMPLETE
DESCRIPTION OF 1'AMOUNT
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17 l rl Ea
6, Cb M boa .
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F
ri L le oy
t� cove,(
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TO OUR CUSTOMERS: Service men are required to have work slip signed.
This is done in order to protect you, the workmen, and ourselves and to
DRAIN CLEANING
ADD'L FOOTAGEenable
us to give you absolute satisfactory service. You are respectfully
requested to examine material and labor statement before workmen leaveADD'L
FIXTURES
PLUMBING LABOR
7BALANCES
the job, and if you find everything satisfactory, okay this ticket. II service is
unsatisfactory, in any way, please phone our office immediately.
PARTS
A PENALTY WILL BE CHARGED AT THE RATE OF 1'1% PER MONTH ON UNPAIDpRODUCTS/fREATMENT
AFTER 30 DAYS OF INVOICE DATE. ANNUAL PERCENTAGE RATE 18%.
TOTAL LABOR
VIDEO INSPECTION
RETURNED CHECK FEE $25.00
find the time and material charged above satisfactory and agree to pay
HYDRO-JETTER
❑ WARRANTY
NOTESI
MINI JETTER
❑ 5 Day ❑ 1 Year
m p
for same on presentation of invoice, and further agree to pay reasonable
LINE/LEAK LOCATION
❑ 3 Month ❑ NO
s ZZ
charged for collection including attorneys fees in the event of my default.
❑ 6 Month
"NOTICE TO OWNER" (Section 7019 -Contractors License Law) Under the
PUMP SEPTIC/GREASE
Mechanles' Lion I.aw, any contractor, subcontractor, laborer, malarial man or other person who helps
WARRANTY CALLS
'ARE
to Improve your property and is not paid for his labor, services or mat vial, has a right to enforce his
eny. Under the law, you may protect yourso gains) such claims by 00ng,
babreoocaworkorimpmvemeni,asariginalcontract
claim agLn'
�CC �� V—
OTHER
SCHEDULED
FROM M -F 8AM-5PM
r a work of Improvement ora
modil canhe oflico dt the county order oft county h ro the property is situated and
requiring tor's payment bond r rded i ch ollic Id bond shall be In an amountTAX
not less tnt (50%) of thea 1 ko n shall, I di any conditions for Ihopintract,
be condtio I r of the claims of all parsons
Iurnis ' g, equlq'Aern rt t k do - din sail nuac
TOTAL
X
X
PAYMENT RECEIVED 1 T7
Initials
❑ CASH ❑ C.C. ❑ BILL .QHECK # X
SIGNATUREOATF
WORK oncr:REDBY:
PAYMENT DUE M�
ON
/g-
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT CITY
AMOUNT
'PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$0.00
PAID BY
METHOD RECEIPT #
CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION.
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT
101-0000-42401
0
$12.09.
$0.00
- PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$7.25
$0.00
PAID BY
METHOD -
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:00
Description: WISH/WATER HEATER CHANGE OUT (1) 50 GALLON PROPANE GAS
Type: PLUMBING Subtype: Status: UNDER REVIEW
Applied: 3/10/2015 SKH
Approved:
Parcel No: 774285018 Site Address: 54625 AVENIDA BERMUDAS LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 302 Lot: ST
Issued:
UNIT 28
ZIP
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $1,115.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
80975 INDIO BLVD #C3
Details: WATER HEATER CHANGE OUT- 50GALLON/PROPANE GAS [2013 ENGERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Tuesday, March 10, 2015 9:13:47 AM 1 of 2 0?
SYSTEti1S
CONDITIONS
NAME TYPE
NAME
ADDRESS1
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #C3
INDIO
CA
92201
(760)218-3120
CONTRACTOR
TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #C3
INDIO
CA
92201
(760)218-3120
OWNER
DENNIS WISH
54625 AVENIDA
BERMUDAS
LA QUINTA
CA
92253
(760)218-3120
Printed: Tuesday, March 10, 2015 9:13:47 AM 1 of 2 0?
SYSTEti1S
n
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
WATER HEATER/VENT
101-0000-42600
0
$7.25
$0.00
PC
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
PLUMBING FINAL"
PARENT PROJECTS
BOND INFORMATION
Printed: Tuesday, March 10, 2015 9:13:47 AM 2 of 2
CRWYS7EMS
06/06/2013 TAU 15:09 FAX La Quinta Bldg & Safety.
a;►r City 0f La Quinta
Building r Safety Dh1fslon
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 • (760) 777.7012
i3 Pub
Building Permit Application (and Tracking Sheet
Project Address: i Owner's Name: 1 meIn
A. P. Number:
Legal Description:
Contractor:
Address:
City, IT, Zip
Telephone:
State Lia # :
Arch., Engr., Designer.
Address:
City, ST, Zip:
` Telephone.
State Lie. #:
Name of Contact Person:
Telmhone *'of Contact Person:
V �
0, Cpl
Address:5H 6
City, sT, Zip: Lo.`�
Telephoner
Project Description:
2001/001
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL: # Stories: #Units:
Estimated Value of Project:
APPLICANT: 130 NOT WRITE RELOW THIS LINE
#
Submittal
Req'd Reed TRACH NG PERMIT FEES
PIau Sets
Pian Check submitted Item Amount
Structural Calm
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
CaUed Contact Person Plan Check Balance.
Title 24 Cates.
Pians picked up Construction
Flood plat, plan
Pians resubmitted Mechanical
Grading plan
2`! Review, ready for correctionslissue Electrical
Subeontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.L
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:
'"` Review, ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees