13-1028 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00001028
Property Address: 44340 BUTTERCUP LN
APN: 604-083-006-69 -22982 -
Application description: PLUMBING
"Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1929
Applicant:
T-ihf
4'44
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
V,,\P
LICENSED CONTRACTOR'S DECLARATION
1 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.: 880269
Date: �5�1Contractor:
l
CJI ' NER-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 1, 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 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 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:
ELIZABETH LELAND
44340 BUTTERCUP LANE
LA QUINTA, CA 92253
(
Contractor:
FRANKLIN PLUMBING, B
3030 MYERS STREET
RIVERSIDE, CA 92503
(800)600-0675
Lic. No.: 880269
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/15/13
ffDI e D
N AUG 155 2013
CITY OF LA QUINTA
FINANCE DEPT.
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 the work for which this permit is
/� issued.
mltave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
L Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier INS CO OF WEST Policy Number WVE502266100
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
O 3700 of the Labor Code, I shall forthwith c mply with those provisions.
Datelk C; -k27 Applicant:
WARNING: FAILURE TO SECURE WORKERS' COM SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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 for inspect i poses.
Signature (Applicant or Agent):
f
LQPERMIT
Application Number . . . . . 13-00001028
Permit . . . PLUMBING 2013
Additional desc . .
Permit Fee . . . . 11.92
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . . 2/11/14
Qty Unit Charge Per
Extension
1.00 . ' 11.9200 EA PLBG WATER
HEATER/VENT
11.92
----------------------------------------------------------------------------
Special Notes and Comments
WATER HEATER CHANGE OUT - 50GALLON/GAS
[2008 ENERGY] CARBON MONOXIDE ALARM(S)-
LARMS)-TO
TOBE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT
ISSUANCE M/P/E
90.57
PLAN CHECK, PLUMBING
7.15
Fee summary Charged Paid
-----------------
Credited
•----------
Due
---------- ----------
Permit Fee Total 11.92
----------
.00 .00
11.92
Plan Check Total .00
.00 .00
.00
Other Fee Total 98.72
.00 .00
98.72
Grand Total 110.64
.00 .00
110.64
Bin.#
QtyOf ici QurCltci
Building & Safety Division
P.O. Box 1504,78-495 Calle Tampico
14.Quinta, CA 92253 - (760) 777-7012
Building Permit Application' and Tracking Sheet
Permit #
2,r�
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Project Add=:
Owner's Name:.
A. P. Number. _ on—
Address: 44;- -A o 6Y C_u
Legal Description:
City, ST, Zip:C, G S3
Contractor. Lyt \LN
Telephone: # :.>
Address; e- C_ SF)� P(�
Project Description: C50O�PA6
City, ST, Zip.
q �0���
0La_V^0_CA,
Telephone'OA X1 (a
State Lie. # : o ;4�9 City Lic. #;
Arch, Engr., Designer. (J 1 Qc
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Conswctlon Type: , Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories:# Unit.5:
Telephone # of Contact Person:
Estimated Value of Project: • 00
APPLICANT: DO NOT WMTE BELOW THIS UNE
# Submittal Rcq'd 'Rec'd TRACMG PERM FEES
-Plan Sets Plan Check submitted Item Amount
Stmctural Cafes.
Reviewed, ready for corrections Plan Check Deposit. .
Truss Caics.
Called Contact Person Plan Check Balance.
Title 24 Calls.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mahaiiicat
Grading plan
2'! Review, ready for correctionstissue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Pians picked up S.M I.
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
/z
Prescriptive Certificate of Compliance: Residential Water Heating _ CF -IR -ALT -WH
General Information
Site Address: LALk-6AO O&kleyrUpClimate Zone: Date: $— G,—
NOrE. This form is only used or alteration or addition of water heatinx systems.
WATER HEATING
List water heaters, and boilers for both domestic, hot water. (DHW)'heaters and hydropic space heating. .Individual dwelling DHW
heaters must be gas or propane fired, and may not exceed 50. gallons.. Hot water pipe insulation from the DHW heater 'to the
kitchen(s) and on all underground hot waterpipes is required in all ctimponent packages in all climate zones.
• 1 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, Parts 1 and 6 of the California Code of.Regiilations.
The building design features identified on this Certificate of Compliance are consistent with the inform ovided to document this
Energy Factor or
Water Heater Type /
Fuel Type'(Standard)`
Distribution Type Number of
System
Tank.Capacity
al
Thermal External Tank
Efficienc Insulation R-Value3
Company: (L�/1.
ate:
Address:
J
o LOI —�
City/State/Zip: �• , ` \ Q �
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). The Prescriptive requirements do
not allow the installation ofa recirculating water heating system for single'dwelling units.
3. The water heating tank and pipes shall be insulated to meet the requirements of 1506),
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
• 1 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.
• 1 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, Parts 1 and 6 of the California Code of.Regiilations.
The building design features identified on this Certificate of Compliance are consistent with the inform ovided to document this
building design on the other applicable compliance forms, worksheets; calculations, plans and s- ' tcat" submitted to the enforcement
agency for approval with this building permit application.
Name: R
Signature:
Company: (L�/1.
ate:
Address:
J
License:
City/State/Zip: �• , ` \ Q �
Phone
2008 Residential Compliance Forms March 2010