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08-1976 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00001976 Property Address: 44400 BUTTERCUP LN APN:' 604-083-010-67 -22982 - Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 500 Tiht 4 4 a" Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Bu iness and Professionals Cade, and my License is in full force and effect. License Class: C36 �yLicenseNo.: 828264 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 ISec. 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 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 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.I. Lender's Name: Lender's Address: LQPERMIT Owner: BRAZIL BEVERLY 44400 BUTTERCUP LANE LA QUINTA, CA 92253 Contractor: FOY, SCOTT A. 43579 MAIN STREET INDIO, CA 92201 (760)775-9405 Lic. No.: 828264 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/23/08 ------------------------------------------a-- 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. I 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' compensation provisions of Section f 3/7}00 of the or Code, I shall forth �with comply with those provisions. WARNING: FAILURE TO SECURE WORKERS' CONI 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 ounty ordinances and state laws relating to building construction, and hereby authorize representatives oft county to enter upon the above-mentioned property for inspection rposes—. Date:/ili:�—Si cure (Applicant or Agent): Application Number . . . . 08-00001976 Permit . . . PLUMBING Additional desc . Permit Fee 22.50 Plan Check Fee 5.63 Issue Date . . . . Valuation . . . . 0 Expiration Date . . - 6/21/09 .Qty Unit Charge Per Extension BASE FEE 15.00 .1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 ----------------------------------------- Special Notes and Comments ------------------= --------------=- INSTALL NEW 40 GALLON GAS 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 LQPERMIT 12/23/2006 11:21 7'607755222 CANON t OF COMPLIANCE: RESIDENTIAL #3907 P.001 /001 3 of 4) CF -IR 3�imr--� Watenige 7Z > SEALED DUCTS aad TXVs (or Ahernative Measures) A signed CF -4R Form most be provided to the building departrnent for each home for which the following. are 0 Scaled Ducts . ail climate zones(Installer tesmZ and cert TXVs, rtadit aeocssibie (climate Zones 2 and 8.15 only) testing and cion and HERS Rater field v Q Refrigerant Charge (clime zones 2 and 8.15 only) (in= verification required. OR D Ahve w Sealed Ducts and Refrigerant Charge (1-(V, PMjCCt Climate Zone in the RM Appendix B Table 151-0 and required.) and cerr ificabon and HERS age U Afternabve Package Features for 7-14. For additions and alterations, duct systems that are not documented to have been prev;ously - scaled as confirmed duvugh field verification and ding ?mm ming in accordance with procedures in the Residential ACM Manual and duct syswms'with more than 40 linear feet in unconditioned spaces shall meet the requirements of Section 150(rn) and duct insulation requimrnents of Package D. Check box if syst�cm meets criteria of a "Standard" system. Standard system is one gas-fired water heater per dwelling unit_ If the water healer is a storage type, 50 gallons is the maximum capacity and recsrculabon system rs not allowed. 13 Check box when using Pteapproved Alternative Water Heating table, Table 54 in Chapter 5 in the Residential Manual. No water calcttiations are required, and the swum co lies aubomabcall Check box if syst,cm does not meet criteria of "Standard" system, and does not comply with tate Preapproved 0 Aftniative Water i-Icsring table. In this case, the Performance Method must be used and must be included in the submittal. 0 Check box to verify first a tune control is required for a recirculating system pump for a system serving multiple units svAelm servi w she dweller ellits I Tank External Standby. Insulation Loss (%) R -Value 1. For small gar storage water heaters (rated irtptrts of less than or equal'to 75,000 Bmthr), electric resistance, and: heat pump water heaters, list Energy Factor. For latge gas storage water hea=3 (rated input of gmater Than 75,000 Bm/hr), list Rated Input, Recovery Efficiency, Thertnsl Efficiency and Standby Loss_ For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe IIS} oel (knelt tines ? 3/4 inches) Ali hot water pipes from the hesfwg source to the kitchen fixtures that are'/a inches or gamin diameter sbali be dmmally insulated as specified by Section 150 0) 2 A or 150 0) 2 B. Residential Compliance Forms . March 2005 Rated I Enemy Tank ! En 1 Tank Input � Factor o r i External Water Heater Distribution Number(kw or ( Capacity Thermai Standby' Insulation T uel TXpe Type in System t3a✓hrs tows Efficiency Loss '% R -Value in Svsem ants) l (rarwos) Efficiency I Tank External Standby. Insulation Loss (%) R -Value 1. For small gar storage water heaters (rated irtptrts of less than or equal'to 75,000 Bmthr), electric resistance, and: heat pump water heaters, list Energy Factor. For latge gas storage water hea=3 (rated input of gmater Than 75,000 Bm/hr), list Rated Input, Recovery Efficiency, Thertnsl Efficiency and Standby Loss_ For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe IIS} oel (knelt tines ? 3/4 inches) Ali hot water pipes from the hesfwg source to the kitchen fixtures that are'/a inches or gamin diameter sbali be dmmally insulated as specified by Section 150 0) 2 A or 150 0) 2 B. Residential Compliance Forms . March 2005 f ! i ! En 1 p� I Tank 'Factor; r Water Heater Disuibution Number (kw or Capacity Thermal I Type Tvve in Svsem ants) l (rarwos) Efficiency I Tank External Standby. Insulation Loss (%) R -Value 1. For small gar storage water heaters (rated irtptrts of less than or equal'to 75,000 Bmthr), electric resistance, and: heat pump water heaters, list Energy Factor. For latge gas storage water hea=3 (rated input of gmater Than 75,000 Bm/hr), list Rated Input, Recovery Efficiency, Thertnsl Efficiency and Standby Loss_ For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe IIS} oel (knelt tines ? 3/4 inches) Ali hot water pipes from the hesfwg source to the kitchen fixtures that are'/a inches or gamin diameter sbali be dmmally insulated as specified by Section 150 0) 2 A or 150 0) 2 B. Residential Compliance Forms . March 2005 aim P&n* 14*1P.O. ����yy++� A C(W A. P. Number City Of La Quints e � Safety 1�Ivfsforl Box 1504, 7&495 Cade Tampico U Quints, CA 92253 - (760) 777.7012 p `� Btaidmg Permit Application and Tracking Sheet :� �.Y �i Oavna's Name: 1 a Z , f. /) Address: V Legal Description: City, ST, Zip: contractor cng V( Tdepbona . ` Address , f . Des�ption: C i City, ST, Zip: I' vv T:7 State Lic. 0: City Lic. #547r6' Arch, Eap. Dwip Address: City, ST, Zip: Tom: C usbuction Type: Oxnpaucy: State Lic. C Project type (tuck one): New Add' n Alta Repair Demo Sq. FL: S Stories: q Units: Name of Contact Person: Telephow # of Contact Person: BS1imsted Value of Project APPLICANT: DO NOT WRITE BBAW THIS LINE Y Sobntdal Req'd _XM'd TBACKM PERM FEES ?tau Seb Pin Cheek submitted Amount Structural Cates. RcvkW d, ready for corrections Phu Chock Deposit Truss Cates. CROW Coetset Peron Plan Ckec k Balance Title 24 Cake. Piaus picked Lip Coastrsctio. Flood plain plan than resubmitted Mechanical Gradiq ph■ Review, ready for earrectioasAssue Fiearieal Subtoatactor Iasi Catled Contact Person Ptunbing Gant Dad Anus pcked rp S.M.L HAA Approval Ptm resubmitted corad'mg IN HOUSE:- I Review, ready for correetloos%-c Developer Impact Fee Phases Approval Called Couttet Person A-LP.P. Pub. Wks. Appr Date of permit lssoe Scbool Fes Tota! Permit Fes )z