12-0031 (PLBG)C"� f�'�itiGv
P.O. BOX 1504 VOICE (760) 777-7012
4
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number.r-----12=0000'0031lIn
Property Address: 5072-0'—CYPRESS POINT DR
APN: 770-110-065-3 -000000-
Application description: PLUMBING
Property Zoning: MEDIUM DENSITY RES
Application valuation: • 750
Applicant: Architect or Engineer:
-----------------
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 Division3 of the Busines and Professionals Code, and my License is in full force and effect.
License Class: C36 License No.: 880103
ate ntractor:
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 Codel 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 (5500)•:
(_ 1 I, 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 contractods) 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:
HARRINGTON RONALD
50720 CYPRESS POINT DR
LA QUINTA, CA 92253
Contractor:
ALVAREZ, JORGE A.
P.O. BOX 984
THERMAL, CA 92274
(760)777-3613
Lic. No.: 880103
Date: 1/12/12
------------------
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 EXEMPT Policy Number EXEMPT
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 Ide, I shall forthwith comply with those provisions.
ate: 1'� 2� 2/%�','{pli/cant:
WARNING: FAIL REO TO SECURE ORKERS' 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 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
h'� county to enter upon the above-mentioned propenr i pection purposes.
eme: // 2 -/Z.gnature (Applicant or Agent):
AV
Application Number . . . . 12-00000031
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
22.50
Plan Check
Fee
5.63
Issue Date . . . .
Valuation
.
. 0.
Expiration Date
7/10/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 7.5000
EA PLB
WATER HEATER/VENT
7.50
---------------------------7------------------------------------------------
Special Notes and Comments
INSTALL NEW 50 GALLON
GAS WATER
HEATER.
2010 CODES.
L
---------------------------------------------------------
Other Fees . . . . .
. . . .
--------------
BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
Due
---------------------------
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 Compliance: Residential CF-IR-ALT-DHW
Residential Alterations Page I of 2
ProjectName: \ r i Climate Zone: Permit #:
General Information
Site Address: rc 5 Pb ; At 4Wnforcenient A enc : Lc, OW i c, Date: 1 - (7- - 17-
Buildin Type: Wingle Famify ❑ Multi Fami!j I Pro'ect e: PMeplacement or Change Out of Water Heater
t
WATER HEATING
List nem+1v installed ►voter heaters and boilers for both dontestic Trot mater heaters (DWH) and Itydronic space hearing. Newly installed
MH heaters and boilers must be M. ro ane, or use fire existingfifel type.
Water Heater
Type/Pttel Type'
lJistribution Type Number to Tank
(Stamtani, System Capacity (gal)
Reciuralatin
Energy Factor or
Thermal Efficiency
External Tank
Insulation
R-VatueJ
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
2. Recirculating systems serving »;"duple . dwelling units shall tneel -the recirculation requirements of §I50(n)..
requirements do nor allow the installation of a recirculating water heating system for single dwelling units. -
.i The external water heafin tank and i es shall be insulated to meet the re airements o 150u),
The Prescriptive
Contractor or Homeowner (Documentation Author's/Responsible Building 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.
w 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, -Part I and 6 of the California Code of Regulations.
a 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 a enc fora roval with this building permit app lication. 4
Name: Signature- w�{
Company;Ili Date: 1
Address: License:
�.
38-0/0
City/State/2ip. Alton:
r � `7 7(00--777- (0Q
(&Anril 'M If)
Storage Water Heater Is defined as:
Max Btu/hr per Galton 30 Gallon 40 Gallon 50 Gallon
4,000 120,000 180.000 200 000
2009 Appliance Efficiency Regtilatlorto fot Small Water Heat®ra
Small Water Heater is defined as:
7
In ut
Gas Storage
75,000 Btu/hr or less
Oil Storage
105,000 Stu/hr or less
Electric Storage
12 kW or less
Gas Instant
200,000 Btu/hr or less
Oil Instant
210,000 Btu/hr or less
Electric Instant
12 kW or less
Heat Pump
24 amps or less
Storage Water Heater Is defined as:
Max Btu/hr per Galton 30 Gallon 40 Gallon 50 Gallon
4,000 120,000 180.000 200 000
1. Per Section 1500) of the 2008 Energy Efficiency Standards.
GAnril 2010
If rated Energy Factor does not EXCEED minimum
Federal Minimum
Values Below, an External Insulating Blanket (R-12,
Energy Factor
minimum) shall be Installed'
Water Heater Fuel Type
Effective Jan 20,20W
30 Gallon
40 Gallon
50 Gallon
Gas-fired storage -type water.
0.62 — (0.0019 x- V)
0.563
0.544
0.525
heaters
,
Oilfired water heaters
0.59 — (0.0019 x V)
0.533
0.514
0.495
(storage and Instantaneous
Electric storage water heaters
(excluding tabletop water
0.93 — (0.00132 x V)
-0.890
0.877
0.884
heaters
Electric tabletop water
0.93 — (0.00132 x V)
0.890
0.877
0.864
heaters
Gas-fired instantaneous water
0.62 — (0.0019 x V)
0.563
0.544
0.525
heaters
Electric Instantaneous water
heaters (excluding tabletop
0.93 — (0.00132 x V)
0.890
0.877
0.864
water heaters
Heat pump water heaters
I 0.93 — 0.00132 x
-- 0.890
0.877
0.864
V = rated volume In gallons
1. Per Section 1500) of the 2008 Energy Efficiency Standards.
GAnril 2010
Bin #, ..
City of La Quinta ,
Building 8T Safety Division
P.O. Box 1504, 78-495 Cafie Tampico
La Quints, CA .92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
1 1
Project Address: 150 `120 C re55
owner's Name:
A. P. Number:
Address: SMIC> S n
Legal Description:City,
ST, Zip: Lo, &x_ Ir•1Ac,` U Q`Z,z
Contractor.
Telephone: , �
Address:ox
Project Description:
City, ST, Zi CA Cil
Telephone:
Em
City Lic. #: 33
State Lic. # : ��Q 103
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. FL:
# Stories: #Units:_
Telephone # of Contact Person:
Estimated Value of Project: f%
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Ree'd
TRACING PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cala.
Reviewed, ready for corrections Plan Cheek Deposit
Truss Coca.
Called Contact Person Plan Check Balance.
Title 24 Cates
Pians picked up Construction
Flood plain pian
Pians resubmitted Mechanical
Grading plan
Z"' Review, ready for corrections/issue Electrical
Subeontactor Ust
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
3" Review, ready for correctioos/issue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub, Wks. Appr
Date of permit issue
School Fees
Total Permit Fees