BPLB2015-000178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 922J,0
Application Number: BPLB2015-0001
Property Address: 60299. POINSETTIA PL PL
APN: 764370019 -
Application Description: WATER HEATER CHANGE OUT - (1) 50GALLON/GAS
Property Zoning: ,
Application Valuation: $900.00
4
MMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT `
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
` Date: 1/27/2015
Owner: ,
WILLIAM BRAGG
60299 POINTSETTA PLACE
t LA QUINTA, CA 92253
Applicant: Contractor:
STATEWIDE SERVICES INC DBA STA . _ STATEWIDE SERVICES INC DBA ST
73804 DINAH SHORE DRIVE 73804 DINAH SHORE DRIVE
PALM DESERT, CA 92211 PALM DESERT,'CA 92211
(760)393-6115
Llc No •936147
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that.l 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.: 9 36147'
'
�f
4D� ��Contra or:
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).:
(_) 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, 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 Name:
Lender's Address:
ti
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 th k for which this permit is issued.
Mor1 have and will maintain workers' compensation insurance, as requiredby
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: Policy Number:
1 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 f the Labor Code, I shall forthwith
co� with those provisions.
Date: _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: " • Signature (Applicant or Agen C'
l l
i
{ -Prescriptive, Certificate of
rReridential Alterations
C]
Climate Zone: 71 Permit #:
--------------
T-DI-M
a>;e 1 of 2
General Information
Site Address: e1 r I Enforcement Aga Date: 1
li'uilding lype. Wingle Famil CI .MultiTamil _ Project T Re lacement or Change Out of Water Heater
WATER HEATING
List newh• installed water heaters and !oilers for both dotnestir hot haler heaters-JDWH) and lndronir space heuting. NeK•h installed
D.WH heaters and boilers must be as, e, or use the existingel ti
Oisuibution type a Of or
Wacerlleater Numbcr.ln Tank NTbcnnal
TYPE Type, R System Capacity !gal) cicw-y
External Tank
Insulation
R-Yatuei
identified on this Certificate of Compliance.
• 1 certify that the energy features and peiforrnance,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.
• 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 spocifications submitted to the
rnfotccment a gency for approval with this building permit applicatiorL
Name:
Sibnanue:CA : ^ ^
�9/ 1 C,
1. Indicate Type (Storage Gas, Heat Pump. Instantaneous. etc.)
2. Recirrulatitng systems serving multiple dwelling units shall meet the recirculation requirements of f l An).
requirements do not allow the installation of a recirculating waterheating stytem jar single dwelling units.
3. The external water heating tank and pipes shall be insulated to meet the requirements of § 150(i).
The Prescriptive.
Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement)
•I certify that this Certificate of Compliance documentation is atxvia[e and complete.
• 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.
• 1 certify that the energy features and peiforrnance,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.
• 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 spocifications submitted to the
rnfotccment a gency for approval with this building permit applicatiorL
Name:
Sibnanue:CA : ^ ^
�9/ 1 C,
Company: Date:
nddtes: I:arirc_
9`7
city/SPMAUP: Phone:
� d-
CF-6R-NIECH-01
Maore I of 2)
Enforcement Agency: i Permit' NUmber:
Rat-
- ,- 1 1 Standibl,
nor , Tank
Loss
id -en -UM, Vo!e
5D.
ter heaters. list
-gczstajzce andheal pimzp ;vat
�l fo 7j'000 ail,
E,:ectfic
Mote 1: Forstria-11 aasstoragge (rale --I 1-han -iT -ell E, I
Ter, j'r 5� Doo B!Ijair). !�Vf R col- Ticie ;q.? (RE).
, P!l. It
Eirelm, Facto.- (EF). For large gas stor
'�-L water heaurs fr-I and Rated Input.
eje,
V 'd Ii
R e lipul. Fa? - insta it ra, r. eo as gia varer it eate rs. I isr 111E TI -a I LJf"
'-hernial Eii-IcielMY, Standby Lo�s ivmd a!
2. Measures
TO CO'I -E:D
vi -FL -11' - -ALL BOX, ---S MUST BE CHECK
] I . - - — - - ission.
i 10-§113. Water heaters, sho werh—d MnCk ZMUCaM Sre Cart7LP'ed b -,F the Cfjaffbrra EtierV COMIn:
ahk- , Msuladori- -��7-d 'arion
Coojina Line Ins -r -L
§ 1506): Water System Pipe and T
1. Storage tank insulation
r than the standard are
'or no sreat'- _jimal
10. A. Storage gas.water heatter-, rated with a -a Energy- Fnc;
I t
ctaUed the -real �-c,- of or sErm er at.
externally wrapped with insulation ha',ingr a3- I w
tanilks have R-1 2 e.�tet
B, Un -fired storid-ge taints or other indLrect hot Wa:�-=T al insulation or R-16 internal
n f
insulation where the iintemal ipsulatti-on R -value is indicates on -h- teOra The Iditb
i - a taickness and conducmv-tt-v
msu
Wat=-r Piping and cooii----.-5-v-;zfery line
n-recircu!atin2 sysrerns, and entire
-rir.-t 5 feet o f �hot and c6ld water. pipI.5 CIOSe-5 to ,7irnre-r 11 eater -tark. no- a - - - and
Sta T ble I 50-B
UIaLid2.SLCtion5 pes -are in,:uiated r.er ndardc
iength olfrecLir�:c ofhorwater!)l -
syste-ins >15 psi. meetss the requirements of
adnL7 Systems or vvpter
Pipe insuiafior'.:'Lorst�= he
e
ronic II
Standards Table 123 '-A-I
-lionie t maintenance, and
Lght i iatum qu.. en
El Insulation 1z, protectdd from damage- including Char due to-sunli- L. 005
15 1 fflSD: If indicated on the C!= -IP, al! hot water piping ;shat rux-3 -orithe hot %-vater source to the l Kitchen fixtures isinsuizaCd per Standards iat+,Ie'
2008 Reside"fial COMP11MIC2 FOi--qis
Align-cl 2009
ST-A-LLATIUN LEKI-Irll-4kF,
"Domestic Hot Water (DHW) I.
Site Address:
P0
1. INA.TER HE MING -SYSTE-
Dil�-- I b i d 0
CK
14
� d-
CF-6R-NIECH-01
Maore I of 2)
Enforcement Agency: i Permit' NUmber:
Rat-
- ,- 1 1 Standibl,
nor , Tank
Loss
id -en -UM, Vo!e
5D.
ter heaters. list
-gczstajzce andheal pimzp ;vat
�l fo 7j'000 ail,
E,:ectfic
Mote 1: Forstria-11 aasstoragge (rale --I 1-han -iT -ell E, I
Ter, j'r 5� Doo B!Ijair). !�Vf R col- Ticie ;q.? (RE).
, P!l. It
Eirelm, Facto.- (EF). For large gas stor
'�-L water heaurs fr-I and Rated Input.
eje,
V 'd Ii
R e lipul. Fa? - insta it ra, r. eo as gia varer it eate rs. I isr 111E TI -a I LJf"
'-hernial Eii-IcielMY, Standby Lo�s ivmd a!
2. Measures
TO CO'I -E:D
vi -FL -11' - -ALL BOX, ---S MUST BE CHECK
] I . - - — - - ission.
i 10-§113. Water heaters, sho werh—d MnCk ZMUCaM Sre Cart7LP'ed b -,F the Cfjaffbrra EtierV COMIn:
ahk- , Msuladori- -��7-d 'arion
Coojina Line Ins -r -L
§ 1506): Water System Pipe and T
1. Storage tank insulation
r than the standard are
'or no sreat'- _jimal
10. A. Storage gas.water heatter-, rated with a -a Energy- Fnc;
I t
ctaUed the -real �-c,- of or sErm er at.
externally wrapped with insulation ha',ingr a3- I w
tanilks have R-1 2 e.�tet
B, Un -fired storid-ge taints or other indLrect hot Wa:�-=T al insulation or R-16 internal
n f
insulation where the iintemal ipsulatti-on R -value is indicates on -h- teOra The Iditb
i - a taickness and conducmv-tt-v
msu
Wat=-r Piping and cooii----.-5-v-;zfery line
n-recircu!atin2 sysrerns, and entire
-rir.-t 5 feet o f �hot and c6ld water. pipI.5 CIOSe-5 to ,7irnre-r 11 eater -tark. no- a - - - and
Sta T ble I 50-B
UIaLid2.SLCtion5 pes -are in,:uiated r.er ndardc
iength olfrecLir�:c ofhorwater!)l -
syste-ins >15 psi. meetss the requirements of
adnL7 Systems or vvpter
Pipe insuiafior'.:'Lorst�= he
e
ronic II
Standards Table 123 '-A-I
-lionie t maintenance, and
Lght i iatum qu.. en
El Insulation 1z, protectdd from damage- including Char due to-sunli- L. 005
15 1 fflSD: If indicated on the C!= -IP, al! hot water piping ;shat rux-3 -orithe hot %-vater source to the l Kitchen fixtures isinsuizaCd per Standards iat+,Ie'
2008 Reside"fial COMP11MIC2 FOi--qis
Align-cl 2009
Description: WATER HEATER CHANGE OUT - (1) 50GALLON/GAS
Type: PLUMBING Subtype: Status: APPROVED
Applied: 1/6/2015 SKH
Approved: 1/6/2015 SKH
Parcel No: 764370019 Site Address: 60299 POINSETTIA PL PL LA QUINTA,CA 92253
Subdivision: TR 30023-2 Block: Lot: 90
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $900.00• Occupancy Type: Construction Type:
Expired:
No. Buildings:.O No. Stories: 0 No. Unites: 0
ADDRESSi
Details: WATER HEATER CHANGE OUT - 50GALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Applied to Approved
FINANCIAL INFORMATION
Printed: Tuesday, January 27, 2015 9:43:04 AM 1 of 2 r7
SYSTEMS
ISNONE°
FAX""
'EIVIi�II
NAMETYPE
NAME`
ADDRESSi
CONTACTS
CITY
STATE
ZIP
APPLICANT
STATEWIDE SERVICES INC DBA STA
73804 DINAH SHORE
DRIVE
PALM DESERT
CA
92211
(760)771-9174
CONTRACTOR
STATEWIDE SERVICES INC DBA STA
73804 DINAH SHORE
DRIVE
PALM DESERT
CA.
92211
(760)771-9174
OWNER
WILLIAM BRAGG
60299 POINTSETTA
PLACE
LA QUINTA
CA
92253
(760)771-9174
FINANCIAL INFORMATION
Printed: Tuesday, January 27, 2015 9:43:04 AM 1 of 2 r7
SYSTEMS
DESCRIPTION.-
"ACCOUNT.,
CITY
BY-
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
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
Total Paid forPLUMBING FEES:
$19.34
$0.00
TOTALS:
$112.19
$0.00
INSPECTIONS
D
DATE
PLUMBING FINAL"
PARENT PROJECTS
Printed: Tuesday, January Z7,2O159:43:O4Am1 2vf2
Permit #
City of La Quinta
Building &Y Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
n Stories:
Owner's Name:
Telephone # of Contact Person: �-7 �—
G � Estimated Value of Project:
A. P. Number:
#
Address: 1 0 0-3-e(
y�
Legal Description:
TRACKING
City, ST, Zip:
11 �-
Contractor: ���`
✓l�s
Telephone:
Plan Check submitted
Address: '
f
Project Description:12
N &,r—
City, ST, Zipc�
•�G 0 V IV
Telephone. L. / V
i)'M•}!+i%:Y: ii:Uyf 4.. iv�t\}};.'i
>:ck.r.•. ;�.st;.":^<';M:�x'�`:
Plan Check Deposit
State Lie. # : G% [o
City Lie. #:
Arch., Engr., Designer:
Plan Check Balance
Address:
Tide 24 Coles.
City., ST, Zip:
Construction
Telephone,,----';;•�
is ,F ;;• u,. .: _ y�
?f�a�� :�„ A �!s��z#!
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lie.
Name of Contact Person:` s Sq. FL:
n Stories:
# Units:
Telephone # of Contact Person: �-7 �—
G � Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
I (,9
Item
Amount
Structural Calcs.
Rcvinved, ready for corrections
Plan Check Deposit
Truss Cafes.
Called- Contact Person
Plan Check Balance
Tide 24 Coles.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for correctionsfissueI
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP,P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total
JAN 0 6 2015
CITY OF UA QUINTA
COMMUNITY DEVELOPMENT