13-0371 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000371
Property Address: - 78600 CARNES CIR
APN: 604-223-019-62 -23268
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 983
Applicant:
T4hf
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
/"e -Z /,,;�L_
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: C10 C20 C3 __LicenseNo.: 811114
i
-Date: 7 / J 1 3 Contractor:
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).:
(_ 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 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:
RUBEN NABARRO
78600 CARNES CIRCLE
LA QUINTA, CA 92253
(
Contractor:
CALIFORNIA DELTA MECHNICAL
6056 E. BASELINE RD, #155
MESA, AZ 85206
(866)692-5273
Lic. No.: 811114
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/27/13
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 STATE .FUND Policy Number 1697823-11
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 shthwith comply 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 15100,0001. 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 co tZy t enter upon the above-mentioned property for ' ction p rposes.
Date: 3 IJ Signature (Applicant or Agent): ��
Application Number . . . . . 13-00000371
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . . 25.50 Plan Check Fee 6.38
Issue Date . . . . Valuation . . . . 0
Expiration Date 9/23/13
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 7.5000 EA PLB WATER HEATER/VENT 7.50
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00
----------------------------------------------------------------------------
Special Notes and Comments
WATER HEATER CHANGE OUT - 48'GALLON GAS
WATER HEATER CHANGE OUT (2008 ENERGY]
CARBON MONOXIDE ALARM(S) TO BE INSTALLED
PRIOR TO FINAL INSPECTION. 2010
CALIFORNIA BUILDING CODES.
------------------ ---------------------------------------------------------
Other*Fees . . . . . . . . BLDG STDS ADMIN (SB1473) .1.00
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 25.50 .00 .00 25.50
Plan Check Total 6.38 .00 .00 6.38
Other Fee Total 1.00 .00 .00 1.00
Grand Total 32.88 .00 .00 32.88
LQPERMIT
MAR/21/2013/THU 11:23 AM DELTA MECHANICAL—NU FAX No,702-369-957E
a��
. 003
Prescriptive Certificate of Com laatace: Residential Water Heating CF -IR -ALT -WH
General Information
Site Address: -78660 Q ( Climate zone: Date: 3 a0 1�1
NOTE: Thu form is only used for alteration or addition of water heating 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 SU gallons. Hot water pipe insulation from the DHW heater to the
kitchens) and on all underground hot water pipes is required in all compo entpackages in al! climate zones.
• 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
Energy Factor or
Water Reater TvneDigtribution-
Nurnher of P
enforcement aizencv for act3roval with this building nermit aoulication. 14
Fuel Tv el
Standard C1e cv Insulation R-Value3
11j55-11
OAS5
Delta Mechanical Juc
1. Indicate Type (Storage Gas, Heat Pump. instantaneous, etc.)
2. Recirculating systents senting multiple dwelling units shall meet the recirculation requirements of 150(n). The Prescriptive requirements do not
allow the installation of recirctilatiitjLr;vaterheafiirz system for single dweltin¢ units.
—Contractor (Documentation Author's /Responsible Designer's DeclarationStatement)
I 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, Pans 1 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 specifications submitted to the
enforcement aizencv for act3roval with this building nermit aoulication. 14
Name: Signature:
John Santos
Company: V
Date:
Delta Mechanical Juc
Address:
License: 811114
6056 E Baseline Rd # 155
City/State/Zip:
Phone. -5 j
A/faon/n 7/Qr�n4
MAR/21/2013/THU 11:23 AM DELTA MECHANICAL -NV FAX No,702-369-9578 P.001
RECEIVED
MAR 212913
CIN lA OF Q, O?t
E�OPMENT
-
COMNIN
41111-
MU
California Delta Mechanical
6056 E Baseline Rd. #155
Mesa, AZ 85206
Facsimile Transmittal
TO: City o1 La Ouinta DATE- 03/21/13
FAX NUMBER: 760-777-7011
NUMBER OF PAGES 5_ (including this page)
❑ URGENT KPOR REVIEW ❑ PLEASE COMMENT PLEASE REPLY Q PLEASE RECYCLE
Thank you,
John Santos
California Delta Mechanical, Inc.
Permit Dept.
johns@deltamechanical.com
`� (866)692-5273, Ext. 236
MAR/21/2013/THU 11:23 AM DELTA MECHANICAL -NV FAX No,702-369-9578
P. 002
Bin #
City of La Qilinta
BullAing U Safety DAvlsion
P.O. Box 1504,78-495 Calle Tampico
La.Quinca, CA 92255 - (760) 777-7012
Building Permit Application and Tracking Sheet
Perinit #
3' 37
pxojectAddress:
A. P. Plumber.
Address: • 18GW Carnes CC('
Legal Description:
City, 5T, zIp: La C 'Wta53
Telephone:
Coab:wtor an (OGiJ
Address .R
Project Descriptiozr:
City, ST, Zip: 30 b
Telepbone:
State Lic. # : j Ci L!c
Arch,., EW., Designer
Address:
City, ST, Zip:
Telephone: Constmction Type:. LIP occupancy:
State Z ic. il: Project type (circle one): New Add'n Aker(R air Demo
Name of Cootagt Person: A Sq. Ft.: it Storibs: # Tirdu:
Tdsphone # of Contact Person: (p(p— (, Estimated Value of project 13•
APPLICANT: DO NOT WRITE BELOW THIS LINE
iv
Sob,wtul
Req'd
Ree'd
TRACXIG
PirlZhxl7' FEFS
PlwrtSets
plan Check submitted
�j
Item Amoaat
Strgetaral tales.
Reviewed, read9 for corrections
Plan Check Deposit
Trnas C2kt•
Called Cogtact Person
Plan Clte4 Sslamce
TltlaU Calc4
Plana picked up
CowrMcdon '
Flood plata plan
Plans resubalitted..
Meehariieal
Giading plan
Z•' Review, reit £or correctioAsAnue
Eleetr3eal
Subcoamctor List
Called Contact Person
lPlu�nb[ng
Grant Deed
)Plans pkked up
S.i►£d.
H.O.A. AppraYal
rlags resabmittcd
Grading
IN HOV9E:-
'"' Review; ready for correctlonsfissue
Developer Impact Fee
Planning Approval.
Called Contact Person
Pub. 7n a. A,ppr
Date of permit issue
School Fees
Total Permit Fees