12-0050 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
12_00.0_0.00.5.0
Property Address:
81120 CHANTICLEER DR
APN:
762 -370 -022 -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1211
T4tyl 4 4 Q"
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 Business and Professionals Code,and my License is in full force and effect.
License lass: C10 C20 C3Li ense No.: 811114
Date:0/a: 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.).
(_) 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.).
(_) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/17/12
Owner:
STEVE WARMICK
81120 CHANTICLEER DR
LA QUINTA, CA 92253 D�LINC
n
�IJ
Contractor: iJAN2012
CALIFORNIA DELTA MECHNICAL
6052 E. BASELINE RD, #1 5 C1'Py0!"!-A 0. UiNTA
MESA, AZ 85206 F!,V02E L;EpT,
(866)692-5273
LiC.. No.: 811114
------------------
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 sh hw' h comply with those provisions.
KDate: 1 / 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 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 Quints, 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��;Ziunature
pon the above-mentioned property for ' . tion pur oses.
,Date: (Applicant or Agent):
'' -
Application Number . . . . . 12-00000050
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 22.50 Plan Check Fee
5.63
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 7/15/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50.
----------- ----------------------------------------------------------------
Special Notes and Comments
WATER HEATER'CHANGE OUT - 75GAL/GAS
[2008 ENERGY] 2010 CALIFORNIA BUILDING
CODES.
January 17, 2012 5:20:01 PM AORTEGA
----------------------------------------------------------------------------
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 x.00 .00
5.63
Other Fee Total 1.00 .00 .00
1.00
Grand Total 29.13 .00 .00
29.13
LQPERMIT
•f
Prescriptive Certificate of ComRliance: Residential Water Heatlnz CF -IR -ALT -WH
General Information
Site Address: \ ���- Climate Zone: I Date: l Z.b'12-
NOrF: Thi arrn is onl used r alreralton or �tddittoir o water lraetin s terns.
WATER MATING
List water healers and boilers for both domestle hot water (DHPP) heaters and hydronic space heating. Individual dwelling DHW
heaters must be gas or propane fired, and may not exceed 50 gallons. Hot water pipe kmladotn from the DEW heater to the
kitchen(:)and on all undargrouird hot waterpipes is ra uired in all corVo entpaakVas in all climate aortas.
• 1 cc* ftt tho ettorgy features and perforx =ec specifications for the bunftg dedgtt identiSed on tbta Certificate of Compliance conform
to the requirements of'Rde 24, Porte 1 and. 6 of the California Coda of Regulations,
• The bOdIng design, fut irss identified on tbia Certificate o£ Compliaaee are consistmt'with the luformation provided to documeat thin
13nergy Factor or
agenoy fur sprioroval with ft buU&x vomit applicaftm
Water Heater Typo %
Distribution Type Number of
Task Capacity
Thermat
Extemal Tank
Fuel Typal
Standard System
�'DQ�886�892-5273
EfflciaAcV
rn5watior, F, -Valu('
j
Standard
1. Indicate 7jpa (Storage Gas, Heat,PoV. Invtntaneous, etc.)
7. Recirculating s}cf*w servtng multipte swelling unite shall meet the racircutathon requirements of 150(n). s Prseer(plive q am�gnts da
not aliglp the in NHadon of a mctrcutatOw water haglaa' skm for at a dwaiu' g - t
3. The water haattng honk and pipes shall be imulaicd to meet the req<cfiwwu q f 1306).
Contractor Tocumentation AWhotr's /RuponOble Desi er's Declaratiou 5tatem!nt
• I certify that this Cart fieate of Campliwwa decontetitation Is accurate end eomplate.
• I am eligible usAw Division 3 of the California Business and Profeasicns Code to accept n:eponsib>7 for the building dcaign id=Ued on
this Certit9oate of complianec.
• 1 cc* ftt tho ettorgy features and perforx =ec specifications for the bunftg dedgtt identiSed on tbta Certificate of Compliance conform
to the requirements of'Rde 24, Porte 1 and. 6 of the California Coda of Regulations,
• The bOdIng design, fut irss identified on tbia Certificate o£ Compliaaee are consistmt'with the luformation provided to documeat thin
balldtag design on the other applicable compliance forma, wadmheets, ealmvlations, plane and speeifieatioae submitted the enforcement
agenoy fur sprioroval with ft buU&x vomit applicaftm
NO.M. 11 / / IA %
signature:
Compaay:Callfornla Delta. Me anicai
Date: ,sem X71 Z_
Addreae:8056 E. Basellne.'Rd., #155
I.icenae;g:lg114
C'Wy iste(zlp'Mesa, AZ 85206
�'DQ�886�892-5273
Din #
City of La Quinxa
Sut(ding at Safety DMIdn
Permit #
P.O. Box 1504, 78-495 01le Tampico
4 Qulnta, CA 92253 • (760) 777.7012
�1..ero5�
Building Permit Applicatlon and Tracking Sheet
Project Address; ^L Owner's Name:
A. Y: Number,
Address: i �2 014* L
Legal Acscri tion:
City, ST, Zip. q uiA L
Contractor: P}m" Ci
�
�L7
telephone:
Address: 605-6 8, b `ro— IS:5—
ProjectDeaoription:
City, sr,zip:/� Z
p.5�206
Telephone; .� 2
State Lie. # :
city Lia l0 k00 y
,
Aroh„ Bag, Designer:
Address:
'
City,, ST, zip:
Telephone:
CoAstruetion Type. Occupeacy:
"rojoet type (otrcie o=): New Add`a 1 :topair Demo
State Lia #:
Name of CotOct Person: C i�W
Sq. Ft: # Sintits: ^ # Unita:
xelephoaa # of Caatect 1?areon: g6 A,6 Z — 7J Bsdtnatad Value of Project 1) , ?j
APPLICANT: DO NOT WHITE BELOW T141S LINE
#
Submitral
Xt 'd
'Xtee'A
TRAC-"fSMG
l?1l:XtIM FM
Plau Sete
Plan Check submitted
Xtem
Amount
8trueturat Calve,
ReAcned, ready for corrections
Plan CbeckDepoalt
Truss Cales.
Called Contactrirson,
Plan Check Balance.
Title 24 Cates.
Plans picked up
Conetraetlon '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
a" Review, ready for cormctionsAme
Xleettical
8ubcontactor Llst
Called Contactftaon
Plumbing
Orant Deed
Plena picked up
S.Mj'
FX,Q.A, Approval
Plans rasubmltted
Grading
M HOUSM.- '
'e0 Review, ready for eorrectionstissue
Developer impact ilea
Planning Approval
Catled Contact Peraoa
AILP.P.
Pub. Wks. Appr
Date of permit Issue
achodl Bees
Total Permit Fera
poi -50H, ILI
Vim
8 d ti56� 'IN. 3AhS MS: S 6106 "9l '�.pf