07-2290 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00002290
Property Address:
46541 ROUDEL LN
APN:
649-051-009-9 -2667 -
Application description:
PLUMBING
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
500
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
4
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 Class:. C36 se No.: 828264
ate: �,1 ontractor:
O ER- R 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.). '
(_) 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.).
(_) Iam 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: 8/13/07
Owner: I
DICK MARON I
46541 ROUDEL LANE Fpf
LA QUINTA, CA 92253b
m 1r, 1 2007 I Lug
5
C I W ®- U. QI-'IitlTA
Contractor: F9f�ifl�Cl= 7!'cEaTg
FOY, SCOTT A. ---
43579 MAIN STREET
INDIO, CA 92201
(760)775-9405
LiC. No.: 828264
-----------------------------------------------
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 ENDR INS Policy Number WEN000882301
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 shall forthwith cqMaLy with those provisions. '
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 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 county to enter upon the above-mentioned property for inspection p pose .
Dat � nature (Applicant or Agent)*:.907' 0.1 / 77
Application Number . . . . . 07-00002290
Permit . . .
PLUMBING
Additional desc .
Permit Fee
22.50
Plan Check
Fee
5.63
Issue Date . .
Valuation
. . .
.
0
Expiration Date
2/09/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 7.5000
EA PLB
WATER HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE WATER HEATER
WITH NEW 50
GALLON
GAS UNIT
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
V. t;EKTIVIC:A E UY UUMYL1A1NUh: KESIOLIN11AL (Page 3 of 4) UV' -1K
Project Title Date
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -411 Form must be provided to the building department for each home for which the following. are
required.
1
Distribution
Type
D
Sealed Ducts all climate zones Installer testing and certification and HERS rater field verification required.)
Ll
TXVs, readily accessible (climate pones 2 and 8-15 only)
:Standby
o%'f
nstaller testing and certification and HERS Rater field verificationrequired.)
1-Refrigerant
0
Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
OR
Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
L_ _ Project Climate Zone in the KM Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
0 scaled as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential AGM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
Ve
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
O
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
:Standby
o%'f
not allowed.
O
Check box when using Preapproved Alternative Water Heating table, Table 54 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the system complies automatically.
Check box if system does not meet criteria of"Standard" system, and does not comply with the Preapproved
O
Alternative Water Pleating table. In this case, the Performance Method must be used and must be included in the
submittal.
0
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Systems serving single dwelling units
Water Heater
/Fuel Type
Distribution
Type
Number
in System
Rated
Input'
(kW or
Btu/hr)
Tank
Capacity
(gallons)
Energy
Factor' or
Thermal
Efficiency
:Standby
o%'f
Tank
External
Insulation
R -Value
ffie qC
System serving multiple dwelling units
Water Heater
Type
Distribution
Type
Number
in System
Rated
Input'
(kW or
Btu/hr)
Energy
Tank Factor or
Capacity Thermal
(gallons) Efficiency
Standby
Loss (%)
Tank
External
Insulation
R -Value
I . For sinal I gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Five Insulation (kitchen lines> 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/4
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 (j) 2 B.
Kesidential Compliance Forms March 2005
Bin #
City of LaQ uinta
BLu7&g 8r Safety DMdc)n
P.O. Box 1504, 78-495 Cage Tampico
La QLdnta, G4 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Pennit #
Project Address. 4`Q to
Owner's Name: 4C Y
A. P. Number:
Address: L4 U - 5H I U -a1 I
Legal Description:
Contractor. O
Addcws: CA- (Y1 �-�
City, ST, Zip: \01 Ir UT q ZLCD---S-
Telephone:ci()q'g1-{U- .=rte". �
Project Description:
City. ST, Zip: YY-) 601-0 CA- aalb
` ►v �ILCCUACVII
�� •,v 1,` y �i, i�<�M S
Telephone -9 Cba ..»'���r�:��:. .)>i:�S., R'�i;%--•:'
State Llc tt Z�2.� city Lic.
Arch., IiW., Designer:
Address•
City, ST, Zip:
Tdcp hone: .'ts`
•,.:y»��,'
State Lie. #: _ .sem<��� _.i<.• -;;s �.. �.,.-x
>v ? ms's i# `z
Marne of Contact Person: av aror\
ConstructioType- ; e
n YP 31:P Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person: qOq (Q-
Estimated Value of Project -1*d0 jW S4'
APPLICANT: DO NOT WRITE BELOW THIS LINE
ff
Submittal
Req'd
Rec'd
TRAC (INVG
PERMIT FEES
Pian Stla
Plan Check submitted
Item
Amount
Struttural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Tlruw Calfa.
Callcd Contact Person
Plan Cheek Balance
Tine 24 Calces.
Plans picked up
Conadvction
1`109d plain plan
Plans resubmitted
Mechanical
Grading ptm+
2" Review, ready for corrections mmt
Electrical
8uhcontactor List
Called Contact Person
Plumbing
Crant Deed
Plans picked up
&M L
14.0.A. Approval
Plans resubmitted
Grading
IN HOUSE:
''" Review, ready for correctionslissue
Developer Impact Fee
Ptannins Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
`
SM661 Fees
Total Permit Fees