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BPLB2016-0138DEC VOICE (760) 777-7125 Q ?FM;.60)'777-70 �rrINNSPECTIONS (760)'77 3 D%SIGNAND mE4A Q INrA 12/7/2016 Owner:�'M�T CURTIS WELLBORI` 44525 SAFFRON C— LA QUINTA, CA 9253 Applicant: Contractor: A R S AMERICAN RESIDENTIAL SERVICES OF C A R S AMERICAN R`SIDENTIAL SERVICES OF C 96S RIDGE LAKE BLVD SUITE 201 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 MEMPHIS,.TN 381?0 (901)271-9700 Llc. No.: 765155 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 Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C36. C4tt2, A License No.: 765155 DaC a _1 ) Y Ccintractor. 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 7600) 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).: (_J 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. Q. Lender's Name: C Lender's Address: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one.of :he following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 5f 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: LIBERTY INSURANCE CORPORATION Policy Number: WC7631508631 - I certify that in the performance of t ie work for which this permit is issued, I shall not employ any person in any manner so as to become subject to ers' compensation laws of California, and agree than, if I should beco u ct to the workers' compensation provisions of Section 3-A00 of the La C I shall forthwith comply with those provisions. _ Date: Appi-ca nY—/ 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 appliotion 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 ownei6 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 st.te that the above information' tett. ' build I agree to comply with all city and county ordirances and state laws rela ing construction, and hereby authorize representatives of this city to en on the above-mentio%n d property for inspection purp•ases. A`ate:, 2 1 I Signature (Applicant x Ate' 78-495 CALL TAMPICO D LA QUINTA, CALIFORNIA 92253. DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2016-0138 Property Address: 44525 SAFFRON CT APN: 604252025 Application Description: WELLBORN RESIDENCE / PLUMBING Property Zoning: Application Valuation: $3,500.00 DEC VOICE (760) 777-7125 Q ?FM;.60)'777-70 �rrINNSPECTIONS (760)'77 3 D%SIGNAND mE4A Q INrA 12/7/2016 Owner:�'M�T CURTIS WELLBORI` 44525 SAFFRON C— LA QUINTA, CA 9253 Applicant: Contractor: A R S AMERICAN RESIDENTIAL SERVICES OF C A R S AMERICAN R`SIDENTIAL SERVICES OF C 96S RIDGE LAKE BLVD SUITE 201 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 MEMPHIS,.TN 381?0 (901)271-9700 Llc. No.: 765155 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 Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C36. C4tt2, A License No.: 765155 DaC a _1 ) Y Ccintractor. 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 7600) 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).: (_J 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. Q. Lender's Name: C Lender's Address: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one.of :he following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 5f 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: LIBERTY INSURANCE CORPORATION Policy Number: WC7631508631 - I certify that in the performance of t ie work for which this permit is issued, I shall not employ any person in any manner so as to become subject to ers' compensation laws of California, and agree than, if I should beco u ct to the workers' compensation provisions of Section 3-A00 of the La C I shall forthwith comply with those provisions. _ Date: Appi-ca nY—/ 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 appliotion 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 ownei6 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 st.te that the above information' tett. ' build I agree to comply with all city and county ordirances and state laws rela ing construction, and hereby authorize representatives of this city to en on the above-mentio%n d property for inspection purp•ases. A`ate:, 2 1 I Signature (Applicant x Ate' • Date: 12/7/2016 Application Number: BPLB2016-0138 Owner: Property Address: 44525 SAFFRON CT CURTIS WELLBORN APN: 604252025 44525 SAFFRON CT Application Description: WELLBORN RESIDENCE/ PLUMBING LA QUINTA, CA 92253 Property Zoning: Application Valuation: $3,500.00 Applicant: Contractor: A R S AMERICAN RESIDENTIAL SERVICES OF C A R S AMERICAN RESIDENTIAL SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 965 RIDGE LAKE BCJD SUITE 201 MEMPHIS, TN 38120 MEMPHIS, TN 38120 (901)271-9700 ----------------------------------------------------------------------------------------------- Llc. No.: 765155 Detail: WATER HEATER CHANGE OUT - 40 GALLON / GAS J2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. DESCRIPTION INFORMATION. ACCOUNT CTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION 13SA: $1.00 DESCRIPTION ACCOUNT CTY AMOUNT PERMIT ISSUANCE 101-0000-42404 A $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $7.60 Total Paid for PLUMBING REES:. $20.27 r # Qty Of LQ Quanta Building 8L Safety Division P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 - (760) 777-7012 Building Permit' Application and Tracking/ Sheet Permit # Project Address:sf ySoZJ�r�IS p Gf _ Owner's Name:. n W�/ A. P. Number. Address: Legal Description: City, ST, Zip:�vi¢5 Contractor.cue Telephone: N;. Address: (�QG- �i 5f. Project Description: City, ST, Zip: LA-- - l W7 pct° /• . . �� � /N � � . Telephone: 3 �� 7� ; ` 4' gir aState Lie. # : 7( V � ECtyLic. #; Arch., Engr., Designer. Address: City., ST, Zip: Telephone: M State Lic. #: Name of Contact Person: Construction Type: , Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Projectj G <4' APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Req'd Recd TRACKING EERMIT FEES Pian Sets Plan Cheek submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Ba:ance Title 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2id Review, ready for corrections�issue Electrical Subeontactor List Called Contact Person Plumbing Grant Deed Pians picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE-- 3"t Review', ready for correctionslissue Developer Inuaet Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr, ' Date of permit issue School Fees Total Permit Fees STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS — WATER HEATER CEGCFIR-ALT-01-E (Revised 06114) WAL11-U NLA cry NLL T wivimiooww CERTIFICATE OF COMPLIANCE CF111-ALT-01-E WATER HEATER Prescriptive Residential Alterations for Water Heater (Page 1 of 2) A. GENERAL INFORMATION Site address: ' - Building Type: fl Single Family Dwelling ❑ Multi Family Dwellings City, Zip Code: , CA Climate Zone: 10 G. WATER HEATING SYSTEMS (Section 150.2(b)1G) 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 Water Water Water # of Water Fuel Rated Rated Heating Heating Standby Exterior Back -Up Central Dwelling Heating Heating Heater Water Heater Type Input Input Efficiency Efficiency Loss (%) Insul. Solar DHW System Unit DHW System System Type Heaters Storage Type Value Type Value R -Value Savings Distribution System Identification Type in Volume Fraction Type Distribution or system (gal) Type Name w (n 157 r--- WATER HEATING SYSTEMS Water heating compliance for an alteration is described. in Section 150.2(b)1G. For single dwelling a gas or propane water heater, with a storage tank of 60 gallons maximum or instantaneous (tankless) can be used. Dwelling Unit distribution systems are limited to Standard trunk and branch or demand recirculation for gas or propane water heater. Demand recirculation is not allowed for electric water heater. If there is no natural gas connected to the building, an electric water heater may be replaced with another electric water heater. However, changing from gas to electric is not allowed. Multi -family central systems must use certified equipment as defined under Section 110.1 and 110.3. NOTE: If the proposed installation does not meet the requirements allowed specifically for alterations, use form CF1R-NCB-01 to document the water heater alteration. Instructions for sections with column numbers are given below: 1. Water Heating System Identification or Name: enter a unique name for the Water Heating System. 2. Water heating system type: Domestic Hot Water (DHW), Hydronic, Combined Hydronic, or Central. DHW is for domestic hot water, hydronic is a water heating system used for space heating only; combined hydronic are when the water heater will provide both space conditioning and domestic hot water. 3. Water heater type: For non -central systems only Small Storage or Small Instantaneous are allowed. For central systems pick from Large Storage, Small Storage, Heat Pump, Boiler, Large Instantaneous, Small Instantaneous or Indirect. CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E WATER HEATER Prescriptive Residential Alterations for Water Heater (Page 2 of 2) 4. Number of water heaters in system: In single-family and multi -family with water heaters in each dwelling units the value is 1. For multi -family central systems serving multiple dwelling units enter the total number of water heaters. 5. Water heater volume (gal): tank capacity in gallons. For individual water heaters for a dwelling unit this will be 60 gallons or less. If instantaneous, enter n%a. For - multi -family central systems enter the total storage volume. ; 6. Fuel Type: Gas, Propane, Electric (Only if natural gas is not available) 7. Rated Input Type: Enter the equipment input rating type, for gas or propane fired units are Btuh, for electric fired system the units are kW. 8. Rated Input Value: Enter the numeric value of rated input. - 9. Heating Efficiency Type: Energy Factor, AFUE, or Thermal Efficiency. From product literature or a California Energy Commission directory. 10. Heating Efficiency Value: Enter the value from product literature or a California Energy Commission directory 11. Standby Loss (percent): Applies only to large storage water heaters, Enter n/a for small storage or instantaneous water heaters. 12. Exterior Insulation R -Value: Enter the R -value if exterior insulation on the storage tank is installed 13. Back-up solar savings fraction: If compliance requires a back-up solar system, indicate the solar contribution (e.g., 0.30). External calculations are required. 14. Central DHW Distribution System: For multi -family buildings with using a central distribution system a demand recirculation system with at least two distribution loops must be installed. This requirement applies to any building with eight or more units. If the system is non -central or project is individual units enter n/a. 15. Dwelling Unit DHW Distribution Type: For a Central DHW this field shall be Standard. If non -central then pick from Standard, Demand Recirculation — Manual r Control, Demand Recirculation —Sensor Control. If non -central electric water heater this must be Standard, no recirculation system shall be installed. DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 17 • I certify that this Certificate of Compliance documentation is accurate and complete. Name: - /I, 1 n ❑Owner p-fkath-rized agent ontractor Signature: Company: / Contractor license #: r�S Address: (� U1 5" Phone: � /U, �� W( J l!( !City/State/Zip: ^ Date: n For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.