13-1339 (PLBG)P.O. BOX 1504
7,8495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00001339
Property Address: 78611 SAGEBRUSH AVE
APN: 646-311-012-12 -000000-
Application description: PLUMBING
FrOoeifty ZOH111g: DIEDIU14 DENDITY RDO
Application valuation: 800
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
4 Q".
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.
LicenseClass: C36 ens 12894
- 2-/-/ 7
Da : Contractor:
At
� BUILD
OWNFR-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, 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 am exempt under Sec. , B.&P.C. for thii 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 (See. 3097, Civ C
Lender's Name:
Lender's Address:
LQPERMiT
Owner:
ROSEANN ZAMARRIPA
78-611 SAGEBRUSH AVENUE
LA QUINTA, CA 92253
(
Contractor:
ALL STAR WATER HEATERS
30300 PUERTO VALLARTA W
MENIFEE, CA 92584
(951)301-0067
Lic. No.: 812894
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/21/13
A) tOLCIT21 20.13
CITY OF LA QUINTA
FINANCE DEPT.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - —
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
"Lvissued '
have an� will maintain workers'co - mpensation 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 OAX RIVER INS - Policy Number 2200062086121
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 �Fs7c
, S:bmp!nsation laws of California,
L ; it.�Zker,%��rnpensation provisions of Section
and agree that, if I should becomi , subject
Labor >Coode, I . sallr"f r PI hose provisions.
3700 of the
2-1 -1 - App
Date/ lit
WARNING: FAILURE TO Sdr�OR�KERS' 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, e . ach 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 cert fY 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 IN ty t t upon the above-mentioned pro:perty for �iinspe tion:pu:rp;os;;s.
r ounL
Da; 7;��-Zignature (Applicant or Agent):
Application Number . . . 13-00001339
Permit . . . . . . PLUMBING 2013
Additional.desc
Permit Fee . . . . 11.92
Plan Check Fee
.'00
issue Date . . . .
valuation
0
Expiration Date 4/19/14
Qty Unit Charge. Per
.Extension
1.00 11.9200 EA PLBG WATER
HEATER/VENT
11.92
---------------------------- 77 --------------------------------------------------
Special Notes and Comments
WATER HEATER CHANGE OUT - 40GALLON/GAS
[2008 ENERGY] CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 201.0 CALIFORNIA BUILDING
CODES.
*
---------- ------ 7 ---------- I -------------------------------------------------
Other Fees . . . . . . . . . PERMIT
ISSUANCE M/P/E
90.57
PLAN CHECK,
PLUMBING
7.15
Fee summary Charged Paid
----------------- ------ --- -- --------
Credited
---------- ----------
Due
7 I
Permit Fee Total 11.92
.00 .00-
11.92
Plan Check Total .00
.00 .00
.00
Other Fee Total' 97.72
.00 .00
97.72
Grand Total 109.64
.00 .00
109.64
LQPERMIT
Bin #
Qty of La Quinta
Building &r Safe tybivision
P.O. Box 1504, 78-495 Calle Tampico
La Ouinta, CA 92253 - (760) '777-7012
Building Permit Application and Tracking Sheet
Permit #
Prqj6cl:Address7-0�� I 4Vt_
'Owner's Name: P,
A. P. Number: U
Address:
Legal Description:
City, ST, Zip:
Contractor:#/�
te
Address: /,VProject
Descr iption:
City, ST, Z�p. CC)
Teleph I x (_x 9 e 3
State Lic. # i City Lie.
Arch., Engr., Designer:
Address:
City, ST, Zip:
X
Telephone:
State Lic #:
Name of Contact Person:
Construction Type: occulixicy:
Project type (pircle one): New Add'n Alter Repair Demo
# Stories:
#-Unils:
Telr,pho.ne#,of Contact Persor�-qrl 131-6--yop,7
1 Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Reqld
Rec!d
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Ciieck Deposit
Truss CaIcs.
Called Contact Person
Plan heck Balance
Title 24 CaIcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3"' Review, ready for corrections/issue
Developer Impa-:t Fee
Planning Approval
Called Contact Person.
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total 'Permit Fe.:s
IRCM
folOpw otmof 4W&nwjvr&M ddAiesle rot =jMM11&Vf* eak*wc .M.No rX.79=17M. zRW
rWATZIL
*own mw k liv #rprqp0wj*wj. and.w4y xqf.fx�ved J#-jaUlsw, imadoloxfhok Ok PHWkwer to Ake kttchvift)
tT:P,
axd ex sU MR&NA Smawshm if In da'.. MOA&IMANAU. UNNO
� 11
Water Renter- Diottibutieff Type Tank Inercy, Fsot4r"or External Tank
Type/fuel Type, (Stgndar4, ...Systa Copoeity Isel) Thermal -Efficiency Insulation I -Value'
COMPOnY : All Star Water Heater
Storaize Gas. Standard
50 .62
Z 16
Menifee,CA92584
Date: IC -1-
L 1"Cau yypf My"Of Owl J91malft* 1ANUMMai-K4
2. RedralaiRSoystemamig wo)WkWom mpdwwrsif 110(h). DePwe?fpttw
twquirawmi do xor elk:w' A# iksoalkdon of a ;wdrcWa#* wwr A ootlq,j�wewfiir *jk aNwIflOr aft.
t1kr
110-1113: Vater heaters. gn-oortified by, thi Enor g_y COWISIon.
-.11310 5.* Water heating -recirculation loops servinj multiple dwelling. units and
c !
opoupoholso Mes the &Jr.'r4loass Volvo, backfJow prevention, pump isolation valve, and roicircuj#�IoA,
150 IA: Storage so# water heaters rated with in Energy Factor no greater than the federal o0jusl sund*r.d,
are es-tfrnally *sPlod. wi-th. Unglatloo -having on Installed thermal resistance of 11-13 or'srsater.
I HOW IB: Unf ired suaw.0 Wks. Rua a's statirage toAks. or backup tanks for so] or 011ti-lest Ing syvttm, or
other Indirect hot water tanks toys R-4 external Insula'tion or R-16 internal Irsulatiop Ooko th.t.
fntir6ej $Agulstie#,.J�-valuo is'.1ndicated on %'he exterior of the tank; -
irst 9 feet of hot and. coli. water pipes' olopost to water heater tank, noft-reciiii1stins systems. and
entire length of recirculating seation's of hot water. pipes are. Insulated per Standards Tsklo- .16,L$s
11500 2: Cooling systom pf-ping Iffuction WO-tii
Milled i r,_ or -brine lines), and'�Ivihg -invulatad betwein hostlai
source and Indirect hot rk".r !M.k shoN be. Insulatod. to Table 150-9. and: tMOph 1WA.
160.02. Pipe insulation for steam hyckonie b"iting oy'stems or hot water system M. �i, meet# the
.requirements of Uspdardo Table 123*t
115DOW: Insulation is potocted ftm ;Urs, olulp"i't
IncTuirliff that due: to sunlight, me.f$
maintenance, and wind,
DOMMon, t9don Author'o R!d!Mft1'ftdmvnt
I aw*,ftt dofflommeftfin 6 46OPM wed
N2a'a - Jeff Sprague 0-9m.or ttAiutharivei agent k6ntraictor
-3 ture:
COMPOnY : All Star Water Heater
812894
Address: 30300 Puerto Vallarta Wa
Phone'. 951- 1 345-4083
Menifee,CA92584
Date: IC -1-