BPLB2015-009478-495 CALLE TAMPICO VOICE (760) 777-7125
• '
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT FAX (760) 777-7011
FAX
(760) 777-7153
BUILDING PERMIT
Date: 8/5/2015
Application Number: BPLB2015-009.4 Owner:
Property Address: 44665 CALLE SANTA BARBARA MARYB ANN WORRELL
APN: 604382039 44665 CALLE SANTA, BARBARA
Application Description: WORRELL RESIDENCE -WATER HET.R CHA , OUT LA QUINTA, CA 92253
Property Zoning: IMF-
AUG
Application Valuation: $850.00
0 5 2015 1b.
Applicant: _ Contractor:
JORGE A ALVAREZ CRO AQUINTA JORGE A,ALVAREZ
PO BOX 984 COMMU_NIT_Y_D_F_'_JELOPMENTDEPARTMENT PO BOX 984
THERMAL, CA 92274 THERMAL, CA 92274
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 License No.: 8801/03
-� Contract!
OWNER -BUILDER DEC RATION
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 fora
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'orher own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one yea(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:
o
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a constructionJending agency for
the performance& the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's
(760)698-8975
LIc. No.: 880103
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: Policy Number:
I certify that in the performance of the work for which this permit is issued, I
shall hot employ any person in any mannerso 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 370 f the Labor Code, I shall forthwith
wmply.with those. provisions.
Dat�o'S^ I S Applicant-.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALUSUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000).. IN,ADDITION TO THE COST OF
COMP.ENSATION,.DAMAGES AS.PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'SFEES.
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 uponwhose behalf this application is made, each person atwhose
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:CityofyLa 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 180Aay0rom date of issuance of such permit, or cessation of
work for 180 days Will subject permit to cancellation.
I certify that I•haye 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 representafives.ofthis city to enter upon the above•
mentioned property for inspection purposes.
D��- 5,, Signature (Applicant or Agent�f'/
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MEMBER,
-DESCRIPTIONy=,-";:`ACCOUNT QTYAMOUNT
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v5k ::. :R.' IS
PAID 6.;Pi41DFDATE.
BSAS SB1473:FEE 101-0000 20306 >
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Total Pya�id for.BUILDING STAN DARDS.ADMINISTRATION BSA $f.061
'fix&_ "F;:'Y`'.::u�YA$`,,F'xd;13.
DESCRIPTION
P.T.. �. ��
AOCOkJNTQT1(°AMOUNT
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PERMIT'ISSUANCE
1010000-42404'
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Total Paid-forPERM IT=ISSUANCE:$91 85 h. $0.00
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WATER.HEATER/VENT.
101 0000-42401' .
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�PAID'DATE°
WATER HEATER/DENT PC :'
101-00,66-`426.00
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Total Paid forPLUMBINGfEES $19 34 :, $0:00
• e 00
Description: WORRELL RESIDENCE WATER HEATER CHANGE OUT
Type: PLUMBING Subtype:
Status: UNDER REVIEW
Applied: 8/5/2015 PJU
Approved:
Parcel No: 604382039 Site Address: 44665 CALLE SANTA BARBARALA QUINTA,CA 92253
Subdivision: TR 25953 Block:
Lot: 130
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $850.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: REPLACE 50 GALLON GAS WATER HEATER 2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR,TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Wednesday, August 05, 2015 1:31:24 PM 1 of 2
SYSTEMS
PARENT PROJECTS
Printed: Wednesday, August 05, 2015 1:31:24 PM 2 of 2 C
sysrenns
Projed address: 4(a S
A. P. Number.
Legal Description:
Contractor r
Adams: p.p -C>
City, ST, Zip:T o r na n l
Telephone: 1 X0.717.3 io
State Lic. # : Fs to to 3
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contaa Person:
City of La Quints
Building a Safety DJvfslon
P.O. Box 1504, 78-495 Cape Tampico
La Quinta, CA .92253 - (760),777 7012
Building Permit Application and Tracking Sheet
le QLA}q, Owner's Name: Mary Arw N W.
. Address. �pla'� lie :`h/l'ha
City. ST, Zip:
c• cC Telephone:
t{ Projed Description:
e
City Lie. #: .$
t-1_
-cLr6
?!� ✓ his'Demi
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N
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sete
Pian Check submitted
item
Amount
Structural Cafes.Reviewed,
nerdy for corrections
Plan Check Deposit .
Trus Cales.Caged
Contact Person
Plan Check Balance
Title 74 Cala.
Pians pierced op
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2 ! Revlew, ready for eorrectionvUsue
Electrical
Subeontactor IM
Called contact Person
Plumbing
Grant Deed
Plana picked up
S M L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review, ready for correcdoas&mn
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
J
STATE OF CALIFORNIA s
RESIDENTIAL ALTERATIONS — WATER HEATER
CEC-CFIR-ALT-01-E (Revised 06/14) GALIFURNIA.ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT=01-E WATER HEATER
Prescriptive Residential Alterations for Water Heater (Page 1 of'2)
A. GENERAL INFORMATION
Site address: Building Type: Single Family Dwelling
❑ Multi Family.'Dwellings
City, Zip Code: tv�. dut n�c� Cdr _ _ Climate Zone: 10
G. WATER HEATING'SYSTEM$;(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
s}.n>
WATER HEATING SYSTEMS -
Water heating compliance for an alteration is described irr5ection 150i2'(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 distributiorrsystems are limited to Standard trunk and branch'or,demand recirculation for gas or propane water
heater. 'Demand ,recirculation is not allowed°for electric'waterheater..lfthere Is..no natural gas connected to the building; an electric water heater may be replaced with
another-electric-.wat&r heater. However-, changing frorrigas to electric Is riot;allowed. Multi -family central systems must use a 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 CFIR-NCB=01 to document the water heater.aIteration.
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 iy'stern 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 CF111-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: Fora Central DHW this field shall be Standard. If non -central then pick from Standard, Demand Recirculation — Manual
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
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name:❑Owner
IOC
❑ Authorized agent Contractor
e, �MQc .re Z
Signature:
Company:
LU M�rji f\
Contractor license #: /,a 8-C) /v3
Address:
Phone:
- `7—%`% 13
" 3�2 u
City/State/Zip:
Date: —�
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.