08-1514 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00001514
Property Address:
52925 CLARET
APN: 1770
-330 -003 -
Application description:
PLUMBING'
Property Zoning:
LOW DENSITY
Application valuation:
500
Applicant:
T4ht 4 4 Q"
COVE
RESIDENTIAL
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Professionals Code, and my License is in full force and effect.
license Class: C36 License No.: 828264
1
Date: Contractor:
WNER-BL1 DER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 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 _ 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.)'
1 _ I 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.).
(_ 1 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
Owner:
NED RYDER
52925 CLARET COVE
LA QUINTA, CA 92253
(
Contractor:
FOY, SCOTT A.
43579 MAIN STREET
INDIO, CA 92201
(760)775-9405
Lic. No.: 828264
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/04/08
SSP 10 2000 1
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 ACE INC Policy Number 045040239
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 comp) with those provisions. '
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO11 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 here y-e0ih rize representatives
of this county to enter upon the above-mentioned property for inspection u o
Date: Signature (Applicant or Agent):
Application Number . . . . . 08-00001514
Permit . .
. PLUMBING
Additional desc .
.
Permit Fee
18.00
Plan Check
Fee
4.50
Issue Date . . .
.
Valuation.
. . .
0
Expiration Date
3/03/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00. 3.0000 EA PLB WATER
INST/ALT/REP
3.00
----------------------------------------------------------------------------
Special Notes and
Comments
REPLACE GAS WATER
HEATER TO NATURAL GAS
12YR. 50 GALLON TANK WATER HEATER.
Fee summary
-----------------
Charged Paid
----------
Credited
Due
Permit Fee Total
----------
18.00 ..00
----------
----------
.00
18.00
Plan Check Total
4.50
.00
.00
4.50
Grand Total .
22.50
.00
.00 ,
22.50
LQPERMIT
09/04/2008 10:21 7607755222 CANON #2100 P.004 /004
CERTMC,ATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -1R
I
. Project Title t Date
SEALED DUCTS aM I-KVs (or Albeoake h1t ares)
A signed CF -4R Form must be provided to the building department for each home for which the following, are
aired.
Alternative to Sealed Ducts and Refrigerant Charge n7CVs (See Package D Alternative Package Features for
Project Climate Fane in the RM Appardix B Table 151-C, Footnotes 7-14.
For additions and alterations, duct systems that are not documented to have been previously i
sealed as confirmed through field verification and disc testing in accordmice with procedures in the i
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned 1
sosces shall meet the reQuirenwnts of Section 150(m). and duct insulation mquirements of Package D.
WATER HEATING SYSTEM
Distribution N=ber
Type in System
0
Sealed Ducts all climate zones(Installer testing and cerdf=don and HERS rater field verificationrequired.)
0
TXVs, readily accessible (climate nines 2 and 8-15 only) i
anstailer tesdrig and certifimrion and HERS.Rater freid verification uired.
r
Refrigerant Charge (clirnme zones 2 and 8-15 only) (Installer testing and certification tification and HERS Rater field
13
verification uired)i
Alternative to Sealed Ducts and Refrigerant Charge n7CVs (See Package D Alternative Package Features for
Project Climate Fane in the RM Appardix B Table 151-C, Footnotes 7-14.
For additions and alterations, duct systems that are not documented to have been previously i
sealed as confirmed through field verification and disc testing in accordmice with procedures in the i
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned 1
sosces shall meet the reQuirenwnts of Section 150(m). and duct insulation mquirements of Package D.
WATER HEATING SYSTEM
cmc cerviny sin¢le dwainsr nuft
Water Heater
' T uel Typ
Distribution N=ber
Type in System
ITank
Inp w Capacity
BuAr) loos
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
TankRated 1
External
I Insulation
R -Value
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum Capacity and recirculation system is
llowed_D
not allowed-
r
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
13
Manual. No water DMM calculations are required, and the system co lies automabcall .
Check box if systean does not. tneet criteria of "Staixiare system and does not comply with the Preapproved
❑
Alternative Witer Heating table_ In this case, the Performance Mcd)od must be used and must be included in the
submittal.
i
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
17
units
cmc cerviny sin¢le dwainsr nuft
Water Heater
' T uel Typ
Distribution N=ber
Type in System
ITank
Inp w Capacity
BuAr) loos
Energy
Factor' or I
Thermal j Standby`
Efficient I Loss %
TankRated 1
External
I Insulation
R -Value
I
Uj
� ✓
r
I
I
I
i
QwC*.M Corwin* mrihiAle fWA164 units
- — -- - - - Energy
Rated
Input' Tank Factor' or
Water Heater Disthbution Number (kW or Capacity Thermal
T T in System BoAr) tons Efficient
I
Standby'
Loss %
Tank I
External i
Insulation
R -Value
i
1. For small gas storage water heaters (rated hipxtts of less than or equal to 75,000 BeAw), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rased input of greater than 75,000
Bt lbr), list Rated Input, Recovery Efficiency, T hmnal Efficiency and Standby Loss. For instantaneous gas water
hearers, list Rated Input and Thermal Efficiencies.
ME lasn6fim (kitchen lines > 3/4 inches) All bot waw pipes fittm the hearing source to the kitchen fixtures that are ;/a
inches or greater in dianidw shall be dwrmally insulated as specified by Scction 150 0) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005
09/04/2008 10:21 7607755222
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ToW Permit Fees