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BPLB2015-0005� 1 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: JORGE A ALVAREZ PO BOX 984 THERMAL, CA 92274 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BPLB2015-0005 53205 AVENIDA NAVARRO 774064022 REPLACE 50 ELECTRIC WATER HEATER $850.00 JAN 0 8 2015 CITY OF LA QUINTA TY DEVELOPMENT DEPARTMENT 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.: 880103 j Date: / O G ­ S Contractor: 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 7000) of Division of the Business and Professions Code) or that he or she is exempt therefrom and the a 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.). (_) 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 Na Lender's Address: 0 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/8/2015 Owner: KIM LOUTSENHIZER 53205 AVENIDA NAVARRO LA QUINTA, CA 92253 Contractor: JORGE A ALVAREZ PO BOX 984 THERMAL, CA 92274 (760)698-8975 Llc. No.: 880103 WORKER'S COMPENSATICIN DECLARATION I hereby affirm under penalty of perjury one of tP.,e following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 a 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 not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, I I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:—� S Applicant: WARNING: FAILURE TO SECURE WORKERS' COM PINSATION 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 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 cancellati in. 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 city to enter upon the above- mentioned property for inspection purposes. Date: ' �S Signature (Applicant or Agent): - STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC-CF1R-ALT-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E Prescriptive Residential Alterations (Page 3 of 4) Project Name: 5-32135 e_nN c\- CL 0_Q C, r ry Date Prepared: F. SPACE CONDITIONING(SC) SYSTEMS — HEATING/COOLING (Prescriptive section 150.2(b)) 01 02 031 AO' Dwelling Unit Name Dwelling Unit CFA (Ft2) Comments, *'Am" � M G. WATER HEATING SYSTEMS (Section 150.2(b)1G) r. AA. W, M . 01 02 03 04 05 06 07 08 A 'A Central Water�H,eatinig System t _%e I fication or Name a i !,-,"�'10 al 12 y 13 14 15 Water Heating # of Water lq� Back Water Heater OHeiting. -Up System Water Water Heaters Storagei Rated Rd Heating'ng, Exterior So lar Dwelling Unit DHW Identification or Heating Heater in Volume Fuel Input i1q.. _Lttl� .&I pu Efficiency J-`Eftency - Standby insul. Savings Central DHW System System Name System Type I Type I system I (gal) I Type TyFig,11, Value Ty 01% 0 ''Ory-alue Loss,(%) I R -Value I Fraction I Distribution Type Distribution Type 5c) 14K O."L '0 - AX0 H. SPACE CONDITIONING SYSTEMS AND WATER HEA, ' IN AIITG 'SYSTEMS TNIDLfIFAMILYff'EtILING UNITS #�A N&'* 01 02 "A' 649V 05 06 Dwelling Unit Name Dwelling UniuMtAKCFA A 'A Central Water�H,eatinig System t _%e I fication or Name a i %rae'll'ing Unit Water Heating System ,-49entification or Name Dwelling Unit: Alteration to the Space Conditioning System(s)? Comm*ents o" 0�i4; "IN V, 0 Registration Number: Registration Date/Time: HERS Provider: CA Building.Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA 71N RESIDENTIAL ALTERATIONS CEC-CF1 R -ALT -01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E Prescriptive Residential Alterations (Page 4 of 4) Project Name: �53 205 Date Prepared: (- 8-- j 5 Ir_ DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. # ' Documentation Author Name: Documentation Author Signature: Company: Signature Date: 9 "$% kskloi Address: o `qR 14 CEA/ HERS Certification Iden"tificition lif applicable): V�. Ir City/State/Zip: py2—l�) Phone: 1 14X -7 S-7 (a rMCIA g. RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: '` 1. The information provided on this Certificate of Compliance is true and correct. r� 2. I am eligible under Division 3 of the Business and Professions Code to accept responsib`I�IItyfor the building desig'n�or system design identified on this Certificate of Compliance (responsible designer). ''� 3. That the energy features and performance specifications, materials, compos¢nits, and manufacture� daevil for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of4teglatlons. Ilk Certificate pliance�are 4. The building design features or system design features identified on this of Co consistein It lie information provided on other applicable compliance documents, a worksheets, calculations, plans and specifications submitted to th forcement agencyf ,� pproval with is tiding permit application. S. I will ensure that a registered copy of this Certificate of Compliance;shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of C mpliance is,re— , ire d'to be included with the documentation the builder provides to the building owner at occupancy. ' : +� Ae Responsible Designer Name: \ + i Responsible Designer Signature: \moi G f a_ L NAP e— Company: Date Signed: Address: e License: labo I0 City/State/Zip:'" Phone: For assistance or -,questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. x Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 • ff.� PAID DATE: `°QTY, AMOUNT' r PAID = *sf FINANCIAL •• �S `DESCRIPTION ,ACCOUNT " Ka YC :;. 3. T +s r tY�.l ,t.•a 8. > , �. s �4 tfxf_ S:uc ,B.F f BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 � ' BY c'' ' `�' cF�"' METHOD ?� `Fd� 'r " ZRECEIPtT # u 'CHECK # tt CLTD a � 1PAID' _, c Y �� vii uu. d t A BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: '$1.00 $0.00 ' DESCRIPTIONS:� ACCOUNT ryY} QTY . 'yF PAID, r PAID DATE' r:4,tµ fAN10UNT �«'`� PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 4. PAID BYf"`�' S 'y .r� 3, �, METHOD '.RECEI.PT # " , `,• _CHECK #p CLTD BY �{ Total Paid for PERMIT ISSUANCE: ..$91.85. $0.00• ti�DESCRI?TION�{`Y.LS•���tr *•;:'ACCOUNT?," +QTY? �AMOUNT4 x '` PAID ,.t PAID DATE, r -r. , WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 '. PAID :BY • `:' :' �` :� " ` "METHOD r � �' "RECEIPT# �r 7 'CHECK # a ' CLTD BY•h ,; i 9 , rz DESCRIPTION-0'1;1°�. -r x' ACCOUNT�r� QTY AMOUNT PAID'DATE t t , r .•-y . r 4 WATER HEATER/VENT PC 101-0000-42600 0 $7.25 $0.00 ghPAID BY:,`..• `�b�METHODtx " RECElP7 .#�?`,* CHECK #� `'CLTD'BYrct 5.i .s �'r f • Total Paid for PLUMBING FEES: $19.34 $0.00 TOTALS:• •• • Description: REPLACE 50 ELECTRIC WATER HEATER CHRONOLOGY ,rr. zI' Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 1/8/2015 PJU Approved: Parcel No: 774064022 - Site Address: 53205 AVENIDA NAVARROLA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 205 Lot: 10 Issued: UNIT 20 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 T Details: REPLACE 50 GALLON ELECTRIC WATER HEATER PER CALIFORNIA 2013 CALIFORNIA PLUMBIING CODE. : "" -_,;. CHRONOLOGY ,rr. zI' W_ CONDITIONS CONTACTS ?DESCRIPTION DA,.T{dE> i«RECEIPT.CHECK �.��'•;rPAID.;.�. as.=:. �}.; ,... . ','S ,� �_ : "" -_,;. r. .- .�i"••F �r ::31.f * ,r`•rh ....�_'Aq'pet ,rr. zI' •..'a'f ..B, CLTD ?DESCRIPTION DA,.T{dE> i«RECEIPT.CHECK �.��'•;rPAID.;.�. as.=:. �}.; ,... . ','S ,� �_ ,METHODP. ' BSAS SB1473 FEE 101-0000-20306 0 . -$1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: Printed: Thursday, January 08, 2015 12:01:04 PM - 1 of 2 _ 07W.SYSTEMS N INSPECTIONS AM 0 PAID INFORMATION J DATE ATTACHMENTS PLUMBING FINAL" PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid forPERMIT ISSUANCE: $91.85 $0.00 - WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 WATER HEATER/VENT 101-0000-42600 0 $7.25 $0.00 PC Total Paid for PLUMBING FEES: $19.34 $0.00, TOTALS: $112.19 $0.00 BOND INSPECTIONS REVIEWS INFORMATION J DATE ATTACHMENTS PLUMBING FINAL" BOND REVIEWS INFORMATION ATTACHMENTS BOND INFORMATION ATTACHMENTS ^ ' . ` Printed: Thursday, January O4ZO151Z:01:04Rw ' . ZofZ ' ` _ C__--_- --.MS~ . Permit . Project Address: '�0S A. P. Number: Legal Description Contractor: k 1G e Mvc Address: City. ST, Zip.` �C Telephone: State Lic. #: FSO 10 3 Arch., Engr., Designer: Address: City, ST. Zip: Telephone: State Lie. #: Name of Contact person: Telephone # of Contact Person: City Of %d Quinta Building W Safety Divfsion P.O. Box 1504, 78.495 Cape Tampico La Quanta, 64.92253 - (760) 777-7012 Building Permit Application and Trackbg Sheet . I G.\)O- rQ Owner's Name: k; M tj u Address: City. ST, Zip: � w_ CA Ci 22--S Telephone 7 Project Description: 6221 0. 50 C4 EIeLir; L OLS 2r ea -t e r �'%%'��>. .✓4�5� 'fit � ,�/�.�i,;,,•r;"i% / r, yi/ is ��: # Submittal Req'd Rec'd - - — ••.... ocwmr r rna Urvt: TRACING PERMIT FEES Plan Seta Plan Check submitted Item Amount Structural Cities.Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Cheek Balanee Tide 24 Cales.- . Plana picked op Constracdon Flood plain pin Plans resubmitted Mechanical Grading plan 2"! Review, oy for eorreetionstissue Electrical Subeontaetor List Called Contact Perioe Plumbing Grant Deed Pians picked up &%LL H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for correetions/isme Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees .