12-0014 (PLBG).,P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:1200000014' Owner:
Property Address: 50820 NECTAREO COGBILL CLINTON L
APN: 772-070-013- - - PO BOX 5742
Application description: PLUMBING LA QUINTA, CA 92247
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: ?3RF
Applicant: Architect or Engineer:
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 ss: C36 L'censeNo.: 880269.
ate: t. tractor:
0 NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 a empt 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 Icommencing 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).:
(_) 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 o.r ,
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—) 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
Contractor:'
FRANKLIN PLUMBING,
2712 E. LA CADENA D
RIVERSIDE, CA 92507
(800)1600-0675
Lic. No.: 880269
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/06/12
JAN 0 C 2012
OF LA
WORKER'S COMPENSATION DECLARATION
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 NTL UNION INS Policy Number WC6506596
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 comply with those provisions. -
te: �O�IETO
nt:
WARNING: FAICURE WOR RS' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN MPLOYER TO CRIMINAL NALT S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TOT T 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 hereby authorize representatives.
of this c unter upon Pe above-mentioned prop rty for inspection purposes .
Dpte: 2.5' ature (Applicant or Agent):
Application -Number 12-00000014
Permit . . . PLUMBING
Additional desc .
Permit Fee 30:0'0 Plan Check Fee
7.50
Issue Date Valuation
0
Expiration Date 7/04/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 7.5000 EA PLB WATER HEATER/VENT,
15.00
---------------------------
Special Notes and Comments
-- -----
WATER HEATER CHANGE OUT - (2) 40GALLON
GAS/R-16 [2008 ENERGY] 2010 CALIFORNIA.
BUILDING CODES...
January 6, 2012 1:55:59 PM AORTEGA
-------------------_-------------------------------------------
Other Fees BLDG STDS.ADMIN (SB1473)
-------------
1..00
Fee summary Charged Paid Credited
----------------- ---------- ----
Due
-------- -
Permit Fee Total 30.00 .00 .00
30.00
Plan Check Total 7.50 :00 .00.
7.50
Other Fee Total 1.'00 .00 .00
1.00
Grand, Total' 38.50 .00 .00
38.50 .
- LQPERMIT
'.
Prescri five Certificate of Com liancei Residential.:' CF-IR-ALT-DWH
Resideirtial Alleratioris
Page ! of
Project Name:`
C. ' � Climate Zone: Permit #:
General Information
Site Address: t%>e,vex-o! Enforcement A enc
Date:: % t.
Building Type: MSin le Family 0 Multi.Family Project Type: TX P lace t or Change Out. of Water Heater
WATER HEATING
• I certif that this Certificate documentation is accurate.and complete. "
List •water heaters and boilers for both domestic hot water (DWH) healers and hydropic space heating. Individual dwelling DWH heaters
trust be as or ro ane tred, and i not exceed 50 allons. r
Water Heater Distribution Type. Number N Tank Ener Factoror
(Standard, By
Type/Fuel Type Recirculating)' System Capacity (Bail) Thermal Efficiency
Company.
External Tank
Insulation
R -Value
y
If Applicable O CEA or O CEPS
(Certification p):
City/State/Zip:
Phone:
Responsible Building. Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design
identified on this Certificate of Compliance.
• I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance
conform to the requirements of Title 24, Part l and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
?. Recirculating systems serving, multiple dwelling units shall meet the recirculation requirements of §150(n).
requirements do not allow the installation of a recirculating water healing systenifor single dwelling units.
3. The external water heating tank and fes shall be insulated to meet the requirements o 150 ' .
The Prescriptive
Documentation Author's Declaration Statement
• I certif that this Certificate documentation is accurate.and complete. "
Name:
Signature:
Company.
Date:
Address:
If Applicable O CEA or O CEPS
(Certification p):
City/State/Zip:
Phone:
Responsible Building. Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design
identified on this Certificate of Compliance.
• I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance
conform to the requirements of Title 24, Part l and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms, .worksheets,. calculations, plans and specifications submitted to the
enforcement agency for approval with this building permit app lication.
Name:
Signature:
Company:
!Dam:
\ _-
t8
Address: f
License:
Phone:
City/State/Zip:
�
we p - 0(0-1 S
Prescriptive Requirements for Water Beaters
r +t, Under'the 2008 Call forn :jEnergy Standaids_;
:.....
Small Water Heater QuallflcatIon
Type
Input
Gas Storage, '
75,000 BtuH or less
Electric Storage
12 kW or less
Gas Instant .
200.000 BtuH or less
Oil Instant
210,000 BtuH or less
Electric Instant
12 kW or less
Heat.PumP
24 am s or,less
, • ;t ,� _:,
Storage Water Heater
Max BtuH per Gallon
30 Gallon 40 Gallon 50 Gallon
Maximum input
4,000
120,000 160,000 '200.000
Federal Minimum
Energy Factor
Published Energy Factor Must EXCEED Values
Below, or Have External Insulating Blanket (R-12,
minimum) Installed
Water Heater Fuel Type
Effective Jan 20 2004
30 Gallon
40 Gallon
50 Gallon
Gas-fired storage -type water
heaters
0.67 — (0.0019 x V)
0.613
0.594
0.575.
Oil -fired water heaters
(storage and instantaneous
0:59 — (0.0019 x V)
0.533
0.514
0.495
Electric storage water heaters
(excluding tabletop water
heaters
0.97 — (0.00132 x V)
0.9304
0.9172
0.904
Electric tabletop water
heaters ..
-. 0.93 — (0.00132 x V)
0.8904
0.8772
0.864
Gas-fired instantaneous water
heaters
0.62 — (0.0019 x V)
0.563
0.544
0.525
Electric instantaneous water
heaters (excluding tabletop
water heaters
0.93 — (0.00132 x V)
0.8904
0.8772
0.864
Heat pump water heaters
0.97 0 0.00132 x
0.9304
0.9172
0.904
V = rated volume in gallons
'Bin #•
Cityof La QUInta .
Building 8t Safety Division
P.0-Box :1504, 78-495 Calle Tampico'. e;
La.Quinta, CA 92253 - (760) 777-7012 `
BuildingPermit Application and Tracking Sheet -
Permit #
°p1`�
Project Address: �� O
Owner's Name:
A. P. Number: , r .6—1 fJ
A dress: 95C>87 C)
Legal Description:
City; ST, Zip: Qn��
r
Contractor:
- ,'
e1'epItone:, }
project Description: �j o 2 .
O
Address:
n
City, ST, Zip: '� 01
TelephonelksI,
21
iris,
City Lic. #.:
State Lic. # : ItQo0 Z(n R
Arch., Engr., Designer.
Address:
City, ST, Zip: ^
Telephone: �.- a• }
State Lic. #:
Name of Contact Person: ^
Construction Type:
Protect tfpe(circle one). New Addrn Alter Repair Demo
Sq. Ft.:
#Stories: #Units:
Telephone # of Contact Person: 'qC1l21--1(--97'4i4
Estimated Value of Project: 7'3StQ , pp
APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item. Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Coastrueion
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2id Review, ready for eorrectionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing .
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3w Review, ready for correctionsliissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees