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12-0755 (PLBG)4 P.O BOX 1504 �VOICE (760) 777-7012 78-495 CALLE TAMPICO -FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/09/12 Application Number: L---fT2 000A� 07557 Owner: Property Address: 7� 8! 094 CALLE]N_ORTE W. NYSTROM APN: 770-012-020- - - 78094 CALLE NORTE Application description: PLUMBING LA QUINTA, CA 92253 D Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 850 ��$ 0 2011 ) Contractor: 1.. L Applicant: Architect or Engineer: ALVAREZ, JORGE A. Ci'yOFLAQUINTA P.O. BOX 984 -FINIAUNCEDEPT. THERMAL, CA 92274 (760)777-3613 rl /L tic. No.: 880103 ------------------------------------------------------------------------------------------------- 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. y'cense Class: C36 License No.: 880103 / Date: .ntractor. OWNER -BUILDER DECLARATION hereby affirm under penalty, of perjury that 1 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).: (_) 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 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.). (_ 1 I am exempt under Sec. , BAP.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 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 EXEMPT Policy Number EXEMPT 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 a Labor Code, I s II f hwith comply with those provisions. Applicant: WARNING: FAILURE TO SECURE WORKE ' 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, 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 b" ing construction, and hereby authorize representatives of/thh* county to enter upon the above-mentioned prope for i spection purposes. Date:igna - re (Applicant or Agentl: Application Number . . . . . 12-00000755 Permit . . PLUMBING Additional desc . Permit Fee . . . . 22.50 Plan Check Fee 5.63 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/05/13 Qty Unit Charge Per _ Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 ---------------------------------------------------------------------------- Special Notes and Comments INSTALL NEW 50 GALLON GAS WATER HEATER. 2010 CODES. ---------------------------------------------------------------------------- Other Fees BLDG STDS ADMIN (SB1473) 1.00 Fee.summary Charged Paid Credited Due . Permit Fee Total 22.50 .00 .00 22.50 Plan Check Total 5.63 .00 .00 5.63 Other Fee Total 1.00 .00 .00 1.00 Grand Total 2.9.13 .00 .00. 29.13 LQPERMIT Prescriptive Certificate of Compliance: Residential CF- IR-ALT-DHW Residential Altercllivns Page 1 of l Project Name: o Climate Zone: 15 Permit 0, c. General information Site Address: e I3of - Enforcement A nc : i3,Ite:. - VDL Buildin T e:,G-Sint le Family ❑ Multi Family. Project T e:d -Re lacement or Chane Out of Water Heater WATER HEATING List netvh- installed stater heaters and boilers for both domestic hot nater heaters (DWH) and lydronic space heating. Newly installed DWH heaters and boilers must be leas. propatre, or use the existingfiieI type. Water Heater Type/Fuel Type Distribution Type Number to Tank standan]. System CapacityaI Resin ttlatin 1s y (Sal) Energy Factor or External Tank y Insulation 'thermal Efficienc R -Value, . , evs.o�Y1 0 l: Indicate 7:spe (Storage Gas, Heat Pump. Instantaneous. etc.) Z. Recirculating systems reeving multiple dwelling units shall ineet the recirculation requiretnenti of §150(n) -77i .Prescriptive requirements do not allow the installation of a recirculating trater heating system for single dwelling nobs. A 77te external water heating tank and pipes shall be insulated to meet the require ents .Of 150U), Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement) • 1;certify that this Certificate of Compliance documentation is.accum.te and complete. • .1 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 I and 6 of the California Code of Regulations. 'fhe building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on tate other applicable compliance forms, worksheets, calculations. plans and specifications submitted to the cnCorcement a ency fora roval with this buildin * ermit a lir ation. Name: _ Signature: 7::S C) r(' Company:Date: { . Address: License: - 0 X G?��A CitytStatelZip: Phone: CN '-Xoo - 7 7 1-3(p GA nr;l min 2009 Appliance Efficiency Regulatlorlit fOk Small Water Heaters Small Water Heater is defined as: Y e input Gas Storage 75,000 Btu/hr or less Oil stoma 105,656 Btu/hr or less Electric Storage 12 kW or less Gas Instant 200,000 Btu/hr or less Oil Instant 210,000 Btu/hr or less Electric instant 12 kW or less Heat Pump 24 amps or less ra a Water Heater is defined as: 30 Gallon 40 Galton 50 Gallon ax Btu/hr erGallon r4,000 120,000 160.000 200 000 0.93 - (0.00132 x V) 0.890 If rated Energy Factor does not EXCEED minimum Federal Minimum Values Below, an External Insulating Blanket (1a-12, Water Heater Fuel TYPO CHUMw@ .+++•� �y �•�- �- .---.._.. - - Gas-fired storage -type water 0.62 -(0.0019X -V)- 0.563 0.544 0.525 heaters Oil -fired water heaters 0.59 - (0.0019 x V) 0.533 0.514 0.495 (storage and Instantaneous Electric storage water heaters 0.93 - (0.00132 x V) 0.890 0.877 0.864 (excluding tabletop water heaters Electric tabletop water 0.93 - (0.00132 x V) 0.890 0.877 0.884 heaters Gas-fired instantaneous water 0.62 -= (0.0019 x V) 0.563 0.544 0.525 heaters Electric instantaneous water heaters (excluding tabletop 0.93 - (0.00132 x V) 0.890 0.877 0.864 water heaters Heat um water heaters 0.93- 0- �lrated ©877 0884 volume in alfons 1. Per Section 1500) of the 2008 Energy Efficiency Standards. GAnril 7010 Bin # .. City of La Quin to Building 8r Safety Dlvision P.O. Box 1504, 78-495 Calle Tampico La Quints, CA .92253 - (760) 777-7012 Building Permit Application and Tracking Sheet - a' Permit # �a Project Address: t.'j� b 94 Owner's Name: A. P. Number: Address: 2 O . Legal Description: City, ST, Zip: L::S_ C Contractor: C)r-cx L oxe Address: — Telephone: (9 —. O Project Description: City, ST, Zip: C 2t Telephone: State Lic. # : "City. #: 401S­171 S Arch., Engr., Designer" P Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: jf ; Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft : #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: �Q APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Req'd . Rec'd TRACKING PERMIT FEES Pian Sets Plan Cheek submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Cheek Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Caics. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical - Grading plan 2" Reviewready for correctionvIssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up L ML H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" Review, ready for cormcdonslissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue ' School Fees Total Permit Fees