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10-0925 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000925 - Property Address: 52130 AVENIDA CORTEZ APN: 773-202-007-16 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 865 c&ty/ 4 4 Q" .'. Applicant: 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 ClWBCl C36 License No.: 811114 tractor: 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 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 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 _ 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 Owner: KNUDSEN CATHERINE ANNE 52-130 AVENIDA CORTEZ LA QUINTA, CA 92253 Contractor: CALIFORNIA DELTA MECHNICAL 6052 E. BASELINE RD, #155 MESA, AZ 85206 (480)898-0007 Lic. No.: 811114 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/16/10 ------------------ 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 willmaintain 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 STATE FUND Policy Number 1697823 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 3 00 of th Labor Co, all forthwit comply with those provisions. ate: 0 plicant: WARNING: FAILURE TO SECURE WORKERS' 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 building construction, and hereby authorize representatives ofShis co ty t enter upo he above-mentioned property r ns 4pp Date: �t/ nature (Applicant or Agent): � Application Number . . . . 10-00000925 Permit. . . PLUMBING Additional desc . . Permit Fee . . . . 22.50 Plan Check Fee 5.63 Issue Date . . . Valuation . . . . 0 Expiration Date . . 3/15/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 -----------------------7---------------------------------------------------- Special Notes and Comments INSTALL NEW 38 GALLON GAS WATER HEATER. 2007 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 1.0.0 .00 .00 1.00 Grand Total 29.13 .00 .00 29.13 LQPERMIT Sep. 15. 2010 - 3:53PM STEVE No, 4904 P. 5 Prescriptive Certificate of Compliance: Residential Nater Heating General Information Site Address: SW O .,q-yQ,f,Ai 69 timate Zone: 15- —IDate, MIS ISform is only used or oHeration or addition of water heetinKsysUe—Im- WATER HEATING List water heaters and boilers for both domestic hot water (DHO9 heaters and hydronic space heatuig. ItrdMdual dwelling DHfir heaters trust be gas or propane fired, and may not exceed 50 gallons. Hot water pipe insulation from the Dh7 heater to the klrchen(s) and on all underground hot water pipes is reptred in all conponentPa as in all climate zones. Bnesgy Factor or Water Heater Type / Distrtbution a Number of Tank Capacity T11e1uta1 Extemg Tank Fuel et Standard System(W) Efficiency tion R Value Standard /340M 540 519 0,60 16.1 I. Inecate Type (SAorrtga Gas, I3'eat 1'ft M Itrstmrtmreovs, etc) 2, Recbmtatmg sysfem serving multiple dwellim wa& shall meet ds recinc lotion ragwpemem of 150(n) no ZnMg IDdye rrae0e nen& do net agm the g—ot—S t7on of a recirculatinP wafer heatbt swam for stint!- dweltinn mdts. 3. The waw heating zw* andprpss shag be bmlated to meet the regutrmments of 130 Coutractor (Docameutadon Author's /Respoustble D er'a Deciatatfoa Statoneat) • I cacti$+ that this CcMeft of Complimce docoateutatioa is aceuratc and complete. • I an aligUo under Divisiea 3 cf the Califb1mia Business and Professions Code to uuxept respmsibi2ity for the building design identified on this Certificate of complieace. • I certify that tit energy fcat<aes and performance specifications for the banding design identifted on this Certifieae of Compliance conform to the requitemrmh of Title A Parts I and 6 of tho California Code of Regulasma. • 11re building design feat identified oa this Cettificate of Compliance are consistent whir the idformatiotn provided to docummA this bnHding design on the other applicable c=pliaace f =6 wurWeets, calculations, plans and speeificad bmine$ to the eatbrcameot RM fa appoval with this bwft Peaut a heation. Nam'Elena Johnson c4MP1mY,Cal1fomia Delta Mechanical base Addresa;6056 E. Baseline Rd„ #155 81811114 Ciry5tawipUesa, AZ 85200 Phoa468-892-5273 2008 Residential Cornpliance Fonns March 2010 Sep. 15. 2010 3:53PM STEVE No.4904 P. 4 Bin # Permit # 0 '01 Proj=t Address: JAZ. � ?J ty 0f La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico la Quinta, CA 92253 - (760) 7777012 Building Permit Application and Tracking Sheet 7AV94L4 fitc?_ ownct•'s X=ee7: A. P- Nurnber. - Legal Description: Address: S L 130 City, ST, Zip: �-GIS/'� �i Z Zg 3 " Coat�cror 01 `4'vl Gj Telephone: �� — � Address: �OS6 �tzse?,ll'i�@. �5.� Prgjedl}escriptlon: City, ST, Zip: J`Le8 Z 5�?-� b ct c� � 23 0,1� 67 aS Telephone: Stato Lic # :J City Lia. #: j0 y00 y Arch., ' Dsslls= Addttss: City, ST, Zip. Telephone: nstrucNon Type: Occupancy: Stato Lia M roject typc (circle one): New Add'n Alter ' = flair Demo Name of Contact Person: Et"t x.4WCFL__ r. : # 3tmies #Units Telephone # of Coact Pcrson: Fsu-maed Va1ae oYPmject: F6,5." /,3 APPLICANT: DO NOT WRITE BELOW THIS LINT: # Submittal Req'd geed TRACLUNG PERWIMEES Plan Sets Plan Check enbmitted Xtem Amotntt 3traetaral Calm Revtewiid, ready fbr corrections Play Check Deposit Truss Calm. . Called Contact Pi son Plan Check Balance. Title 24 Cala. Plans pleked up Construction ' Flood plain plan plans resubmi'tted Mechanical Grading plan Zed Review, ready for correcYwnsfiasue Electrical SubcontactorList Called Contact Person Plumbing GrantDeed Pians picked up H.O.A. AppraJal Plans resubmitted Grading IN HOUSE:, Review, ready for correctioneliasuc Developer Impact 17ca Planning Approval Called Contact Person Pub. Wks. Appr Date of permit issue Schodl Fees Total Permlt Fees Received From: �u� /''f COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL / ' : { Date: Address: Account No. Lot(s) _- Tract C Service Address ,ol LITE . Con T is G.A. Code / ^/ VMeier(s) CJ IE-<',lce(s)�/ Q� S � r (� ❑ Backflow(s) ❑ House Lateral(s) ❑ Detector Check(s) ❑ Meter Surcharge anl'tation Capacity Charge a Ut a 1 :72, 77 ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water i Sewer - Tract - ❑ Bond Payment- A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other dG' TOTAL $ " --- Remarks: ❑Copy to: Cash Check GI o -i.-7 Money Order Water Service Cashier.