BPLB2014-100478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
T4t!t 4 4 Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BPLB2014-1004
78137 CRIMSON CT
604024009
WATER HEATER CHANGE OUT
$0.00
Applicant:
STATEWIDE SERVICES INC DBA STA
73804.DINAH SHORE DRIVE
PALM DESERT, CA 92211
JUL 2 9 2014
CITY OF LA OUINTA
COMMUNITY 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 NoDate: Contr
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).:
(_) 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 Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/29/2014
Owner:
MILLS FAMILY TRUST
78137 CRIMSON CT
LA QUINTA, CA 92253
Contractor:
STATEWIDE SERVICES INC DBA STA
73804 DINAH SHORE DRIVE
PALM DESERT, CA 92211
(760)393-6115
Llc. No.: 936147
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:— 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, if I should become subject to the
workers' compensation provisions of Section 37 o the Labor Code, I shall forthwith
comply with thoseprovis.
Date: 'io Applicant:
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 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 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 a laws relating to building
construction, and hereby authorize representatives of is c' to enter upon the above-
mentioned property for ins ection purposes.
Date: �I�I ignature (Applicant -
FINANCIAL ••
1.
DESCRIPTION
ACCOUNT
QTY AMOUNT
PAID PAID DATE
PERMIT ISSUANCE
101-0000-42404
0 $90.57
$0.00
PAID BY
METHOD
RECEIPT #
CHECK # CLTD BY
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT
101-0000-42401
0
$11.92
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$7.15
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $19.07 $0.00
TOTALS:$109.64 $0.00
Bin # City of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Permit # �La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Fj5ctAddress: 3 Sv�l Owner's Name:
. Number. . ! - Address: -7013-7
Legal Description: City, ST, Zip:
[!Contractor: Telephone:
Address: C,) U�-l(,(� L'_[.tlPi� t/L,�� Project Description:
City, ST, Zip: L)
-
6f—.01,
p/�
Telephoner�U cl 3 �!�(�
a at.6yi 6i:H�fi i•{;y. •G; - %y.E,'v� •i:
f f l Esc >f •:ice;
State Lie. # (p /q7.
City Lie. #;
Arch., Engr., Designer.
Address:
i
City., ST, Zip:
Telephone: --
State Lic. #:"y
:r.
nFN
Construction Type: Occupancy:
Project type circle one • New Add'n Alter Repair Demo
Name of Contact Person:
t
Sq. Ft:
n Stories:
#Units:
Telephone # of Contact Person%
a
%`
Estimated Value of Project:
1
APPLICANT:60 NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
1 TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calm
Called Contact Person
Plan Check Balance
Tide 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review,l ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
I
Plumbing
Grant Deed
I Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
s"' Review, iready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
ITotal
Permit Fees
Property Detail Report Page 1 of 1
LI DIGITAL MAP eeyanaMnppfr�
Property Detail Report for: PRODUCTS
78137 CRIMSON CT, LA QUINTA, CA, 92253-3825
Owner Information:
Owner Name:
MILLS FAMILY TRUST
Construction:
Mailing Address:
78137 CRIMSON CT, LA QUINTA, CA, 92253-3825
Heat Type: CENTRAL
Vesting Code:
FAMILY TRUST
Air Cond: CENTRAL
Phone Number:
Location Information:
Roof Type:
Parking Type:
Legal Description:
UNIT 313 CM 079/196 INT IN COMMON IN LOT 9
Yr Built/Effective: 1989/
County:
RIVERSIDE
FIPS Code: 06065
Census Trct/Blk: 045215/4
APN:
604-024-009
Alternative APN:
Map Ref: F7-819
Twnshp-Rnge-Sect:
- -
Legal Book/Page:
Tract No:
Legal Lot:
313
Legal Block:
Assessor Lot SgFt:
Subdivison:
No of Buildings:
Land Use Desc: CONDOMINIUM
Last Market Sale Information:
I
Res/Comm Units:
Sale Date:
6/1/2002
Sale Price:
1st Mtg Amount:
Sale Doc No:
2002-0314353
Price Per SgFt:
1st Mtg Int Type:
Transfer Doc No:
2002-314353
Price Per Acre:
2nd Mtg Amount:
1 st Mtg Doc No:
2nd Mtg Int Type:
Sale Type:
Deed Type:
Title Company:
Lender:
Seller Name:
Property Characteristics:
Building Area: 912
Total Rooms:
Construction:
Living Area: 912
Bedrooms: 2
Heat Type: CENTRAL
Garage Area:
Baths: 2
Air Cond: CENTRAL
Basement Area:
Fireplace:
Roof Type:
Parking Type:
No of Stories: 1
Roof Material: GRAVEUROCK
Yr Built/Effective: 1989/
Quality:
Style:
Pool Code:.
CA HOMEOWNER
Tax and Value Information:
Assessed Value:
$180,142
Assessed Year:
2013
Est Market Val: $217,666
Land Value:
$26,353
Property Tax:
$2,533
Assessor Appd Val:
Improvement Value:
$153,789
Improvement %:
85.37
Total Taxable Value:
$1
Tax Exemption:
CA HOMEOWNER
Site Information:
Assessor Acres:
0.08
Zoning:
Land Use Code: 112
Assessor Lot SgFt:
3,485
No of Buildings:
Land Use Desc: CONDOMINIUM
Lot W/D:
I
Res/Comm Units:
1
County Use Code: RC
Calculated Acres:
0.0203
Sewer Type:
Calculated Lot Sq Ft:
884
Water Type:
http://dcl.parcelstream.com/GetByKey.aspx?dataSource=%24%28ACCOLNT NAME%2... 7/21/2014
Prescriptive Certificate of Compliance: Residential- CF-IR-ALT-DH[W
Residential Alterations
Project Name: .,' Climate Zone: Permit#:
General Information
Site Address: : Enforcement A e Date.
Building Type-,ff Single Family 11 Multi Family Project Type4 Replacement or Change Out of Water -Heater
WATER HEATING
• I certify that this Certificate of Compliance documentation is accurate and complete.
List nen-b- installed water heaters and boilers for /wilt dontestic hot water heaters (DWH) and ltidronic space !eating.
NeN•h• installed
D1VH heaters and boilers mutt be gas. propane. or itse die existin.R fitel qpe.
conform to the requirements of Title 24. Part I and 6 of the California Code of Regulations.
Distribution Type
Water tater NumlxY In Tank Energy Factor or
Capacity (gal) Therl Efficiency
Typdrvct Type' (StWWWd, system ma
Recirculate y:
External Tank
Insulatiw
R -Value
enforcement agency for approval with this budding permit application.
Name:
Signature
C y: Date: %t
A Z U .�' U, 6 !
City/stmdzip: /3 r Phone: �y
1. Indicate Type (Storage Gas. Heat Philip. Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §/An).
The Prescriptive
requirements donor allow the installation of a recirculating nater heating system for single dwelling units.
J. The e.vernal Nater heating tank and s shall be insulated to meet the rc uirentents of f 1
Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Dedaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
. 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 I 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 budding permit application.
Name:
Signature
C y: Date: %t
A Z U .�' U, 6 !
City/stmdzip: /3 r Phone: �y