BMCH2017-003278-495 CALLE TAMPICO V VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-701.1DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/21/2017
Application Number: BMCH2O17-0032 Owner: cm
Property Address: 50505 VERANO DR JOHN BAUGH Q
APN: 777240013 50505 VERANO DR Z
a
Application Description: BAUGH /WATER HEATER CHANGEOUT LA QUINTA, CA 92253
Property Zoning: o c7 n
Application Valuation: $1,612.50 �m O
o �
Applicant: Contractor: cb
TOMMY ROOTER PLUMBING INC TOMMY ROOTER PLUMBIRTC; ry
80975 INDIO BLVD #139 80975 INDIO BLVD #B9 Q a o
INDIO, CA 92201 INDIO, CA 92201 a
(760)574-4444
Llc. No.:.: 930. 930133
--- --- -------------=----------7----------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 1 hereby affirm under penalty of perjury one of the following declarations:
(commencing with Section 70001 of Division 3 of the Business and Professions Code, and _ I have and will maintain a certificate of consent to self -insure for workers'
my License is in full force and effect. ensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: C36 License No.: 930133 o he ork for which this permit is issued.
I n 3have and will maintain workers' compensation insurance, as required by
700 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: NORGUARD INSURANCE COMPANY Policy Number: TOWC851139
_ 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.
Date: lo—) Applican C 1/ /
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.
Date: 4 a lkn— (-) 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 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).:
( 11, 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.).
( 11, 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:
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 thisapplication 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: —), (Q II Signature (Applicant or Agen
Date: 2/21/2017
Application Number: BMCH2017-0032
Owner:
Property Address: 50505 VERANO DR
JOHN BAUGH
APN: 777240013
50505 VERANO DR
Application Description: BAUGH / WATER HEATER CHANGEOUT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $1,612.50
Applicant:
Contractor:
TOMMY ROOTER PLUMBING INC
TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #69
80975 INDIO BLVD #69
INDIO, CA 92201
INDIO, CA 92201
(760)574-4444 "
------------------------------------------------------------'-----------------------------_--
Llc. No.: 930133
Detail: WATER HEATER CHANGE OUT - 50GALLON/GAS [2016 ENERGY] CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2016 CALIFORNIA BUILDING CODES.
DESCRIPTION
1 .1•
FINANCIAL
ACCOUNT CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27.
Total Paid for PERMIT ISSUANCE:
$96.27
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
05/06/2013 T1;d 15:09 FPA La Quints Bldg & Sa; ei+y
2001/001
City OT u1n.
80ding 9 Wety DMft
Permtr
P.O. Box 1504, 78.495 Ure Tampico
La QuhU,. CA 92253, (760) 777.7012
Ulding Permh Application and Wracking Sheet
"*'� t Addrm' 5C).s 0
Y.!2 JYYl OwRei'8 Nene,
:LCA,
. C
A P. Nasi:
Address:
I,ogal
City, ST, ZIP: LCt
Contractor.
U TOno'
Address O� S
\ �} Pmgfiae4 Dmrlptlow
air• ST, zip. --Tn G� \ d C, "�a,L �- • `Ck Csc
Talophona-71 \j (--) "14 t -A L1,1
*4
State LIc• # : - \ . � ���
C51y T.te. #: - .
Arch., Eagr., Designer:
Addrei n
City., ST, zip:
Telepltaae
Convkttction Type; Ooa3peaay:
Staff Lia
Prcdeot We (utrcle ane): New Add'n Alter Repair Dano
Name ofConfut Pinson; >— Ll V 1L Sq, Ft,: Storibs: e Y r
Tel host fof Contact person:
0 -1q LAI I Value of "WWU
APorA.1a;A11 T, DD NO ELOW THIS LINE
i1 Balamltdil Req'd
RW4 TRACIIG P$1tM1T �9
1lalan Sea:
PIRn Check ev6ratttetl Item Anwort
9tmetarn1 C21M
R MMM ready for eorteefiana
plan Clecde Ilcpoeic
Tie Calm
Called Canfact Person
Plan Check Bah►uee
irtle2A Cala.
Pians piskcd up
Canatrartlan
VIVO plain plan
Placa resabmltted
M¢ekanical
Gritdtng lms
Z° Revtgw, romyfor correcttans/fsaue
Edeetricsl
L�ttbeontsctar Litt
Called Contact Person
Plambirig
GrgofDecd
Plias pr¢Yed up
H.O.A. ApovvW
Plane reaa6m(tted
Grading
iPt AOU5)r^
iL�vimv, rcadp Ibr sot rectloralfage
awdoper Impact Fro
Planutag Approval
Called Coataet person
A l Pte,
M Wk& Appr
Dote orpeMlt Issue
SckoviPoea
.
Tohi lP lt peep
r and boilers jor both domestic hot ivarOr heaters (DWH) and hpdranic space heating:: NeivFy it
DIVH-heoters and-boitom must -be• os x ro ante, or ttse the e.tial"11tel.
Distribution Typo NumbcsTn Tank �-Ene'igjFacturorf
TaA
water 14e�ter ' �wtil tic i
TyWFue1 Type' . lStrt aro 5ystcm CxpzcitY (gal) Thermal Ffficiw►Cy R.,'Vaidc�
.. Rectieulaiin
O CE41 (2)
/-:.indicate Type (StaiYigs'c^, ps:'Heat Pwitp, fristanlonevas, etc:)
,Z. RicihUdtfng systems• serving multiple -dwelling units shill timet Phe rscikidO60n 'require iients'of �ISO(n . 7id :P<atsrtrlptive
-401rements do not dltowAr installation of a weircntating water heating sy,#rem jbr
P7tt a tteinpl r c fisingled►veltlnir unim .
bef an, (l d t re i nM3:
- . Coutmcto>i or Horwowner (Documentation Autbor's/RespottAble, HuMag Dest�ter'ti'Declib;atfom Matta n4)'
' o't certify that this Cettifieate of Compliance documentation is accurate acrd cnroplete. '
o• I ant Ajible under. Division 3 of the California` Business and Professions Code to accept responsibility for the building design
identified'on this Certificate of Compliance,
i cottity that the ®netgy Features and performance specifications fat the building design identified on this Certificate or Compliance
conforet to the requirements of -ritla 2d, Patt i and 6 of the California Code of Regulations.
s The building design' features identified on thli; Certificate of Compliance are eoToistaitt with ilia iiifo'iaiattdn provided toiitti
-dtiient this
buildtrig"&a ign on the other applicable compliance F611 . worksheote, calculations, plans and specifications sullittattcd to the
enPottertiertt. enc • f h this.build'tt t 8Ann•
Natits Si
Cottipatiy:
VY
AJdteast
,ee
CitytStare2lp: phone:
�AA
r �-
PLUMBING WORK ORDERAN11 OICE ::
` oigmY frobTa� 2$130
HELPING THE DESERT
q,•
ONE FRIEND AT A TIME Co.
e OR PARTe e .N`
Pkaft% Drain Clearaing& letteTSpecla W Inv.#
r / p
OD975 Indio Blvd., $89 Auth.#,ari Adz
Indio, CA 92201
760-574-4444
Fax 780.444-2717
/ 'ANCleroi'
% 7D G
VdWW.00QAUC IRP9301 3R.COM Out
C Pre,/ r-( Gq . l6�
�pZ r r
NAME ��/�
DAT ES^C/� w %%
(n
n r
Lr
s11iEET -SaSGS Q,,t /Z)9 t7 p PA
PHONE
,�-r U �v�
G-40-
CITYSTATE ZIP
4of ov-:9,
WAARAfM
❑ CONTtACY
4-f/�/L
JilTOTAL
f
"A"EMODEL
SERIALNUMBER
SERVIM CONTRACT
MATERIALS
r� v l jai 6/�/ Qi93g�3 S�r�
o o �'o�"� ATE
PESCPe e.
•
Ss
n fl jj r2
Pelzf'I''�
e .
. ,
e
TO OUR OUSTMMRSI Service men are regtifed to have Awo ships".
DRAIN CLEANING
This is dale in aft to protect you, the wrlanen, and ourseA138 and to
ADDT F00TAGE O
too
enable us to om }nur absolute satisfactory seruim. You are test wNly
requested to examine material and labor Mlement before workman Ime
AWLRXTUR89
PLUh19iEdG LABOR
the job, and if you find wEFyOieg satisfacb3 y, d4 this tldcet If sedca is
unsatWam), In any vray, please phone cur oface Immecria*.
PARTS
A PENALTY Y1ti1 BE CIMRCED AT THE RATE OF 11h% PER RIONTH 019
UNEWDSA1ADICFSAFTER 30DAYS OPPMEC£DATE:ANNUALPEipEKTAGE
PR011lfCTSlfRfATME4lT
VIDEO INSPECTION
TOTAL
LABOR
RITE 10%. RETURMO CHEC1i FEE;24.OD.
❑ WARRANTY
e e e e
I lied 1hs tine end' material charged above satislactay and agree m Pay
HYDRO -TETTER
IAIM SETTER
❑ 5 Day Q t Mmr
r some on presontaCmn of Inv*e, and further agree to pay reasortahle
UNEIL£AtILCCATIM
❑ 31*mth .0.140 ..
7�ch-argiodfDroallecol3n
hc�. /�. ,r� (/i`C�-
lncludlr�allarr�aysfeesntheeverltofRrydefa�t.
❑ e Month
I G� .
SCC XO
FNI)TICE TO OYn M.Poe1/oar_7ate-Conhactom LJcm= L*wl WER Dy
hleNnrf�'klm luA. erlm.iuw., uhcuA»:1wr, h2am, mauRu rrvimaDaPaeosvAU Ldte
.�4p.8EpTtwREASE.
.. ...
'
OTHER
YiARRAt1TYCALIS
WI�TvpgiWIMmYEA Pikrahbkburx snm+terld,has9*PI bOF= hb
Bg rnrpway,LN6Uytrrr,yau.oaj tl�wrmguOnrisjOWnstriiinnn,
ARES�CHEDULED
odaoNti6[niblMhPaQOrIIgIPHg10t89 anlanlnft'A"c{aYI M&WrROf0
autl►:l4aflmV,Mitsorioidenmuelrro AoauUyNte;o�hepap�'uNu�faad
TAX
-FROM M-PBAWSPM
,oq,Mtadtivam�lechr%penadWrdm ��ecn�s�liomi&+giEai+o+ennm
,om kae na+itrr�d Ws+) or Ae rpr ard atul m eeium m m� xro.i7mr 6f on
TOTAL
SQ
Inn` W� nr&Os eM Iov alf* rorewwi I / eic" caaert
X
6
X
YMENTRECEfVED.
0 Q'
[:]CASH❑C.C. ❑BILL CHECKd El
PAYMENT DUE
rsY7
SD
INlEals
1Y�iKorTUEREDEI`.
I h