BPLB2015-0007k
78-495 CALLE TAMPICO
D VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/12/2015
i
Application Number: BPLB2015-0007 Owner:
Property Address: 52675 AVENIDA VELASCO SERGIO ORTIZ
APN: 773294020 52675 AVENIDA VELASCO
Application Description: REPLACE 40 GALLON WATER HEATER LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $1,000.00
Applicant: L4_7._nRTMENT Contractor:
AMERICAN INSTALLATION AMERICAN INSTALLATION
4211 LATHAM ST 4211 LATHAM ST
RIVERSIDE, CA 92501 LRIVERSIDE, CA 92501
CITY (888)622-3522
LIC. No.:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: j_ License No.: _ q\
Date: t \ 1 1 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 folra
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:
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 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: ( 1 Z' I Applicant: �i�----J
j' ^�
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 state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
Date: C I �/ Signature (Applicant or Agent):
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONSp
CEC-CF1 R -ALT -01-E Revised 06/14)CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 3 of 4)
,Project Name: Date Prepared:
F. SPACE CONDITIONING(SC) SYSTEMS — HEATING/COOLING (Prescriptive section 150.2(b))t�
01 02 03#3
Dwelling Unit Name Dwelling Unit CFA (Ft2) C�om� nts°" * 4,
G. WATER HEATING SYSTEMS (Section 150.2(b)1G)
01
02
03
04
05
06
07
08
10
p1,1
v12
13
14
15
Water Heating
Alteration to
Nof
Water
(fit
;e, ,*
i,,srigentification or Name
6
Comments
Back -Up
Water
Heater
-Heating
fHe
i
Dwelling Unit DHW
System
Water
Water
Heaters
Storage
Rated
Rated
g
Exterior
Solar .
Identification or.
Heating
Heater
in
Volume
Fuel
Input
�,,Knnpuft
Efficiency g
Effiiciency
Standby
Insul.
Savings
Central DHW System
System
Name
System Type
Type
system
(gal)
Types
y Value
Typed
Value
Loss,(%)
R -Value
Fracti
Distrii ut'on Type
Distribution Type
40
/T�yy��pyye
/n�
t
V11_ % 1101 W, CL Is &%'b 1 -
H. SPACE CONDITIONING SYSTEMS AND WATER HSE TNG SYSTEMS I ,IIV�IULTIFAMILYhD FEEING UNITS
01
02
03
"A 040
05
06
v Centrall Wa er,,Heating
/�pter.�Heatin
e�ling Unit
S stem
g Y
Dwelling Unit:
the Space
Dwelling Unit TotahCFA .
System Identification or
Name
Alteration to
Dwelling Unit Name
(fit
;e, ,*
i,,srigentification or Name
Conditioning System(s)?
Comments
s�o1%
Registration Number:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time:
HERS Provider:
June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS �?
CEC-CFIR-ALT-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF111-ALT-01-E
Prescriptive Residential Alterations, (Page 4 of 4)
Project Name: Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1.1 certify that this Certificate of Compliance documentation is accurate and complete..
Documentation Author Name:
Documentation Author Signature: t e
L ^�
Signature Date:
te: ( � O Cr6c�p �J
Ila
v
Address:
'Z)t2
CEA/ HERS Certification Iden`ti ication°(if applicabl i�
b OS L— I /iry L A -s✓ 1 t
° a
City/State/Zip:
S - c. R y Z r �E,
Phone: �.
��. 0
RESPONSIBLE PERSON'S DECLARATION STATEMENT 4` W
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. lam eligible under Division 3 of the Business and Professions Code to accept responsil li y for the building design or system design identified on this Certificate of Compliance (responsible
designer).
3. That the energy features. and performance specifications, materials, components, and rrianufactured ddevices for the building design or system design identified on this Certificate of
Compliance conform to the requirements of Title 24, Part1 and Part 6 of the California Code of'Reg� tions.,
are documents,
4. The building design features or system design features identified on this Certificate of Comoliance consistentwithh th information provided on other applicable compliance
toa`th-ee -n 8rcement age rjcy to pproval with his il. ing permit application.
worksheets, calculations, plans and specifications submitted e ,
5. 1 will ensure that a registered copy of this Certificate of Compliance -,shall be made avalllaable' with the bu'I g permlt(s) issued for the building, and made available to the enforcement agency
for all applicable inspections. 1 understand that a registered copy of this Certificato.,f, Compliance is ire 'to be included with the documentation the builder provides to the building
owner at occupancy. Aek
Responsible Designer Name: �v
Responsible Designer Signature:
Company: '�5 v Y
Date signed:
-�Z �� /�
Address: �` ,, �
License:
.5Z /5
City/State/Zip:
57 .l'�G Z
Phone:
�SZJI O l 00
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
FINANCIAL .• 1
^_ry-DESCRIPTION�'y �s .,�, .''i�ACCOUNT':'- r QTYi AMOUNT%'r .j -PAID PAID`DATE.
BSAS 581473 FEE 101-0000-20306
0
$1.00 $0.00
BY „METiOD "
k "CHECKCLTD:d4?PAID
BY',
;r .,t.�
_
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 »
' DESCRIPTION.u"
'ACCOUNT'° ,`QTY
'AMOUNT
PAID
`PAID DATE:.
,
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
METHOD " a '
w' _
RECEIPT#
� XHECK # -'
FCLTD BY y
�, ,
_ ,
6
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
f ^'
V-VACCOUNT
QTY
AMOUNT
PAID `j
PAID DATE
2` ,DESCRIPTION
WATER HEATER/VENT
101-0000-42401 "'
0
$12.09,
$0.00
'PAID BY
'INIETHODt r
iRECEIPTa# fi f't
CHECK #'
nCLTD BY
t
sµ
' ' }DESCRIPTION �' , Y
";T s � ` �'
"' AMOUNT>, i a
PAID �' "''PAID:DATE
,
,FACCOUNT
s�QTY
WATER HEATER/VENT PC
101-0000-42600
0
$7.25
$0.00
METHOD 'y f
' `r�� r1RECEIPT #
CHECK #:
CLT D BY
r
,
;,
Total Paid for PLUMBING FEES: $19.34 I $0.00
TOTALS:0•
1
.
r
r
Description: REPLACE 40 GALLON WATER HEATER
Type: PLUMBING Subtype:
-Status: UNDER REVIEW
Applied: 1/12/2015 PJU
Approved:
Parcel No: 773294020 Site Address: 52675 AVENIDA VELASCO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 151
Lot: 7
Issued:
UNIT 16
Lot Sq Ft: 0 Building Sq Ft: 0 -
Zoning:
Finaled:
Valuation: $1,000.00 Occupancy Type:
Construction Type:.
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: REPLACE 40 GALLON GAS WATER HEATER CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013
CALIFORNIA BUILDING CODES. '
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
DESCRIPTION ACCOUNT. QTY AMOUNT• PAID PAID DATE RECEIPT # =CHECK # METHOD PAID BY +'CLTD
. ' BY
T k
BSAS S61473 TEE 101-0000-20306 0 $1.00 $6.00-
Total
0.00-Total Paid forBUILDING STANDARDS ADMINISTRATION } -
BSA: $1.00 $0.00
Printed: Monday, January 12, 2015 2:15:05 PM 1 of 2 CITsrsrEMS
_
DESCRIPTION.
r v^
F ACCOUNT
QTY
AMOUNT.
4 y x
PAID
PAID DATE
RECEIPT#
CHECK #• `
_
METHOD
' PAID BY,—" ; »$
Dz
CB
.
-:
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
WATER HEATER/VENT
101-0000-42600
0
$7.25
$0.00
PC
_
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:• -
PARENT PROJECTS 0
BOND INFORMATION
ATTACHMENTS
Printed: Monday, January 12, 2015 2:15:05 PM 20 f2 c srsiEms
i
Bin. #
C1�}/ ofla Quintd
Building 8T Safety Division
Permit # P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: S�Zf��- t��
wner's Name:. ZZ
A. P. Number: Address: s�� e,n ia�q V. e- 4a�p '
f Legal Description: City, ST, Zip: Lot- 62u, h4-c. C .02
Contractor: !
Telephone: '76i�/7?7i 4 f wxl v>
- s•
Address: ( S . Project Description:
City, ST, Zip: 2�/ Sr Lam_ (2l iii
Telephone: �i s'O& � %1„ 1 .. S T�
�—
P fir, Q �i« GL Tom/
State Lic. # : City Lie. #: "
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
P Construction Type:. Occupancy:
i State Lic. #: ....... 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:, two
APPLICANT: DO NOT WRITE BELOW THIS LINE
# 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 Cslcs. Called Contact Person Plan Check Balance.
Title 24 Calcs. Plans picked up Construction
Flood plain plan Plans resubmitted.. Mechanical
Grading plan 2`4 Review, ready for cotrectiionstiissue Electrical
Subcontector List Called Contact Person Plumbing
Grant Deed Plans picked up
H.O.A. Approval Plans resubmitted Grading
IN HOUSE: '^' Review; ready for corrections/issue Developer Impact Fee
Planning Approval Called Contact Person A.I.P.P.
Pub. Wks. Appr Date of permit issue
School Fees
• i
Total Permit Fees `•,
Page 1 of 1
IqEAT System- Work Order yyy r
Enrollment #: 954482 �American`Insulation Inc (888) 622-3522
Work Order: Gas Appliance Work Results Appointment: Crew Name: Unassigned
ORTI2; SERGIO Home: (760) 777-1947 Gas Acct: 290256249 Meter Type: Individual Meter
,
760 989-2479 Electric Acct: Occupancy: Owner
52675 AVENIDA VELASCO Alt Phone: ( ) Date Enrolled: 12/16/2014. Status: Open
LA QUINTA, CA 92253 3348 Installed: 12/29/2014 Housing Type: Single Family Home
Prizm Code: 49 Language.-� English Year of Home: 1979
Climate Zone: 15 Senior. No 1st Insp:
Correction: Sq Footage: 1500
2nd Insp: Heat Source: IOU
Thomas Bros Page:
Thomas Bros Grid:
Water Heater Results Measure Source Approved Type Replacement Costs
Ultra Low NOX -
Type: 40 GS
Fuel Type: Gas Make:
Op Status: Operational Model:
Location: Garage Serial #:
Tenant Owned: No
Assessment Comments
W/H is leaking from the tank customer has been trying to patch it to stop leaking
Authorization Comments
REPLACE WATER HEATER.
a Installation Comments
Measure / Labor Qty Material
Measure Source Measure Name Unit I Price Unit 1 Price Subtotal
Total Amount $0.00
Comments Customer Signature:
Contractor. Badge #
Date: Time In: Time Out:'
i
i
littps://heatprod. socalgas;:com/Enrollments/WorkOrder-aspx?sid=4423 995&eid=1270868 1/6/2015
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Permit Issuance
I
Permit Issuance (Mechanical; Plumbing, Electrical)
$ 91.85
9 1_950
2
Installation or relocation of ebch forced -air or gravity-typelurnac�e or
36.26
24.17
60.43
burner,including ducts and ve6ts attached to such appliance
4
3
Installation or relocation of e�ach suspended heater, recessed wall
$ 24.17
12.09
36.26
heater, or floor -mounted unit heater
4
Repair of, alteration of, or addition to each heating appliance,
$ 12.09
$ 4.83
16.911
refrigeration unit, cooling unit, absorption unit, or each heating,
11
cooling, ab'sorption, or evaporative cooling system, including
.installation of controls regulated by the UMC
5
Installation or relocation of each boiler, compressor, or each
absorption system
36.26
24.17
$ 60.43
6
Air-ha6dling unit, including attached ducts
36.26
$ 12.09
$ 48.34
7
Eva porkive cooler, other than portable -type
12.09
12.09
$ 24.17
Ventilation fan connected to a single -duct
$ 12.109
4.83
$ 16.92.
9
Installation of each hood which is served by mechanical exhaust,
$ 12.09
$ 4.83
$ 16.92,
including the ducts for such hood
10
Each appliance or piece of equipment not classified in other alipliance
$ 36.26
$ 36.26
$ 72.52
categories, or for which no �ther fee is listed
Plumbing
11
Each plumbing fixture or trap or set of fixtures on one trap (including
$ 12.09
$ 12.09
$ 24.17
water, drainage piping, and backflow protection)
13
Rainwater systems, per drain (inside building)
$ 12.09
$ 12.09
$ 24.17�
14
Cesspool / private sewage d isposal system
$ 12.09
'$ 4.83
16.92
15-
-Water heater.and/or.vent-L:l
16
Industrial waste pretreatment interceptor including its trap and vent,
$ .36.26
$ 12.09
$ 48.34
excepting kitchen -type grease interceptors functioning as fixture traps
�
�
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.
. `
^
.
.
'
.�
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.
Page
' Pagezmz/
Sched6le7of Building Fees -`Mechanical;;,P.,lum6ing and{Electrical;W.---11*''
F,gql�•Ljl. .
17
Installation, alteration, or repair of water piping and/or water -treating
$ 12.09
$ 12.09
$ 24.17
equipment, drainage or vent piping, each fixture
18
Backflow protective device other than atmospheric -type vacuum
$ 12.09
$ 4.83
$ 16.92
breakers
19
Gas piping system - 1 to 4 outlets
$ 12.09
$ 24.17
$ 36.26
20
Gas piping system - 5 or more outlets
$ 36.26
$ 24.17
$ 60.43
Electrical
New Construction
21
Residential - First 1,000 Livable SF
$ 145.03
$ 47.86
$ 192.89
(Includes livable and non -livable SF)
22
Residential - Each Additional 1,000 Livable SF
$ 12.33
$ 5.08
$ 17.40
(Includes livable and non -livable SF)
23
Non -Residential - First 2,000 SF
$ 108.77
$ 84.12
$ 192.89
24
Non -Residential - Each Additional 2,000 SF
$ 36.26
$ 9.67
$ 45.93
Receptacle, Switch, and Lighting Outlets
25
Receptacle, switch, lighting, or other outlets at which current is used or
$ 24.17
$ 24.17
$ 48.34
controlled, except services, feeders, and meters - first 20
26
Receptacle, switch, lighting, or other outlets at which current is used or
$ 2.42
$ 0.60
$ 3.02
controlled, except services, feeders, and meters - each additional
Lighting Fixtures
27
Lighting fixtures, sockets, or other lamp -holding devices - first 20
$ 24.17
$ 24.17
$ 48.34
28
Lighting fixtures, sockets, or other lamp -holding devices - each
$ 2.42
$ 0.60
$ 3.02
additional
29
Pole or platform -mounted lighting fixtures, each
$ 24.17
$ 24.17
$ 48.34
Residential Appliances
30
Fixed residential appliances or receptacle outlets for same, including
$ 12.09
$ 12.09
$ 24.17
wall -mounted electric ovens; counter -mounted cooking tops; electric
ranges; self-contained room, console, or through -wall air conditioners;
space heaters; food waste grinders; dishwashers; washing machines;
water heaters; clothes dryers; or other motor -operated appliances not
exceeding one horsepower (HP) in rating, each
Page 2 of 17
>, s City of La Quirita
AMERICAN -INSULATION, INC.
4211 LATHAM ST
Invoice Date: 1/12/2015
Record # Record Type Fee Group
LIC -762576 CONTRACTOR,
Fee Description
A OR B, ANNUALLY
SB -1186 STATE FEE
INVOICE #
INV -154. -
Date Due: 2/11/2015
Quantity Amount
0 $100.00
0 $1.00
$101.00
Before you can set up a license record, you must set up a business record for the business to which you
will issue the license. You can set up both business records and license records for individuals if your
S .
organization issues noncommercial licenses such as pet licenses.
You can assign more than one license record to the same business record.
Example: You establish a business record for Gourmet Grill, a local restaurant. You set up a food
service license record and assign it to the Gourmet Grill business record. Later, the restaurant adds a
small bar. You set up a liquor license record and assign it to the Gourmet Grill business record.
A year later, the restaurant expands into the catering business. You set up a catering license record
and assign it to the Gourmet Grill business record.
You cannot assign more than one business record to the same license record. Each business location
must have its own business license and associated licenses.
Example: The Gourmet Grill opens a branch location across town. You must set up a new business
record for the new location and new license records for each license needed for the new business
location.
Purging license records
Your organization may want to periodically purge inactive business and license records that have been
inactive for two years or more. When purged, the status of a business and license changes to 'Purged"
and all other detail is deleted. Licenses that have been renewed or are inactive are purged. When you
run the "purge" feature, BL presets the purge date to the date two years prior to the current date. BL then
purges all business and license records that have been inactive since before that date. An audit report
prints a list of all records that were purged. You are prompted to make a tape backup, but it is not
required.
If you are not certain whether you want to purge records up to the date you selected, you can choose not
to run the program in update mode. The Business/License Purge Audit Report prints a list of business
and license records you selected for the date you entered, but the records are not purged. You can then
rerun the purge program in update mode if you choose.
• Related Information:
0
• Overview of license setup and change
• Overview of business records.
• Purging business and license records