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11-0826 (PLBG)P.O..BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: '11-00000826 Property Address: 54055 AVENIDA VELASCO APN: 774-214-025-4 -000000 - Application description: . PLUMBING Property. Zoning: COVE RESIDENTIAL Application valuation: 520 (;&4 4 4 Q" Applicant: Architect or Engineer: USED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjthat I a ed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the BIS I ness a Pr si als Code, and my License is in full force and effect. License Class/: C36 se No.: 7J0 44 Date: lyi i 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)•: 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 I, as owner of.the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions C •The Contractors' State License Law does not apply to an owner of property who builds or improves ereon and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' St a Licens Law.). ' (_ 1 I am exempt under Sec. B.&P.C. f son Date: L�� ' 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: CHALOUX RAYMOND G 54-055 AVENIDA VELASCO LA QUINTA, CA 92253 Contractor: A REEMDY•ROOTER & PLUMBING Ii PO BOX 77355 CORONA, CA 92877 (951)272-8966 Lic. No.: 790544 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/02/11 ); 2011 IL— C 4t -- 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 CA INS CO Policy Number 460073170104.1 I certify that, in the n4rPorm nce of the work for which this permit is issued, I shall not employ any person in any mLner s ecome subject to the workers' compensation laws of California, and agree that,b o e bject to the workers' compensation provisions of Section 3700 of the La I all orth i omply with those provisions. Date: b 1 N.1 11 Applicant WARNING: FAILURE TO SECURE WORKERS' COM NSATION 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 appl' n becomes null and void if work is not commenced within 180 days from date of issuanof suc permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and stat that v in rm tion is correct. I agree to comply with all city and county ordinances and state laws relatin to uilding nst cti and hereby authorize representatives of this to nter upon the above-mentioned ro rty fo sp io urpo r 0,Date: u a' Signature (Applicant or Agent): Application Number. . . . 11-00000826 Permit PLUMBING Additional desc _ Permit Fee 22.50 Plan Check Fee 5:63 Issue Date . . . Valuation 0 Expiration Date.. 1/29/12 . Qty Unit.Charge -Per Extension BASE FEE 15.00 1.00 7.5000. EA PLB WATER HEATER/VENT 7.50 ---------------------------------------------------------------------------- Special Notes and Comments 40G ELECTRIC WATER HEATER CHANGE OUT [.67EF/R-16 TANK INSULATION] 2010 ENERGY CODE. August.2, 2011.1:10:00 PM AORTEGA --------------------------------------------------------------_-------------- 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 29.13 .00. .00 29.13 Prescriptive Certificate of Compliance: Residential, CF-M-ALT-DHW Residential Alterations t,. , s t4(kPage I of 2 Pro'ect Name: qcraR CY1r_\V Climate Zon Permit #: General Information Site Address: Enforcement Agency: Date:. Building Type: 0 Sin le Family 0 Multi Family Project Type: 0 Replacement or Change Out of Water Heater WATER HEATING Sig_ ruse: List newl' installed water heaters and boilers for both domestic hot ater heaters (DWH) and hwlronic space heating. Newh^ installed DIVH heaters and boilers must be gas. propane, or use the existin it , e. Address: LLicense: aOL��ii� Distribution Type Water Heater � (Standard. Number In- Tank Energy Factor or Type/Fucl Type r System Capacity (gal) Thermat Efficiency Recirculating). External Tank . Insulation R -Value bQcrf C mrd ' d 1. Indicate Type (Storage Gas, Heat.Punip. Instantaneous, etc.) 2. Recirculating systems serving multiple dwelling units shall tenet the recirculation requirements' of §150(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. 71e external water heating tank and pipes shall be insulated to mteet the requirements of § / Contractor or. Homeowner (Documentation Author's/Responsible Building Designer's Declaration.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. • 1 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 l and 6 of the California Code. of Regulations. • The building design features identified on this CertificatcofCompliana \consistent with the information provided to document this building design on the other applicable ;compliance+forms, wocalculations, \ plans and specifications submitQed to the enfnnrement awenry fnr annrnvA with this huilrtina nermit annlirahnn /�1 Nam: Sig_ ruse: Company: V Date: Address: LLicense: aOL��ii� . 7�OS City/statelZip: �o-�� �: ck, q ac Phone. qsl G Bin # City of La Quinta Building & Safety Division P.O. Box 1504, 78495 Calle .Tampico La Quinta, CA 92253 - (760) 777-7012 Permit Application and Tracking Sheet Permit # <<• cls*Building Project Address: Sqclss Avewao,Owner's Name: A. P. Number: Address: 5540! '5 Legal Description: City, ST, Zip: LA. (Zcsl w�k e 'd Contractor: a t"z Q`P l Wl i::Yli%l,•%N^:v�:{,i:^i>.�:i::'F,.�.�;irij:v1::K Address: �� EyyL g� Project Description: �t no `-1fO City, ST, Zip: QAt'O N is C_A • q aW( ~ C 1� Tele hone: P 9S! a'1a <r;;<>`::> z,';><g<:''.>:.:<'- ><<,>v r:_> ;>:;.:v.. kf1 1pavio (—oC',YVI4. k-ccNt, State Lic. # : —130sz4q City Lic. #: 07 1 Arch., Engr., Designer: Address: City., ST, Zip: Telephone:rri...; v<:; :s>.'::>:>•<z:":::s:> y.;.:..,s,.,. .:;;;::::::::.:. .:.;..:.:. ::;<•:;•:r;_;,ez::;::>;;::> Construction Type: Occupancy: 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: i5 O APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit r Truss Cates. Called Contact Person Plan Check Balance !w Title 24 Calcs. Plans picked up Construction i Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionsrissue Electrical Subcontactor List Called Contact Person Plumbing {� Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading �— IN HOUSE:- 3" Review, ready for correctionstissue Developer Impact Fee �+ Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees