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13-0008 (PLBG)4 44- P.O. BOX 1504 " 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number:\ -13=00000008 _ Owner: Property Address: 54407 SHOAL CREEK MARCIA• FOLLI APN: 775-071-052- - - 54407 SHOAL CREEK Application description: PLUMBING LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL D Application valuation: 700 Contractor: Applicant: Architect or Engineer: STATE WIDE PLUMBING 40244 CATANIA COURT INDIO, CA 92203--0 (760)636-0315 ha Lic. No.: 731855 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/03/13 w u �,''' 0 3 2013 CITY OF LA QUINTA ---------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. I have and will maintain a certificate of consentto self -insure for workers' compensation, as provided License Class: C36 License No.: 731855 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is L /uatej �nt C„ractor: - issued. I have and will maintain workers' compensation insurance. as required by Section 3700 of the Lahor Code, for the performance of the work for which this permit is issued. My workers' compensation ' OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier MARKEL INS CO I - Policy, Number MWC00329801-01 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he.or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor C e, I shall forthwith comply with those provisions. ' 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).: at -k a 3 . pplicant (_) 1, 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 WARNING: FAIL RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of .property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - - - 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.). (_ ) 1 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: LQPERMIT 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. 1 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 county 14 ttoo` ter u on the above-mentioned erty for inspection urpoossee/sem., te: 7 ignature (Applicant or Agent Application Number . . . . . 13-00000008 Permit PLUMBING - Additional desc . Permit Fee 22.50 Plan Check Fee 5.63 -Issue Date . Valuation . . . . 0 Expiration Date 7/02/13 Qty Unit Charge Per' Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50'.' ---- -=-------------=-`--=------------------------------------- ------------------------------ --------------- Special Special Notes and Comments ---------------- INSTALLL NEW 40 GALLON NATURAL GAS WATER ' HEATER. 2010 CODES. ------------------------ ----------------------------------------------- Other Fees, . . . . . . . . .' BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid _ Credited. ---------- Due r----------------------------------------------- Permit Fee Totals 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 LQPERMIT Pi-escri tip Residential Pm ect.Name General Infor Site Address Building Typ cAte of Com lianee; Residential.. CF=tR_ -ALT'.DHW t Pagc t of 2 V Climate Zoite: Permit #: - Z t!1 _ :Enforcement enc :. Date: Family O Multi Family -Prniect Tvoe-- Renlacement or Chanee Out of Water. Heater WATER HEATING List nein!~• installed tivater heaters and boilers for bvth dorntstic hot water hraterr(DWH) and 11rlronic space heating. Ne%ly insratled OLYH heaters and boilers must be Xtaus. p or tar the raison el type. Water Heater tribe(Standard.a Number.ln . Tank Fogy Fact" or .Insulation Typalfitel Type Rea" System Capacity (gal) Thermal Elficicncy R_Va(ue' 1. indicate 7jpe (Storage Car. Heat PtwW Instantaneous, etc.) 2.Recbrulaing systems serving multiple dwtlling itnits shalt'irieer the recirrulation requirenertts of §ISO(n}. The Prtexripth requirements do not allow the bwallation of a mirrulating water heating s wetn for single dwelling tutits. 3. The external water heating snit and pipes shall be insulated to meet the rc uirements of § 1 Contractor or Homeowner (Documentatiou Author's/Responsible BuikUng Designer's Declaration Stateawnt) • t cerdify that this Cenifk=e of Cotnpli;u= doc uoeatation is acauau and comptae. • 1 am eligible under Division 3 of tete California Busincss and Ptofessions Code. to accept responsibility for -the building desjign identified on this Certificate of Compliance_ • t certify that the energy features and performance specifications for the building design identified on this Certificate of Complia conform to the requtteincnts of Tttle.24. Pial and 6 of the California Code of Regulations. • The building design featums idemifted•on this Certificate of Compliance aro consistent with the infonmation provided to documentbuilding design on the other applicable=cotnpliance forms. worirshoas. calatlations...plans and spccificattoms submitted to enf -for toval with this,build'm ligation_ Name: S"�natu= V;1C-t City/SutoRip: Phonc: sin.# City. Of La Quints Building ff Safety Division P.Q. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 - (760) 777-7012 Building Permit -Application and Tracking Sheet , Pennit # I 3 , Project Address: L b-1 Owner's Name:. VTCk . r o I . A. P. Number. Address: Sh Croedf' Legal Description: Contractor. Address: o City, ST, Zip: I t + � '��f;;��' 1 Telephone: L S 11r" � � Ili � Project Description: 4- D ' P City, Telephone: (p 6" a s p2 x< -� ,, 4. State Lie. # : Arch., Engr., Designer: City Lir #: Address: City., ST, Zip: Telephone: State Lic. #:� Name of Contact Person: r Construction Type: Occupancy: ^ '_.r�.�.%.'»;;r� � '. Project type (circle one): New Add'n Alter Repair Demo II [�� Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: .� -6) Estimated Value of Project: (� APPLICANT: DO NOT WRITE BELOW THIS UNE p Submittal Req'd ' Rec'd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person Plan Check Balance Title 24 Calci. Pians picked up Construction Flood plain plan Plans resubmitted Mechariical Grading plan 2id Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review; ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr ' Date of permit issue School Fees Total Permit Fees