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09-1214 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property•Address: APN: Application description: Property Zoning: Application valuation: Applicant: - 09z00001214 54504 SHOAL CREEK 775-071-078- - - PLUMBING LOW DENSITY RESIDENTIAL 894 Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: ROB SIEBERS 54504 SHOAL CREEK LA QUINTA, CA 92.253 Contractor: CALIFORNIA DELTA MECHNI 6052 E. BASELINE RD, #1 MESA, AZ 85206 (480)898-0007' Lic. No.: 811114 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/24/09 e CA C 55 DEC 012009 CITY OF LA GIUINTA FRE ICE DEPT. -—--------—--- —------———-------—--- --------------—------—------------ ,.,: 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. 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided • License Class: B -C10-1236 License No.: 811114 T l a� _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. /nate/ ontractor: [/ G/ �" / r(�� 1 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 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 STATE FUND Policy Number 1697823 _ following reasonISec. 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 - — - - - ---=- -that he or she is -exempt -therefrom and the basis for -the -alleged exemption:- Any violation -of Section -7031•:5 by -- - - -- 3700 of the Labor Code 1 shall forthwith com ly with those provisions. _ --- -- - --- --- --// - - - - - - • - - -- - -- - - --- - - ---- ^- - — - ` any applicant for a permit subjects the applicant to a civil penalty, of not more than five hundred dollars (5500).: ate, icant:N7 7'- ( ) 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 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 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 ) I am exempt under Sec. BAP.C. for this reason L PERM[ 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 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. 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 pis coounnn yo nter upon th above-mentioned property for inspection purpose Date: �CJ� /0 ure (Applicant or Agent): f Application Number . . . . . 09-00001214 Permit PLUMBING ` Additional desc ' -Permit Fee 22.50 Plan Check Fee 5.63 Issue Date Valuation 0 Expiration Date 5/23/10 ' Qty. Unit Charge Per Extension - BASE FEE 15.00 1.00- 7.5000 EA- PLB.WATER HEATER/VENT 7.50 ------------------- 77 ----------------------------------------------------- Special ------ ------- -------------- --- - ----- Special Notes and Comments y REPLACE 38 GALLON GAS.WATER HEATER. 2007 CODES. -- ----- ----- --------------------------- Other Fees . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary c Charged Paid Credited Due .« Permit Fee Total 22•.50 .00 .00 22.50 K 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 r LQPERMIT , _ - Nov: 24. 2009 11:28AM STEVE No. 6:84 F. 13 CERTMICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4 CF -1R Project Title Datt + SEALED DUCTS and TXVs or Alternative Measures A signed CF4R form must be provided to the building department for each home for which the following. are required. 113 Alternative to Sealed Ducts and Refrigerant Charge fT Vs (See Package D Alternative Package Features for Pru ect Climate Zone in the RM ApMdix.B Table 151-0, Footnotes 7-14. OR For additions and alterations, duct systems Haat are not documented to have been previously sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the Residential ACM Manual and duct systems with more than.40 linear feet in unconditioned spaces shall meet the requirements of Section 150(m) and duct insulation reapirernents of 'Package D. Check box if system•meets criteria of a "Standard" system. Standard system is one gas-fired water heater per dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is not allowed. 17 Check box when using Preapproved Alternative Water Heating table, Table 54 in Chapter 5 in the Residential Manual. No water heating calculations are rawired. and the system compliesautornatically. Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved ❑ Alternative Water Heating table. In this case, the Performance Method must be used and must be included iri the submittal. Ll Check box to verify that a time control is required for a recirculating system pump for a system serving multiple units Systems service single dweilinu units Water Heater Type/Fuel T Distribution ❑ Sealed Ducts all climate zones(Installer testing and certification and HERS rater field verification required.) 0 TXVs, readily accessible (climate zones 2 and 8-15 only) taller testing and certification and HERS Rater field verification required.) ❑ Refrigerant Charge (climate zones 2 and 8-15 only) (installer testing and certification and HERS Rater field verification required.) 113 Alternative to Sealed Ducts and Refrigerant Charge fT Vs (See Package D Alternative Package Features for Pru ect Climate Zone in the RM ApMdix.B Table 151-0, Footnotes 7-14. OR For additions and alterations, duct systems Haat are not documented to have been previously sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the Residential ACM Manual and duct systems with more than.40 linear feet in unconditioned spaces shall meet the requirements of Section 150(m) and duct insulation reapirernents of 'Package D. Check box if system•meets criteria of a "Standard" system. Standard system is one gas-fired water heater per dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is not allowed. 17 Check box when using Preapproved Alternative Water Heating table, Table 54 in Chapter 5 in the Residential Manual. No water heating calculations are rawired. and the system compliesautornatically. Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved ❑ Alternative Water Heating table. In this case, the Performance Method must be used and must be included iri the submittal. Ll Check box to verify that a time control is required for a recirculating system pump for a system serving multiple units Systems service single dweilinu units Water Heater Type/Fuel T Distribution • Number in System Rated Input' (kw,r Buhr) Tank Capacity ( ons) 3 8 Energy Factor' or Thermal ciency . Co Standby Loss % Tank External Insulation R -Value G� G T 3 g System serving multiple dwelling units Water Heater Type Distribution Type Number in System Rated Input' (kw or awhr) Tank Capacity (geons Energy Factor' or Thermal Standby Efficiency Loss % Tank External Insulation R -Value 1. For simali gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe IIISulatiOn (kitchen lines a 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are % inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B. Residential Compliance Forms March 2005 Nov, 24. 2009 11:28AM STEVE No, 6584 P. 12 Bin g A. City of La Quinta Building a- Safety Dhwon Permit #P.O. Box 1SO4� 78-495 Cafle Tampico P Qufnta, CA 92253 - (760) 777-7012 0 Building Permit Application and Tracking Sheet Project Address: jr�S0 • SIXCU Owner's Name: k49 b Si e A. P. Number Address: 5-Y 5•o Legal Description: City. ST, Zip: &4 Qtt,�P tCj4 CA C( 2 ZS -3 Contractor. M't l ba Telephone: 6— L*)Lf —L?C)6tf Addrrss:6ojr6 �.15a"Pig- ls_j ProjectDascription: % O City, Sr, Zip: 6 a,��- 'telephone: State Lic. # : MY Lie, if: ID y 00 y Arch.. Engr., Designer Address: City. St, Zip: Telephone: Construction Type: Occupancy. ME State Lic. #: Project type (Circle one): New Add'u Alter R,epalr Demo Name of Contact Person: Sq, Ft.: #Stories #Units - Telephone # of Contact Person: 8 6 — 2 -3-2 �3 Estimated Value of Project: ?4N , / 3 APPLICANT: DO NOT WRITE BELOW THIS LINE # Sabwittal 'd Reed TRACKNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Coles. Revlewed, ready for corrections Plan Check Deposit Trus Cates, Ca led Contact Person Plan Cheek Balance. Title 24 Calca. Plans pleked up Construction Flood plain pun Plana resubmltted Mechanical Grading plan 2e Review, ready for corrections/tssueEleetrtcal Subcontsctor List Called Contact Person Plumbing GmutDeed Plans picked op &IVLL HAA. Approval Plans resubmitted Grading IN HOUSE. Rtview, ready fbr correetionallasut Developer Impact Fee Planning Approval Called Contact Person Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees t