08-0456 (PLBG)P.O. BOX,1504r '1'
78-495 CALLE TAMPICO
LA QUINTA;. CALIFORNIA 92253
Application Number: 08-00000456
Property Address:. 78,925 SKYWARD WY
AP.N:' 609-470-021-40 -23773 -
Application dcscription: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 500
Applicant: j Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that faro licensed under provisions of Chapter 9 (commencing with•
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C36Gicense No.: 828264
Date: Contractor:. {
O NER•BUI ER 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).:
1 _ 1 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.).
1 _ 1 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:
LQPERMIT
Owner:
CURRENS STEVEN D
78925 SKYWARD WAY
LA QUINTA, CA 92253
(760)772-1858
Contractor:
FOY, SCOTT A.
43 MER
�EETE
IND
(76 5-9405
LicUt - MAK2 144 2008
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/14/08
r VIVC1d�cr ,.M ------------------
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 ACE INC Policy Number C45040239
certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner sous 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, II -shall forthwith comply with th6se provisions.
Date Applicant: ��'
i � Il
WARNING: FAILURE TO SECURE WORKERS' OMPENSAY ON 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 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. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, and here uthorize representatives
of this county to.enter upon the above-mentioned property for inspection rposes -
Date Signature (Applicant or Agent):
Application Number
08-00000456
Permit . . . PLUMBING
Additional desc .
Permit, Fee 22.'50
Plan Check
Fee
00
Issue Date':....
Valuation
.
. O.
Expiration Date 9/10/08
Qty Unit Charge Per
Extension
-.BASE--•FEE-_...._-_--LL
" 1.00 7..5000 EA PLB
WATER HEATER/VENT
7.50
------------_--------
Special Notes and Comments "
-----------------------
---------------
REPLACE WATER HEATER WITH•50 GALLON
GAS
UNIT
\
Fee summary Charged
Paid Credited
Due
Permit Fee Total 22.50
.00
00
22.50
Plan Check Total .00
.00
.00
.00
Grand Total 22.50
.00
.00'
22.50
Bin #
0ty of Lel Quints
Bm7(fing $r Safety DivWm
P.O. Box 1504, 78-495 Cape Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
pennit #
Project Address: O` 2 b SY-a.1 wayY� W
Owner's Name: C
A. P. Number..
Address: -i6g2- 5 (�,xWord IJJGI
I egnl Description:
Coub-Ador.
Address: rr\cx \Y)
City, ST, Zip: `(- (0Il(1itk CAA q Z,ZS'J
//� � [r . '
Telephone: ' ; � Fa"•���"�`��?.
Project Description:
City. S"f, Zip. TY -\ CAor
P tYI-`— C 0. O r
Telephone: 7V
i" cJ - 0 Ql l
<.:
}F:
7Y
City Lic. #;
ArvIL. Ew.. Designer.
Addr� •
City,, SIT, Zip:
i///lA/t{ VTj is\rt`•51`�.ti ^'r, ytY i%.
/tl21N/�/ S5A.AYAW
it Gl )iTU11C:
9 ;�»;tr �,��, < �? ,•
$laic Lic 1{: `k > Wr""m,;"'
Ntune of Contact Pcrsnn: SEtqe, Cwf enS
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Derr o
Sq. Ft.:
# Stories:#Units:
Telephone I of Concoct Pelson: - — 5 —T
-Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
p
ttnetntttai
R ,4
Recd
TRACKNG
PERMIT FEES
Pbw S:ts
Plan Cheek submitted
Item
Amount
Strottural Caleq.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Pian Cheek Balance
Me 24 Calor.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2? Review, ready for corrections/usue
Electrical
Snmautettor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.0 -A. Approval
Plans resubmitted
Grading
IN ROUSE.
"' Review, ready for corrections/issue
Developer Impact Fee
lKnaning Approval
Called Contact Person
A.LP.P.
Pats. W is_ Appr
Date of permit issue
Schvvl Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE::RESIDENTIAL (Page 3 of 4) CF -ISR
Project Title Date
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -411 Form must be provided to the building department for each home for which the following. are
required.
V/
Distribution
'1'ype
❑
Sealed Ducts all climate zones Installer testing and certification and.HERS rater field verification required.)
❑
TXVs, readily accessible (climate zones 2 and 8-15 only)
Installer testing and certification and HERS Rater field verificationrequired.)
❑
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
OR
Alternative to Scaled Ducts and Refrigerant Charge /TXVs (See Package'D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
❑ waled as cunfirined (Iuuugh field verification and diagnostic testing in accordance with procedures in the
RrsidCntial 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 requirements of Package D.
WATER HEATING SYSTEMS
r
Distribution
'1'ype
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
13
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Standby
Loss %
nut allowed.
0
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the. Residential
I
Manual. No water heating calculations are required, and the system complies automatically.
Check box if system does not meet criteria of"Standard" system, and does not comply with the Preapproved
O
Alivrnalive Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
G
Check box to verily that a time control is required for a recirculating system pump for a system serving multiple
units
Systems serving single dwelling units
Writer I )enter
f /Fuel 'I'
Distribution
'1'ype
Number
in System
Rated
Inputs
(kW or
Btulhr)
Tank
Capacity
( ►ons)
Energy
Factor or
Thermal
Efficiency
Standby
Loss %
Tank
External
Insulatiom
R -Value;
lr1 ,R S
GAS
I
L4uw .
, t X
Svttlem servinu multiule dwelling units
Water I-Icater
Type
Distribution
Tyvc
Number
in System
Rated
Input'
(kw or
Btu/hr)
Tank
Capacity
( Ions)
Energy
Factor or
Thermal
Efficient
Standby
Loss %)
Tank
External:
Insulation
R -Value:
I . For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water beaters, 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 'Ibermal Efficiencies.
PIDe Insulation (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are v✓4
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