13-0402 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO '
LA QUINTA, CALIFORNIA 92253
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
13-00000402
Property Address:
78342 TALKING ROCK TURN
APN:
770 -300 -001 -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation: .
1003
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am 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: C102 C20 C3 Lice a No.: 811114,
Date: fl3 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).:
(_ 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 oroffered 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 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. , 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.I.
.. Lender's Name: _
Lender's Address:
LQPERMIT,
Owner:
JIM CANNAVINCO .
78342 TALKING ROCK TURN
LA QUINTA, CA 92253
(
Contractor:
CALIFORNIA DELTA
6056 E. BASELINE
MESA, AZ 85206
(866)692-5273
Lic. No.: 811114
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
MECHNICAL INC
RD, #155
Date: 4/03/13
-----------------------------------------------
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.
7r I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T Code, for the performance of the work for which this permit is.issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1697823-11
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 f with comply with those provisions.
Date: Applicant:
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 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.
certify that 1 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 onstiuctjon, and hereby authorize representatives
of this co my no enter upon the above-mentioned property fo inspec Ic
Date: 3 f3 Signature (Applicant or Agent):
Application Number . . 13-00000402
Permit PLUMBING"
Additional desc
-"
_ Permit Fee 22.50`- Plan Check
-Fee
5.63.
Issue. Date Valuation"
0
Expiration Date 9/30/13
Qty Unit Charge - Per
Extension
BASE FEE
..15:00.
1.00" 7`:5000 EA PLB WATER HEATER/VENT-
7.50
---------
Special Notes and Comments.
WATER HEATER CHANGE OUT. -'48 GALLON GAS•.
WATER HEATER CHANGE -OUT [2008 ENERGY]
CARBON MONOXIDE ALARM(S) TO BE INSTALLED,
PRIOR TO FINAL INSPECTION. 2010
CALIFORNIA BUILDING CODES.
-----------------_-_-------------------------------
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
LQPERMIT ..
-- — . ... ............ ..... .
flre-,criptive Certificate of Compliance: Re-ii.d.crilial
—01 C
La -ai Mai -
.1
'
Contractor or i!,irrevvfter Doc umen c.l,: on Author'-.,,Rciponsiblie Building J>51,,,ner'3 Declarac.;o
--n 5wemen,,
3, of 3u..;xcs3 ,nd C;,]u- zo 1c:-2:)(
r
'.0 24, hr. i;'omij Code Jr Rz: 21--1 LIE:(-,,! 3.
1:, L n .)n iXUrr N
iia
n !1,- YO-er apphc� hie compli-anct! for -ms. worksrit:�::3, aicu!auons. pixis and iubmit:z-d
r. a joolicit.nn.
law
7
-j
yJSR - .35-7
0 ---------
'
Contractor or i!,irrevvfter Doc umen c.l,: on Author'-.,,Rciponsiblie Building J>51,,,ner'3 Declarac.;o
--n 5wemen,,
3, of 3u..;xcs3 ,nd C;,]u- zo 1c:-2:)(
r
'.0 24, hr. i;'omij Code Jr Rz: 21--1 LIE:(-,,! 3.
1:, L n .)n iXUrr N
iia
n !1,- YO-er apphc� hie compli-anct! for -ms. worksrit:�::3, aicu!auons. pixis and iubmit:z-d
r. a joolicit.nn.
law
i rZ
ISS"I'ALLA FION CERTIFICATE
—Domestic Illot M.'ater (WAV) Wat;e'l ot'2)
sife Wilresi: 'Nimilier:
'72'%U') V. -I -r..,—
N,ve 1, Forslitall-as storage (rwed ;Iipia !es.: dum orcilwilio 7�J)00 Bitiehri. electric re'visl0tixiind heat pump water heaters. i4st
Ener',u F�u•tnr rEFt: F.�r large _,us start,, •water• Ireulc•rs ti'uted hrput o/ '�renrer [Iron '',t)rl0 l3tu.!„•t. use kecnt•z,•ti• Ftjieieucr� �Rc;: ,
Thermal Suvulbv Lass.cmd Ruied hipia. Foi- inslanialleous gas mater heaters, lisi die Thermal Eyfichmc.--v cmd Retied,lovat.
2, iNtandat,ory :Measures
TO COMPLY -:ALL BOXES MUST BE CHECKED
3I 10-§ 113: Water heaters, showerhead and faucets are certified by the California Energy Commission.
§ I 50(j): Water Systbm. Pipe and Ta'qk Insulation. And Cooling Line Itisulation.
L Storagc-taukin�ulation
A. water heater . s rated with an Energy Factor no greater than the federal minimal standard are
extem-ally wrapped with insulation having an installed thermal resistance of R- 12 or greater: and
B. Unfired.,storage ca rn IISLI I jjorr R. I *11terijal
tanks or oi her ffldlre�m hot water tanki have R� 1.2 exte al i a', i 0
insulation w-h.erc clic.internal insulation R -value is indicated on tlie,c.-aerior of tli: tial!:.
I Water piping and C06linQ system line insulation thickness and conductivity
First -5 Feet of hot and cold water pipes closest to water heater talk, non-reclrculjun',�, 'ivstems, and entire
lemnli of recirCLdatilb! SCCD011,; of . hor water pipe., arQ insulated per'Standards- Tabled 50-13: and
Pipe insulation for steam h\dronic heating systems or hoc waier.ivstcriis >I_5 psi, meets the recluffernerits Of
Standards Table 123-A. '
UJ , That -ht. ink, -Irld
Insul-.-ttjon is prm�:cwd fii)(111 inclUdiInu i due to iunh I
wind.
I t 11),D' If indica'. d or. -he LIC . I R. all hot, Piping 111:11 runs from the hot �Okirce to 111' k-.itchen
insulated Per Standards I'able 150-13.
2001 ReShle,irial Conuvionce Forms Aw,,usi
1. k% A I'ER
I-IL.kTING sys'rEms:
------
.... ..... ..
... . ...........
C F C
Tc
F Ink
iw
r
Nunlhcr
Jnlr.,t 1'. pe Svilcm . Ahrnih
m.-o
N,ve 1, Forslitall-as storage (rwed ;Iipia !es.: dum orcilwilio 7�J)00 Bitiehri. electric re'visl0tixiind heat pump water heaters. i4st
Ener',u F�u•tnr rEFt: F.�r large _,us start,, •water• Ireulc•rs ti'uted hrput o/ '�renrer [Iron '',t)rl0 l3tu.!„•t. use kecnt•z,•ti• Ftjieieucr� �Rc;: ,
Thermal Suvulbv Lass.cmd Ruied hipia. Foi- inslanialleous gas mater heaters, lisi die Thermal Eyfichmc.--v cmd Retied,lovat.
2, iNtandat,ory :Measures
TO COMPLY -:ALL BOXES MUST BE CHECKED
3I 10-§ 113: Water heaters, showerhead and faucets are certified by the California Energy Commission.
§ I 50(j): Water Systbm. Pipe and Ta'qk Insulation. And Cooling Line Itisulation.
L Storagc-taukin�ulation
A. water heater . s rated with an Energy Factor no greater than the federal minimal standard are
extem-ally wrapped with insulation having an installed thermal resistance of R- 12 or greater: and
B. Unfired.,storage ca rn IISLI I jjorr R. I *11terijal
tanks or oi her ffldlre�m hot water tanki have R� 1.2 exte al i a', i 0
insulation w-h.erc clic.internal insulation R -value is indicated on tlie,c.-aerior of tli: tial!:.
I Water piping and C06linQ system line insulation thickness and conductivity
First -5 Feet of hot and cold water pipes closest to water heater talk, non-reclrculjun',�, 'ivstems, and entire
lemnli of recirCLdatilb! SCCD011,; of . hor water pipe., arQ insulated per'Standards- Tabled 50-13: and
Pipe insulation for steam h\dronic heating systems or hoc waier.ivstcriis >I_5 psi, meets the recluffernerits Of
Standards Table 123-A. '
UJ , That -ht. ink, -Irld
Insul-.-ttjon is prm�:cwd fii)(111 inclUdiInu i due to iunh I
wind.
I t 11),D' If indica'. d or. -he LIC . I R. all hot, Piping 111:11 runs from the hot �Okirce to 111' k-.itchen
insulated Per Standards I'able 150-13.
2001 ReShle,irial Conuvionce Forms Aw,,usi
IN)TALLATION CER'('IFICATE' CF-6I1-MEO.1-61
Domestic [lot Water IDI -LW) (Page 2 of 2) r
Site :kddress: • iEnforcement :l -en v, ; Permit `umber:
$342 Ta '
1. Centr;il Water Heating in.Buildings with Multiple Dwelling Units (required I'or prescriptive)
T.0 C.:UNIPLY -ALL BOXES til."ST BE CI-IEC:'KED
® All hot water piping in.hmin circulating loop is insulated to requiremenu.of ;? I. )(j')
Central iiut.water systems serving six or fewer d•:velhng units which have (I ) lass than 35' of distribution piping
outdoors; (^_) zero distribution piping underground', (3) no racirculatiun.pump; anis iii) insulation on distribution
pipill-I that n?eets the requirements of Section 150ij i
�.
Central hot waters stens scr;ing mor, that -6 d`Xiahng units - pr;:sLriccof either a tlmc control or a
iimeltenmperawre control
S .
7
DECLARATION STATEMENT
• I cerify under penalty of perjury, under he lows of the State of California, the information provided un this Form is in)e and cuirect.
• 1 am eligible under'Di.vision 3 of the Business and Professions Code to accept responsibilirj for construciion, or an 'authorized
representative of the person responsible for construction (responsible person).
• 1 certify that the installed Features, materials. cumpunents. o.r manufactur d de4iczs identified on :his certificate the installation)
conforms to 311 applieablecodes and regulations, and the installation is consistent with the plans and S'pecificatio'ns approved by the
enforcement 3genc Y.
i • i reviewed atopy oFthe Certilieate'ofCompliance.(CF-IIt) form approved.by.the eu!'orcement agency that ideniities.the specific
requiren.enis for the installation' I 14erti6i that the requirements detailed un the CF -I P that apply fo the installation have beenmet.
•. I will ensure thara completed, signed copy of this Installation Certificate -shall be posted: or made available with the budding
permit(s) issued .for the building, and made available to the enforcement agency for all applicable -inspections. I understand
that a "signed copy or this Installation Certificate is required to be included with the documentation the builder.provides to
the building.owner at occupancy.
Company Name: (Installing, jubcuntractor or General Ciaitractor or BuilderrOwner)
Ca�iFoc�nio� D�l�a Mechanical 2nc
i Responsible Person's 4;u te: j Resuorsi ile P_rson`s. $i_gnal-.- _.
CSLB'Ucense- Date S1211o' Pusa:bti 11 nth Cur: p;uty (T;de
Tech
00.0 Res;dep,;;al f Jrtl:•i
1 •
R
r
Din #
Qty. Of La Quinta
Building &r Safety Division
P.O. Box 1504,"78-4.95 Calte Tampico
La.Quinta, CA 92253.(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
3
Project Address: 'l $ j y;t
is l k i n R oC{C Ti,t, r•.
Owner's Name:. Can n CA U i n "
A. P. Number:
Address: MQ Ta b &A TAtr.n
Legal Description:
City, ST, Zip: L& Q . ka
Contractorbtlia le
Telephone: z�`
��`�"^'�`�'
111 , r>
Address: E ,)e. (55
Project Description: @ lQ ce %c 116 a
ST, Zip: e 2 to
—L
WA ( a6;6 r i (1
G
Telephone: v�o�o _ ,1'SP-73
State Lic. # :
City Lie. #:
Arch.; Fngr.; Designer:
Address:
City., ST, Zip:
Telephone:
o '
Construction Type: Occupancy:
State Lie. #:
Project nPa circle one): Alew Add'n. Alter Repair Demo
Name of Contact Person:Sq.
Ft.:
# Stories: - #.Units:
Telephone # of Contact Person: 273
1 Estimated Value of Project: I �.3
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Reg1d Rec1d TRACICTMG PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit.
Truss Cales.
Called Contact Person
Pian Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mecharilcal
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor Inst
Called Contact Person
Plumbing
Grant Deed
Pians picked up
SM.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:.
'^` Review, ready for correctionslissue
Developer Imps ct.Fee
Planning Approval
Called Contact Person
I Ad.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees