13-1131 (PLBG)r
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUTNTA, CALIFORNIA 92253
Application Number.
13-00001131 �>
Property Address: llllllll5rrT0
AVENIDA VALLEJO
APN:
774-245-015- -
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
185
Applicant:
�Vov
Architect oror Eng
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: C36 License No.: 930133
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 ISec. 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 (55001:
(_) 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.).
(_ 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. , BAP.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:
SONIA MARTEL.
54440 AVVENIDA VALLEJO
LA QUINTA, CA 92253
(760)777-4663
Contractor:
TOMMY ROOTER
80975 INDIO'BOULEVARD #C
INDIO, CA 92201
(760)574-4444
Lic. No.: 930133
VOICE (760) 777-7012
FAX. (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/09/13
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
isci ied
_ 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 NORGUARD INS Policy Number THWC435917
_ 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, j64all forthwith comply with those provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP 70 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. -
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 this county to enter upon the above-mentioned erty fo 'spa tion purposes.
QN�.._..._r,-,
Date:` — `,ignaturelApplicabt�o�,Agentl:-,
LQPERMIT
Application Number. 13-00001131
Permit PLUMBING 2013
Additional desc
Permit Fee . . . . 11.92 Plan Check Fee
.00
Issue Date . . . . Valuation
0
Expiration Date 3/08/14
. Qty Unit Charge Per
Extension ?'
1.00. 11.9200 EA PLBG WATER HEATER/VENT
11.92
----------------------------------------------------------------------------
Special Notes and Comments
WATER HEATER CHANGE OUT 40 GALLON
STANDARD NATURAL GAS 2010 CODES.CARBON
- MONOXIDE ALARMS TO BE INSTALLED PRIOR TO _
FINAL.
------------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
Fee summary Charged Paid Credited
Due
Permit Fee Total 11.92 .00 .00
11.92
Plan Check Total .00 .00 .00
.00
Other Fee Total 91.57 .00 00
91.57
i. Grand Total 103.49 .00 ,00
103.49
LQPERMIT
1
LQPERMIT
06/06/2013 THU 15:09 FAX La Quinta Bldg & Safety
Bin #
City Of La Quinta
Building.BT Safety Dftjon
Permit # P.O. Box 1504, 78-495 Calle Tampico
` / \ La Quinta,. CA 92253 • (760) 777.7012
1� Building Permit Application and Tracking Sheet
Project Address:
Owner's Name: S
A P. Number:
Address: .� `A D C �t
Legal Description:
Contractor: City, ST, Zip:
Address: IRO S
City, ST, Zip:
Telephone: u _S -)q
State Lie.
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal Rel
Pian Sets
i
Structural Calcs.
Truss Cates.
-Title 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Great Deed
H.O.A. Approval
IN HOUSE:
Planning Approval
Pub. Wks. Appr
Scbool FM
V P Tele phone:� iu -71. ^j — L4U 6 3
�o rd, Project Description:
Uj G7�e_ V L—A P r, i t
0-57t�yLy
APPLICANT: DO NOT M
RecV TRA
Plan Check submitted
Reviewed, ready for tori
Called Contact Person
Plans picked up
Plans resubmitted
2'! Review, ready for coi
Called Contact Person
Pians picked up
Pians resubmitted
Review, ready for cor
Called Contact Person
Date of permit issue
0001/001
t
D
Construction Type:
Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq Ft.: #Stories: #Units:
Estimated Value of Pmject: _
RITE BELOW THIS LINE
CMG PERMIT FEES
Item Amoaat
tedons
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
rections/issue
Electrical
Plumbing
S.M.I.
Grading
rectionstissue
Developer Impact Fee
A.LP.P.
Total Permit Fees
t
Prescriptive Certificate of Compliance: Residential CF-IR-ALT-DHW
Residential Alterations Page I oft
Project Name: C Climate Zone: Permit #:
General Information
Site Address: LyQ0 Enforcement Agency: Date: 01— - )
Building T Sin le Family ❑ Multi Fa it Project T Re laceritent or Change Out of Water Heater
WATER HEATING
• i certify that this Certificate of Compliance documentation is accurate and complete.
List newly installed water heaters and boilers for both domestic hot water heaters (DWH) and l>.vdronic space heating. `Newly installed
MVH heaters and boilers must be gaus. pro ane, or use the exisringAel type.
Water Heater
Type/Fuel Type
Distribution Type Number in Tank Energy Factor or,
(Standard. System Capacity (gal) Themtal Efficiency
Recirculatin
conform to the requirements of Title 24, Partl and 6 of the California Code of Regulations.
External Tank
Insulation
R -Value
r
enforcement agency for approval with this building permit application.
me:
C
Si
Y
Company:
50 M m (�c�c
Date:
9 -5 -
Address: U
k D * C-3
License:
q901-33,
City/State zip:
.o C
Phone:
7Lp o -F)l q- qq� q
1. Indicate Type (Storage Cas. Heat Pump, Instantaneous, etc.)
2. Recirridating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n).
requirements do not allow the installation of a recirculating water heating system for single dwelling units.
3. The a sternal water heating tank and pipes shall be insulated to meet the requirements o 1 SO ' .
The Prescriptive
Contractor or Homeowner (Documentation Author'stResponsible 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, Partl and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the
enforcement agency for approval with this building permit application.
me:
C
Si
Y
Company:
50 M m (�c�c
Date:
9 -5 -
Address: U
k D * C-3
License:
q901-33,
City/State zip:
.o C
Phone:
7Lp o -F)l q- qq� q