11-1000 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00001000 --
-Property
Property Address:
78187 INDIGO DR
APN:
604 -021 -037 -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
850
Applicant: Architect or Engineer:
a
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 lass: C36 License No.: 880103
/Date: '�S �� C ractor: _
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 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 _ 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: If
Lender's Address: pit
LQPERMIT
Owner:
FOTI ANTHONY
78187 INDIGO DRIVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/15/11
Contractor:
ALVAREZ,
JORGE A.
P.O. BOX
984
THERMAL,
CA 92274
(760) 777-3613
Lic. No.:
880103
CIT`�OE r`O ilINTP�
i?,�PT
-----------------------------------------------
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 EXEMPT Policy Number EXEMPT
{, certify that, in the performanceof 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 t e Labor de, I shall forthwith comply with those provisions.
te: Applicant:
elpWARNING: FAILURE TO SECURE RKERS' 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, indemnity 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 '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 pr rty for inspection purposes.
a�u to: Sig re (Applicant or Agent .
Application Number .
. . . .
11-00001000
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
22.50
Plan Check Fee
5.63
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
3/13/12
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 7.5000
EA PLB
WATER HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and Comments
INSTALL NEW 40 GALLON
GAS WATER
HEATER.
2010 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
Pres cri tive Certificate of Compliance: Residential CF-IR-ALT-DHW
Residential Altercations ` '`' �' , i Page I of 2
Pro'ect Name: Climate Zone: l S Permit #:
General'Information -
Site Address: % Enforcement Agency:', i -A, l_Lj' Date:
Building Type: Main le Family O Multi Family Project Type: CWe lacement or Change Out of Water Heater.
WATER HEATING
• 1 certify that this -Certificate of Compliance.documentation is, accurate and complete.
List newly installed water heaters and boilers for both domestic hot ►eater heaters (DWH) and hydropic space heating. Newly installed
DWH heaters and boilers must be gas. pro ane, or use the existingfiieI type. -
• I certify, that the energy features and performance specificationsTor the building design identified on -this Certificate of. Compliance
Water Heater - Distribution Type Number In Tank t Energy Factor or
(Standanl, {
i'The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
External Tank
Insulation
_
Type/Fuel Type Recirculatin r' System Capacity (gal) Thermal Efficiency
Name
R -Value
Company: _
Date:
Address:
License:
City/State/Zip:
Phone:
—7
LA
1: Indicate Type (Storage Gas, Heat Prunp, Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall 'rneet d:e• recirculation requirements of §150(n).
The Prescriptive
requirements do notallow the installation of a recirculating water heating system for single dwelling units.
3. 77te external water heating tank and pipes shall be insulated to meet the requirements of §150U).
t
Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement)
• 1 certify that this -Certificate of Compliance.documentation is, accurate and complete.
-•-I am eligible under Division 3 of the California Buiiness and Professions Code to accept responsibility for the building design
identified on this Certificate of Compliance. -
• I certify, that the energy features and performance specificationsTor the building design identified on -this Certificate of. Compliance
conform to the requirements'of Title 24, Part I and 6 of the California Code of Regulations.
i'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 approyal with this building rmit application.
Name
Signature:. a
Company: _
Date:
Address:
License:
City/State/Zip:
Phone:
—7
LA
SA aril 7010
Storage Water Heater is defined as: •
Max Btu/hr per Gallon 30 Gallon 40 Gallon 50 GallonEj
4,000 120,000 160,000 200,000
2009 Appllance Efficlericy Aegulatlons for Small Water Hdatets
Small Water Heater Is defined as:
Input
-Type
Gas Storage
75,000 Btu/hr or less
Oil Storage
105,000 Btu/hr or less
Electric Storage
12 kW or less
Gas Instant
200,000 Btu/hr or less _
Oil Instant
210,000 Btu/hr or less
Electric Instant
12 kW or less
Heat Pump
24 amps or less
Storage Water Heater is defined as: •
Max Btu/hr per Gallon 30 Gallon 40 Gallon 50 GallonEj
4,000 120,000 160,000 200,000
1. Per Section 1500) of the zuuts Energy tmciency oauwalw.
QA"ril2nio
If rated Energy Factor does not EXCEED minimum
Federal Minimum
Values Below, an External Insulating Blanket (R-12,
Energy Factor -
- - minimum)
shall be Installed'
Water Heater Fuel T e
Effective Jan 20 2004
30 Gallon
40 Galion
50 Gallon
Gas-fired storage -type water
0.62 — (0.0019 x- V)
0.563
0.544
0.525
heaters
Oil -fired water heaters
0.59 — (0.0019 x V)
0.533
0.514
0.495
(storage and instantaneous
.Electric storage water heaters
(excluding tabletop water
0.93 — (0.00132 x V)
0.890
0.877
'
0.864
heaters
Electric tabletop water
0.93 — (0.00132 x V)
0.890,
0.877
0.864
heaters
Gas-fired instantaneous water
0.62 — (0.0019 x V)
0.563
0.544.
0.525
heaters
-
Electric instantaneous water
heaters (excluding tabletop
0.93 — (0.00132 x V)
0.890
0.877
0.864
water heaters
Heat um water heaters
0.93 — 0.00132 x
0.890
0.877
0.864
V = rated volume in gallons
1. Per Section 1500) of the zuuts Energy tmciency oauwalw.
QA"ril2nio
Bill #
Permit 11
Prqjcct..Addrcss:
ii. l xgal De.;criptiol):
Comm --Clor:
Add
City,
Arch., Engr, f)csjgncj-:
Address:
City, ST, zip:
Stateit Lie. It:
! Taame or Contact Person:
I, Telephone'll of Contact Person:
uty of La Ou"
Building Pj' Safety Division
'P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 922.53 - (760) 777-7012
Building Permit Application and Trarking Sheet
Addres�;: --7
Q)
1. U."(11pnow
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City Lis. if:
N
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utle): New Adtfii Alter RcIl,-tir Demo
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4TStructural
C"11CS.
Estill -Fated Val tic of Proji:('t
APPUGANT: DO NOT WRITE' BELOW THIS UNE
vuss Cat—
PERMIT FITES.
1: Kin Chech Sulmlifted
ti Iff.111 Amount
Energy CHICS.
Man Check Deposit
Wood PIMAk Phil
Grading plan
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Contact flcrsmi
IN IIOUSF:-
Phns viched Up
.'Appnw.),
:1 Plaits resilbluitt(-d
Grmling
Pub. Ms. Appr
Review, ;-'nt ly'l'or Con-cctiolWismir.
D*e'veloper lutpaci Fee
uty of La Ou"
Building Pj' Safety Division
'P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 922.53 - (760) 777-7012
Building Permit Application and Trarking Sheet
Addres�;: --7
Q)
1. U."(11pnow
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City Lis. if:
N
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utle): New Adtfii Alter RcIl,-tir Demo
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Stol e.,-;: It Ullits:
Estill -Fated Val tic of Proji:('t
APPUGANT: DO NOT WRITE' BELOW THIS UNE
2"CCd TRACKING
PERMIT FITES.
1: Kin Chech Sulmlifted
ti Iff.111 Amount
w-derved, re,,id.y for correc(ions
Man Check Deposit
Pialls j)idzed 111)
"'ollmnuctioll
v
LTSW)1tlit(?,(11...._.._._milic-ai
J! -1.,
,
fill. cointdioll'Osm,
Is '!cetrical
Contact flcrsmi
Phns viched Up
:1 Plaits resilbluitt(-d
Grmling
Review, ;-'nt ly'l'or Con-cctiolWismir.
D*e'veloper lutpaci Fee
11 CaUed Om(ac( Person
if
Date urpumit issue
Fees