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12-0027 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000027 Property Address: 43309 PARKWAY ESPLANADE W APN: 609-380-997-27 -293233- Application description:. PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 250 Applicant: Architect or Engineer: NT/Jhcn.�rt- �.11k� 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 Pro essionals Code, and my License is in full force and effect. LicenseClass: �C336- D34 Lic,ase No.: 915215 �( Date: Contractor: _ ♦ _ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury at I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Busin s and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish,, r 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): (_) 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 saleJ. (_ 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.). Lender's Name: _ Lender's Address: LQPERMIT Owner: THELEN,LEONARD P & SHAYNE S 43309 PARKWAY.ESPLANADE W LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/10/12 Contractor: PLUMBING INSTALLERS 13400 SATICOY STREET NORTH HOLLYWOOD, CA 9 Q ,1 (818)982-6952 U LiC. No.: 915215 -CITY Of LLAQUINTA► WORKER'S COMPEN _ ,(_W_ 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 3706 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 TOWER SELECT IN Policy Number WCCO2130900 1 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 ecome subject to s compensatidmprovisions of Section 3700 of the Labor. Code, I II forth � o with those provision's. r ,C Date: Applicant: WARNING: FAILURE TO SECURE WORKE COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITIO 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 cons tion, and hereby authorize representatives of this county to enter upon the above-mentioned property for i ec ' urposes. Date� Signature (Applicant or Agent): Application Number . . . . . 12-00000027 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 22.50 Plan Check Fee 5.63 Issue Date Valuation . . . . 0 Expiration Date 7/08/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 ---------------------------------------------------------------------------- Special Notes and Comments WATER HEATER CHANGE OUT - 40GALLON/GAS [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. January 10, 2012 1:56:07 PM AORTEGA -------------=--------------------------------------------------------------- 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 Pi esr.ii tip a E:`ea tific:ate of G'eiui li ince: Re. dent isl CIF -IR -ALT. Resi�€erttirtL, b rittrains (Paje of Pro'ect \;gene: Climate Zone i. = of Stories Geaerftl Information Site Address: Enforeem.eatAgenc ; Date: Biulcatg Type ®' Singlee Family 0 Mfidti Family Circle the: Froin Orientation: N. E. S. Vf, or degreGa Condiaened Fioor Awa (CTA): i xa� i•Type: 0 AitEraiiom ❑ Eu-vzloge..❑ Fenestr-atios3 ❑ Raof ❑ INAC. ; I l: cau�itt os Chau Ovt ❑ DFic�t.l enh,x t L'! It ater Heater T!'ti'- f©rw is not to irk aasedfia A'e,cfj'; C r7srri(wedEtizidi rgs ar jdc irivin WATER HEATING L1Si Li'atF�' %leate7S and boilers f07' I7Qt%8 dOl77eSttc %iQ!<-Orate)' (DHII %if3Rtfa7`S alir` lrvdron%spac.¢ Iteaiing: Indittiditcl du elling DHJV hsaters ntilst be gas or p>•oaane fired. Hot water ptDe insulatio n Orth) aIle. DHW heaters to the brchen(s) and on all underground hot viwrer pipes is regnired in all cont onenr packages %7t ail cl%i7tate =ones_ Co p L V'5�rl� CT A 001.Address:� Date: If ApphcalAe ❑ CEA or CEPE (Certification CitylSta etZip: n � LXI � External Tank Water Heater Typz/Fuel Distriotttion Type ltuntiff In Tank Energy Factor or Insulation Type' (Standard_ Recirculating)', System Capacity (gal) Thenual Efficiency R -Value. CA -S S14 - 7 1. Indicate Type (Storage Gas, Heat PwnD, butcintaneatis, rte) I '� `L'J 2. Recirculating systews se7ving ntalltiDie dtve; ing units shall meet rhe recircidation reguire7)iel')ts of g150(n). file Prescriptive re- tWre7nents do nQt dllQti4: the installation Of a MOT-ct,'lating owner heating system for single dwelling 7tni s. ' 3. The evernol ivater heating i ik and:DiDes shall be bnsUlated to Meet he mcgJrarnents o : of 50(i)_ Documentation Author's Declaration,St tteinent , • , I certifti' that this Cert ficate. of Compliance docurnentation is accurate and MMP te. \int e: 'tc ,'-: Signature: Co p L V'5�rl� CT A 001.Address:� Date: If ApphcalAe ❑ CEA or CEPE (Certification CitylSta etZip: n � LXI � P r - For assistance or questions regarding the Energy -Standards, contact tire. E7)ergv Hotline at: 1-800072-3300. Registrarion Iihanbe)'_ _ Registration Date/TPnta: HERS Provider: 2003 Residentiai Compliance Foms Angatst 2009 Bin # City of La' Quinta Building .& Safety Division j P.O. Box 1.504� •78-495 Calle Tampico i La Quints, CA 92253 =. (760) 777-7012. Building Permit Application.and Tracking,Sheet Permit # 11.101 Project Address: Y LS Owner's Name: A. P. Number: Address: 1 Legal Description:i Contractor: (i(. k1bTe :Ci'ty ST, Zip: q Z_ 2, le hone: J p s.2 Address: \��� mil. `� ,.• ~Z Project Description:e City, ST, Zip:' �'� ` b v Tel hon _ ;��:`��Y'�".' nom:: �`?`�''.�.,,•;�,c�:r:{ Lic. # (� State Lic. #: `i E-2-1City Arch., Engr.,-Designer: Address: City., ST, Zip: Telephone: ��� s Y:..:v�.:... ` a rr',2,• r?. Construction, Occupancy: State Lic. ':'Project type (circle one):. New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd _ Rec'd TRACIMG PERMPT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up pConstruction Flood plain plan Plans resubmitted Mechanical Grading plan V Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up . S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'rd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees