08-0589 (PLBG)tf
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 08-00000589
Property Address: 79120- KAYE CT
APN: 604-371-004-96 -27899 -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 500
Applicant: j_arI c�
T,iht 4 4 Q"
Architect or Engineer:
N f
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
FLAGG DARREN E
79120 KAYE CT
LA QUINTA, CA 92253
(
Contractor:
FOY, SCOTT A.
43579 MAIN STREET
INDIO, CA 92201
(760)775-9405
Lic. No.: 828264
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/10/08
--------------------------------------------------------------'---
LICENSED CONTRACTOR'S DECLARATION
--------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed underprovisions of Chapter 9 (commencing with
' I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._
C36
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
license Class: License No.: 828264
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
-� r `r S . l
Date Contractor:
issued.
:
•
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
`
' O --BUILDE ECLARATION
Code, for the performance of the work for which this permit is issued. My workers' compensation
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
insurance carrier and policy number are:
Carrier ACE INC Policy Number 045040239
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section
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).:'
700 of the Labor Code, I shall forth it, comply w -those provisions.
^ Date: ! Applican_t:. r
1 _ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
_ f
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' CO NSATION CQ410ERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own.employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
_ improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.)._
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
1 _ 1 I am exempt under Sec. , BAP.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta its officersnt d I f
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
,as ge an emp oyees or 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 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 nter upon the above-mentioned property for insp
Dater Signature (Applicant or Agent):
LQPERMIT
Application Number
08-00000589
Permit . .
. PLUMBING
.Additional desc .
.
Permit Fee . . .
. 22.50
Plan Check
Fee
5.63
Issue Date . . .
.
Valuation
. . .
. 0
Expiration Date .
. 10/07/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000
----------------------------------------------------------------------------
EA PLB WATER
HEATER/VENT
7.50
Special Notes and
Comments
REPLACEMENT WATER
HEATER 40 GALLON
NATURAL GAS UNIT.
Fee summary
Charged Paid
Credited
Due
--
Permit Fee Total
---------- ----------
22.50
----------
.00
----------
.00
22.50
Plan Check Total
5.63
.00
.00
5.63
Grand Total
28.13
.00
.00
28.13
r.
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -IR
VIP�
Project Title Date —'
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF4R Form must be provided to the building department for each home for which the following. are
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Proiect Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-14.
AD
For additions and alterations, duct systems that are not documented to have been previously
❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential 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 HE,ATYNG SYSTEMS
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑
Sealed Ducts all climate zones(Installer testing and certification and HERS rater field verificationrequired.)
Standby
Loss (0/o),
TXVs, readily accessible (climate zones 2 and 8-15 only)
❑
(Installer testing and certification and HERS Rater field verification required.)
❑
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
❑
verification required.)
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Proiect Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-14.
AD
For additions and alterations, duct systems that are not documented to have been previously
❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential 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 HE,ATYNG SYSTEMS
Cvctems cervine sinale dwellino units
Water Heater
T uel T�pe
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Standby
Loss (0/o),
not allowed.
Gs ��6rL5
Check box when using Preapproved Alternative Water Heating table, Table 54 in Chapter 5 in the Residential
❑
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
❑
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Cvctems cervine sinale dwellino units
Water Heater
T uel T�pe
Distribution
Type
Number
in System
Rated
Input'
(kw or
Bwnv)
Tank
Capacity
(galIons
Energy
Factor' ori
Thermal
Efficiency
Standby
Loss (0/o),
Tank
External
Insulation
R -Value
Gs ��6rL5
4/1 X 60- -
t]
S stem servingmulti le d etting units
Water Heater
Type
Distribution
Type
Number
in System
Rated
Input'
(kW or
Btu/hr)
Energy
Tank Factor or
Capacity Thermal
(gallons) Efficiency
Standby'
Loss %
Tank
External
Insulation
R -Value
1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, 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 Thermal Efficiencies.
Pipe Insulation (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are -1/4
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
I
#
Submittal
Req'd
# !l.
TRACIONG
City of La Quinta
'
Plan Sets
Building 8i Safety Division
P.O. Box 1504, 78-495 Calle Tampico
#
Permit
5
U QLdnta, CA 92253 - (760) 777-7012
Building Permit Application Tracking Sheet
Structural Cales.
and
Project Address:n
w
►
Owner's Name: y'
A_ P. Number:
Traps Cates.
Address: 'J
Legal Description:
Plan Cheek Balance.
City, ST, Zip:
Title 24 Calcs.
Contractor: S �i
Telephone: -
/Address:
Address:
ep C; `
Project Description:
City, ST, Zip:
L
, 1
Plans resubmitted
Tel hone: S I l :
eP
..fiY.,
Ji�.,
Grading plan
�SYYh „� yS��•��A.
2" Review, ready for correetioostissue
State Lic. # :
Electrical
City Liic. C
Subcontactor Last
Arch., Engr., Designer.
Called Contact Person
Address:
Grant Deed
City., ST, Zip:
Plans picked up
Telephone:
H-O.A. Approval
„
Construction Type: Occupancy:
State Lie. #:ss
s .
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
` j
Sq. Ft:
# Stories: # Units:
Telephone # of Contact Person: 7-75/20ZZ:J
Estimated Value of Project
Planning Approval
APPLICANT: DO NOT WRITE BELOW THIS LINE
I
#
Submittal
Req'd
Reed
TRACIONG
.. PERMIT FEES
Plan Sets
Plan Cheek submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Cheek Deposit
Traps Cates.
Called Contact Person
Plan Cheek Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correetioostissue
Electrical
Subcontactor Last
Called Contact Person
Plumbing
Grant Deed
Plans picked up
H-O.A. Approval
Pians resubmitted
Grading
IN HOUSE:
''a Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issne
School Feu
Total Permit Fees