13-0009 (PLBG)'�.0. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000009
Property Address: 79280 DESERT WIND CT
APN: 604-332-015-20 -23935 -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 700
T4VI
"
VOICE (760) 777-7012
410FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT a INSPECTIONS (760) 777-7153
BUILDING PERMIT
Owner:
JANET HERNANDEZ
79280 DESERT WIND CT
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: STATE WIDE PLUMBING
40244 CATANIA COURT
INDIO, CA 92203--0
(760)636-0315
r/pr Lic. No.: 731855
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 Busr and Professionals Code, and my License is in full force and effect.
Lice a Class: C36 License No.: 731855
atent,act
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, 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 of 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, 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.).
( ) 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: r /^
LQPERMIT
Date: 1/03/13
2.13
CITY OF LA QUIN-M
. �r�"2irCF r�c�g
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.
1 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 MARKEL INS CO Policy Number MWC00329801-01
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 sh uId become subject to the workers' compensation provisions of Section
�' 3017000 of the Labor e, I shall forthwith comply with those provisions.
a�0 te: 1 .J�[ pplica
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.
I . 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 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 buildi construction, and hereby authorize representatives
Of is county t nter upo the above-mentioned proper rinspection purposes.
gnature (Applicant or Agen o
Application Number . . . . . 13-00000009 >
Permit PLUMBING
Additional desc . .
Permit Fee . . . . 22.50 Plan Check
Fee
5.63
Issue Date . . . . Valuation
. . .
. 0
Expiration Date . 7/02/13.
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and Comments
INSTALLL NEW GALLON NATURAL GAS WATER
-40
HEATER. 2010 CODES.
:
-----------------------
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
LQPERA1IT
• i
•Pcescrlpt ve, Certificate of Compliai
_ Residential Aftqatims
Pm'ec t. Name•
te
CV--IR-ALT:-DR
Page 1 of 2
Climate Zone.• Permit #:
General Information
Site Address:Enforcement Agency: Date:
BuildingT Sin le Family❑Multi FilmProject
T e lacement or Change out of Water Heater
WATER HEATING i
list neu4v installed water heaten and boilers for borlr do+n?slit hot water heaters`(DWH) and lnr/romic space heating. Newly installed
DtVH heaters and boilers must be as, p or ttse the existing el hpe.
Water tkater Type
Typdfvt Type (Surdaid.
n
Number In Tank F—gy Factor
SyiteCapcty (gal) by►c�y
E•x�1 Tank
Insulation
natn
� � GO
enforccmad for approval with this budding it applkxjotL
Named Imo, / i
ignature: n
Is
1, V (1,
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167 3
!. Indkw,l I)pe (Storage Gas, Heat Pump: Instaivaneots, etc.)
2. Reci►rulatinig systems serving multiple dwelling ,its shall meet the recirculation requirrments of §ISO(n).
requirements do not allow the installation of a recirculating water heating swum for single dwelling runts.
3. Thr e:rtema! water heat' tank and s shalt be insulated to meet the R uirememts o !
The Prescription,
Contractor or Homeowner (Documentation Author's/ResponssHAe Building Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is attune and comptete.
• 1 am eligible under Division 3 of the Califomia Business and Professions Code to accept responsibility for the building design
identified on this Certificate of Compliance.
• I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliattci
conform to the requirements of Title 24, Part I and 6 of the California Code of Regutaemns.
• The building design features identified on this Certificate of Compliance are consistent With tete information provided to document this
building design on the outer appikable(compliance fomes, worlaheets, calculationm plans and specil-"fwns submitped to the
enforccmad for approval with this budding it applkxjotL
Named Imo, / i
ignature: n
Is
1, V (1,
company: Daw.
167 3
City/SC�I/•'�' � � l� 0 � •�3 to � � � lS
Bin.#
Cit} Of, %d Quintd
Building Si Safety Division
Box 1504,76-495 Calle Tampico
1a.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
0
Project Address:
Owner's Name:.
A P. Number. �•
In 0,i
Adder: .
Legal Description:
City, ST, Zip: i G
Contracto . j 1 �,
�� 1 UM LJ l
'ai�
Telephone .- MINN.
Address: t4o I:yq CQ, ,
Project Description:
City, ST, Zip:
I D n &
Telephone: Z , 3
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State Lic. #77S City Lic. #; 0
Arch, Engr., Designer.
Address:
City., ST, Zip:
Tele hone: `Sw
P .Y
Lic. #:.:,,J, -
Name of Contact Person:4
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alte epair�o
Sq. Ft.: # Stories:
# Units:
Telephone # of Contact Person: �(�
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd'Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calm
Plans picked up
Construction
Flood plata plan'
Plans resubmitted..
Mechanical
Grading plan
r' Review, ready for correctiionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S M I
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for correctionsfissue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees