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BPLB2017-000578-495 CALLE TAMPICO V �14tII�Cl/ LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2017-0005 Property Address: 60518 WHITE SAGE DR APN: 764330062 Application Description: POPICH / CHANGE OUT (1) 50GALLON GAS WATER HEATER Property Zoning: Application Valuation: $2,997.00 Applicant: A R S AMERICAN RESIDENTIAL SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 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 Professions Code, and my License is in full force and effect. License Class: C36. C10, C20 License No.: 765074 Date: -� Contractor: 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).: (_) 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.). (_) 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.). (_) 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: GREGORY POPICH 10129 CHERRY LN NW GIG HARBOR, WA 92253 Contractor: A R S AMERICAN RESIDENTIAL S 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 (951)276-9744 Llc. No.: 765074 Date: 1/11/2017 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 rk for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Secti , n 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: LIBERTY INSURANCE CORPORATION Policy Number: WC7631508631 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, I shall forthwith comply with those provisions. Date: ��- / Applicant: 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 Building Official 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 city to enter upon the above-mentioned property for inspection purposes. Date: �- /r Signature (Applicant or Agent): Application Number: BPLB2017-0005 Property Address: 60518 WHITE SAGE DR APN: 764330062 Application Description: POPICH / CHANGE OUT (1) 50GALLON GAS WATER HEATER Property Zoning: Application Valuation: $2,997.00 Applicant: A R S AMERICAN RESIDENTIAL SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 Date: 1/11/2017 Owner: GREGORY POPICH, 10_29 CHERRY LN NW GIG HARBOR, WA 92253 Contractor: A R'S AMERICAN RESIDENTIAL SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 (95°)276-9744 Llc. No.: 765074 --------------------------------------------------------------------------------------------- Detail: WATER HEATER CHANGE OUT - 50GALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. . DESCRIPTION' FINANCIAL INFORMATION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $7.60 Total Paid for PLUMBING FEES: $20.27 CF111-ALT-01-E WATER MEATER CERTIFICATE OF COMPLIANCE n—'.A.-+ia1 Alterations for Water Heater i 4. 'Number of water heaters In system: In single-family and multi -family YAth water heaters In each dwb1lin JnIts<.thewa1ae4s4.:Fdr•,�'tm'IfihfanSNycertralsystems serving multiple dwelling units enter the total . number of water heaters.,, unit this will b on -.essf�.if.'InstantameouApep.tter..n/a. For 5. Water heater volume (gal): tank capacity In gallons. For Individual water . . heaters for i dwelling multi -family centra Isyste;ms �entert the to.talistoragemolume. 6. Fuel .Typ#:r.Gas,! Pr6pan e; Vectric (Only If natural gas is not available) fqr ear . 5 or Dropane .. fired olts are ptuh, for electric fired system the units are kW... 7. Rated Input Tvae. Enter the djgUjjDment Ino 8. Rated Input Value: Enter the numeric value of rated input. .. -ffi 9. Kiating'EffictinoType' Erj&&Pact6r, AFUE,6f Thermal tfftlin6y. FrbOffdiff ,Ehergy CommisMbdifedory 10. Heating Efficiency­VaI6e:'Eht4r- the value from 1product literature ora .'.'Calft' rn15;ori nstantaneous-wati r. heaters. 11. Standby Loss!(petcent): Applies:oniyA*-Iarge,storagL-waterheaters, Enterm/a for small storage 12.'E)(tetidr'lnsulatldhr R-Valuel. Ehteeth-R=VbIu#,jf,,&t&dr Irisufmidivion thVstorage-tank. is installed required. 13. Back-up solar savings fr9dtioh: if. compliance: recliu-ires a back-up solar-systeM, Indicate the solar'contfIb6tion (6*.'9..-,'0.30).`Ekt#rnaI calculations are a cl.,rgcIrculation system with at least.two, distribution 14. Central DHW Distribution System- For multi -fa mily buildingswith usingia central distribution system,a,.Oem n ,..enter n1a. lies to anybuilding with eight or more units, If the systemisnon-central or project Is individual units loops must be Installed. This requirement app Central . DHW this field shall I 1 9 be Stamdard. If non -cent . ral then pick from Standard, Demand Recirculation — Manual 15. Dwelling Unit DHW Distribution Type: Fora Ce electric . *ater heater this must be Standard, no recirculation system shall be. installed. Control, Demand Recirculation —Sensor Control. if non -central Prescri DOCUMENTATION AUTHOR'S DECLARATION STATEMENT efiCompliance+decur��n€a'tidfl�iS�aectifiren8�eoglYete Name: Company:: Address: , City/State/Zip: oOwner o Authorized agent Signature: ..contractor,liicense•,#:. 7 Phone: For assistance,or qu.estionsregarding.the.-Ener..gy<St-andards,.contaLl.,the -Energy H9tII.nqj!t; 1-800-7.72-3300. .3 1 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS - WATER HEATER CEC-CFIR-ALT-01-E (Reviled 061141 CERTIFICATE OF COMPLIANCE CALIFORNIA ENERGY COMMISSION Prescriptive Residential Alterations for water Heater MR -ALT -01-E WATER HEATER (Page 1 of 21 A. GENERAL INFORMATION' Site address: ' l ^ %tWl`//TE Bulldln T BYPe: Ingle Family Dwelling City, Zip Code: o Multi Family Dwellings U 1,10 7-7f Climate Zone: 10 G. WATER HEATING SYSTEMS Section 150.2 b 1G 01 02 03 04 05' 06 Water Water Water q of Water fuel Heating Heating Heater Water Heater 07 08 Rated - Rated 09 Heating 10 11 Heating Standby 12 13 14 .Exterior Back -Up Central -15 Dwelling Type System System Type Heaters Storage Input Input Type Value Efficiency Type Efficiency loss (%) Value Insul. Solar DHW System Unit DHW . Identification Type In Volume R•Value Savings Distribution System or system (gal) Fraction Type Distribution Name Type WATER HEATING SYSTEMS Water heating compliance for an alteration is described In Section 150.2(b)1G. For single -dwelling a gas or propane water heater, with a storage tank of 60 gallons maximum or instantaneous (tankless) can be used. Dwelling Unit distribution systems are limited to Standard trunk and branch or demand recirculation for gas or propane water heater. Demand recirculation is not allowed for electric water heater. If there is no natural gas connected to the building, an electric water heater may be replaced with another electric water heater. However, changing from gas to electric is not allowed. Multi -family central systems must use certified equipment as defined under Section 110.1 and 110.3. NOTE: If the proposed installation does not meet the requirements allowed specifically for alterations, use form CF1R-NCB-01 to document the water heater alteration. Instructions for sections with column numbers are given below: 1. Water Heating System Identification or Name: enter a unique name for the Water Heating System. 2. Water heating system type: Domestic Hot Water (DHW), Hydronic, Combined Hydronic, or Central. DHW is for domestic hot water, hydronic is a water heating system used for space heating only; combined hydronic are when the water heater will provide both space conditioning and domestic hot water. 3. Water heater type: For non -central systems only Small Storage or Small Instantaneous are allowed. For central systems pick from Large Storage, Small Storage, Heat Pump, Boiler, Large Instantaneous, Small Instantaneous or Indirect. l3in.tt Permit # ProjectOwer Address: � (�Jh�'7 S ..Cl ty of La Q (. in t3 Building 8i: Safety Division 78-495 Caffe Tampico La Quinta, CA 92253 - (760) 777-701,2 Building Permit Application and Tracking Sheet n's Name• 's ,Q�L� as '� Nam! . -!I E A. P. Number: Address: 60 5 % Legal Description: City, ST, Zip: z'( 74 Contractor: // Tele hon . -'r (/D Address: 3v,?b S? Project Description: S City, ST, Zip l/?,,gS�,dX TeleP h0n S C State Lic. #: r (rQs0 City Lie. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction type: ancY: u hQ i Occupancy: t ic. # State a L Add'n Alter Repairair Demo type circle one): New Name of Contact Person: VP Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: �(�(�, �D_O ('p %S Estimated Value of Project: , APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrcal Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"! Review, ready for corrections/issue Dcvclo�cr Impact Fee Planning Approval Called Contact Person A.I.P.P Pub. Wks. Appr Date or permit issue School Fees, Total Parmit Fees