BPLB2016-0086Q�aw
78 495 CALLE TAMPICOY D VOICE (760) 777-7125
LA QUINTA; CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/9/2016
Application Number: BPLB2016-0086 Owner:
Property Address: 55151 WINGED FOOTEl
ALLEN SHACKELFORD
APN: 775330006 'J 55151 WINGED FOOT
Application Description: SHACKELFORD RESIDENCE /WATERUT LA QUINTA, CA 92253
Property Zoning: 2015Application Valuation: $3,495.00
JINTAENT DEPARTMENTApplicant: Contractor:
IE INC HARRISON ENTERPRISES INC DBA GENERAL AIR
31225 LSA BAYA 31170 RESERVE DRIVE
WESTLAKE VILLAGE, CA.91362r THOUSAND PALMS, CA 92276
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: C20, C36 License No.: 686310
Date:s(eCl. 1_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 Address:
(760)343-7488
Llc. No.: 686310
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 2700 of the Labor Code, for the performance
ofthe work for which this permit is issued.
�dZ I have and will maintain worker.:' 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: _ Policy Number: '
I certify that in the performance of the work for which this permit is issued,
shall not employ any person in any mannen 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 Secticn 3700 of the Labor Code, I shall forthwith
comply with those provisions.
lie �Applicant�—
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRF AINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($10[,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED =OR 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 -he City of La Quinta, its officers, agents, and
employees for any act or omission related Ib 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 carcellation.
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 Qdinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
ate -It p SigQtur" (A plic tna or_Agent):91Z, C
FINANCIAL INFORMATION
},DESCRIPTION
�4 ACCOUNT r' 3 QTY
;AMOUNT'
ePAID �
:PAID DATE;.
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$0.00 '
METHOD <r, '� ,, z RECEIPT #
CHECK # 1 1�,CLTU BY "`
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
z* DESCRIPTION ' € *.
A000UNTt x�xa,
QTY'
rAMOUNTs
A
..
'PAID DATE:
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
€ ^PAID BY<�� -
,x
"> -METHODS �'' "`
� RECEIPT#
CHECK # `Y
LTD,
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION a�w`.
;ACCOUNT, `
QTY.'
t}? ��x A TyePAIDr
MOUN
PAID DAT'Erd
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00 t "
sMPAID BY ; �* =` �
' A METHODS
aa` `¢ RECEIPT#L
„- CHECK # #
; CLTD BY-
x DESCRIPTION �.: -�
a Y P
b�4F ACCOUNT ��
QTY :�
W
AMOUNT' >
Viz. v. PAID
PAID DATE'
WATER HEATER/VENT PC
101-0000-42600
0
$7.25
$0.00
PAID BYsRECEIPT
#
< CHECK # ' ��k
r �CLTD BYx�y
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:6b
Description: SHACKELFORD RESIDENCE / WATER HEATER CHANGE OUT
SITES
CHRONOLOGY
Type: PLUMBING
Subtype:
Status: APPROVED
Applied: 6/9/2016 MFA
Approved: 6/9/2016 MFA 7
Parcel No: 775330006 Site Address: 55151 WINGED FOOT LA QUINTA,CA 92253
Subdivision: TR 29121
Block:. Lot: 6
,�..
CITY.,
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0_ :
Zoning:
Finaled:
Valuation: $3,495.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
Details: REPLACE 75 GALLON GALLON GAS WATER HEATER. PER 2013 CALIFORNIA BUILDING CODE
VILLAGE
- Applied to Approved °
SITES
CHRONOLOGY
CONDITIONS-
�-.CONTACTS
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,,STATE - ZIPS.:; PHONE, +
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APPLICANT IE INC 31225 LA BAYA
WESTLAKE
CA, 91362. (760)777-8548
VILLAGE
CONTRACTOR HARRISON ENTERPRISES INC DBA 31170 RESERVE DRIVE
THOUSAND
CA 92276 (760)777-8548
FRANCISCO@CALLTHE
GENERAL AIR
PALMS.
I
GENERAL.COM
OWNER ALLEN SHACKELFORD 55151 WINGED FOOT
LA QUINTA
CA 92253 (760)777-8548
DESCRIPTION:
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT.#
CHECK # .
mmMETHOD
PAID BY ;:~
CLTD
BY
BSAS SB1473 FEE
101-0000-20306 .-OT
$1.00
$0.00'
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.uu $u.uu
BSA:
PERMIT ISSUANCE
101-0000=42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
WATER HEATER/VENT
101-0000-426000
$7.25
$0.00
PC
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:��
Printed: Thursday, June 09, 2016 11:43:14 AM 2 of 2
SYSTEMS
Bin #
' City 'f La Quinta .
Building 8r Safety Division
P.O. Box 1504,78-495 Caiie Tampico
ta.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 55151 Winged Foot
Owner's Name:. Allen Shackelford
A. P. Number.,
Address: 55151 Winged Foot
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor! General Air Conditioning
Telephone: 760-777-8548
g.
mast•• x
Address: 31170 Reserve Drive
Project Description: Replace 75 Gallon Water Heater
City, ST, Zip: Thousand Palms, CA 92276
''
Telephone: 760-343-7488M-11 MEMO,
State Lic. # : 686310 City Lie'. #:
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
.,� . wir%. a
Construction Type: Occupancy:
State Lic. #:.
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Steven Schnierer
Sq. Ft.:
#Stories: #Unite:
Telephone # of Contact Person: 818-735-7876
Estimated Value of Project $3,495.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKNG
PERMIT FEES
Plan Sets
Plan Cheek submitted
Item Amount
Structural Calks.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calks.
Called Contact Person
Plan Check Balance
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mecharilcal
Grading plan
2a0 Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
SIAL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
A. -GENERAL INFORMATION
Site address:�-^ Building Type::
SS is V tj ir�sed 1
o Single Family Dwelling
oa�
o Multi Family Dwellings
City, Zip Code: ClimateZone:
05 '
G. WATER HEATING
SYSTEMS Section 150.2(b)1G) ..
01
02
03
•04.
05 '
06
07
08
09
10
11
12
13
14
is
Water
Water
Water
p of .
Water
Fuel
Rated
Rated
Heating _
Heating
Standby
Exterior
Back -Up
Central
Dwelling
Heating
Heating
Heater
Water
Heater
Type
input
Input
Efficiency
Efficiency'
Loss (%)
Insul.
Solar
DHW System
Unit DHW '.
System.
System
Type
. Heaters
Storage
Type
Value
Type
Value
R -Value
Savings
Distribution
System
Identification
Type
in
Volume
Fraction
Type
Distribution
or.
system.
(gal)
Type
Name,
D N Q
75
Gas
DA ,�--
o,CEO
F..-+11
, S 8
8
N A
N A
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, arl 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 Centra)_ ,DHW is for domestic hot water, hydropic 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 Instariianeous or Indirect.
CERTIFICATE OF COMPLIANCE CRR -ALT -01-E WATER HEATER
Prescriptive Residential Alterations for Water Heater (Page 2 of 2)
4. Number of water heaters in system: In single-family and multi -family with water heaters in each dwelling units the value is 1. For multi -family central systems•
serving multiple dwelling units enter the total number of, water heaters.
5. Water heater volume (gal): tank capacity in gallons. For individual water heaters for a dwelling unit this will tie 60 gallons or less. If instantaneous, enter n/a. For
multi -family central systems enter the total storage volume.
J
6. Fuel Type: Gas, Propane, Electric (Only if natural gas is not available)
7,. Rated Input Type: Enter the equipment input rating type, for gas or propane fired units are Btuh, for electric fired system the units are kW.
8... Rated Input Value: Enter the numeric value of rated input.
9.. Heating Efficiency Type: Energy Factor, AFUE, or Thermal Efficiency. From product literature or a California Energy Commission directory.
10, Heating Efficiency Value: Enter the value from product literature or a California Energy Commission directory
11. Standby Loss (percent): Applies only to large storage water heaters, Enter n/a for small storage or instantaneous water heaters.
12. Exterior Insulation R -Value:. Enter the R -value if exterior insulation on the storage tank is installed
13. Back-up solar savings fraction: If compliance requires a back-up solar system, indicate the solar contribution (e.g., 0.30). External calculations are required.
14. Central DHW Distribution System: For multi -family buildings with using a central distribution system a demand recirculation system with at least two distribution
loops I.must be installed. This., requirement applies to any building with eight or more units. if the system Is non -central or project is individual units enter n/a. .
15. Dwelling Unit DHW Distribution Type: For a Central DHW this field shall be Standard. If non -central then pick from Standard, Demand Recirculation —Manual
Control, Demand Recirculation - Sensor Control. If non -central electric water heater this must be Standard, no recirculation system shall be installed. "
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name: ❑Owner Authorized
0�w,5, CJEi
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
agent ❑Contractor
Signature:
Company : e .., Co...ci; A;oa.iv,
Contractor license #:
Address; l
Phone: %(off -343-71{$9
City/State/Zip:
Date:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name: ❑Owner Authorized
0�w,5, CJEi
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.