14-0653 (MFD5) Apt C-8P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
r'
Application Number: 14-00000653
Property Address: 42800 WASHINGTON ST APT C-8
APN: 609-040-007- - -
Application description: DWELLING - 5 OR MORE FAMILY
Property Zoning:
Application valuation: 400
Tiht 4 4 Q"
Applicant: Architect Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury th 1 am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busin and Professionals Code, and my License is in full force and effect.
,�kLicense Class: C36 Licery4e No.: 928636
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 (5500): /
1—) 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 theieun, aitd 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
LA QUINTA REDEVELOPMENT AGENCY
C/O LA QUINTA REDEVELOPMENT AG
78495 CALLE TAMPICO
LA QUINTA, CA 92253
Contractor: D
MR ROOTER PLUMBING
P.O. BOX 3385
PALM DESERT, CA 92261
(760)779-0190
Lic. No.: 928636 1
Date: 5/19/14
MAY 1 � 2n'14
CITY OF LA QUwTA
------------------
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.
_ 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 Policy Number WCCO032923
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner s as to become subject to the workers' compensation laws of California,
and agree that, if I sh d become subject to the workers' compensation provisions of Section
3700 of the Labor , I shall forthwith cc
ate: 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 ($100,0001. 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.
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 appllcatlun,
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 inf mation is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi�onst coon, and her authorize representatives
not this cop may//t/meg9 enter upon the above-mentioned property p tion purposes.
JDate–_j�L r Signature (Applicant or Agent):
Application Number
. . . . . 14-00000653
Permit . . .
PLUMBING 2013
Additional desc . .
Permit Fee . . . .
11.92 Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
11/15/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA PLBG WATER HEATER/VENT
11.92
------------------------------------------ ---------------------------------
Special Notes and Comments
REPLACE 40 GALLOON
WATER HEATER PER 2013
PLUMBING CODES.
----------------------------------------------------------------------------
Other Fees . . . .
. . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, PLUMBING
11.92
Fee summary
-----------------
Charged Paid Credited
----------------------------------------
Due
Permit Fee Total
11.92 .00 .00
11.92
Plan Check Total
.00 .00 .00
.00
Other Fee Total
103.49 .00 .00
103.49
Grand Total
115.41 .00 .00
115.41
LQPERMIT
Bin #
City of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: Li,)-000 u/a31i, Wn
Owner's Name:
A. P. Number:
Address: Ll b- - Wo wl&s5 ), S
Legal Description:
City, ST, Zip: 5e-(1M,ekp_ ttAt-._S ,
Contractor: Ot , I�
3`� •UW►�.�c
l
Telephone:
Address: (' &�o Qano- l e
Project Description:
City, ST, Zip:��(
ele h 0
Telephone: P e -C� 1 O
0 I n s
p�
State Lic. #:—C-1 a- V�o3Cz,
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
>:
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...........................
Construction Type: Occuoanc .
YP Y'
a
St to Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories
Telephone #,of Contact Person:
Estimated Val Project: Ul) t
APPLICANT: DO NOT WRITE BE THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
ITERMIT FEES,
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check De?osit
Truss Calcs.
Called Contact Person
Plan Check Ba_ance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
''d Review, ready for correctionstissue
Developer Iin6 act Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Prescriptive Certificate of Compliance: Residential CF-IR-ALT-DHW
Residential Alterations
Project Name: ' A b Climate Zone: ) Permrt c K
WATER HEATING
• I certify that this Certificate of Compliance documentation is accurate and complete.
-List newly installed %voter heaters and boilers jor both domestic hot water heaters (DWH) and h►rlronic pace heating. Newly installed
DIM heaters and boilers illus( be gas. propane, or use the exis(ingfitel tipe.
DisuiNAirn Type
Water t4cater (Standard. Numtxx In Tank Energy Factor Or
TypdFucI Type Recirrulating)l System Capacity (gal) Thcrntat Effi9erxy
External Tank
Insulation
R -Valuer
conform to the: requirements of Title 24. Part I and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance ane consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations.. plans .and specifications submitted to the
enforcement agency for approval with this building permit application.
Name:
Si
DU
1. Indicate Type (Storage Gas. Heat Pump. Instantaneous. etc.)
2. Recirculating systems serving. multiple dwelling units shall #nee( the recirculation requirements of §156(n).
requirements do not allow the installation of a recirculating water heating system for single dwelling rtnier.
3. The externalwater heating tank and poes shall be insulated to #nee( therequirements of § I
The Prescriptive
Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California 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 Compliance
conform to the: requirements of Title 24. Part I and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance ane consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations.. plans .and specifications submitted to the
enforcement agency for approval with this building permit application.
Name:
Si
DU
Company: Date:
f�
Addms: t icence:
Se d Q6kr2
City/S p: Phone: