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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 -------------------------------------------------- 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: >: :w€ ........................... 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: