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BPLB2014-1045 A-4i 78-495 CALLE twlPpicO LA QUINTA, CAL. -ORNIA 92253 Application Number: BPLB2014-1045 VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Property Address: 42800 WASHINGTON ST A4 APN: 609040007 Application Description: WATER HEATER CHANGE OUT - 40GALLON/GAS Property Zoning: Application Valuation: $400.00 Applicant: DM DOBKIN INC DBA MR ROOTER PL P 0 BOX 3385 PALM DESERT, CA 92261 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 License No.: 928636 Dadr (� Contractor�� , VQ_aU � f 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 (y 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 Na Lender's Address: Date: 12/2/2014 Owner: .REDEVELOPMENT AGENCY CITY OF 78945 CALLE TAMPICO LA QUINTA, CA 92253 E Contractor: DM DOBKIN INC DBA MR RP 0 BOX 3385 PALM DESERT, CA 92261(760)779 0190 Llc. No.: 928636 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of ;he 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 th rk for which this permit is issued. t I have and will maintain workers' co npensation insurance, as required by Sectio 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, I shall not employ any person in any manner so z s 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 3-00 of the Labor Code, I shall forthwith comply with those provisions. �(��l ,�11 Date: Applicant? De"i1 to a V.,. 1^ 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 FOF 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 thi: application. 1. Each person upon whose behalf this appli:ation 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 t ie 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 ,ssuance of such permit, or cessation of work for 180 days will subject permit to tante 9ation. 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 ran1a-ting to building construction, and hereby authorize representatives of this city to en,� upon the above- mentioned property for inspection purposes. ��^ Dat Signature (Applicant or Agent : 1 •1• FINANCIAL DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $91.85 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT PC 101-0000-42600 0 $7.25 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $19.34 $0.00 TOTALS:00 Permit Details PERMIT NUMBER BPLB20Y4=1045 4 - ^ City of la Qu i nta. Description: WATER HEATER CHANGE OUT - 40GALLON/GAS Type: PLUMBING Subtype: Status: SUBMITTED Applied: 12/2/2014 SKH Approved: Parcel No: 609040007 Site Address: 42800 WASHINGTON ST A4INDIO,CA 92203 Subdivision: PM 12323 Block: Lot: 1 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $400.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: WATER HEATER CHANGE OUT - 30GALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SITES CHRONOLOGY CONDITIONS Printed: Tuesday, December 02, 2014 11:36:36 AM 1 of 2 CRWsrsTEMS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT DM DOBKIN INC DBA MR ROOTER PL P O BOX 3385 PALM DESERT CA 92261 (760)777-7000 CONTRACTOR DM DOBKIN INC DBA MR ROOTER PL P O BOX 3385 PALM DESERT CA 92261 (760)777-7000 OWNER REDEVELOPMENT AGENCY CITY OF 78945 CALLE TAMPICO LA QUINTA CA 92253 (760)777-7000 FINANCIAL INFORMATION CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: Printed: Tuesday, December 02, 2014 11:36:36 AM 1 of 2 CRWsrsTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY 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 101-0000-42600 0 $7.25 $0.00 PC Total Paid for PLUMBING FEES: $19.34 $0.00 TOTALS:00 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES PLUMBING FINAL" Printed: Tuesday, December 02, 2014 11:36:36 AM 2 of 2 RIffSYSTFMS %*�<*<(<&<$<"< <M<V<<P3T@-:$KKTB:;!!OKKSB;;3+Kgr R;:2+K;; p[4 AY;�@ f Bin li �. City, of La Quinta. Building & Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: Lia-.t(jaD " �, /� 1 r Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: , Contractor: `�� W�( Telephone: Address: + J -e ` Project Description: } pd City, ST, Zip: f 0�11��I1/� �a��" �,-{ Tele hone: P-ULcIQ" :;.;F.;;.;::::;;:.::.:;.;;;:::<?»:::. Vel In V\ l �� State Lic. # : City Lie. #; Arch., Engr., Designer: Address: City, ST, Zip: Tele hone: P : <>:;:> ;<:; <: _>:::;::;:.>:;::$.;:::;:.;:.:: :::::$;$,; .... >.r:;•$:.;: ConstructionOccupancy: Type: Occu an State Lic. #: Project circle one): New Add'n Alter Repair Demo h'Pa (circle Name of Contact Person: Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Proj ect: O -\cc' APPLICANT: DO NOT WRITE BELOW THIS LINE #f Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Cheek Deposit Truss Cala. Called Contact Person Plan Check Balance. Title 24 Cala. Plans picked up Construcson Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrcctionslssue Electrical Subcontactor List Called Contact Person Plumbing Grant Dccd Plans picked up S.M.I. R.O.A. Approval Plans resubmitted Grading IN ROUSE:- '`" Review, ready for eorrectionslissue Develope.- Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Pcxmit Fecs WATER HEATING • 1 certify that this Certificate of Compliance documentation is accurate and complete. List newel►• installed water heaters and boilers for loth domestic hot water heaters (DWH) and lr►Ylro►tic W( -e heating. Ne%-I.v installed DIM heaters and boilers must be gaus, r e, or use the esistin tel 1)7e. conform to the requirernems of Title 24, Part I and 6 of the California Code of Regulations. Water Heater DisuitwtiOn Type Number In Tank Energy Factortx Extemat Tank tion TypdFud Type' RodrruuWn) System Capacity (gal) Thenal Efficiawy R-Vakbcl a 3D } N /+ CitytstatcrLip: p6dw, Qin 1 l Phone: ��J� QA - ►J - I 51v,,oA . O tj I _ Indicate Type (Storage Gas. Heat Punrp. Instantaneous, etc.) 2. Recirculating systems serving multiple dwelling units shall ►meet the recirculation requirements a' §156(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling twits. 3. The externa) water heating tank andipes shall be insulated to nwet the requirements of §ISO(%). Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the Califomia Business and Professions Code to accept respons3-bility for the building design identified on this Certificate of CongAiance. • 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirernems of Title 24, Part I and 6 of the California Code of Regulations. features. The building design features identified on this Certificate of Compiiutce are 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 MSna for approval with this building it application. Name: Signa v� a y� + Dais � PLl Mar : SIMl Oke CitytstatcrLip: p6dw, Qin 1 l Phone: ��J�