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BPLB2014-1046 C-3_t; �._ 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&tit 4 4� Q" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2014-1046 Property Address: 42800 WASHINGTON ST C-3 APN: 609040007 Application Description: WATER HEATER CHANGE OUT - 30GALLON/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 Date: %a jar Contractor:' �/� tf • 1p JJ}Y 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 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 N Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/2/2014 Owner: REDEVELOPMENT AGENCY CITY OF 78945 CALLE TAM PICO LA QUINTA, CA 922 53 Contractor: DM DOBKIN INC DBA MR P 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 the following declarations: I have and will maintain a certificate if consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of j pr♦ for which this permit is issued. I have and will maintain workers' cornpensation insurance, as required by Section 3700 of the Labor Code, for the perforir®nce of the work for which this permit is issued. My workers'. compensation insurance zarrier 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 a:, 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. A C Date: a Applicant:�'V'D DM`( Yl 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 N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the 3uilding Official for a permit subject to the conditions and restrictions set forth on this a pplication. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performe-J 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 Cty 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 applica- ion 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 ordinEnces and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above- mentioned prooperty for inspection purposes. Date: � Signature (Applicant a- Agent)' I Z JEO @1 a% it DESCRIPTION FINANCIAL INFORMATION 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 ACCOUNTQTY 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 Description: WATER HEATER CHANGE OUT - 30GALLON/GAS Type: PLUMBING Subtype: Status: APPROVED Applied: 12/2/2014 SKH Approved: 12/2/2014 SKH Parcel No: 609040007 Site Address: 42800 WASHINGTON ST C-3 LA QUINTA,CA 92253 Subdivision: PM 12323 Block: Lot: 1 Issued: Lot Scl 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 P O BOX 3385 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 11:47:14 AM 1 of 2 CN?1717 I"SYSTEMS ZIP PHONE FAX EMAIL NAME TYPE NAME CONTACTS ADDRESSI CITY STATE 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 DESCRIPTION ACCOUNT QTY FINANCIAL AMOUNT INFORMATION PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 Printed: Tuesday, December 02, 2014 11:47:14 AM 1 of 2 CN?1717 I"SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLT'D BY PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid forPERM1T 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 11:47:14 AM 2 of 2 CI? SYSTEMS Bin # City of La Q uin ta. Building sr 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 a -WO • U-AkbyN t 4 �� Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contractor:iTelephone: Ci�Y w Address: d 4 J &V -e— &A Project Description: 1t � p -n City, ST, Zip: • f t7ill��ll/���� �0-4 Telephone: U -O i D't� 2- � v` State Lic..# : Arch., Engr., Designer: Address: City, ST, Zip: Telephone:ne: " <'' »' %'•:>' ""` " an Construction TYPe• Occupancy: cY: State Lic. #: Project type circle one): New Aden Alter Repair Dem Name of Contact Person: Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project:t— APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cala. Called Contact Person Plan Check Balance Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for correctionsrissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'rd Review, ready for eorrectionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees j Prescriptive Certificate of Compliance: Residential. CF-IR-ALT-DH[W Residential Alterations Project Name: Climate Zine: Permit #: General Information Site Address: Enforcement Agent:: Date: Building T Single Family Ek Multi Family I Proiect TyperIM-Replacement or•Chanee Out of Water Heater WATER HEATING • 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 List new!). installed water !eaters and boilers -for loth dontestir hot Nater heaters (DWH) and h vironic space heating. Nem•h• installed DWH heaters and bailers test be as, e. or use the existingfi,d type. 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 are consistent with the information provided to document this Watcr "Later Disuibuuotr Type Nurnbcr In TankE—gy ( Factor or Extemal Tank ulation nsalum TypclFud Trcl R Scircuystem Capacity (gal) Tiwrmal Elfficirncy Address: License: rA City/StatolZip:POW, pts: °lag- Il (� 7 �1� v L Indicate Type (Storage Gas. Heat Pump. Instantaneous. etc.) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §I50(n). The Prescriptive requirements do not allow the installaion of a ncircularing muter heating system for single d%wlling units. 3. The a vernal mater heating tank and pipes shall be insulated to nwet therequirements off 1 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 Cetiifx=e of Compliance. • 1 certify dim 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 are consistent with the information provided to document this building design on the other applicable compliance forms, worksheets. calculatnons . plans .aid specifications submitted to the enforcement agency for approval with this building it application. Name: Sibna Company: ► i �0� (V�,yy�Jt Date d� I L Address: License: rA City/StatolZip:POW, pts: °lag- Il (� 7 �1� v