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BPLB2016-0079 G-478-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T,iht 4 4 QR&rcv COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2016-0079 Property Address: 42800 WASHINGTON ST G4 APN: 609040007 Application Description: WASHINGTON APTS / PLUMBING Property Zoning: Application Valuation: $400.00 Applicant: DM DOBKIN INC DBA MR ROOTER PLUMBING P O BOX 3385 PALM DESERT, CA 92261 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/2/2016 Owner: REDEVELOPMENT AGENCY CITY OF 78945 CALLE TAMPICO V C 2 2016 LA QUINTA, CA 92253 COM�dUNIT ITV0 O�QN DTiEP_ A�,�NT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C36 License No.: 928636 It Date:_ �� IIJ(cn Contractor:. 1) — 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 contractors) 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 Lender's Address: Contractor: DM DOBKIN INC DBA MR ROOTER PLUMBING P O 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 of consent to self -insure for workers' compensation, as provided for by Section 3:00 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: 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 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 Section 3700 of the Labor Code, I shall forthwith comply with those provisions. %_ Dater, 6 Z�L 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 ($100000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED =0R 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 -o 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 ca icellation. 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 relating to building construction, and hereby authorize representatives of t' ity to enter upon the above-mentioned 'fproperty for inspection purposes. D�� l Si`natur,,,,e Applicant or Agent): DESCRIPTION FINANCIAL INFORMATION ACCOUNT CITY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING 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 CITY AMOUNT PAID PAID DATE WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY - DESCRIPTION. ACCOUNT CITY 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: $112.19 00 Description: WASHINGTON APTS / PLUMBING CONDITIONS Type: PLUMBING Subtype: Status: APPROVED Applied: 6/2/2016 MFA Approved: 6/2/2016 MFA Parcel No: 609040007 Site Address: 42800 WASHINGTON ST G4 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 STATE Details: INSTALL 30 GALLON GAS WATER HEATER PER 2013 CALIFORNIA BUILDING CODE PHONE Applied to Approved .wY CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT DM DOBKIN INC DBA MR ROOTER PLUMBING P 0 BOX 3385 PALM DESERT CA 92261 (760)777-7000 CONTRACTOR DM DOBKIN INC DBA MR ROOTER PLUMBING P 0 BOX 3385 PALM DESERT CA 92261 (760)777-7000 OWNER REDEVELOPMENT AGENCY CITY OF 1 78945 CALLE TAMPICO I LA QUINTA I CA 1 92253 1 (760)777-7000 FINANCIAL INFORMATION Printed: Thursday, June 02, 2016 10:27:14 AM 1 of 2 SYSTEMS DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY C{ BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 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 101-0000-42600 0 $7.25 $0.00 PC Total Paid for PLUMBING FEES: $19.34 $0.00 TOTALS:00 PARENT PROJECTS Printed: Thursday, June 02, 2016 10:27:14 AM 2 of 2 SYSTEMS Prescriptive Certificate of Compliance: Residential CF -IR -ALT -D HW Residential Alterations Project Name: Climate Zone: Permit #: General Information by re Sf av- Site Address: L -i a-vCL) W,,,SH, ,• S Enforcement Agency: Date: 6 a I Building Type: ❑ Single Family ❑ Multi Family Proiect Tvtx: eolacertyent or•Chanee Out of Water Heater WATER HEATING Contractor - I certify that this Certificate of Compliance documentation is accurate and complete. -list new -h• installed water heaters and boilers for both dornestic hot water heaters (DWH) and h dronic space hating_ New•h• installed DIVH heaters and boilers must be gas. e. or use the existing eel h . conform to the requirements of Title 24. Part I and 6 of ttie California Code of Regulations. Water Htntcr Typd ud Type,Rocircutati Disu btAion Type (Standard, Numtx-r to Tank Elxrgy Factor tx E Insula Tank tion Name: )t System Capacity (Ell) 11xTmal Etfi.cieney R-Vaksc' 0, 1 O ,10fzlb Address: Bonne: S-� Ok� &A i 2, C 7 a 1 $p fic', 1110 SIH CA S I 3 . 'W w � i 3 1. Indicate Type (Storage Cas. Heat Pump. Instantaneous. etc.) 2. Recirculating %: sten serving multiple dwelling units shall nneet the recirculation requirements of § An). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling emits. 3. The external water hearing tank and pipes shall bi insulated to meet the requirements o 150(i) - ). Contractor or Homeowner (Documentation Auttior's/Responsible Building Designer's Dedaratiou Statement) - I certify that this Certificate of Compliance documentation is accurate and complete. - 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design. identified on this Ctxtifucate of Conggiance. - 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 ttie 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, calculations., plans .and speci5icati6ns submitted to the enforcement a9M for approval with this building permit lication. Name: Si nature Company: � pp of \t ( Date: Address: Bonne: S-� Ok� &A i 2, C 7 CityfstatarLip: (work: New) Dp�es4-