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BPLB2017-0027 C-678-495 CALLE TAMPICO `w' p D w'*P a" LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2017-0027 Property Address: 42800 WASHINGTON ST C6 APN: 609040007 Application Description: LA QUINTA REDEVELOPMENT AGENCY / HOT WATER HEATER CHANGE Property Zoning: OUT Application Valuation: $500.00 Applicant: DM DOBKIN INC DBA MR ROOTER PLUMBING P O 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 / 1 Date: A-�� s 1 Contractor;:�JJ 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.). (1 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 Name: Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIRS (7 +7 ZDate: 2/ Owner: 4=P n , I REDEVELOPMENT AGENCY CI -CMP M 78945 CALLE TAMPICO gym— TO CID D LA QUINTA, CA 92253 Z J10 N m n v Contractor: —1 DM DOBKIN INC "DBA MR RCI ER P(� NG P 0 BOX 3385 PALM DESERT, CA 92261 (760)779-0190 Llc. No.: 928636 WORKER'S COMPENSATION DECLARATION 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' ompensation, as provided for by Section 370D of the Labor Code, for the performance f the work for which this permit is issued. DDI have and will maintain workers' ompensation insurance, as required by ection 3700 of the Labor Code, for the performance of the work for which this permit issued. My workers' compensation insurance carrier and policy number are: arrier: WESCO INSURANCE COMPANY Policy Number: WWC3236697 I certify that in the performance of the work for which this permit is issued, I hall not employ any person in any manner sc. as to become subject to the workers' ompensation laws of California, and agree tfat, if I should become subject to the corkers' compensation provisions of Section 3700 of the Labor Code, 111 II forthwith omply with those provisions. i1 Y late: rLr� Applicant: v� YARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER GE IS UNLAWFUL, NO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO INE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF OMPENSATION, DAMAGES AS PROVIDED FGR IN SECTION 3706 OF THE LABOR CODE VTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT VIPORTANT: Application is hereby made to the Building Official for a permit subject to ie conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose -quest and for whose benefit work is performed under or pursuant to any permit sued as a result of this application , the owrer, and the applicant, each agrees to, and hall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and mployees for any act or omission related to Rhe work being performed under or )Ilowing issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is of commenced within 180 days from date d issuance of such permit, or cessation of fork for 180 days will subject permit to cancellation. certify that I have read this application and :tate that the above information is correct. agree to comply with all city and county ordinances and state laws relating to building Dnstruction, and hereby authorize represencatives of this city to enter upon t116 bove-mentioned property for inspection purposes. a ate: p_%_1 Signature (Applicant or Agent): Date: 2/8/2017 Application Number: BPLB2017-0027 Owner: Property Address: 42800 WASHINGTON'ST C6 REDEVELOPMENT AGENCY CITY OF APN: 609040007 78945 CALLE TAM PICO Application Description: LA QUINTA REDEVELOPMENT AGENCY / HOT WATER HEATER CHANGE LA QUINTA, CA 9253 Property Zoning: OUT Application Valuation: $500.00 Applicant: Contractor: DM DOBKIN INC DBA MR ROOTER PLUMBING DM DOBKIN INC DBA MR ROOTER PLUMBING P 0 BOX 3385 P 0 BOX 3385 PALM DESERT, CA 92261 PALM DESERT, C<. 92261 (760)779-0190 Llc. No.: 928636 Detail: WATER HEATER CHANGE OUT - 30GALLON/GAS [2016 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLEC PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES. FINANCIAL • . DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY 'AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT IQTY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $7.60 Total Paid for PLUMBING FEES: $20.27 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611:�] 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 Bit # City of La Quin to Building a Safety Division Permit.# 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-701,2 Building Permit Application and Tracking Sh3et Project Address: L-A 2,Yi00 wLk. %'L�Y' S Owner's Name: v t� % � Go A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: YY1 t r TeIP e hone: Address: 0 �"e Project Description: City, ST, Zip: Telephone: h one: (?foo) )� State Lic. # : v ja.C663 j(0 City Lie- #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone. hone Construction T .ane Type: Occupancy: Y E Y: P Sta toi L c. #: • Project type (circle ne • New Add'n Alter Repair.ar Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person:Estimated Value of Project: () V • C APPLICANT: DO NOT WRITE 13ELOW 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 Cafes. Called Contact Person Plan Check Ral:.nce Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical . Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. 1-I.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, - I Total Permit Fees P Prescriptive Certificate of Compliance: Residential CF-1R-ALT-DHW Residential Alterations Project Name: I Climate Zone: Permit #: General Information Nn A, G 6 Site Address: L+)-yov tv A!,VHIC Enforcement Agency: Date: Building Type: 0 Single Family 0 Miti Family I Project Type: 0 Replacement or•ChanRe Out of Water Heater WATER HEATING • ( certify that this Certificate of Compliance documentation is accurate and complete. -List new•lh• installed water heaters and boilers -for both domestic hot Hater heaters (DWH) and h%Vronic space heating. MH heaters and bo r5118115(bega"s.p or rise the existingfitel type. New•lt• installed Wates Heater TypdFud Type' Distribution Type NumbLr In TankE1e*8Y Factor or R�,� u ' )r System Capa��ity (gal) T+�I �k�y External Tank ns atiot S - o Name: `` T�Mq 1_9 Signatum: Company: Qatc: 0T.�- Addms: L;ca sc: SIO l � � hare. �� I -e • � a�� City/SutdZiip: o� Phone: AY1n It C)) 7 31'0 C � I. Indicate Twe (Storage Gas. Heat Pump. instantaneous. etc.) 2. Recirculating systencs serving mulliple, dwelling units shall #neer the recirculation requirements of §156(n). requirements do not allow the installation of a recirculating water heating system for single dwelling units. J. The external water heating tank and pipes shall be insulated to meet the requirements o I The Prescriptive Contractor or Homeowner (Documentation Authoes/Responsible Building Designer's Dedaration Statement) • ( 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 Certificate of Compliance. • I ccrtifY that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the mquirements of Title 24. Part l and 6 of the Califomia 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. worlmhoets. calculatic ens .and specifications submitted to- the enforcement agency for approval with this budding permit application. Name: `` T�Mq 1_9 Signatum: Company: Qatc: 0T.�- Addms: L;ca sc: SIO l � � hare. �� I -e • � a�� City/SutdZiip: o� Phone: AY1n It C)) 7 31'0 C �