09-0256 (PLBG)di=e. �N • � ,
f�'�itrGu
P.O. BOX 1504 , - VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA,lCALIFORNIA 92253 BUILDING & SAFETY'DEPARTMENT ECTIONS (760) 777-7153
BUILDING PERMIT O
Date: 3/19/09
Application Number: 09-00000256• Owner. a
Property Address: 49185 WASHINGTON ST MELODY ST- JOHN /l�
APN: 646-170-021- - - - 49185 WASHINGTON STR 41jQ
Application description: PLUMBING LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL ) /-
Application valuation: 500 qy�� 009 i
( F Qp
Contractor:
Applicant: Architect or Engineer: ~ FOY, SCOTT A.
_. 43579 MAIN STREET
INDIO, CA 92201
(760)775-9405
Lie. No. 828264 '
— — — — — — - — — — — — — - — — — —'— — — - - — — — — — — — — — — — — — — — — — — — — — — — — — —t- — — — — — — — - — — — - — — — — — — — — ---
LICENSED
rLICENSED CONTRACTOR'S DECLARATION .WORKER'S COMPENSATION DECLARATION f
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty.of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.•-c. ' _ I have and will maintain a certificate of consent to self-insure for workers' compensation,: as provided,' _
License Class: C36 License No.: 828264 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is '•�:
issued. t
atetT�ntractor: I Z.174- V I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor f
r �C Code, for the performance of the work for which this permit is issued.- My workers'. compensation. r
OW R-BUILDER CLARATION• _ �, • insurance carrier and policy number are: ,
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier FIRST COMP INS Policy Number WS1004457
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires permit to• _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any -
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the _ person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's. State - and agree that, if'I should .become subject to the workers' compensation provisions of Section, -,A---
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 370�TOSECURE
orCode; I shalLforthwith comply withthose provisions. - ...
that he or sheds exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by G?N111'1
•any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.: atLF' 1, as owner of the. property, or my employees with wages as their sole compensation, will do the work, andthe structure is not intended or offered for sale (Sec. 7044, BusinessandProfessions Code: The - WA: FA URE WORKERS' OMP ATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors` State License Law does not apply to an owner of property who builds or improves thereon, - SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the I DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N
improvements are not intended or offered for sale. If, however, the building or improvement is sold within`, SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. "
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.). APPLICANT ACKNOWLEDGEMENT
1 ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to, the
' 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. -
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for - ..
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, V
(_) I am exempt under Sec. B.&P.C. for this reason . 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 z
performed under or following issuance of this permit.
Date: Owner: 2. Any permit issued as a result ofthisapplication becomes null and void if work isnot commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the - I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). _ city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this unty to enter up o the above-mentioned property for inspection pur
Lender's Name: � � -
�. t.% gnature (Applicant or Agent):
Lender's Address: - ^ '
LQPERi111T - - -
Application Number . . . . 09-00000256
Permit . . . PLUMBING
Additional desc .
Permit Fee 22.50 Plan Check Fee
5.63,
Issue Date, Valuation
0
Expiration Date 9/15/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7.5000 EA- PLB WATER HEATER/VENT
7.5-0
------------------ --------------------
-- - - - ---------------------
Special Notes and Comments
'Speci
REMOVE & REPLACE 40 GALLON GAS WATER
HEATER"
Other Fees _ BLDG STDS ADMIN (SB1473)
1.00- ---
Fee summary Charged Paid Credited
Due
- - ------ - - - - ------- - - - ----
Permit Fee Total 22.50 - .00 00
-- - - - ---
22.50"
Plan Check Total 5.63 •' —00 .00
5.63
' Other Fee Total .. 1.O0 .00 00
1.00
Grand, Total 29.13 00 `.00 .,
29:13
LQPERMIT
' �I
e
CERTIFICATE OF COMPLIANCE: REShDENTIAL (Page 3 of 4) CF -IR
Project Title Date
SEALED DUCTS and TX -Vs (or Alternative Measures)
A signed CF4R Form must be provided to the building department for each home for which the following, are
❑Sealed Ducts: all climate zones Installer testis and certification and HERS rater field verification required.
❑ TXVs, readily accessible (climate zones 2 and 8-15 only)
Installer testing and certification and HERS Rater field verification required.)
Refrigerant Charge (climate zones 2 and 8- l5 only) (Installer testing and certification and HERS Rater field
❑ --- -- __ .._ a .
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features
Prniect Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
E3sealed as confirmed through field verification and diagnostic testing in, accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
snaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑ dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
not allowed.
❑ Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter S in the Residential
Manual. No water heating calculations are required, and the system corn lies automaticall
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑ Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
e..��e...� aowvno kinale dwellin¢ units
Water Heater
TuefTe
Distribution
T e
Number
in S sten
Energy
TanK
Rated
t'
Tank
Factor' or
o_...a..... nnrt mn.nnle mwrsuuv.u..lu
Number
in Svsten
Water Heater
T e
Distribution
T e
Number
in S sten
Energy
TanK
Rated
t'
Tank
Factor' or
External
Capacity
Ener y Tank
Rated Factor or External
Input' Tank
(kw or Capacity Thermal Standby' Insulation
n.,.n,., (canons) Efficiency Loss % R -Value
1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
r pipes from the heating source to the kitchen
Pipe Insulation (kitchen lines >_ 3/4 inches) All hot watefixtures that are 1/4
inches or greater in diameter shall be thermally insulated as. specified by Section 150 (j) 2 A or 150: Q) 2 B.
March 2005
Residential Compliance Forms
Energy
TanK
Rated
t'
Tank
Factor' or
External
Capacity
Thermal
Standby'
Insulation
(kw
Btulhr)
(allons)
Efficien�cn
Loss %
R -Value
I/ /r%
o (/O_ ( /
Ener y Tank
Rated Factor or External
Input' Tank
(kw or Capacity Thermal Standby' Insulation
n.,.n,., (canons) Efficiency Loss % R -Value
1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
r pipes from the heating source to the kitchen
Pipe Insulation (kitchen lines >_ 3/4 inches) All hot watefixtures that are 1/4
inches or greater in diameter shall be thermally insulated as. specified by Section 150 (j) 2 A or 150: Q) 2 B.
March 2005
Residential Compliance Forms
t",
Bin #
City of La Quinta
Building gr Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La QuInta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Pem* #
a.
Project Add=: q 7 tnq*n.
Owner's Name: MtqJ6(lv 4 -
A. P. Number:
Address: q 91 g5
Legal Description:
City, ST, Zip:
Contractor: �6\unbmoTelephone3
-4 j ?I
Address: 43<; 791 &� 0 (:�f -
.5t- &/
Project Description: Q e-10 69 �&
City, ST, Zip: n n C_
Telephone: 7 (-00 '7 7
1� I `c ?_ CP Pcity Lie.
State Lie. # Ci
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: ............. `Construction
State Lic. #: . . . . . . . R.
Name of Contact Person:
Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
les:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check s ;d n,
, rtry
Item
Amount
Structural CaIcs.
Truss Cates,
Reviewed, reldy Or corrections IIIPlan
id or
I IVIAR f U
Called Con ta P on [U)
check Deposit
Pi - an Check Balance.
Title 24 CaIcs.
Plans picked
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2' Review, ready for correctionvIssue
Electrical
Subcontactor ]List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for carrectionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fen
Total Permit Fees