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11-0602 (PLBG)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO - FAX (760) 777-7011 LA QUINTA,• CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 - BUILDING PERMIT r Date:. 6/06/11 Application Number:. ��T1=0000060 Owner: Property Address: 52493-AVEN-IDA LLA CHRIS SIPS APN: 773•-273-023-11 -000000- 52943.AVENIDA VILLA Application description: PLUMBING LA QUINTA, CA 92253— Property 2253"Property Zoning: COVE RESIDENTIAL Application valuation: 112 ' Contractor: Applicant: Architect or Engineer: EXPRESS PLUMBING HEA ,, 9245 DOWBY DRIVE, SUITE 201 SAN DIEGO, CA 92131. \ 11 (858)6.93-4079 I Lio. No.: 954579 - - - - - - - - - - - = - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - �� i• - - �� - - - - - — s LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLA�AT10N 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. _ I have and will maintain a certificate of consent to self-insure for workers' cort; ensation, as provided License Class: C20-C36 License No.: 954579 - for by Section 3700 of the Labor Code, for the performance of the w�rkfor which this permit is ,, /_ .issued. Date:`V ontractor: f'l _LI 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 OWNER-BUILDER DECLARATION 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 SOUTHERN INS Policy Number WS100455010' following reason (Sec. 7031.5, Business and Professions Code:' Any city or county that requires a 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 tile 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 , License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall fo with coo ly with those prow��s RR999SS5 - 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.0500).: at� "cant- 1, can 1, 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN 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 , 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 acontractor(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, (_ 1 I am exempt under Sec. , BAP.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 _ _ - 1performed under or following issuance of this permit.- ,- Date: Owner: 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 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 court y to nter upon the above-mentioned property for ins e_ction purposes. Lender's Name: �� at Sig re (Applicant or Agee .. 'Lender's Address: LQPERMIT r Application Number . . . . '11700000602 Permit . . PLUMBING Additional'desc . Permit Fee 22.50 Plan'Check,Fee 5.63. Issue Date . . Valuation 0 Expiration Date 12/03/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 Special Notes and Comments REPLACE 40 GALLON.GAS WATER HEATER. 2010 CODES. -----------.----------------------------------------------------- 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 1.00 .00 .00 1.00 Grand Total 29.13 .00 .00 29.13 LQPERMIT ' Prescriptive Certificate of Compliance: Residential CF-IWALT-DHW Residential Alterations Page I of 2 Project Name: '1 Climate Zone: Permit #: General Information Site Address: 7-4 cjA� Enforcement Agency: L � Date: & J � Building Type: 0 Single Family D Multi Family Project T Re lacement or Change Out of Water Heater WATER HEATING • I certify that this Certificate of Compliance documentation is accurate and complete. . List newly installed water heaters and boilers for. both domestic hot water heaters (0 Wit) and hydronic space heating. Newly installed DWH heaters and boilers must be gas. pro ne, or use the existingfileI q e. • l certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance Water Heater Distribution Type Number In Tank Energy Factor or External Tank Insulation Type/Fuel Type' R�S� ti .)= System Capacity (gal) Thermal Efficiency R=Value3 IfW Signature: Company: Date: IQ r�5 AA it ,rl I\ 0.Ccr� ? .6 t/ � [ License: i 1. Indicate Type (Storage Gas. Heat Ptunp. Instantaneous, etc.) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §15U(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water heating tank and pipes shall be insulated to meet the requirements of § 150(i). Contractor or Homeowner (Documentation Author'stResponsible 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 Certificate of Compliance. 1 • l 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 the Cal ifomia 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 specifications submitted to the . enforcement agency for approval with this building permit application. Na 712i Signature: Company: Date: IQ r�5 AA it ,rl I\ 0.Ccr� ? .6 t/ � [ License: City,Staterz,ip:,� 1 j 69 3, qo7 Bin City of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 922531- (760)'777-7012 Building Permit Application and Tracking Sheet Permit # l'J Project Address:�? L V (' l CA Owner's Name: � A. P. Number: Address: 2 Legal Description: City, ST, Zip: ( CCl Z Contractor: L Tele hon GJL611fov-571 9 4 rs? L f V Address: 1— D -C .hT 2c l Project Description:12 Ia O 1 City, ST', Zip: -q'L( 3 Wt:, ci in e Telephone 7 D% State Lic. # T5 Lf l City Lie. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone: ....i:Vti:J};i:Ciiij x: ti -%i{. .. .: }i;vJ•}}N-}}' <:..:. );:-.:;;:'•;;;;;:._:::(:,..}::::- :y'ij><L'.M?nr�tyr:F . u s'%%:" % f%>;;«>;, `c«:: 's ; Construction Type:. Dccupancy: State Lic. #: Project ty A pe (circle one): New Adc'n lter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 6,M Y — 2 C.( Estimated Value of Project: ' 2 APPLICANT: DO NOT WRITE BELOW THIS LINE q Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cities. Reviewed, ready for corrections Plan Ch.=k Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 14 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanihai Grading plan 21" Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3d Review, ready for corrections/'issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue Schodl Fees Total Bermit Fees