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09-0065 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09-00000065 Property Address: 48609 CALLE ESPERANZA APN: 646-121-005- - Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 500 Applicant:4,aC � / Architect or Engineer: --------- 7 -------- LICENSED CONTRACTOR'S DECLARATION 44 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Professionals Code, and my License is in full force and effect. License'Cllaasss: C366 License No.: 828264 Date: Contractor: OW ER -BU ER 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).: (_ 1 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 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: LQPERINIT Owner: MILLAM DONALD A 48609 CALLE ESPERANZA LA QUINTA, CA 92253 ( Contractor: FOY, SCOTT A. 43579 MAIN STREET INDIO, CA 92201 (760)775-9405 Lic. No.: 828264 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 1/28/09 ------------------ WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 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 FIRST COMP INS Policy Number WS1004457 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 co y with those provisions. Date: "�Opplicant: WARNING: FAILURE TO SECURE WORKERS' MPENSA N COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety 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 the City 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 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 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 ordinances and state laws relating to building construction, and her y authorize representatives of this county to enter upon the above-mentioned property for inspe ion ses. Date/' 0/'/C4 Signature (Applicant or Agent): Application Number . . . . . 09-00000065 Permit . . PLUMBING Additional desc . Permit Fee . . . . 22.50 Plan Check Fee 5.63 Issue Date - Valuation 0 - Expiration Date 7/27/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 ---------------------------------------------------------------------------- Special Notes and Comments REMOVE AND REPLACE WATER SOFTNER. ---------------------------------------------------------------------------- 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 LQPERN11T CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -1R 18&0 9 C )iect Title -Ro-©7 Date SEALED DUCTS and TXVs (or Alternative Measures) A signed CF -411 Form must be provided to the building department for each home for which the following. are required. OR Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for Project 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 sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the Residential -ACM Manual and duct systems with more than 401inear feet in unconditioned spaces shall meet the requirements of Section 15.0 m and duct insulation requirements of Package D. WATER HEATING SYSTEMS Distribution Type ❑ Sealed Ducts all climate zones Installer testing 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 8-15 only) (Installer testing and certification and HERS Rater field verification required.) OR Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for Project 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 sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the Residential -ACM Manual and duct systems with more than 401inear feet in unconditioned spaces shall meet the requirements of Section 15.0 m and duct insulation requirements of Package D. WATER HEATING SYSTEMS Svstems serving sinele dwelline units Water Heater Type/Fuel Type Distribution Type Number in System Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per Tank Capacity (anions) dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is Standby' Loss % not allowed. ❑ Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential Manual. No water heating calculations are required, and the system complies automatically. 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 Svstems serving sinele dwelline units Water Heater Type/Fuel Type Distribution Type Number in System Rated Input' (kw or Btu/hr) Tank Capacity (anions) Energy Factor' or Thermal Efficiency Standby' Loss % Tank External Insulation R -Value System serving multiple d elling units Water Heater Type Distribution Type Number in System Rated Input' (kW or Btu/hr) Tank Capacity (gaeons Energy Factor' or Thermal Efficient Standby' Loss % Tank External Insulation 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. Pipe Insulation (kitchen'lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are -/4 inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B. Residential Compliance Forms March 2005 Bin # Qty Of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La ;Quints, CA 92253 - (760) 777-7012 Buildin Permit g Application and Tracking Sheet pit # I _ Project Add=: ��Q Owner's Name ndd. M ` I Ia rn ' A. P. Number: Address: Ww� oq 7 Legal Description: City, ST, Zip: (�(� ((a (a 221 Contractor: S C- r 1� : ' ` .q :`` .• ; Telephone: Address: y 3 -7 1, 1 ck - n S • Project Description: City, ST, ZipT(N t ocj) 12 2 0 Telephone: 7(o0 775--i' I �;( y,f.N`%,. •`''� '� State Lic. #: 41 City Lic. #: g Arch., Engr., Designer: Address: City., ST, Zip: Telephone: ��•s3 �� : :x:vConstruction State Lic. #: "; yN's{.. Name of Contact Person: cY: Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories-.# Units: Telephone # of Contact Person: Estimated Value of Project: 50 vY�y\\ V APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'.d TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain pian 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. H.O-A. Approval Plans resubmitted Grading IN HOUSE: ird Review, ready -for corrections/mue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees