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08-1511 (PLBG)P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 08-00001511 Owner: Property Address: 78590 FORBES CIR EGGERS ROGER C APN: 604-221-001-43 -23268 - 78590 FORBES CIRCLE Application description: PLUMBING LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL ( Application valuation: 500 Contractor: Applicant: Architect or Engineer: FOY, SCOTT A. 43579 MAIN STREET INDIO, CA 92201 (760)775-9405 Lic. No.: 828264 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 Professionals Code, and my License is in full force and effect. License Class: C36 No.: 828264 Date: Contractor: 0 NER-B 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).: (_) 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 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/03/08 ,-P 0 412000 OF Lr41a A 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 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 ACE INC Policy Number 045040239 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. Date: Applicant: �� WARNING: FAILURE TO SECURE WORKERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 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 hereby representatives of this county to enter upon the above-mentioned property for inspection os Date Signature (Applicant or Agent): Application Number . . . . . 08-00001511 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 22.50 Plan Check Fee 5.63 Issue Date Valuation . . . . 0 Expiration Date 3/02/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 --------------------------------------------- Special Notes and Comments ------------------------------- REPLACE 40 GALLON GAS WATER HEATER UNIT Fee summary ----------------- Charged -------------------- Paid Credited ---------- ---------- Due Permit Fee Total 22.50 .00 _ .00 22.50 Plan Check Total 5.63 .00 .00 5.63 Grand Total 28.13 .00 .00 28.13 01 LQPERMIT -Y f CERTIFICATE OYCOMPLiANCE: RMDENTUL (Page 3 of 4) • CFJR Project Title ��% Date SEALEDDUCTS and TXVs (or Alternative Measuires) A signed CF -4R Form must be provided to the, building department'for each home,for which the following- are . rern�iretl_ . OR 0 Altemativtto Sealed Ducts and Refrigerant Charge lI7CVs.(Sop Package D Alternative Package Feahhres for Project ClkWo Zone in the RM Appendix B Table 1S 1�Footnotes 7-14 -OR For additions and alterations, duct system that aro not documented to.have been previously 13 scaled as confirmed through field verification and diagnostic testing in aoeordance with procedures in the R esiderltial ACM Manual and duct sysipms with more than 401inear feet im unconditioned aces shall meet the dimments of Section 150(m) and duct insulation r irementsofftckweD. WATER ARATMOv rYR MI M!Q Distribution . Number. in. Check box if system meets criteria ofa. "Standard" system. Standard system is one gas -fled water heater Per QSealed Ducts all climate zones InsWlei testin and certification and HERS ratex.fidd verification ed: Tank . insulation R-YaIao _ TXVs, readily. accessible (climate. zones 2 and 8-15 only) . Cheek box whenusing Preapproved Alternative Water Heating table, Table 54in-Chapter 5 in the. Residential. (installer testing and certification and HERS Rater field verifrcatiourequired)... . 13 Refrigerant Charge (climate zones 2 and 8-15 only).(lastaller testing and certification and HERS Rater field Alternative Water Heating table. in this case, the Performance Method must be used and must be included in the verification mqulied OR 0 Altemativtto Sealed Ducts and Refrigerant Charge lI7CVs.(Sop Package D Alternative Package Feahhres for Project ClkWo Zone in the RM Appendix B Table 1S 1�Footnotes 7-14 -OR For additions and alterations, duct system that aro not documented to.have been previously 13 scaled as confirmed through field verification and diagnostic testing in aoeordance with procedures in the R esiderltial ACM Manual and duct sysipms with more than 401inear feet im unconditioned aces shall meet the dimments of Section 150(m) and duct insulation r irementsofftckweD. WATER ARATMOv rYR MI M!Q .Cwcfpmc ceovvino cinoio riveAlino nnifc Water Heater ueI Distribution . Number. in. Check box if system meets criteria ofa. "Standard" system. Standard system is one gas -fled water heater Per 0- dwelling unit If the water heater is a storage hype, 50•gallons is the maximum.capacity andrecirculation system is Tank . insulation R-YaIao not allowed Cheek box whenusing Preapproved Alternative Water Heating table, Table 54in-Chapter 5 in the. Residential. Manual. No water heating calculations are and thestem oo tics sutornatiCall. Check box if system does not meet criteria of "Standard" system, and does not comply :with the Prespproved O Alternative Water Heating table. in this case, the Performance Method must be used and must be included in the .submittal: . E3 Check box to verify that -a time control is required for a m*culadng system pump fora system serving multiple , units .Cwcfpmc ceovvino cinoio riveAlino nnifc Water Heater ueI Distribution . Number. in. Rated Inputi (kw a DUVU u�y Tank Factor' orExternal Clapacity Thermal kns Efficien Standby' Loss °Jo Tank . insulation R-YaIao Tank External Insulation R -Value r' CvcfPm cptvinv tnnitinlp [rwpllinor unite Water Heater Distn'bution e- Number . 'in stem. Rated a "swrar ,1 t�pa k tow Eti Factor' or T�>ezmal Efficien Standbys ' Doss % Tank External Insulation R -Value �l L- 1. ror smau gas storage wafer neatens kratea inputs 91 iess uuuh or ex;ua i to io,vvv Duartu), pump water heaters, list Energy Factor, For large gas storage water -heaters (rated input of greater than 75,000" Ptu/hr), 5,000- Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby I:dss. For instantaneous gas water 'heaters; list Rated. Input and Theininal Efficiencies. >' PiRc Xnsulation (kitchen lines >_ 3/4 inches) All hot water pipes from the tecating source to the kitchen fixtures that are inches or greater in diameter shall be thermally.insulated as specified by Section 150 (j) 2 A or 150 U) 2 B. March -2005 Compliance Forms 10/12/2004 TUE 8:53 FAX 760 777 7112 Bldg & Saftey ' Permit # Project A ddress: A. P. Ntnnber: 1z 001/001 City of La Quinta Building ar Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777.7012 Building Permit Application and Tracking Sheet Owner's Name:. Address: lb -- - City, ST, Zip: l blLt 110-4-A 0� 4 4 n� ®�.�_ Contractus. � �b ► L/ A e Telephone:VAN- Address: s Address:? j11 ' _ Project Description: City, ST, Zip:�rk 2). " LO ' Tele hone- .a"<s. ::- �' • ,�:z?> ; State Lia 9: -; 7aSa�p City Lic. Arch., Er.gr., Designer: Address: i City; ST, Zip: A r KfFf. . f ?' Telephone: . „��o � - jc*�� Construction Type: Occupancy: State Lic. #: Name of Contact Person: Telephone # of Contact Person: 4 Submittal Req'd Plan Sets Stractoral Cates. Tncss Cala. Trite 24 Coles. Hood plain plan Gncding plan Subcontactor List Grant Dted H.Q.A. Approval IN *HOUSE-. Planning Approval Pub. Wks. Appr School Fees r �;�'3 F4'..`'�,y':�'9n°7%5n.�� ':J• ��i3R" Pro ect type (circle ono): NewAdd'n Alter Re air Dtxno Sq. Ft.: # Stories: 4 Units: Estimated Value of Projee V APPLICANT: DO NOT WRITE BELOW THIS LINE • Reed TRACKING PERMIT FEES Plan Check submitted Item Amount Reviewed, ready for corrections Plan Cheek Deposit Called CoutactPerson Plan Check Balance Mas picked up . Construction Plans resubmitted Mechanical tad Review, ready for correcionsilssue EWrital Called Contac. Person Plumbing Plans picked up S.M.). Plana resubmitted Grading Rtvierv, ready far correcdons/issue Developer Impact Fee Called Contact Person A.LP.P. Date of permit issue Total Permit Fees