BPLB2015-007578-495 CALLE TAM PICO 4D �IU�iI/
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPART
BUILDI
D Q
Application Number: BPLB2015-0075
Property Address: 43840 GENOA DR 201�j
APN: 609521014 MAY 2
Application Description: WATER HEATER CHANGE OUT- 50 GA
Property Zoning:
Application Valuation: $1,185.00
Applicant:
TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #C3
INDIO, CA 92201
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.: 93013.3 _
Date:. J—)— t15 Contract
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).:
(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.).
(_) 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
INSPECTIONS (760) 777-7153
Date: 5/27/2015
OFFENHAUSER
BEECHWOOD
A MESA, CA 92253
Contractor:
TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #C3
INDIO, CA 92201
(760)574-4444
Llc. No.: 930133
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
rk for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Se n 3 00 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: _ Policy Number:
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; r��S Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 Building Official 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 authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
Date:— cX
L5 Signature (Applicant or Agent)cb - C Q—,�,
DESCIkIPTION
FINANCIAL INFORMATION
ACCOUNT QTY AMOUNT PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306 0
$1.00 $0.00
PAID BY
METHOD RECEIPT # CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION
ACCOUNT
QTY
- AMOUNT
PAID
PAID DATE
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$7.25
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:00
Description: WATER HEATER CHANGE OUT - 50 GALLON/GAS
Type: PLUMBING Subtype: Status: APPROVED
Applied: 5/26/2015 JFU
Approved: 5/26/20151FU
Parcel No: 609521014 Site Address: 43840 GENOA DR LA QUINTA,CA 92253
Subdivision: TR 28457-2 Block: Lot: 3
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $1,185.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
JAKE FUSON
Details: WATER HEATER CHANGE OUT - 50 GALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
__-._I Applied to Approved
FINANCIAL INFORMATION
Printed: Wednesday, May 27, 2015 11:13:44 AM 1 of 2 IrIpw_..___.
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME
ACTION DATE
COMPLETION DATE
NOTES
E-MAIL
JAKE FUSON
5/26/2015
5/26/2015
TELEPHONE CALL
JAKE FUSON
5/26/2015
5/26/2015
CONDITIONS
CONTACTS
NAME TYPE NAME
ADDRESSI
CITY STATE
ZIP PHONE FAX EMAIL
APPLICANT TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #C3
INDIO CA
92201
CONTRACTOR TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #C3
INDIO CA
92201
OWNER GUY OFFENHAUSER
1636 BEECHWOOD
COSTA MESA CA
92253
FINANCIAL INFORMATION
Printed: Wednesday, May 27, 2015 11:13:44 AM 1 of 2 IrIpw_..___.
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
PLUMBING FINAL" BLD
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
WATER HEATER/VENT
101-0000-42600
0
$7.25
$0.00
PC
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:i0
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
PLUMBING FINAL" BLD
ATTACHMENTS
Printed: Wednesday, May 27, 2015 11:13:44 AM 2 of 2 OrA .
06/06/2013 THD 15:09 FAX La Quinta Bldg & Safety.
2001/001
Bin #City
of La Quinta
Building er Safety Division
P.O. Box 1504, 78-495 Calle Tampico
1.a Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: , 4 3 9, lik' )r Owner's Name: `
A. P. Number: Address: 3%LA17
Legal Description: City, ST, Zip:
Contractor: -' i Telephone:
Address: $O� S �a Project Description:
City, ST, Zip: _L C> ? W G-4-e� y1 c—CJ AP- ^
Telephone:—) kj 05-1?s?f
„'„ i
State Lia # : 0� 3 O 1
City Lie. #;
Arch., Engr., Designer.
Address:
City; ST, Zip:
Telephone: !, ^'� s ;; e:, Construction Type: Occupancy:
State Lie. #: �.>.a..;,.a;x:�a«.•s <..ProJect tYPa circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq. FL:
# Stories:
#•Chits:
Telephone:!# of Contact Person: Estimated Value of Project:
APPLICANT: Do NOT WRITE BELOW THIS LINE
d
Submittal
Req'd
Recd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Stractaral Coles.
Reviewed, ready for corrections Plan Check Deposit
Truss Calfs.
Caped Contact Person Plan Check Balance
.Title 24 Calcs.
Plans picked up 'Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2nd Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.L
H.OA. Approval
Plans resabmitted Grading
IN HOUSE:-
'"' Review, ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Prescri" tive,Certificate of Com fiance: Residential CF -1R -ALT -1 HNV
Residential Alterations Page I of 2
Project Name: Yl Climate Zone:. Permit #:
General Information
Site Address: E3
Enforcement Agency': Date:
Buildin 'T e: R Single Family 13'Multi Famil •
Project Type: 13:11e lacenient or Change Out of Water Heater
WATER HEATING
• i certify that this Certificate of Compliance documentation is accurate and complete. '
List newly installedwater heaters and boilers for both domestic /tot water heaters (DWH) and hYdronic space heating. Newly installed
DWH healers and -boilers must be as,. ro ane, or use the existingfifel e.
Water Heater
Type/Fuel Type
Distribution Type
(Standard'
. Recimulatin
Number In
System
Tank Energy Factor or
Capacity (gal) Thermal Efficiency
External Tank
Insulation
R -Value
cx+ . S
Name:
C
I
ompany:
Date:
11 ^^
II ^^
Address:
License:
9 0OC1 �'�
J' o)3 3
City/State/Zip:
c a��
Phone:
1. Indicate Type (Storage Gds, -Heat Pump,'Instantaneous, etc.)
2. 'Recircidating systems serving multiple divelling units shall meet the recirculation requirements of §150(n).
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 9150U).
The Prescriptive
Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statenkht)
• 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.
• I 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'California Code of Regulations.
o 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.
Name:
C
Sijznaturw.
ompany:
Date:
11 ^^
II ^^
Address:
License:
9 0OC1 �'�
J' o)3 3
City/State/Zip:
c a��
Phone:
Uld, T" 11 K --17A Y ( /l/ %, \
PLUMBING -WORK OR®ERANVOICE
�roMMY ROOTER
20691
JTEM • • PART • • ® •
i
i80975
J .O
a
HELPING THE DESERT
o ONE FRIEND AT A TIME Co.
v ) Plumbing, Drain Cleaning & Jetter Specialist Inv.#
Indio Blvd., #B9
, Indio, CA 92201 Auth.#
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f' -5% 2 /C
®.. ,.•� i j7ks8 760=574-4444
Fax 760-444-2717
"All Clear!" WVVW.TOMMYROOTER.COM
CA LIC. #930133
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❑ WARRANTY
❑ CONTRACT
MAKE
MODEL
SERIAL NUMBER
❑ SERVICE CONTRACT
❑ NORMAL
TOTAL MATERIALS
0 RET. C] COMM.
❑ NOT COMPLETE
DESCRIPTION OF WORK
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TO OUR CUSTOMERS: Service men are required to have work slip signed.
DRAIN CLEANING
77
This is done in order to protect you, the workmen, and ourselves and to
enable us to give you absolute satisfactory service. You are respectfully
requested to examine material and labor statement before workmen leave
ADD'L FOOTAGE
ADD'LFIXTURES O
PLUMBING LABOR
the job, and if you find everything satisfactory, okay this ticket. If service is
unsatisfactory, in any way, please phone our office immediately.
A PENALTY WILL BE CHARGED AT THE RATE OF 1 t"Yo PER MONTH ON UNPAID
BALANCES AFTER 30 DAYS OF INVOICE DATE. ANNUAL PERCENTAGE RATE 18%.
RETURNED CHECK FEE $25.00
PARTS
PRODUCTSITREATMENT
TOTAL LABOR
VIDEO INSPECTION
WARRANTY•RECOMMENDATIONSI
find the time and material charged above satisfactory and agree to pay
HYDRO-JETTER
MINI JETTER
❑ 5 Day ❑ 1 Year
p 3 Month ❑ NO
for same on presentation of invoice, and further agree to pay reasonable
charged for collection including attorneys fees in the event of my default.
LINE/LEAK LOCATION
6 Month
WARRANTY CALLS
ARE SCHEDULED
FRONPM-FBAM-5PM
-
"NOTICE TO OWNER" (Section 7019 -Contractors License Lew) under the
Mechanics' Una Law, any connector, subcontractor, taborer, material man at other person who hetes
to Improve your property and is not paid for his labor, soMcos or material, has a right to enfero his
claim against your property. Under the law, you may protect yourself against such claims try filing,
before commencing such work or improvement, as original contract for the work of Improvement or a
modification thereof, in the office of the county recorder of the county where the property is situated and
requiring that a contractor's payment bond be recorded in Such olfice.Said bond shall beInanamount
not I Ihen fifty percent (50%) of the contred price and shag, in addilfon to arty co ' ions for the
parfo a of the contract, be ditional for the payment in lull 1 Ih claims all persons'
turns n la r, '�a�uipmforls/ t de ri in dconlr 1.
PUMP SEPTIC/GREASE
OTHER
TAX
o TOTAL
X
X "v ' " _
PAYMENT RECEIVED
Initials ❑CASH ❑ G.C. ❑BILL CHECK # X
SIGNAT E DATE
WORK ORDERED 9Y:
�p
PAYMENT DUE
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Pr02etx type (0d0 oils): New Add$n Altar Repay Demo
Name of Cantaotpc�on
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