12-1335 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
.12-00001335 1
78845 GRAND TRAVERSE AVE'
770-070-011-44 -25389 -
PLUMBING
MEDIUM DENSITY RES
1286
Tiitf
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
--------------------------------------------------
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: C10 C20 C3 License No.: 811114
ate:ontractor:MIA
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 _ 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 6wn 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.).
1 1 I am exempt under Sec. , BAP.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
Owner:
LINDARS ARTHUR
78845 GRAND TRAVERSE AVE
LA QUINTA, CA 92253
Contractor:
CALIFORNIA DELTA MECHNICAL
6052 E. BASELINE RD, #155
MESA, AZ 85206
(866)692-5273
LiC. No.: 811114
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/09/12
----------------------------------------------—
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.
1 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 STATE FUND Policy Number 1697823-11
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 fort h omply with those provisions.
pplicant:
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 (5100,000). 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 an state laws relating to building construction, and hereby authorize representatives
oft co my enter upo eabove-mentioned properti pection ur osas.
ab te: l o /� ' nature (Applicant or Agent):
LQPERMIT
Application Number . . . . . 12-00001335
Permit . . .
PLUMBING
Additional desc . .
Permit Fee
22.50
Plan Check
Fee
5.63
Issue Date
Valuation
. . .
. 0
Expiration Date
5/08/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 7.5000
EA PLB
WATER HEATER/VENT
7.50
------------------------------------------------------------------------
Special Notes and Comments
INSTALL NEW 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
NOV/09/2012/FRI 09:00 AM DELTA MECHANICAL -NV FAX No,702-369-9578• P,003
Prescriptive Certificate of Compliance: Residential CF -IR -ALT -DMV
Residential Alterations Pahe (ora
Pru ect Name: -7714$ 6ranel Traverse AJe Climate Zone: Permit W.
General Information
Site Address: 11 tqS Grand
Enforcement Ag enc : ha u i n }a. Date: 11147 ra
Building Type; Q Sin le Family ❑ Multi Family
Project Type, CIYRe laeement or Chane Out of Water Heater
WATER HEATING
List newly installed water heaters and boilers for bolt dornestic /lot tracer heaters.lD1VH) and hpdronie space Treating. Newly installed
heaters and boilers artist be gas. propane. or use the eviiiing fitel ry e.
—MVH
Water Heater
Type/Fuel Type
Distribution Type Number In Tank Energy Factor or
tsata' System Capacity (gal) Thermal Efficiency
Recirculroularin
External Tank
Insulation
R -Volae
• I certify that the energy features and performance specifications for the building design identified on thi's Certificate of Compliance
TRob 110-15(d46
6.8
building design on the other applicable compliance forms, worksheets, calculations, plans and pecifications submitted to the
enforcement agency for approval with this building permit application.
Name:
Signature:
�.1 O f't J1'ia
Company:
Date:
1, Itrdicare Type (Storage Gas, Heat Pwnp, Insrantdneotts, etc.)
z. Recirculating systems serving multiple divelting 'units shall meet the recirculation requirements of 9/50(n).
requirements do not allow the installation of a recirculating water heating system for single divelling toots.
3. The errerndl stv ter heating rank and p tees shall be insulated to meet the re uirements o /50(').
The Prescriptive
Contractor or Ro'meowner (Documentation Author's/Responsible 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.
• I certify that the energy features and performance specifications for the building design identified on thi's Certificate of Compliance
conform to the requirements of Title 24, Pard and 6 of the California 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 pecifications submitted to the
enforcement agency for approval with this building permit application.
Name:
Signature:
�.1 O f't J1'ia
Company:
Date:
Address:
License:
60s(D E cline. P, t) ISS
gllll�
CitylstatdZip:
Phone:
P9 2 $5L90'0
4, It: -a�4A
APR— 1=91:2 W E D 1Z :32 MARQUIS M A N A G E M E N T P. 0 1
MANAGEMENT I/ GROUP
35-975 pale Palm Drive, Suite 200
Cathedral City, California 92234
{619! 324.77DO . FAX (619) 324.1908
i
DESERT FAIRWAYS
ARCHITECTURAL VARIANCE AUTHORIZATION
NAME Lindars Houston
ADDRESS 78-845 Grand Traverse
Your request for Architectural Variance has been approved
by the Architectural Committee. Any changes requiring a
Building permit must be obtained through the City and must
pass any City Inspection. All changes must comply with City
and County Codes.
SPECIAL NOTES_ please submit copies Qf all Cityitsand a
ar�rPi� S
Than You,
NyDpne
Account` Executive
REGIONAL OFFICES
NOV/09/2012/FRI 09:00 AM DELTA MECHANICAL -NV FAX.No,702-369-9578 P,002
City of La Quinta .
Building 'z Safely Divlslon
T�rrrit 4 P,O. Box 1504, 79-495 Calle Tampico
,1 P Qulnfa, CA 92253 • (760) 777.701 Z
Btfilding•Permit Application and Trac,(inc Sheet
?rojeet A ldre;s: 8 v Owner's Name; A r4ur LiMarg
A. P. Dluinbcr: Addfess.
Levil Description: Cit", 5T, Zip:
Contractor. ��1 btrL.�,.,1"�
�
Address: ��56 C, VwaC�l%lQ� j?p{, kS Project Description:
Cir/, ST, zip:/f �P.3 Z � 2.� (� C�CQ.� 6 a.,Ua L Cl Q, .
Telephone: 366 -oz"— 7
Stats Lic. # ; i 1 City Lic, #; %� x(00 ,
Arch., Eng, Designer.
Address:
(3—
City, ST, Zip:
--
Teiaphone; Construction Type: Occupancy;
State Lic. #: project type (circle one)-, Neti7 Add'n rA]� :.npair Demo
vamp of ContactPsrson: n p/j Sq. Ft: # stories' •0 Units:
Telephone of Coudact Person: Es Z., R'ed Value of Project;
APPLICANT; DO NOT WRITE BGLOW THIS LINT;
9 Submittal Ractd TRAC LNG XAItIIITFEF�S
Plan Sets Plan Check submitted Item Amount
Structural Cafes. Revimd, ready for corrections Plan Check Deposit
Truss Calcs, Celled contact Pirson Plan Check Balance
Title 24 Cales, Plans picked ap Construction
Flood plain plan Plans resubmitted B?eeba¢(eal
Ci-ading plan 301 Review, ready for corrartlons/issue Eiccttitcat
Subcontaetor List Called Contactperson Plumb(ng
Grant Deed Plans picked up S.KJ,
si.O s approval Plansresobmltte'd Grading
114 $OTJSE:,
J d Rkvlew, ready for corereflonsAssue
Developer Impact Fee
I Planning Approval
Called ContaetPerson
A.iP.P. ,
Pub. Wks. Aopr
Date of permit issue
School Pecs
Total Permit Fees