11-0993 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
11-00000993-
51277 EISENHOWER DR
773-091-013-1 -000000-
PLUMBING
COVE RESIDENTIAL
1500
Tit!t44Q"
Architect or Engineer:
P1
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
HYDEE HARDING
51277 EISENHOWER DRIVE
LA QUINTA, CA 92253
rj oO
Contractor: U
STARRETT, DAVID D.
39705 VIA CACHO
TEMECULA, CA 92592
(951)514-9133
Lic. No.: 885220
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/14/11
U
4 201 D1
crry p,F ►!A QurNrA
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-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
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' compensation, as provided
License Class: B License No.: 885220
1 ` `
ate: �' �'I I C ractor:
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
,/ issued.
0.I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Y-'- Code, for the performance of the work for which this permit is issued. My workers' compensation
1101, NER-BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 272
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 file 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
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
3700 of the Labor Code, I sh f rthwit mply with those provisions.
_
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
te: L/Applic t:
1 _ 1 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: FAILU O SECURE WORKER OMPENSATION 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.).
I_ 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 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:
�f
LQPERMIT
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 authorize representatives
of this county to enter upon the above-mentioned property for i ction purposes.
Dave` Si ture (Applicant or Agent):
Application Number . . . . . 11-00000993
Permit . .
. PLUMBING
Additional desc .
.
Permit Fee . . .
. 22.50
Plan Check
-Fee
5.63
Issue Date . . .
.
Valuation
. . .
. 0
Expiration Date
3/12/12
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
LQPERMIT
Prekri tive'Certificate of
Residential Alterations
Pmiect Name: TK . t
ce: Residentiat
Climate Zine: 1 S I Permit #:
-1R-ALT-DHW
Page I of 2
General Information
Site Address: S / z'7 j e� Enforcement Agency: Date: — L
.Building T ' Sin le Family 0 Multi Family Project Type: 0 Replacement or Change Out of Water Heater
WATER HEATING
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
List newh installed evater heaters and boilers for both domestic hot water heaters (I)WH) and hYdronic space heating. Newh• installed
DWH heaters and boilers must be gas. propane. or ttse rhe existing ueI h e.
Water Heater.
TYp�'I Type
Distribution Type Number In Tank Energy Factor or
R (Standard, ): System Capacity (gal) Thermal Efficiency
External Tank
Insulation
R -Valuer
L40e,a.
enforcement agency for approval with this budding permit77ig
Name: ^
ure:
�
Co-patiy= Date:
,DScJ7-
Addms: License:
u l b G:PiZ S d—
City/StateRip: Phone:
e C. 64 -7Z-'f7 9;�l 30W �t
1. Indicate Type (Storage Gas. Heat Ptunp. Instantaneous. etc.)
2. Recirculating systems serving multiple dwelling units shall tenet the recirculation requirements of §156(n).
requirements do not allow the installwion of a recirculating water hewing sesrem for single dwelling'anits.
3. The external water heating tank and pipes shall be insulated to meet the requirements of § 150(i).
The Prescriptive
Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Dedaration Statement)
• 1 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.
• 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 budding permit77ig
Name: ^
ure:
�
Co-patiy= Date:
,DScJ7-
Addms: License:
u l b G:PiZ S d—
City/StateRip: Phone:
e C. 64 -7Z-'f7 9;�l 30W �t
Bin .# :..:. ..
City of la Qulilta.
Building BL Safety. Division f?
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 777=7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: cj Z — `s e,I\ �� lA1C
Owner's Name:
e
A. P. Number:
Address: I :ems
Legal Description: ,(
City, ST, Zip: `
Contractor: i✓,.:
Telephone: � % ��^�.,�,;• :� Vie: ,, s;: '.o>
Address: 'Z i �j 6 Q 2 V, . /--7-10r/77
Project Description:
City, ST, Zip: �� G'
G
Telephone: s' s'ss''
.:: y.;:;;; . c� .
f,:;>, r,.." fp"
CityLic. #-.
State Lic. # Z Z
Arch., Engr., Designer: q
Address:
City, ST, Zip:
Telephone:
State Lic. #: fir" `x:;:x>?`y
` a"'° c '�''�
?yr
Construction Type: Occupancy:
Pro'ect circle one): New Add'n Alter Repair Demo
1 type )' ep81
Sq. Ft.: # Stories: #Units:
Name of Contact Person: q f'
Telephone # of Contact Person: G , f Estimated Value of Project: .:r o v . O 0
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Req'd
Rec'd
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cafes.
Reviewed, ready for corrections Plan Cheek Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Title 24 Cala.
Plans picked up Construction
Flood plain plan
Pians resubmitted Mechanical
Grading plan
2'' Review, ready for correctionsfusue Electrical
Subcontaetor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
W HOUSE:-
Review, ready for correctionslissue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees