12-0925 (PLBG)i. "'I
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
12-00000925
Property Address:
54305 EISENHOWER DR
APN: 1774-252-016-4
-000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
700
Applicant: I
Architect or Engineer:
• "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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.
Lic 'se Class: C36 X License No.: 731855
Dat
/onractor.
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.).
(_ 1 1, 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
1 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:
CHARLOTTE WANG
54305 EISENHOWER DRIVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/15/12
Contractor:
STATE WIDE PLUMBING Lr��
40244 CATANIA COURT
INDIO, CA 92203--0
(760)636-0315 AUG. j 2n!2
Lic. No.: 731855 j
TY OF LA QUIN
1'4P�6'l�3w DEP
------------------
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 MARKEL .INS CO Policy Number MWC00329801-01
_ 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 become subject to the workers' compensation laws of California,
and agree that, if I shout ec me subject to the workers' compensation provisions of Section
37700 of the Labor Code/1 shill forthwith comply with those provisions.
/e b��plicant: _
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 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 th ove information is correct. I agree to comply with all
city and county ordinances and state laws relating to bu' i g construction, and hereby authorize representatives
of this county to enter upon the above-mentioned pro rt or inspection purposes.
DateQignature (Applicant or Ag
Application Number . . . . . 12-b0000925
Permit
PLUMBING.
Additional desc .
Permit Fee . . . .
22.50
Plan Check
Fee
5.63
Issue Date.
Valuation
. . .
. 0
Expiration Date
2/11/13-
/11/13Qty
QtyUnit 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
ELECTRIC WATER
HEATER. 2010 CODES.
-----------------------------------------
Other Fees ..
-----------------------------------
. . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
Due
---------------------------
Permit-Fee
Fee Total
----------
22.50
----------
.00
----------
---------Permit
.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
pr cri five Certifcate of
Residential Alterations
"ect.Name:
General Information
Site Address:
nee; Residential.. �1
! Climate Zone: Permit #:
Buildin T : � Sin le Famil .Multi Fay
. 4
Enforcement Aeerx:y:
LT-DHW :
Date:
or Change Out of Water Heater
WATER HEATING
• 1 certify that this Certificate of Compl"ranceldocumentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to ac pt responsibility for the building design
List nem4r installed ►nater heaters and boilers for b6th domestic hot water heaters--(DWH) and h dror►ic space heating.
Newl. installed
DIM heaters and boilers n►ust be as, e. or use the existing el ore.
enforccmcm for approval with thisbuilding lication.
Wales Reales �
Typdr-,i Type
D�
Rec
NtarAud.umtxx In - Tank Energy Factor or
System Capacity (gal) Thnmat ElficiencY
Etemal Tank
• Insuluioa
R -Value►
n 4,4 yak- y ' C®r c.�- License:1 �s
CitylS "p: 1, 0 � ! � � � Plane
I
f
1. Indicate Type (Storage Gas. Heat Pwap. Instantaneous. etc.)
2. Recirculating systems serving multiple dwilling units shall inter the recirculation requirr►nents of §/ Art).
The Prescriptive.
requirements do nes allow the installation of 4 recirculating water heating system for single dwelling units.
j_ The external ►►user heating tank and poes shall be insulated to meet the requirements o
Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement)
• 1 certify that this Certificate of Compl"ranceldocumentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to ac pt responsibility for the building design
identified on this certificate of comps- ace.
• 1 certify that the energy features and perfomtatice specifications for the building design identified on this Certificate of Compiiattce
conform to the requirements of Title 24. Past I and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance arc consistent with the information provided to document this
building design on the other applicable Icompliance forms. wmekslteets. calcul ion& plans and specifications submiumd to the
enforccmcm for approval with thisbuilding lication.
'� 'I
Names -' n ICA
y 1 lA 4
Sip+atere:
Q
2� we,01
i?uc:
n 4,4 yak- y ' C®r c.�- License:1 �s
CitylS "p: 1, 0 � ! � � � Plane
sir,.#.
O La Qut* lta -
Building 8t. Safety Division ..:.. ..
P.O. Box -1504, 78-49S Calle •Tampico
La.Quinta, CA 92253 -:(M) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: C 1
Owner's Name:
A. P. Number.
Address:15 `011
Legal Description:
City, ST, Zip:
Contractor.(
Telephone %
Address: 4
Project Description:as—D
City, ST;'Zip:
ZOQ�l , .
Telephone
State Lie. # : 1 �5 s
City Lie. #,
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:. Y ' ' ::' Construction Type:. Occupancy:
State Lie. #:w�M ..r Project type (circle one): New Add'n Alter Repair. Demo
Name of Contact Person: Q Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: '
Estimated Value of Proj "17, (J .
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Pian Check submitted
Item Amount
Structural Cales..
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Gales.
Called Contact Person
Plan Check Balance _
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical l
Grading plan
2`a Review, ready for rnrrectionsfissue
Electrical
Subcontactor List
Casted Contact Person
Plumbing
Grant Deed
Pians picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.T.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees