11-0787 (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:
11-00000787
48210 CALLE
646 -092 -029 -
PLUMBING
LOW DENSITY
800
Tih
t 4 40"
FLORISTAS
RESIDENTIAL
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.
Licen a Class: C36 License No.: 812894
Date: ontractor:
NER-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):
I _ 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 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: `
LQPERMIT
Owner:
STEVENSON DONALD E
48210 CALLE FLORISTAS
LA QUINTA, CA 92253
Contractor:
ALL STAR WATER HEATER I
30300 PUERTO VALLARTA WA
MENIFEE, CA 92584
(800)727-0977
LiC. No.: 812894
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/21/11
JUL 212011 ID
LA QUINTA
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 DELOS INS Policy Number 02DKRM120074
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 comp y with tho provisions,
ate: pplicant:
WARNING: FAILURE TO SECURE WORKERS' COM�/ NSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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 air d county ordinances and state laws relating to building construction, and hereby authorize representatives
of i''s%%cou ty tc enter upo a above-mentioned property for inspection purposes.
Oatignature (Applicant or Agent):
Application Number . . . . . 11-00000787
Permit . .
. •PLUMBING
Additional desc .
.
Permit Fee . . .
. .22.50
Plan Check
Fee
5.63
Issue Date
Valuation
. . .
. 0
Expiration Date
1/17/12
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 50 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
Prescriptive Certificate of
Residential Alterations
Pmiect Name: id 9A ) ('7
liance: Residential
Climate Zone
1
CF-IR-ALT-DHW .
Permit q: ,
WATER HEATING
e I certify that this Certificate of Complmice documentation is accurate and complete.
. ['am eligible under Division 3 of the Califomia Business and Professions Code to accept responsibility for the building design
List new -h• installed %Nater heaters and boilers - for loth domestic hot Nater heaters (j)WH) and Indrottic .Vxtce heating.
Hew•h installed
D1VH heaters and boilers must be gaus. propane, or use the existingfitel npe.
enforcement agency for appioval with this budding rtapplication-
Water 14catcrh �Ntion TypeTNumbsY Energy Tank gy �or tx
External Tank
Thenal Efficiency
Typdrvd Type Recirctt System Capacity (gal) m
R-Vatue'
3o e-
Address: Lice
xer
citytstatetzip: Phone-.
�,A S, l' �o 0 7�7- 097
1. Indicate 7bpe (Storage Gas. Heat Pump. Instantaneous, etc.)
2. Recirculating systems serving .multiple dwelling units shall meet the recirculation requirements of §ISO(n).
The Prescriptive
requirements do not allow the installation of a recirculating water heating system for single dwelling rtnits.
3. The emerial %vter hearing sank and ' s shall be insulated to meet the rrquirements of § 1
Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement)
e I certify that this Certificate of Complmice documentation is accurate and complete.
. ['am eligible under Division 3 of the Califomia Business and Professions Code to accept responsibility for the building design
identified on this Certificate of CompiWwe.
e l certify that the energy fcaunw and. performance specifications for the building design idauified 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 outer applicable compliance forms, worlcstmeets calculatioru plans and specifications submitted to the
enforcement agency for appioval with this budding rtapplication-
Name:
S'
h )VI
Company: Date:
STS WA-TeR /tee 7�e7"
Address: Lice
xer
citytstatetzip: Phone-.
�,A S, l' �o 0 7�7- 097
Bin #
City of La Qu' inta
Building at Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
1�
Project Address:
1
Owner's Nae:—'2o
ON S 2 it /✓
A. P. Number:
Address: 8dk0 C
Legal Description:
City, ST, Zip: t �t 9 7 ---Z
Contractor: A ) S 714 Q
Address: OO �u ,q
Telephone: ;<�a
Project Description:
nn
City, ST, Zip: e liq , AS-
Telephone: .� `Qt70 �%�7'O
rj l3kyai.::;•9f;.;:... sur{x}t..:
;f. :;rl,•c{r•N?y�„??:�?x'; ��':•r
State Lic. #: P / 9F
City Lic. #; .
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
r'brrv:!' y?!}4.•<ri
State Lic. #: :n .;4f>'J s?t
Name of Contact Person: Jt -N e
Construction Type: Occupancy:
yP
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: / - � %
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"° Review, ready for corrections/issue
Electrical
Subcootactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees