11-0462 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: X11-00000462
Property Address: 48231 CALLE
APN: 646 -092 -016 -
Application description: PLUMBING
Property Zoning: LOW DENSITY
Application valuation: 750
Applicant:
., N-4
Tity/ 4 4 Q"
FLORISTAS
RESIDENTIAL
Archite t or E ineer:
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.
License Class: C36 License No.: 880103
Date: '5 Xz— I 1 Contracto
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).:
(_) 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 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.).
(_) 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.I.
Lender's Name:
Lender's Address:
LQPERM[T
Owner:
DALBEC PATRICIA
48231 CALLE FLORISTAS
LA QUINTA, CA 92253
(
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/05/11
Contractor:
ALVAREZ, JORGE A.
P.O. BOX 984 PMAY _THERMAL, CA 92274
(760)777-3613�Lic. No.: 880103052011
----------------------------- .�.-----r--
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 EXEMPT Policy Number EXEMPT
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 Lab*WORRS'
orthwith comply with those provisions.
Date: S-5 -11 .Applicant:
WARNING: FAILURE TO SECUROMPENSATION 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 the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to wilonstruction, and hereby authorize representatives
of this county to enter upon the above-mentioned pro ;�yiinfgoir�ZtZ:oses..
Date: � Signature (Applicant or Agent):.
Application Number . . . . . 11-00000462
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
22.50
Plan Check
Fee
5.63
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
11/01/11
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 7.5000
EA PLB
WATER HEATER/VENT
7.50'
--------7-------------------------------------------------------------------
Special Notes and Comments
REPLACE AND REMOVE 40
GALLON GAS
WATER
HEATER.
----------------------------------------------------------------------------
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 Certiticate of Com liance: Residential CF-IR-ALT-DHW
Residential Alterations °:' • • ' Page I of 2
Project Martie: t`' e L Climate Zone: I Permit #:
General Information : +
Site Address: l r • -Enforcement A enc. ," L0. & p, Date: ctT - _ l
Building Type: twin le Family O Multi Family Project Type; 131ti lacement or Change Out of Water Heater
WATER HEATING .
• I certify that this Certificate of Compliance documentation is accurat&and complete:
List newly installed water treaters and- boilers for both danestic hot neater heaters (DWH) and hydronic space heiiting.,Newly installed
OWH heaters and boilers rnust.be us, rone, or use the existingfit l f3pe.
• 1 certify that the energy featurevand perfoiinance specifications for the building•design identified on this Certificate of Compliance
Water Heater
Distribution Type Number In Tank
{$)zmInrd,
gy,F�or or' ;
External Tank
i Insulation'
TypdFuel Type
Reeitwladn 'System Capacity (gal) .
Thermal Efficiency
R -Value
Company:
Date:
Address:
Uceiue:
X801 �3
City/StatdZip:
Phone:
C.K -n_
o - 7 7 7-36 /,3
I. Indicatr7vpe (Storage.Cas,;Heat Put* Instantaneous. etc.)
2. Recirculating systems serving multiple dwelling: units. shall °meet the recirculation • requirements of §I50(0).
The Prescriptive
• requirements do not allow the installation of a recirculating natter heating, system for single divelling units.
3. The external roarer heatin tank and: i s shall be•insulated to ►rieit'the re' uleeinents o %§ 150U).
Contractor or Homeowner (Documentation Autbor's/Responsible Building Designer's, Statennetit)
• I certify that this Certificate of Compliance documentation is accurat&and complete:
• 1 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.
• 1 certify that the energy featurevand perfoiinance specifications for the building•design identified on this Certificate of Compliance
conform to the requirements of Title 24. Part I and 6 of the Califomia Code of Regulations,
•' The building design features identified on this Certificate of Compliance. are consistent with the information provided to documeni this
building design on the other applicable compliance forms. worksheets, calculations, plans and specifications submitted to the
enforcement agency , fora roval with this building permit application.
Name:
Signaturm
`\ \
r Q lV Gll'.c
Company:
Date:
Address:
Uceiue:
X801 �3
City/StatdZip:
Phone:
C.K -n_
o - 7 7 7-36 /,3
QgAnril 71116
Stora a Water Heater Is defined as:
Max 8tulhr per Gallon 30 Gallon 40 Gallon 50 Gallon
4,000 1 120.000 1 160,000 1 200,000
2009 Appliance F.Mclency Regulations for Small Water Heaters
Small Water Heater Is defined as:
Type
Input
Gas Stora a
75,000 Btu/hr or less
Oil Storage
10-51000 Btu/hr or less
Electric Storage
12 kW or less
Gas Instant
200,000 Btu/hr or less
Oil instant
2_10,000 Btu/hr or less
Electric Instant
12 kW or less
Heat Pum
24 amps or less
Stora a Water Heater Is defined as:
Max 8tulhr per Gallon 30 Gallon 40 Gallon 50 Gallon
4,000 1 120.000 1 160,000 1 200,000
1. Per Section 150Q) of the 2008 Energy. Efficiency Standards.
QAnril 2010
If rated Energy Factor does not EXCEED minimum
Federal Minimum
Values Below, an External Insulating Blanket (R-12,
Energy Factor
minimum) shall be Installed'
Water Heater Fuel Type
Effective Jan 20, 2004
30 Galion
40 Gallon
50 Gallon
Gas-fired storage -type water
0.62 - (0.0019 x V)
0.563
0.544
0.525
heaters
Oil -fired water heaters
0.59 - (0.0019 x V)
0.533
0.514
0.495
(storage and Instantaneous
Electric storage water heaters
'
(excluding tabletop water
0.93 - (0.00132 x V)
0.890
•0.877
0.864
heaters
Electric tabletop water
0.93 - (0.00132 x V)
0.890
0.877
0.864
heaters
Gas-fired instantaneous water
0.82 - (0.0019 x V)
0.563
0.5 44
0.525
heaters
Electric instantaneous water
heaters (excluding tabletop
0.93 - (0.00132 x V)
0.890
0.877
0.864
water heaters
Heat pump water heaters
I 0.93 - 0.00132 x
0.890
1 0.877
0.864
V = rated volume in gallons
1. Per Section 150Q) of the 2008 Energy. Efficiency Standards.
QAnril 2010
Bill #
Permit 11
AV�
f1r(ljjcct.Addrcss:
A. 11. Ntimber:
Contractor: c
Cily, ST"Ai
3(90
Slaw (.11 - 11 - (c)
Arch., Fjtgr., Designer:
Address:
City, ST, Zip:
is Telephone:
St-Ite Lie V
It Name of Contact Person:
Telephone :'f of Contact Person:
I; Submittal
i'lan Sets
Structural Calm
Energy CRICS.
1400d ptaill Phil
Grading plan
Su bcoji I n co w- I is(
C:1•ant (iced
R.O.A. Approval
IN HOUST!'.:-
Pub. Wlm Appr
School ]Fee's
4 R,a u.mcd
Building 1-v Safety Division
11.0. Box 1504, 78-495 Calle Tampico
1,a Quinra, CA 9225.-S - (700) 777-7012
Building Permit Application and'Fracking Sheet
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Storic...;: I Units:
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T'Stitl)Wd V..l1klC 0FP1-0j-,C1: -2
APPLICANT: DO NOT WRITE BELOW THIS
LINE
'I'MCKING
M
't4`1
;4 Miall Amount
Rc -vicived, r?.xdy for correc(imis
Phn Check Deposit
Conine! llcrsoll
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7", Rcvic.xv, 1'1Iftdv for corrvxtiollsfissw
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J! -C-Med Cor1c;t.cl. Person
Date orpunfit issuc
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Tot:d 11 - ces