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13-0446 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000446 Property Address: 55036 FIRESTONE APN: 775 -153 -029 - Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 700 Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION •4 ����I{,.cv VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT 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 Bus' ss and Professionals Code, and my License is in full force and effect. Lice se Class: C36 License No.: 936147 Dat U4s Contractor: 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.). (_) 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: RUHL PATTY 55036 FIRESTONE LA QUINTA, CA 9225, ( Contractor: STATEWIDE SERVICES 40244 CATANIA CT BERMUDA DUNES, CA (760)636-0315 Lic. No.: 936147 Date: 4/10/13 ----------------------------------------------- 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 STATE FUND Policy Number 1948371 I certify that, in the perform ce of the work for which this permit is issued, I shall not employ any person in any manner s s to become subject to the workers' compensation laws of California, and agree that, if I sh I become subject to the workers' compensation provisions of Section 700ofthe Labor de I shall forthwith comply .th those provisions. . �D 'Applicant 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that t above information is correct. I agree to comply with all city a d county ordinances and state laws relating to b I ing construction, and hereby authorize representatives of th' c myt`$�ant er upon the above-mentioned pro r for inspection purposes. Date. ✓v Signature (Applicant or Age O Application Number . . . . . 13-00000446 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 22.50 Plan Check Fee 5.63 Issue Date . . . . Valuation . . . . 0 Expiration Date , 10/07/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE AND REMOVE 40 GALLON NATURAL GAS STANDARD WATER HEATER. 2010 CODES. --------------------------------------------------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Permit Fee Total 22.50 Plan Check Total 5.63 Other Fee Total 1.00 Grand Total 29.13 LQPERMIT Paid -Credited Due .00 .00 22.50 .00 .00 5.63 .00 .00 1.00 .00 .00 29.13 Prescri tive,Certificate of Compliance; Residential.-CF-1R-ALT-DHW Residential All ations Page I of 2 Project Name: jV, CW Ht, I Climate Zone: Permit p: General Informat Site Address: (�y' Enforcement Agency: bate= Buildin T in le R` mil ❑Multi Family Project T e lacemcnt or Chane Out of Water Heater WATER HEATING List nemly installed water heaters and boilers for both domestic hot water heaters (DWH) and h drottic ywce heating. New'I)' installed OWH heaters and boilers must be gas. propane. or use the existinghu..Its Waren Heater llistribution Type Number In Tank Energy Factor ur TYPE Type' (Standard, 'tlic+rrtnal F�nhnal Tank lasritation R Systan Capacity (gal) Efficiency R -Valuer r 1. Indicate TyPe (Storage Gas. Heat Pump. Instantaneotm etc.) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). 71e Prescriptive rrgairements do not allow the hwallwim of a recirculating water heating system for single dwelling units. 3. The external water hewing tank and pipes shall be insulated to meet the rrouirements off 1500). Contractor or Homeow wr (Documentation Author's/RespondlAe BWMng Designer's Dedaratkin Staten"t) • 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 Catifx=e 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 Trek 24, Pact 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 od= applicable compliance forms, worksheets calmmitations. plans and specification submitted to the . enfomemant Mency for approval with this building rtapplication. TF C%( Ci �'-5-i3 Ad&m: Pa�� u c Ciry w" -Zip: Phase: Bin.# City of b- Quinta -Buiitrigg u Safety Division ' P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92233 -:(760) 777-7012 Building Permit -Application and Tracking Sheet Permit # yob Project Address: CaC5 Owner's Name:. A. P. Number. Address:5.. �j e Legal Description: City, ST, Zip: Contractor. �� ` Telephone. ( xz rs%y Address: �a /' Project Description: City, ST, Zip: Telephone*'/' 000 r:.�: ., State Lic. # City Lic. #; Arcfi., Engr., Designer Address: City., ST, Zip: Telephone:- .Y �w State Lia #: Name of Contact Person: Construction Type: Occupancy: 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 UNE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit. . Truss C21cs. . Called Contact Person Pian Check Balance Title 24 Cala. Pians picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan tad Review, ready for correctiouslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading 04 ROUSE:-. 7n° Review; ready for correetiouslissuc Developer Impact Fee Planning Approval Called Contact Person AJ.P.P. Pub. Wks. Appr ' Date of permit Issue Schodl Fees Total Permit Fees L...... -..... ..... _ _..