09-0013 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
5'54-50—FIRESTONE
APN:
775 -151 -067 -
Application description:
PLUMBING
Property Zoning:
LOW-DENSITY RESIDENTIAL
Application valuation:
500
Applicant:
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.
License Class: C36 License No.: 828264
ate: I q -J r:
T OWBUILDER D RATION
I hereby affirm under penalty of perjury that I am a mpt from th ontractor'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 _) 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—) 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: 1 I a V
Lender's Address: 01
LQPERMIT
Owner:
KENT WISHART
55450 FIRESTONE
LA QUINTA, CA 9225
Contractor:
FOY, SCOTT A.
43579 MAIN STREET
INDIO, CA 92201
(760)775-9405
Lic. No.: 828264
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/07/09
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 FIRST COMP INS Policy Number WS1004457
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
,��3�7C0�0 of the Labor Code hall forthJwith comply with those provisions.
;ate.� plicant: C r ARAND SHALL
UBJECT AN EMPLOYER TO CRIMINAL PENAL ES 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 comply with all
city and county ordinances and state laws relating to building construction and eb authorizer resentatives
of,fhis county to ant upon the above-mentioned property for inspecti s s.
/[U/ate i ature (Applicant or Agent):
_i
Application Number . . . . . 09-00000013
Permit . .
. PLUMBING
Additional desc .
Permit Fee . . .
. 22.50
Plan Check Fee
5.63
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date
7/06/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 7.5000
EA PLB WATER
HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and
Comments
REMOVE & REPLACE
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
t..
Pemlit g
U -^
Prgect Address.
A- P. Number.
City Of %d Quints
Burg 8t Safety division
P.O. Box 1504, 78-495 Cage Tw m
pi!.a (NMU, CA 92253 - (760) 777-7012
BwIding Permit Application and Tradang Sheet
Owner's Name: Qnt 1 SY1CL��
Address: 5,5 -�
�d �l remon ;L.
'.ego' Description:
Coatrr»orV
Address
- f
CrtY> sr. Zip: l Q u► 0\�R - '
Telephone:
Project Description:
City, ST, Zip- t� f
I�
\X -J
Telephone: -7
State Lic. # :
City Lic. #51-7
Arch_, E W-, Desi c -
Address:
City, ST. Zip:
Tciephone:
Surae Lic. #:
Construction Type: Occupancy:
Project type (cards one): New Add'n Atter Repair Demo
Sq. FL: S Stories: Units:
Name of Contact Person:
Telephone # of Coact Person:
Estes Value of Pmjcct
APPLICANT: DO NOT WEM 88.OW THIS UNE
d
&&,utsi
Req'd
lRee'd
TRACKING
Pl$t11 T FSEs
Plan Set;
Plan Cheek submitted
item
Amoant
savebaral Cara.
Revicwsd, ready for eorrectim
Plan Check Deposit
Trees Cats.
Called Coated Person
Plan Cheek Baianct
T k 24 Calcs.
Pians pieced ap
Construction
Flood phis pian
Pians resWNWtted
MecAsaical
Grsdtq plan
2-' Review, ready for eormcdons/issne
Electrical
Subeoataetor Iht
Called Coated Person
Ptembiag
Grant Dad
Plana pidoed ap
s.M.L
H.Oa. Approval
Plain retabmitted
Grading
EN HOUJSEc-
'"' Review, ready for carrecdonsrame
Developer Impact Fee
Plan Approval
Called Coated Person
Pub. Wks. Appr
Date of permit lanae
Set" Foo
Total Permit Few
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -IR
Projekt Title Date
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the following. are
renuired.
OR
0 Alternative to Sealed Ducts and Refrigerant Charge ITXVs (See Package D A Iternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-:14.
OR
For additions and alterations, duct systems that are not documented to have been previously
0 sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D. J
WATER HEATING SYSTEMS
Distribution
Type
Number
in System
Ducts all climate zones (Installer testis and certification and HERS rater field verification required.)
r13Sealed
TXVs, readily accessible (climate zones 2 and 8-15 only)
Standby
Loss %
nstaller testis and certification and HERS Rater field verification required.)
(d
Refrigerant Charge (climate zones 2 and 8-15 only) (installer testing and certification and HERS Rater field
0
verificationrequired.)
OR
0 Alternative to Sealed Ducts and Refrigerant Charge ITXVs (See Package D A Iternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-:14.
OR
For additions and alterations, duct systems that are not documented to have been previously
0 sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D. J
WATER HEATING SYSTEMS
Q—+—. a rvi.," ainoio AmuMNimn nni+a
— - --- -
Water Heater
Ty uel Type
Distribution
Type
Number
in System
eck box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
Tank
Capacity
elling unit. If the water heater is a'storage type, 50 gallons is the maximum capacity and recirculation system is
Standby
Loss %
not allowed.
(d
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
0
Manual. No water heating calculations are required, and the system complies automatically.
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
0
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
0
units
Q—+—. a rvi.," ainoio AmuMNimn nni+a
— - --- -
Water Heater
Ty uel Type
Distribution
Type
Number
in System
Rated
Input'
(kW or
BuAr)ions)
Tank
Capacity
Energy
Factor or
Thermal
Efficiency
Standby
Loss %
Tank
External
Insulation
R -Value
(d
&S
I
V WWW w
Water Heater
Type
Distribution
Type
Number
in System
Rated
(kw or
Btu/hr
Tank
Capacity
Ions
Energy
Factor or
Thermal
Efficienc •
Standby'
Loss %
Tank
External
Insulation
R -Value
I. For mall gas storage water heaters (rated inputs of less than or equai,to r7,VW ouyuri, cictiu i%. Icauuunz, auuv iicat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Bu3/hr), list Ratted Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Pipe Imulation (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/e
inches or greater in diameter shall be thermally insulated as specified by Section 150 6) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005