08-0457 (PLBG)P.O. BOX 1504 ^' VOICE (760) 777-7012
78-495 CALLE ,TAMPICO FAX (760) 777-7011.
LA QUINTA" CALIFORNIA 92253' ? , - BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/14/08
Application Number. �- 08-00000457 _ Owner:
Property Address: 44215 VIA DEL SOL SERGIO AMIEVA
APN: 604-201-OQ2-2 • -23971, 44215 VIA`DEL SOL
Application description: PLUMBING LA QUINTA, CA. 92253`. 4 '
Property Zoning: LOW DENSITY RESIDENTIAL" , (760)834-9739 y
Application valuation: �S�d
Contractor:
Applicant: Architect or Engineer: FOY, SCOTT A. e
43579 MAIN STREET O
INDIO, CA 92201
(760).775-9405 �in
Lic. No.: 828264
F.ITY PPIom 09 B$
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the'following declarations: -
section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C36 License No.: 828264for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
'17,,., .J!�+. issued. .
Date. 7&ntractor. _ 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
OW ER-BUILDje DECLARATION - insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt fro the Contractor's State License Law for the Carrier ACE INC Policy Number 045040239
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any ,
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions,
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 ($5001.: ^ Dat , Applicant:
1—) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and – – ,–C/7
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' C PENSATION OVERAGE Is UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work Aimself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). - APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. - property who builds or improves thereon, and who cpn(fagtS for the nrnjerts with n rnntmnrnr(o) livonead - i. caul person upi)n Whose behalf this appjjcation is made, each person at whose request and for .
• puisualit Lu the L.ontratt&s'. State License Law.). • whose benefit work is performed under or pursuant to any permit issued as a result of this application,
I—) I am exempt under Sec. BAP.C. for this reason 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. .
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation. -
- I hereby affirm under penalty of perjury thatthere is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). a- city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purpos -
Lender's Name: - - -
Date: '`Signature (Applicant or,AgenU:
Lender's Address:
LQPERMIT
J
Application Number 08-00000457
Permit PLUMBING
Additional desc
_
Permit. Fee'. 22.50 Plan Check
Fee
00 .
Issue Date..... Valuation
0
Expiration Date .. '9/10/08
Qty .Unit Charge Per ..
Extension
-BASE FEE
15.00.,.:
1.'00-. :. -:"7.5000 EA PLB WATER HEATER/VENT
7.50
---------------------------------------------------
Sp.ecial Notes and Comments
REPLACE WATER HEATER WITH 50 GALLON -GAS
UNIT
Fee summary" '' Charged Paid Credited
Due
Permit Fee Total 22.50 .00
00
22.50
' Plan Check Total .00 .00
..00.
.00.
- Grand Total 22.50 00
.00
22.50
LQPERN11T ...
_
Bi'
City of La Quinta
BLA&g 8z Safety Division
P.O. Box 1504, 78495 Cabe Twlpiw
fa Qtanra, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Perrrdt #
1�J
Project Address: LIS i �� 5
Owner's Name: Se>' (� '
A. P. Number.
Address: L Of
Legal Description:
City, ST, Zip: G I • ? vz6
Contractor
Address:
Telephone. `
Project Description: W
r
City, ST, Zip:
Telephone:7Z5-1f y
State Lic. # : City Lic. #;
Arch., Fir., Designer
Address:
City, ST, Zip:
Telephone:
h _
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alta Repair Demo
Name of Contact Person:F ,E
Sq. FL:
# Stories:
# Units:
Telephone # of Contact Person: ''t
�G
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG
PERMIT' FEES
Plan Sets
Plan Cheek submitted
Item
Amount
Stroetmll Calc&
Reviewed, ready for eorrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Cheek Balance
Title 24 Cala.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correetionslissue
Electrical
Subeontaceor I.ist
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.L
ILOA. Approval
Plans resubmitted
Grading
IN HOUSE:
'"` Review, ready for eorreetionsAssue
Developer Impact Fee
Planning Approval
Called Contact Person
A-U.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -IR
Project 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
wired
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
❑ 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.
W ATF.R RV ATiN(_ CVCTVM.S
✓
---
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑
Sealed Ducts all climate zones(Installer testing and certification and HERS rater field verificationrequired.)
Standby
Loss %
TXVs, readily accessible (climate zones 2 and 8-15 only)
0
Installer testing and certification and HERS Rater field verificationrequired.)
❑
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
❑
verification required.)
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
❑ 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.
W ATF.R RV ATiN(_ CVCTVM.S
✓
---
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Standby
Loss %
not allowed.
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
❑
Manual. No water heating calculations are required, and the system complies automatically.
5 v
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
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
❑
units
Cvctemc cervine cinele dlwellina units
-- - --- --- -- -- -
Water Heater
Type/Fuel Type
---
Distribution
Type
Number
in System
Rated
Input'
(kW or
Badhr)
Tank
Capacity
Ions
Energy
Factor' ori
Thermal
Efficiency
Standby
Loss %
Tank
External
Insulation
R -Value
b vu-,
5 v
Cvctom cprvine mnitinle dlwelline unit-.
Water Heater
Type
Distribution
Type
Number
in System
Input'
(kW or
Ba,/hr
Enemy
Tank Factor ori
Capacity Thermal
Ions Efficiency
Standby
Loss %
Tank
External
Insulation.
R -Value
1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Pipe Insulation (kitchen lines >! 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/4
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005