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11-0441 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: J1'-00000.441. Property Address: 48506 VIA ENCANTO ' APN: 646-091-049- Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 600 Applican/t, Architec or E ineer: --------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT _ Owner: VINES RAMONA 48506 VIA ENCANTO LA QUINTA,- CA 92253 ( 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.: 618140 +, DateL.J / / Contractor: OWNER- BUILDER DECLARATION ' 1 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, 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 r pursuant to the Contractors' State License Law.). - ( I I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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: ' LQPERi\1IT Contractor: CAMPESINOS UNIDOS, In P.O. BOX 39 BRAWLEY, CA 92227 (760)344-4500 Lic. No.: 618140 VOICE (760) 777-7012 FAX (760) 777-7011. INSPECTIONS (760) 777-7153 Date: 5/02/11 WORKER'S COMPENSATION DECLARATION 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 protlided 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 CYPRESS INS Policy Number 3330058264 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 sub'ect to the markers' compensation laws of California, and agree that, if I should4iecome subject to a workers' compensation provisions of Section ?7p0 of the Labor Code, I shall forthwith—,4121v with those provision SI -Y, lY�SI-Y,e Date:. Applicant:r+c/ 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 1$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 certif that I have read this application and state that the above information is correct. I agree to comply with all city c9ur>9,� prances and state laws relating to bu' cons coon, and hereby authorize representatives Of th ou -the ter upon the above-mentioned p erty for ins coon purposes. Date: Signature (Applicant or Agent) • Application Number . . . . 11-00000441 Permit r PLUMBING .. ' Additional desc '. .. Permit Fee 22..5.0,°, Plan Check"Fee .; 5:63' Issue Date Valuation - 0 .s. Expiration Date 10/29/11 , Qty Unt.Charge Per Extension ` BASE FEE 15.00 " 1.00_ 7.5000 EA PLB WATER. ,HEATER/VENT •. 7.,50_ Special Notes acid Comments GAS WATER HEATER CHANGE'OUT'40'GALLON.-. -- ---------=------------------------------ y Other Fees --------'--------------------------- BLDG STDS•ADMIN (SB1473) 1:00 Fee summary - Charged ------------ - ---- -- Paid Credited' -------------- Due t ---------- •---- Permit Fee Total 22.50. 00 .00 22.50 r Plan Check Total. 5.63' .00 .0,` 5.63 Other Fee Total 1.00 .00 '. 00 1.00 Grand Total • ' 29.13 .00 00' F 29.13 - - Prescriptive Certificate of Compliance: Residential CF-tR-ALT-DHW Residential Alterations Paget of , Pm'ect Name: R Climate Zone: Permit #: General Information _ Site Address: = SvE �i `o`. C.:�ec�r., Enforcement A enc.: Date: _ -J Buildin T in le Family ❑ Multi Family Project Type: ❑ Re lacert>tint or Change Oat of Water Heater WATER HEATING ' • I certify that this Certificate of Compliance documentation is accurate and complete. List newly installed switer heaters and boilers for both domestic hot water heaters (D WH) and 6vironic space heating. Newly installed DWH heaters and boilers must be gamus. p or use the e.►istin tel tY e. Water treater Distribtaion Type Number In Tank Favor (Standard. Energy Typelfvrt Type (StanPtecircuiar System . Capacity (Sal) Thermal Efficiency External Tank �yl�� . conform to the requirements of Title 24. Part l 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 other applicable compliance forms, worksheets, calculations. plans and specifications submitted to the enforccment enc for approval with this buddingpermit_ application. Name C�>J CCA, Signa Company: _ Date: I. Indicate Tvpe (Storage Gas. Heat Ptunp. Invantaneous. etc:) ; 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). requirrinents do not allow the insiallation of a recirculating water heating system for single dwelling units. 3. The a i7ernal Nater heating tank and pipes shall be insulated to nteet the requirements o 1 The Prescriptive Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate 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. • I certify that the energy features and performance specifications for the building design identified ora this Certificate of Compliance conform to the requirements of Title 24. Part l 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 other applicable compliance forms, worksheets, calculations. plans and specifications submitted to the enforccment enc for approval with this buddingpermit_ application. Name C�>J CCA, Signa Company: _ Date: ,4ddt,ess ,.;cense Ciry/Stato2i Phone: Bin # Qty Of La Quints Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012: Building Permit Application and Tracking Sheet Permit # — Project Address: DV i A CoNA- b Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: ZjA ZZ Contractor: w� hAu>::3<:<....; 'ei S V\- AziS Telephone: ( ,>>:>:• ;::;.::;f; i< Address: �? • C) , p Project Description: City, ST, Zip: rG w i G �122Z ` l I Telephone: U - L. �/ >(� �_' }.:•J::�?< Ct'i':: :i�:?`,iy ti:$::r j::;� V}`+:;:j:: �i ::r<fi<:�:.� .>.><><rz<,:�':••>:�::;:. •;:si:, v'.i fi}:�iiv} .i3:'i: ref: i?•. � L�,ta �2. v' �� . State Lic. City Lic. Arch., Engr., Designer: Address: .City,, ST, Zip: iii: i:i< p iii?:fiiii' ;•p; �f:.4:••• ..-.::.. Telephone: •>;�;::<:,; �:•.::;.:::s.<;> t moi.#:�?; <';,�::;.;::. ,:»? •.;;�,v.`:<:`i •'�,:.;.: •:.%J ;til.+:i�•:yn'•:}r!.•.v:'rCC ��i":.� ';,; fiYh;�:zy�??� 3;i$}44:•:.'4•{'; ;� i:iv;d^^ff11:yi,>..}:�iyY`� State Lic. #: .:?; �<: �::,;�• Name of Contact Person: 5- SC . Construction Type: Occupancy: Project type (circle one): New Add'r_ Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 7 G O " L-12 - Estimated Value of Project: Q d APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Constructioe. Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for corrections/issue Developer ILapact Fee Planning Approval Called Contact Person A.I.P.P. Pub..Wks. Appr Date of permit issue School Fees Total Permil Fees