11-0949 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-=00000949
Property Address: 47875 VIA-JARDIN
APN: 643-1'30-035-35 -26152 -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 750
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
B. WELCH
47875 VIA JARDIN
LA QUINTA, CA •92253
LICENSED CONTRACTOR'S DECLARATION
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
rs
tract
o . -
OWNER:BUILDER DECLARATION
hereby affirm under penalty ofperjurythat 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, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' Slate 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' StateLicenseLaw.).
1 _ 1 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 ISec. 3097, Civ. C.). '
Lender's Name:
.'Lender's Address:.
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/01/11
0
Ssp 012011
LA
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate ofconsent 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
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
3700 of the Labor de, I shall forthwith comply with those provisions.
t/
'/ Ap - an
WARNING: FAILURE TO SECURE ORKERS' 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 forthonthis 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 LaQuinta, its officers, agents and employees forany 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 building construction, and hereby authorize representatives.
of thiscountyto enter upon the above-mentioned pr rty for inspection purposes.
pare: `- It • S' ature (Applicant or Age
Contractor:
Applicant: Architect or Engineer.
ALVAREZ, JORGE A.
P.O. BOX 984
THERMAL, CA 92274
IIUI
(760)777-3613.
It'
Lic. No.: 880103
I`JI
P"'
LICENSED CONTRACTOR'S DECLARATION
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
rs
tract
o . -
OWNER:BUILDER DECLARATION
hereby affirm under penalty ofperjurythat 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, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' Slate 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' StateLicenseLaw.).
1 _ 1 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 ISec. 3097, Civ. C.). '
Lender's Name:
.'Lender's Address:.
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/01/11
0
Ssp 012011
LA
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate ofconsent 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
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
3700 of the Labor de, I shall forthwith comply with those provisions.
t/
'/ Ap - an
WARNING: FAILURE TO SECURE ORKERS' 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 forthonthis 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 LaQuinta, its officers, agents and employees forany 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 building construction, and hereby authorize representatives.
of thiscountyto enter upon the above-mentioned pr rty for inspection purposes.
pare: `- It • S' ature (Applicant or Age
Application Number
11-00000949
-
Permit
PLUMBING.;
Additional desc .
Permit Fee`
22.50 Plan Check
Fee
5.63
Issue Date
Valuation
0
Expiration Date
2/28/12
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 40 GALLON GAS
WATER HEATER.,2010
CODES.
---------------------------------------------------------------------------
- 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 ,1
. LQPERMIT
.. ' .
Prescriptive Certificate of Compliance: Residential CF;1R-ALT.DR
Residential Aftirittiohs' J; , fA, Page I of 2
P e: a 5RAC_k Climate Zone: I Permit #:
J.
General Information
Siti Address: "V5- 3OLQA;E_
=__Enforciment Agens y: Date. -
B uildin'T le: ingle Family 0 Multi. Family_
I Project Type: O,Repla66meftt or Chan gi_Out of WiitefHeater.
WATER HEATING -
List nevviv installed tvater heaters, and boilers for both doinestic hot svdter,,healersj(DWH) and hydronic' Apace Ieatm, Newlyinstalledt
DWH- heaters and boilers must be as, propane, or use the existing fit I type.
witer He'afer
Distribution Type
Number.ln Tank' A�-, rj I - Epergy F�aqqr 9!,
External Tank
lniulati6n
Type/Fuel Type' - "'
(5wndanl.
--:7-Recirculatinge
system "Capacity (gal) Theirmal Efficiency
,$ignatuTe;
J_C Uk .7.
Company:
Date:
N
Address-
-
Lieen]serr
City/StatdZip:
Phone:
7(oo-7?7-,3(P1_3
4. --indicate Tvpe (Stordge'Gas, Heat Piano, Instantaneous. etc.)
2. systems ling sysms -serving-multiple- dwelling units'sliall',pneit the;:-recirridalidn requirements .6f -P rescr�iplive
-water
L. do notw1low the installation of a recirculating heating systenifor single' dwelling tmits.,*
requirements
g tank and pipes s4�
1-77re,external uuter. heatin4116e insulated to meet the re4uirelnentslof § 15 0u).
T
Contractor; or Homeowner (134kumentation Author?s/Risonsible ffiiilding Designer's DMiration Stat4'inint):--
lete.
O"i certify that this Ceiritificate of Compliance documentation is accurate and'CoMpr
' and F�;iess-.? eWthe building' design
_A I .am. eligible under Division 3 of the California Business ions Code'to accept responsibility'
i, H identified on this.Certificate of Compliance.
16i the building design identified on this' C ertificate of Compliance
1. certify. that- the energy features and performance specifications ;
.conform to the requirementsitle 24, Part land 6 of r the California Code of Regulations.,.-.
The building gn-,Te'atures identified on this Certificate of;Compliance -_*if-Corripance are consistent with' the information provided to document this
I - .
biiildingdesign-on the -other applicable -compliance' forms, worksheets, calculations. plans and specifications submittid. to the
,enforcement agency for approval with this building permit appli tion.
Name-
,$ignatuTe;
J_C Uk .7.
Company:
Date:
N
Address-
-
Lieen]serr
City/StatdZip:
Phone:
7(oo-7?7-,3(P1_3
- 4
GA nr;lgn in
1. Per Section 1500) of the 2ous tnergy tmciency oianuiuus.
QAnril 2010
2009 Appliance Efficiency Regulations for Slinall Water Heaters,
Small Water Heater Is defined as:
Type
Input
Gas Storage
75,000 Btu/hr or less
Oil Storage
106,000 Btu/hr or less
Electric Storage
12 RW or less
Gas Instant
200,000 Btu/hr or less
Oil Instant
210,000 Btu/hr or less
Electric Instant
12 kW or less
Heat Pump
24 amps or less
1. Per Section 1500) of the 2ous tnergy tmciency oianuiuus.
QAnril 2010
If rated Energy Factor does not EXCEED minimum
Federal Minimum
Values Below, an External Insulating Blanket (R-12,
Ener -Factor
minimum) shall be Installed'
Water Heater Fuel type
Effective Jan 20 2004
30 Gallon..
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
0.62 - (0.0019 x V)
0.563
0.544
0.525
heaters
Electric instantaneous water
heaters (excluding tabletop
0.93 - (0.00132 x V)
0.890
0.877
0.864
water heaters
Heat um water heaters
0.93 - 0.00132 x
0.890
0.877
0.864
V = rated volume in gallons
1. Per Section 1500) of the 2ous tnergy tmciency oianuiuus.
QAnril 2010
Bin #
Qty of La Quinta
Building 8L Safety Division r
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: ��
Owner's Name:U e-(c-.k
A. P. Number:
Address: 1_47R.1-77 \ I t1 k-
Legal Description:
City, ST, Zip: q. -L7
Contractor: '(J�LCM (/3 r CI
Telephone: <<:<'> <:'z<:>?•.`<:'s
Address: C LF-
Project Description:
City, ST, Zip ci 22.7 y
GC e74 0 Q CvA s Cs�P
Telephone: I &o_9 I
.?�<>>€�:<;:.,<::«::<::<:;.;:.;:.;>;;.;:•;::�:.«>:•«;>:
State Lic. # City Lie. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
-
Telephone:
2i2:i°
:...
ii'v`L::%:ii':::�:
Construction Type: Jccupancy:
.. -
State Lie. #:
Project type (circle one): New Adc'n Alter Repair Demo
Name of Contact Person:Sq.
Ft. i
#'Stories:
#Units:
Telephone# of Contact Person: — -
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
4
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
Construct®n
'Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' 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 impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue "
School Fees
Total Permit Fees
X_ .