13-0180 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING 8c SAFETY DEPARTMENT
-=� BUILDING PERMIT
Application Number._' 13-00000180,E
Property Address: 47560 VIA MONTIGO
APN:. 643-120-056=251 -26152
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: '1083
i
Applicant: Architect or Engin en
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153 .
Date: 2/19/13 `
Owner:
DEVELYN RICHARD
47560 VIA MONTIGO
LA QUINTA, CA 92253
CU11UUVLU1:
CALIFORNIA DELTA MECHNICAL INC
6056 E. BASELINE RD, #155
MESA, AZ 85206.
(866)692-5273
Lic. No.: 811114 `
LQPERMIT
--
----�iATAHCE
LICENSED CONTRACTOR'S DECLARATION "
WORKER'S COMPENSATION DECLARAT �iM
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 Cla s:.C10 C20 C3 License No.: 811114 -
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
q _
'0 f� 3Contractor.
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the. Contractor's State License Law for the
Carrier STATE FUND Policy Number 1697823-11
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 ecome 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 tal -forthwith comply with those, provlslons.
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).:
-
�- -,/
- - Date: J Applicant:
(_) 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 -
WARNING: FAILURE TO SECURE WORKERS'. COMPENSATION COVERAGE 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 himself 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 contractirig 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 contracts for the projects with a contractor(s) licensed
- 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State .License Law.). -
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I,am exempt under Sec. , B.&P.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 that there 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.).
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
•
.of this cou ty t enter upon the above-mentioned property ispecti n purposes.
Lender's Name:
Signature (Applicant Agent):
Lender's Address:
.Date: or. .
LQPERMIT
Application Number
. . 13-00000180
Permit
PLUMBING
Additional d'esc .
,Permit Fee.
22.50
Plan Check Fee:.
5.63
Issue Date . .
Valuation
0
Expiration Date ..
8/18/13
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 50 GALLON GAS
WATER HEATER IN
CLOSET 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
LQPERMIT -
FEB/14/2013/THU 11:52 AM DELTA MECHANICAL—NU
FAX No.702-369-957$
Bin #Qty. Of La QuInt'a
Biugdlltg tat Safety I)Won
Permit # P.O. Box 1 SO4, 76-49S Cage Tampico
U.Qulnta, CA 92253 • (760) 777-7012
Building Permit Application, and Trackin, Sheet
Project Address: 1�'Igltp Owner's Nszltm: .
A. P. Number Address 4-6w Vi Mtfcko
Legal Des tion: City, ST, Zip: LnLL CA.9 aas�
Contractor.
Address= W& 1E Projeotbeacription:
City, 3T, Zip: a�B
Telcpha= QQ 11 . .2 7 3
State Lic. fl : pl I I l City Lic }E;
Arch_ Engn, Designer.
Address:
City, ST, Zip:
P. 002
Te[ephoae.
State Lia i{:
Construction Type: •� Occupancy:
Project type (putts one): Near A-Wn Alter <ELZ>Detno
Sq.. Ft.: g Stories: # Pints:
1 Fstbutated value of Projeet 13
Name of Contact Person: Q n
Teleplmne # of Contact person: 52,7 5
APPLICANT: DO NOT WnfPE BELOW THIS LINE
0
Submittal
RrWd
Reed
ItACfiIPICr
PERMIT I ES
Play Sets
Plan Check submitted.
Jt® Amount
Structural Cales.
Reviewed, ready for ftorrecdons
Pian Check Deposit
Truss Calm
Called Contact Person
Klan C beck Balance
It Bic 24 Calces
Plans pieked up
Canstnclion
Flood plain plan
Plana resubmitted
Mec[1a11eal
Giading plats
Z"! Review, ready for correctimstinue
Elccb*al
Subcontactor Ud
Called ContactPerson
Plumbing
Graaf Deed
Plans picked up
S MJ
ILOA— Approval
Plans resubmitted
Cradmg
IN DOUSE:-
"`Reaiew, ready for corrcetionsrissae
pevel aper impaetFee
Planning Approval.
Called Contaetperson
&U.P.
Pub. Wks. Appr
Date of pertolt issue
School Fees
Total Permit Fees
J]')
FEB/14/21013/THU 11;:53 AM DELTA MECHANICAL—NV FRY No, 702-369-9578
General InFormation
Site Address: p Enforcement A enc ti D'aie: la hJ
BuildingT e: Sin le Family❑ Neu t FamilyProject Type: ❑ Replacement or Change Out of Water Heater
WATER HEATING {
a I certify that this Certificate of Compliance: documentation is accurate and complete.
List newly installed water hearers and boilers for built domestic hot seater hearers (DtVH) and hrdronic space /fearing.
DWH hearers and boilers must be as, propan or use dee e.risrin net t e.
Newly installed
Water Heater. Oistribulion Type
Type/Fuel Type' titin(Stant[tin t
Rrcin;ulatin)
Number In Tank
System Capacity (gal)
Energy Factor or.
nermal Efficiency
E.eternal Tank
Insulation
R-Valud
CAS 51D
116- TO
Signature:
L
----(('' SCO
JA SCOP O
Company:
Data:
Adams:
t icensc
fiasco E c RD I55
Blllly r
CitytstatdZip:
Phone: r
MesaAl �S�ao�
1. Indicate Type (Storage Gas, Heal Ptrn�p. Instantaneous. etc.)
Z. Recirculating systems serving multiple dwelling units shall meet the recirculation. requirernenty of 1150(x).
regrriretnents do ito� allow rhe installation of a recitr:dating water hearing .ryslem for single dwelling ru�irs.
3: The external water heating tank and i es shall be insulated to meet the re rrirernents o ISO(' .
Vie "Prescriptive
•
Contractor or Homeowner• (Documentation.Author'st'Responsible Building Designer's Declaration Statement)
a I certify that this Certificate of Compliance: documentation is accurate and complete.
• I aRn eligible under Division.`3 of the Califomia• Business and Professions Code to accept responsibility ror, the building design
identified on.this Certificate 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 Title 24• pent I and 6 of the California Code of Regulations.
. The building design features identified on this Certificate of Compliance art consistent with the information provided_ to document this
building design on the other applicable compliance forms_,, worksheets, calculations, plans and pecifications submitted to the
enforcement agency fora roval with this buildingermit application.
Name:
Signature:
L
----(('' SCO
JA SCOP O
Company:
Data:
Adams:
t icensc
fiasco E c RD I55
Blllly r
CitytstatdZip:
Phone: r
MesaAl �S�ao�
8 -(412- 5233 Ex•4 23(0