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13-0245 (PLBG)P.O. BOX 1504 - 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: (13-00000245 Property Address: '47560 VIA MONTIGO APN: 643.-120-056-251 -26152 - Application description: PLUMBING Property Zoning- LOW DENSITY RESIDENTIAL< Application valuation: 1083 Applicant: Architect o Engineer. 4 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 arIcLerofessionals Code, and my License is in full force and effect. License CI ss: C10 C20 C3 ense No.: 811114 Date:. �3 Contractor OWNER -BUILDER DECLARATION - I 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-ofthe 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).: (_ 1 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 arenot 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' 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 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: Lender's Address: - LQPERMIT Owner: DEVELYN RICHARD 47560 VIA MONTEGO LA QUINTA, CA 92253 ( (; nntrartnr- ' CALIFORNIA DELTA MECHNICA 6056 E. BASELINE RD, #155 MESA, AZ 85206 (866)692-5273 Lia. No.: 811.114 Fro VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Dater 3/06/13 /u1 t> 0 a 2013 r r ur LA WUINTA FINANCE DEPT WORKER'S COMPENSATION DECLARATION - I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consentto 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 STATE FUND Policy Number 1697823-11 _ 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 Code, a I forthwith comply with those provisions. - Date: Applicant: - 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 ($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 Quima, 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. - 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 buildin construction, and hereby authorize representatives ; of this c nt to enter upon the above-mentioned propert specti n purposes. :Date: I� Signature(Applicantor Agent): - Application Number . . . . . 13-00000245 Permit. . . PLUMBING Additional,desc_- Permit Fee 22.50 Plah _Check'Fee .., V- .., " 5.63': �. Issue Date . . Valuation' . . . . 0 Expiration Date 9/02/13 Qty Unit Charge Per- Extension BASE FEE 15.00. 1.00 7.5000 EA PLB WATER HEATER/VENT' 7.50 ------------- - Special Notes and Comments _ REMOVE AND. REPLACE 50 GALLON GAS WATER HEATER CHANGE OUT IN CLOSET 2010 CODES. ----------------------------------------------------------------------- Other Fees .. . . . . ..: BLDG-SIDS 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 a;r, #Qty Of La Quinta Building tai Safety Division P.O. Box 1504, 78-495 Calle Tampico la.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # ,,11 II Project Address: Owner's Name: R e Address: h A. P, Number: Legal Description: City, ST, Zip: �� Contractor:�� 3 Tale hon"i r.. c p :' :�:>< :. Address: + SC Project Description: R City, ST, Zip: 95,20(P Telephone: p, 2 '7 t t � rS ' p � 'Ode 1 � y',<az z>:;��1�: � :;�o , � . ,r% >'s. ab -16A 00-bw hm,-6r inn State Lic. # : City Lic. #•: t Q Arch., Engr., Designer: Address: e City, ST, Zip: Telephone: State Lic. #: -::' ,M:K,. <• Construction Type: -Occupancy: New Ad j> Demo Project n Alter Name. of Contact Person: �® Sq. Ft.: # Stories: # Units: Telephone 4 of Contact Person: ' % Estimated Value of Project: r� APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACNTNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Clack Ralance, Title 14 C3 les. Pians picked up Construction Flood plain plan Plans resubmitted 'Mechaticat Grading plan V, Review, ready for corrections/issue Electrical Subcontactor List. Called Contact Person Plumbi eg Grant Deed Plans picked up S.M.L II.OA. Approval Pians resabmitted Gradin IN ROUSE:- '"' Review, ready for correctionsAssue Develo>>er Impact Fee Planning Approval Called Contact Person Ad.P.E. Pub. Wks. ApprDate of permit issue School Fees Total Permit Fees ` ! Prescriptive Certificate of,Com_ pliance: 'Residential CF-1R-AL't-DHW Residetlticll Alterations ,"; P:>ge I of , Project Name: Climate Zone: Permit K: r General Information - Site Address: 5 pAA,6Q O : Enforcement Agency: ' {r)L Uate: ta% 13 E3uildin d ' e: Single Family ❑ NfulfiRmilly Project Type: ❑ Replacement fir Chan eOut of Water Heater WATER HEATING • 1 certify thatthis Certitic;ue-of Compliance documentation is accurate and complete. List newly installed water heaters and. boilers fvr both domestic hot water treaters (MM) and hn'dror:ic space heating. Newly installed 1)u. H heaters and bniWy must be _bus, prapane, or use the existing idyl t^.: e. Water Heater_ Distribution'rype Number In Typulzuei'rype',' (Standuil, systein Recirculating)' Tank Energy Factor or - Csp3city 1331) Thermal Efficiency conform to- the requirements of Title 24. Part 1 and b of the California Code of Regulations. External rank' Insulation R -Value 51D Ila. glaaa. enforcemen(agency for approval with this building permit -application.' Name: Signature: jo%0,�O t l 4 n Company: Date: .13 :Wdress: - - License= �045(o E eine RD 155 glllly !. Indicate 'rope (Srorage Gets. Heat Ptrtnp, Instantaneous, etc.) 2. Recirculating systems serving midltiple dwelling units shall meet the recirculation requireineirts .of $I•.i0(n). - requirements do not allow the installation o/ a recirculating water heating system for single dwelling snits. „ 3. The external water heating tank and pipes shall be insulated to meet the re uirenrents o .;$1.50('). Fite Prescriptive Contractor or Homeowner (Documentation Author's/Responsible Building Designer's Declaration Statement) • 1 certify thatthis Certitic;ue-of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the California -Business and Professions Code to accept resx)nsibility for 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. Part 1 and b of the California Code of Regulations. • The building design Features'identified on this Certificate of Compliance are consistent with the inbrmation provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans acid specifications submitted to the enforcemen(agency for approval with this building permit -application.' Name: Signature: jo%0,�O t l 4 n Company: Date: .13 :Wdress: - - License= �045(o E eine RD 155 glllly CityistatelLip: ' Phone: Mese- z 83a0c" r 8(a9-(9137 53-73 rx+ 213c0