12-1083 (PLBG)P.O: BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
t
Application Number: <1 -00001083
Property Address: 7854.0--VIA—SONATA
APN: 646 -290 -013 -
Application description: PLUMBING
Property Zoning: -LOW DENSITY RESIDENTIAL
Application valuation: 902
BUILDING 8c SAFETY DEPARTMENT
`. BUILDING PERMIT
Applicant: Architect or Engineer:
• 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 and Professionals Code, and my'License is in full force and effect..
License CI s: C 0 C20 C3 cense No.: 811114
)
Date: ! ntractor:
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 -
constiuct, 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 Lavv (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 _ 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 LicenseLawdoes 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.). -
(= 1 I am exempt under Sec. , 8.&P.C. for this reason
Date: Owner: r -
f CONSTRUCTION LENDING AGENCY .�
I hereby affirm under penalty ofperjury'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 - r - . • _ -
i VOICE (760) 777-7012
FAX (760) 77777011
"-� INSPECTIONS 760 777-7153
` Date: 10/30/12
Owner:
PALMISANO RICHARD L
78540 VIA SONATA
LA QUINTA, CA 92253
(760)564-3129
-D a
2012
Contractor: 'UMTA
CALIFORNIA DELTA MECHNICAL . INC -CITY C NCE
DEPT.
6052 E. BASELINE RD, #155 I �IygCE
MESA, AZ "85206
(866)692-5273
LiC. No.: 811114
'r •WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have andwillmaintain"a certificate of consent 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.
V� 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
t' I certify that, in the performance of the work for which this permit is issued,,l shall not employ any
person in any manner so as to become subject to the workers' compensationlawsof California,
and. agree that, if I should become subject to the workers' compensation provisions of Section
3700 of th bor Cod` I -Shall forthwith comply with those provisions. _
ate:+(�,}S / _ pplicant:
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 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 certify that I have read this application and state that the above information is correct. I agree to complywith all
city and county -ordinances and state laws relating to building construction, and her authorize representatives
of this c �Ionterthe above-mentioned property fo pe tion c rposes.
re (Applicant or Agent):
Application,Number. 12-00001083
Permit PLUMBING
Additional desc
Permit Fee -22.50 Plan Check Fee
5.,63
'
Issue:.Date' Valuation
0
Expiration Date 4/28/13
•
;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 38 GALLON GAS WATER HEATER 2010
CODES.
---------------------------------------------------------------------------
Other Fees . . . . . BLDG STDS ADMIN (SB1473)•
1.00 r
Fee summary. Charged Paid Credited
Due
Permit Fee Total 22.5*0 00 .00•
22.50
{
Plan' Check Total 5.63 .00 .00`
Other Fee Total 1.00 .00 .00
1.00
Grand Total; .29.13 .00 .00
29.13
' LQPERMIT
SEP/20/2012/THU 03:39 PM DELTA MECHANICAL -NU
Prescriptive Certificate of Compliance: Residential CF-IR-ALT-DINY
Residential Alteraliom Page 1 of 2
Project Name: WO i S-0 nw Climate Zone:.]-ISPt rmit #:
General Information
Site Address: ti$5go ViOL Sona.
Enforcement A enc :. , tar bate:
Building Type: X Single Family 0 ultiFamily
I Project Type: ❑ Replacement or Chane Out of Water Heater
WATER HEATING -
List newly. installed water hearers and boilers for both domestic hot water heaters (DWH) and h dronic space heating. Newly installed
MH heaters and boilers must be as, propoane, or use the e.ristin • t I rn e.
water Heater Distribution Type Number in
T Fuel Type' (Standard'
YP� Yee z System
Recirculating)'
Tank
Capacity
I?nergy Factor or
Thermal Efficiency
H.itemal Tank
Insulation
R -Value
Gas dard -
3
d. o
enforcement a enc -for a royal with this building ermit application,
Name:
Sigaat
L
W
Company:
Lk I t ca f y
8a l.?
Address:
Licens : .
F �i neRD 415S
1. Indicate Type (Storage Gas, Heat'Ptunp, fnsnintaneotts, etc.)
2, Recirculaling systems serving nuthiple dwelling units shall meet the recirculation requiremenrs of §150(n).
requirernents do not allow the installation of a recirculating tater heating system for single dwelling units.
3. The ecternal water heating tank and pipesshall be insulated to meer the requirements -of §150('). '
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.
• I 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 on this Certifrcate.of Compliance
conform to the requirements of Title 24, Part I 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, plan and specifications submitted to the
enforcement a enc -for a royal with this building ermit application,
Name:
Sigaat
L
W
Company:
Lk I t ca f y
8a l.?
Address:
Licens : .
F �i neRD 415S
City/State/Zip:
Phone:
SEP/20/2012/THJ 03.39 PM
DELTA MECHANICAL -NV FAX No,702-369-9578 PA02
Lin
(tY ofLa QLIInta
Build/ng 8& Safety blvlslon
Permit #
P.O. Box 1504,78-495 Calle Tampico
La Qulnta, CA 92,253 • (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address;S 1
SO no..
Owner's Name;
t�
A P. Nunober
n0
Address: 18' 640 dia.
Legal Description:
City, ST, Zip:
Contractor: C"�o MIA
Telephone: (�• a
Address: W, 6 'Ap— ?-01. ��j j
Project Description: p
City;. ST, zip: ,1 Z
052a 6
3
67 ` .
.
Telephone: �?
State Lic. # : �� I I
City Lic,:
Arch., Eagr., Designer.
---------------------------
I
Address:
City., ST, Zip:
Telephone:
Comttuction Type: pccupavy:
State Lic. #:
Prudect type (circle one): New Add'ia AI :,epalr Demo
_
Name of Contact Personph r7
^r1'i 9 S
sq. Ft:
Stories.# Uaitr
Telephone of Coolant person 86 �J''6
�{ C. f
/3
Estfinated Value of Project: Of
APPLICANT: DO NOT WRITE BEl,6w THIS LINT
#
3ubnalttal
Req'd
ReC'd
TRACKING
PkR1l2IT i1 A1PS
-
Plan sets
Plan Check sbbmlttad
item
Amount
Structural Calcs:
Reviewed, ready for corrections
Plan Check bepoatt
Trues Calc9.
Called Contact Person
klaa Check Balance
Title 24 Cslrs.
Plans picked up
Construction
Flood ptatn'Pisa
Plans resobmttted
Keehanical
Grading plat
VI Review, ready for correctlons&sue
Electrical
SubcontactorLiat
Called Contact Person
Plumbing
Grant Deed
Plans picked up
g•hLL
H.O,A Approwl
Plans resubmitted
Grading
IN DOUSE
'"'Reylew,ready for mrrectlonshfisue
DeveloperImpaetFee
Planning Approval
Called ContactPerson
ALpP .
Pub. Wks. Apps
bate of permit Issue
school Fees