09-0927 (PLBG)P.O. BOX 1504 .
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09-0000092:7,-
Property Address:
78705 ' VIA SONATA
APN:-.
646 -050 -001 -
Application description:
PLUMBING
_ Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
757
Applicant:
Architect or Engineer:
0(A -
VOICE (760) 777-7012
4 4 Q"
FAX (760) 777-7011.
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 77777153
BUILDING PERMIT
Date: 9/01/09
Owner:
HODGE ROBERT
78705 VIA SONATA
LA QUINTA, CA 92253'
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.
Licen Class: B -C10 -C36 License No.: 811114
ate: �✓ A�ontractor. E~T/' 0-4�10'~
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 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 ($5001.:
(_ 1 1, 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 thathe 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
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , BAP.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
Contractor:
CALIFORNIA DELTA
6052 E. BASELINE
MESA, AZ 85206-
(480)898-0007
Lic. No.: 811114
------------- ----------------------- - -
�---
WORKER'S COMPENSATION DECLARATION
I 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 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
1'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
37,00 ot;thp Labor Code, I/s/hall fro/rthwith comply/mowith
�those
/provisions.
Date:!v PP pplicant: [�Er T�, ✓ .e+T(�~
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 comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of ttljier co
tt to/enntter upon th above-mentioned property for i spection purpose�� ,�
D� ate:""/ "�/vim nature (Applicant or Agent): ��N��� '✓//) !7,"
Application Number
. . . 09-00000927
Paid
Permit . . .
PLUMBING
--=------------:--'
Permit Fee Total
22.50
Additional desc .
----------------------
.00
22.50
Plan Check Total
Permit Fee
22.50
Plan Check Fee ".
5.63
Issue Date
1.00
Valuation
0
Expiration Date
• 2/28/10
29:13
.00
Qty Unit Charge
Per
-
Extension
BASE FEE
15.00
1.00 7:5000
EA, PLB WATER
HEATER/VENT
7.50
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
Orand.Total
29:13
.00
- .00
29.13
- LQPERMIT
Sep. 1, 2009 3:13PM STEVE No', 3615 P. 5
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -IR
1TSq C>-5-
Project Title Date
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF4R Form must be provided to the building department for each home for which the following. are
required.
UK
13Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features
Project Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
O sealed as confirmed through field verification and "diagnostic testing in accordance with procedures in the `
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section I50 m and duct insulation requirements of Package D.
rrt� AMM 13 IL L iul V 31 M ]P MIN
Distribution Number
Type in System
Cl
Sealed Ducts all climate zones installer testink and certification and HERS rater field verification required.)
13
TXVs; readily accessible (climate zones 2 and 8-15 only)
Installer testing and certification and HERS Rater field verification required.)
❑
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
UK
13Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features
Project Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
O sealed as confirmed through field verification and "diagnostic testing in accordance with procedures in the `
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section I50 m and duct insulation requirements of Package D.
rrt� AMM 13 IL L iul V 31 M ]P MIN
Systems serving simile dwelling units
Water Heater
Type/Fuel Type
Distribution Number
Type in System
Rated
Input'
(kw or
Whr)
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Tank
External
Insulation
R -Value
not allowed.
❑ .
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
tAQ
Manual. No water heating calculations are required, and the system complies automatic all .
Check box if system does not meet criteria of"Standard" system, and does not comply with the Preapproved
U
'Alternative Water Heating table. In this case, the Performance .Method must be used and must be included in the
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump for a system. serving multiple
units
Systems serving simile dwelling units
Water Heater
Type/Fuel Type
Distribution Number
Type in System
Rated
Input'
(kw or
Whr)
Tank
Capacity
(gallons)
Energy
Factor' or
Thermal
Efficiency
Standby
Loss %
Tank
External
Insulation
R -Value
10
tAQ
System serving multiple dwelling units
Rated
Input,
Water Heater Distribution Number (kw or
Type Type. ins stem nm/hr)
Tank
Capacity
(plions
Enerp�y Tank
Factor orExternal
Thermal Standby' Insulation
Efficiency Loss % R -Value
1.. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Pipe Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are'/a
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005
Sep, 1. 2009 3:12PM STEVE
Bin #
a' �
POM* #
Project Al*v= rl
ruS
A. P. Number.
3;
cilly. ST. zip: t4T-,—% A 1
Telephonej.�kpjo,
State Lie,
Arch., Eng., Desiper
Address:
City, ST, Zip:
Telephone:
Slate Lic, #:
Name of Coma Pam:
Telephone # of Contact person:
N Submittal Re
P122 Seta
Structural Calc&
Truss Cales.
Mile 24 CalcL
Flood plain plan
Grading plan
Subcontactor Llit
Grant Dead
HAA. Approval
Plaanlog Approval
Pub. V4j. Appr
School Fen
No, 3615 �P- 2
City of La Quints
Building 8t Safety Dwo"
P.O Box 1504, 78-495 Calle Tampico
L2 Qdnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
;a�q,a e5t.&, Owner's Name.
Addm& r)S952S Sh,^, !QQt144Q_7rA
city, sT, zip-. L^ C -A 51 .
=T:A-
Telephone
Proj d Description:
Construction Type:
Occupancy:
Project type (circle one):- New Add'n Alter Repair Demo
Sq. PL: # Stories # Units:
Esthnatod value of Project 16-n
APPLICANT: DO NOT wRrm BELOW THIS LINE
Reed TRACXNG
PEPO= FUS
Plan Check submitted
Item Amount
Reviewed, ready for corrections
Plan Cbeck Deposit
Called Contact Person
PlaucheckBiduce
Mus picked up
—f?t,,s
Construction
resubmitted
Mechanical
V Review, ready for correctionsftwe
Electrical
Called Contact Pmou
Plumbing
Plan picked up
S.M.I.
Plans renbmitted
Grading
Rgvitw, ready for torrecdonirmat
Developer Impact J?c*
Called Contact Perron
A.I.P.P.
Date of permit lame
Total Permit I?ea L