10-1331 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA. QUINTA, CALIFORNIA 92253
BUILDING &-SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
REIL PAUL E
79-378 CALLE VISTA VERDE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) .777-7153 .
Date:12/07/10
4
r`U
Contractor: U
Applicant: Architect or Engineer: CALIFORNIA DELTA MECHNICAL INC
6052 E. BASELINE RD, #155 j O
MESA, AZ 85206
r, IA (866) 692-5273
/,f LiC. No.: 811114
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
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 Wc1or:
36 Li ense Nd.: 811114 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
i issued:
/ate: �, 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
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 become 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 _ 700 of the abor Code, I sh orthwi comply -with those provisions.
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: /O pplicant:
(_) 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
(_) I, as owner of the property, am exclusively contracting 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
Date: Owner:
'CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that thereis a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: A
Lender's Address: 1 '
LQPERMIT
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 {o 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 is W
he'above-mentioned property f / specti n purposes.
Date:e (Applicant or Agent): �l
Application Number:
x__10-.00001331 -
^CALLE
Property Address:
79378 VISTA VERDE
APN:
604-392-034-75 -25953 -
Application description:
PLUMBING
= Property Zoning:-
LOW DENSITY RESIDENTIAL
Application valuation:
.940 '
BUILDING &-SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
REIL PAUL E
79-378 CALLE VISTA VERDE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) .777-7153 .
Date:12/07/10
4
r`U
Contractor: U
Applicant: Architect or Engineer: CALIFORNIA DELTA MECHNICAL INC
6052 E. BASELINE RD, #155 j O
MESA, AZ 85206
r, IA (866) 692-5273
/,f LiC. No.: 811114
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
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 Wc1or:
36 Li ense Nd.: 811114 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
i issued:
/ate: �, 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
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 become 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 _ 700 of the abor Code, I sh orthwi comply -with those provisions.
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: /O pplicant:
(_) 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
(_) I, as owner of the property, am exclusively contracting 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
Date: Owner:
'CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that thereis a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: A
Lender's Address: 1 '
LQPERMIT
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 {o 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 is W
he'above-mentioned property f / specti n purposes.
Date:e (Applicant or Agent): �l
Application Number .
. . . . 10-00001331
Permit
PLUMBING
Additional desc
Permit Fee . . .
22.50 Plan Check
Fee
5.63
Issue Date
Valuation
0
Expiration Date
6/05/11
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. 2007
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 -
Dec, 1. 2010 10:38AM DELTA MECHANICAL
rres
211ve Uertificate of Compliance: Residential Water Aeati;s
General Information
Site Address: 3
.NOTE. This form is o,
Climate Zone:
Date:
No. 4015 P. 1
CF-1R--ALT-WH
WATER MATING
List water heaters and boilers for both domestic hot water (DH1) heaters and hydronic space heatoq Inm4dual dwelling DHW
heaters must be gas or propane fired and may not exceed 50 gallons. Hot water a insalatton
kitchens and on all rrrn p Prem ue DFIW heater to the
� dergrowad hot water i es it re fired in all corrrponem aclmges In all climate zonas..
W.afsr Heater T / Bnergy Factor or
YPe Distribution I rpe Number of Tank Capacity Thermal &tamal Tank
FuG1 e' S`tndat� em Efficiency ation R -Vales
a I 1 stendarrJ 1% - q f01 (3. Z ZO
I. Lwycdw ype (5rorage Gem, Bee Pump, Inetantarteoua etc)
2. Reciratla ft eywtenas serving mulnpla dwellLtg writs sha11 meet tha recbmid5don requbmaer& 150(n).
wthe irtstall�ion ofa recirettlatintrwrier heggm,� (or rte of ���'g reaah�mments de
3. The watBr heating [tank and fr w shall be *UlaW to meet tha requDvmerts of150G).
Contractor (Documentation Author's /Responsible A is beclaration Statement
• I certify that this Certific9c of Compliance doeuncntation is 0mrate and complete.
• I am cligible Under Division 3 of the California Duainess and Professions Code to accept responsibility for the bu1ildi ag design identified on
this Certificate of Comphawc.
• I certify that the energy featnw and performance spectiiestions for the building design ideutEfied on this Certificate oitiCompliaaoe conform
to the fie Oremeats of itie 24, Farw I and 6 of the CUMmia Code of Regulations.
• The bWldfug design feaiulm ideatifim on this Cler0cate of Campimcc are consistent with the infarmatiaa provided to document this
building design on the other applicable compliance forms, wodtasbeeta, oelcnlatiom, plans and specifications submitted to the enforce rant
agency for STE131 with7dw buildm ucation.
Name MAI�� sigaatore �_
�
CaR�a.V'Califnrnia Deb Mech ici
A&11=6056 E. Basellne Rd., #155
C"YM" 'Mese, AZ 85205
I''c`II�'811114
Phone.866-692-5273
7008 Residential Compliance Forms tyfarcii 2010
Dec. 7. 20.10 10:37AM DELTA MECHANICAL
No, 40.15 P. 6
Bin #
City of La Quinta
Btffeing SE Safety Dfvtsfon -
Pem4t #
P.A. Box 1504, 78-495 Caffe Tampico
�1
O ,\�
La Qt6nta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address; r7 Gt %$
Owncr's Name: rod X:e—fl
P. Number.
Address: / 93 75
Legal Description:
City, ST, 75p: Z4
Contractor. ca'�
Telaphoae. I/d � %
Address: 6D
ISj
ProjcctD�stxiptian:
City, ST, lip: Z ?5ZO A,
SD a. - as .
Telcpbone:
State Lia 0:
City Lia 01 /0
Arch., Eng.. Designer.
Address:
City, ST, Zip:
Telephone:
Cotlamlatioa Type: Occapansy:
State Lia #:
Project We (circle one): New Add'n :'Opsin Dcmo
Name of Contact P=
j 1 lr%
sq. Ft.: 3tcsiev: # Unitsr
Telephone # of contact Parson: 86 6--' 07
�y
M=1ted Value of Project:
APFUCANT! DO NOT WRITE BELOW THIS LAVE
N
8abmdttal
Req'd
Recd
TRAC NG
9'kT>=FEES
Plan Seta
Pian Check submitted
Item
Amount
Stmatnral CsleL
Revlewe� readyfar corrections
Plan CheekDeposit
'Dass Coles.
Called Contact Person
Plan CheckBelance
Title 24 Cabs.
Plans picked up
CoMRtr=doa
Flood plain plan
Plans renbmttted
Mechanical
Gmdtng plan
2' Review, ready for corrections/issue
Electrical
SubcontnetnrList
Called Contact Person
Plumbing
Grant Deed
Plans pfeked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE:-
'"' Rgvicw, ready for correctionAlimc
Developer Impact1?aa
Piaawng Approval
Called Contact person
A.U.P.
Pub, Wks. Appr
bate of permit issue
School Fees
Total Parmlt Fees
E