13-0468 (PLBG)4.4 P.O. BOX 1504; VOICE (760) 777-7012
78-495 CALLE•TAMPICO FAX (760) 777-7011
LA•QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT, INSPECTIONS (760) 777-7153
BUILDING PERMIT'
Date: 4/16/13
Application Number: 13-00000468 Owner: -
Property Address: 50021 AVENIDA VISTA BONITA . LUPO SAM J <
APN:. 658-260-060-126 -14496 - 50021 AVENIDA VISTA BONITA
Application description: PLUMBING LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (831) 234-5638
Application valuation: 1200 "
Contractor: y
Applicant: Architect or Engj er: CALIFORNIA DELTA MECHNICAL
6056 E. BASELINE RD, #155
U MESA, AZ 85206
(866)692-5273
f - , LiC. No.: 811114
t
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.
LicenseGlas/s/ C10 C20 C3 Licen eNo.: SI1114
Date; l!p 3Contractor:
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 thathe 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 ($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 t-
47' 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, 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 contractors) 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.). i
Lender's Name:
Lender's Address:
LQPERMIT
WORKER'S COMPENSATION DECLARATION h + :
hereby affirm under penalty of perjury one of the following declarations:.
f
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 1697823-11
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, all forth 't mpl�with those provisions.
Date: l (O 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 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.-
APPLICANT
EES.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 Ouinta, 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
ofthis cou ty to nter upon the above-mentioned property for i e tion purposes. - -
Date: I I� Signature (Applicant or Agent):
Application Number ..
. . . ..
13-00000468
Permit
PLUMBING
,,:;;•. Additional desc .
Permit Fee
22.50
Plan Check'Fee
-5:63
Issue Date
Valuation
0 ;
Expiration Date
10'/13/13
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 40•GALLON GAS
WATER HEATER..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
Preseri ptive Certificate of Cont liance: Residential Water Fteatim� CF-I-R=ALT-WFI ta,
General Information _
Site Address: ViClimate "Lone: Date:
NOTE: This form is only useil for alteration or aeldition of roarer healing systems.
WA,rEk HEATING:
List waiel`heifiers and bciilenv for both doniestic hot water (HR) heaters and htxh-onic space heating. Individual thwelling DI -IR'
heaters ntiist be gas (.')j-pi-olmriet fired, and Witty not cxceet/ .ill gallons. I -lint water pipe insulation front the DRIP heatei-.Io the
kitc-hen(s) and on till undeq round hot water pipes is required in all component packages'in till climate --ones.
• 1 certify that the energy features and pertbrmancc specifications tial- the building design identified on this Certificate of Compliance conform
to the requirements of Title 24, Pares I and 6 ofthe California Code of Regulations.
• The building design features identified on this Certificate of Complianceare consistent with the infonnation prodded to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and.specificatio s submitted to the
Energy Factor or
Name:
Water Tvt
Yst •ih I •o vn •
Numher of
Companv:
Thermal
Delta Mechanical Inc
Fuel Type1
(Standard)�
System
606 E Baseline Rd # 155
EfFiciencv
Insulation R-Value3
GAs
SIM
o. a
1. Indicate Type (Storage Gas. lledt Pwnp; lnsiantaneous.'eic.) .
2. Recirctileuiu; susieors -servii;q multiple thi•elling units shall meet th0 recirculation requirements nJ' 150(nj. The Prescriptive requirements tlo not
—
allow the installation Of recirculatin;? ivater heating .system for sin,le dwellinc units.
..�........q ....,r...,... ti.t,�., ::..u.. �•c rrr..u.urx:.r ni urccr uw r caul-. cnrcm.i. vj r.ivll/•
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and cotitplete:
• I am cli_ible under Division 3 cif the California Business and Professions Code to accept respon ibility for the building design iduitified on
` this Certificate of Compliance'
• 1 certify that the energy features and pertbrmancc specifications tial- the building design identified on this Certificate of Compliance conform
to the requirements of Title 24, Pares I and 6 ofthe California Code of Regulations.
• The building design features identified on this Certificate of Complianceare consistent with the infonnation prodded to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and.specificatio s submitted to the
enforcement ar,encv for a inroval with this buildin: oennit anolication.
Name:
Si,naiurc:
John Santoz 1
V F
Companv:
Date:
y �/3.
Delta Mechanical Inc
Address:
License: 811114
606 E Baseline Rd # 155
City.'Stare/Zip:
Phoiie.866-692---)273
I XV AT I., P I t F kT I N C., ti V S * 1, VX 11;, -
N"otv 1: Forsinall ,-us storaae.0-tiled ilipill less (Imll or ?qwd io 75.000 BtuAfir). electric resistance cmd'hectpump m-ater heaters. lisi.
Ener ,V Factor (EF). For targe gas storage ivaler heaters ((cried input o ., areater, than .75.000 6nahrj. list Recove-r: Ejficiencv (RF).
TIlermal E 0
.51andhy /-ass and Rmed hiputi. For instwitime us ous (vater heaters. list the 7-hermed.Elficienev and Rated hipitt.
2. Mandatory Meast'ires
TO CONIPLY ALL 13OXES NIUSI BE CHECKED
D § 110-§ 113: Water heaters. showerhead and faucets are certified bv the Califoriiia Enerav Unimission.
§ 1500): Water Systdii Pipe and Tank 111SUlatiOn. And Cooling, Line Insulation
I. Storage tank insulation
D A. Storaae Baas water heaters rated with an Ener_v Factor no greater than the federal minimal standard are
externally wrapped with insulation having in inst.illed thermal resistance of, R- 12) )r erreatcr: and
B. Unfired storaLe tanks Or other indirect hot water tanks have R-12 external 111SAition or R-16 internal
illAllatiOii where the internal -Insulation R -value is indicaled on the exterior of tIle.:,,iiik-.
2. grater piping. and cooling systern line insulation thickness and conductivity
First 5 feet -of hot and cold water pipes closest to water heater tank, non-recircidating, systerns. and en ire
length of recirculating section.; of hot water pipes are iIISUIaLed per Standards TaDle I 50-Band
Pipe inAllation for stea.iii liv-dronic lieatinL, syst'ems or hot water svitems > 15 psi meetsthe reqUirenlentS Of
Standards Table I 213-A.
Insulation Is protected From daniage. inCILKII]ILI that Clue tO S1.1111h.1.11C. I 110imUre. e(U-Iiptllellt maintenance, kind
\vind.
D �151(1)81D: lCindicated on the CF -IR. all liw water pipi nu that runs frons i lie hot \vawr SO.WC,- to the kitchen fixtures is
irtstllaleii p-rStannard s -Fable 156-13.
.41i""Itsi '009
-D im ri but il in i
CEC p
uF
Ratcd
Input (kw
tank i
-standl)v
I lemer
l CCnifict-IN-1 frName &M, 00 i 1 ..si'L Point -of- Rcvir�:uhiiori.
ItIvniieA
BIL:hr.
unic i
Efficiencv
L. i i,.'i
[".--PC
U.'ie, etc) Control 1, �r PC
. . ..... .... ....
svmcms
loh��!
I`F. RL)
.,01
4
G
56 qor)*A"TX K StaMard .0
NIA
0,i
0 1
� !
t
N"otv 1: Forsinall ,-us storaae.0-tiled ilipill less (Imll or ?qwd io 75.000 BtuAfir). electric resistance cmd'hectpump m-ater heaters. lisi.
Ener ,V Factor (EF). For targe gas storage ivaler heaters ((cried input o ., areater, than .75.000 6nahrj. list Recove-r: Ejficiencv (RF).
TIlermal E 0
.51andhy /-ass and Rmed hiputi. For instwitime us ous (vater heaters. list the 7-hermed.Elficienev and Rated hipitt.
2. Mandatory Meast'ires
TO CONIPLY ALL 13OXES NIUSI BE CHECKED
D § 110-§ 113: Water heaters. showerhead and faucets are certified bv the Califoriiia Enerav Unimission.
§ 1500): Water Systdii Pipe and Tank 111SUlatiOn. And Cooling, Line Insulation
I. Storage tank insulation
D A. Storaae Baas water heaters rated with an Ener_v Factor no greater than the federal minimal standard are
externally wrapped with insulation having in inst.illed thermal resistance of, R- 12) )r erreatcr: and
B. Unfired storaLe tanks Or other indirect hot water tanks have R-12 external 111SAition or R-16 internal
illAllatiOii where the internal -Insulation R -value is indicaled on the exterior of tIle.:,,iiik-.
2. grater piping. and cooling systern line insulation thickness and conductivity
First 5 feet -of hot and cold water pipes closest to water heater tank, non-recircidating, systerns. and en ire
length of recirculating section.; of hot water pipes are iIISUIaLed per Standards TaDle I 50-Band
Pipe inAllation for stea.iii liv-dronic lieatinL, syst'ems or hot water svitems > 15 psi meetsthe reqUirenlentS Of
Standards Table I 213-A.
Insulation Is protected From daniage. inCILKII]ILI that Clue tO S1.1111h.1.11C. I 110imUre. e(U-Iiptllellt maintenance, kind
\vind.
D �151(1)81D: lCindicated on the CF -IR. all liw water pipi nu that runs frons i lie hot \vawr SO.WC,- to the kitchen fixtures is
irtstllaleii p-rStannard s -Fable 156-13.
.41i""Itsi '009
VS`1'AIA,ATIUS1 CEW11-1 L;Ch-6R- °IF;C [-1.-1
tiniestic [-lot Nater (131114W) (Page 2 o
to ,lddress:i I Enforcement Agency: ' Perm
\umt)er: "
La Qui n%a
3. Central Water Hcatitw'in Buildin-s with N[ultiple Dwelling Units (required for prescriptive)
'ro C'ONIPL.Y - AIA.. BOXES CHECKED ,
D All 110t water.piping in main circulating loop is insulated to requirements of § 150(j)
D Centrtil'hot t.Jater,systems serving sib or fewer (I\VC11im1 units which have (I ) less than 25' of distribution pibing
i?utdoors:. (2) zero distribution piping underground: (3) no recirculation pump; -and W insulation.on distribution
piping that meet, the requirements of Section 1500)
D Central hot waterSYSLefIlS serving more than h d:vel)in17 unit; presence of either a time control or a
ume!temperature control
h
o t
i
DECLARATION STATEMENT J �'
1 certify under penalty of pctjury, under the lamvs of the State'Of California, (lie infomiiui n provided im this form is true and correct.
• I am ch--ihle under Division ; of the Business and Pratte ,ions Cede to accept responsibility for construction: or an authorized
representative of the person responsible for constrttctiori (responsible per>on). r
I certify that the installed features, material::, components. or ntanul'actured devices identified on this certificate (the installation.) •
contbrrtt, to all applicable codes and regulations, and the in.;tallatiz>n is cOnsiment with the plan and specifications approves by the
'entin•cemettt agency. � '
- I re\ icxved a.copy of the Certificate of Compliance (CF -I R) forst approved by the enforcement agency that identities the'spe6fic
rciluiretncnt; for the installation. 1. certify that the requirements &tailed oil the CF -1 R that'apply to the installation have been met.
• I .will ensure that a completed, sighed coPy of this tnstallation Certificate shall be posted, or made available with the building y y
permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. 1 understand
that a signed coPy of this Installation Certificate is required to be included with the documentation the builder provides to
the building owner at occupancy.
Company \'ante: I Installing Subcontractor or General Contactor or BuildcrOwner) _
Culitctrnia'Delnt k•tedianical.. Inc.
Respon Chic Person's Name:,-
i'.lohtt
�CSCB l_icen>e: t Dare 'i_: cd: --- I Pusiti . ith Ctxnp.ny (Title): —
81I114s t` t/13 PemitTech.
- --=J
:!// IJ ' s
_.. Rtsrr1eh"rr-1! Cvntpliarr(v 1`t, IMN - lar ars! �OUV
er_
Bin #
.Ow of La. Quin to
- Building 8z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La .Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit N
41P
Project.Address: SOOa tj4LOwner's
Name: m Lu
A. P. Number:
Address: .i �tfti
Legal Description:
City, ST, Zip: ,
Contractor:u
DA& McC6l
"� a z' <'$? c
Telephone: �. 4- (p r�
»ir : %•
W
Address:4056 E r
Project Description: GICt 'a
City, ST, Zip:Hew- A sa,049
f Q
...�.
Telephone: $f'Diaa . % 3;tc.
.t0
State Lic. #: 101114 City Lie. I,"- !9 VO
Arch., Engr., Designer:
Address;
City, ST, Zip:
Tele hone:
p�
State Lie. #:
rta =x
fifes
h . •�;,,, .M,.s.,�?„'
Conshvetion Type:. C3 Occupancy:
Project type (circle one): New Aod'n Alter a a' Demo
Name of.Contact Person:
Sq. Ft::.
# Stories: M UnitS:_
Telephone # of Contact.Person:
Estimated Value of Project: � � d O
APPLICANT:
DO NOT WRITE BELOW THIS LINE
!1
Submittal
Req'd.
Reed
TRACKING
PERMIT FEES
Plan Sets
Pian Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Cluck Deposit
Truss Cater
. Called Contact Person
Pian Cock Balance
Tide 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for. corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
ILO.A. Approval
Plans resubmitted
Gradk;
IN IiOUSE:-
'^` Review; ready for corrections/issue
Develoaer Impact Fee,
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Schedl Fees
Total ]Permit Fees
•t"
l
•t"