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BPLB2015-012078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: c% 4 4� Q" .. COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BPLB2015-0120 80872 HERMITAGE 762220010 CHASE / WATER HEATER CHANGEOUT 50 GAL $2,175.00 Applicant: A R S AMERICAN RESIDENTIAL SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 s�NEI cc1 L 3 2015�UI CON !•10'� TY OE,E?"`.EtiT DEPART" .ENT 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 Pro ionsCode and my License is in full force and effect. License Class- C3CC6,, C42 A License No.: 76515 iDat 1�/ C,on�tractor: 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 ($500).: (_J 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 provingthat he or she did not build or improve for the purpose of sale.). (� 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.). (_) 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: 11111111111111111111 30 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/23/2015 Owner: BRIAN CHASE 4 DRAKES BAY DR CORONA DEL MAR, CA 92253 Contractor: A R S AMERICAN RESIDENTIAL SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 (901)271-9700 Llc. No.: 765155 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 frk for which this permit is issued. -11 have and will maintain workers' compensation insurance, as required by oy 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: _ Policy Number: 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 bec a sub' o the workers' compensation provisions of Section 3700 of the r Co , shallforth comply wi thopro ' ons. f _F gate:' A 6pr, cant: 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 Building Official 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 informatio cor I agree to comply with all city and county ordinances and state laws rel g to ilding construction, and hereby authorize representatives of this city to a po e above -men f ned roperty for inspection purposes. Jj D !- K Sign�(Applicant orAgent): DESCRIPTION FINANCIAL INFORMATION ACCOUNT.. QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION. BSA: .' $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD - RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $91.85 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT 101-0000-42401 0 $32.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT PC 501-0000-42600 0 $7.25 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $19.34 $0.00 TOTALS:•0 Description: CHASE / WATER HEATER CHANGEOUT 50 GAL Type: PLUMBING Subtype: Status: APPROVED Applied: 10/23/2015 SGU Approved: 10/23/2015 SGU Parcel No: 762220010 Site Address: 80872 HERMITAGE LA QUINTA,CA 92253 Subdivision: TR 28603-1 Block: Lot: 31 Issued: Lot Sq Ft: 0 Building Sq Ft: 0. Zoning: Finaled: Valuation: $2,175.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 NAME TYPE Details: WATER HEATER CHANGE OUT - SOGALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT' A R S AMERICAN RESIDENTIAL SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS TN • 38120 CONTRACTOR A R S AMERICAN RESIDENTIAL. SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS TN 38120 OWNER BRIAN CHASE 4 DRAKES BAY DR CORONA DEL MAR CA 92253 Printed: Friday, October 23, 2015 1:44:00 PM 1 of 2 SYMMS Permit Details PERMIT NUMBER City of La Quinta BPLB2015=0120 �. Printed: Friday, October 23, 2015 1:44:00 PM' 2 of 2 SYS7EhiS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY ' BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total.Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 WATER HEATER/VENT 101-0000-42600 0 $7.25 $0.00 PC Total Paid for PLUMBING FEES: $19.34 $0.00 TOTALS:0i Printed: Friday, October 23, 2015 1:44:00 PM' 2 of 2 SYS7EhiS Bin.# City of" La Quinta Buliding a Safety Division �I �1 P.O. Box 1504,78-495 Calle Tampico (�✓ 14.Quinta, CA 92253 - (760) 777-7012 Building Permit App(ication'and Tracking Sheet Permit # .0 Project Address:a/� Owner's Name:. S (L 1 A. P. Number: �% Z1, 0 0 "10 Address: " g9 Legal Description: Contractor: S City, ST, Zip: `� Q u l N q4 i ei� 2 2S3 n ssf *t 2 d b12 � �.. ` Telephone: � y > J o�- 1 J ..;>"->r ;"�;: ,.s•� Address: Pro jectDescription: Qkifrit City, ST, Zip:e4t5toe— % L pk t N Telephone: j 1 3q I ") ! 'a`lM"M " State Lic. # : "" �% 5 City Lia #•: `- p(p Arch., Engr., Designer: 'Address: City., ST, Zip: Telephone: a P ;' ` State Lic. #: : ,:" �; »sru Name of Contact Person:Sq. Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACENIG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Coles. Called Contact Person Plan Check Balance. Title 24 Cates. Plans picked up Construction Flood plain plan Pians resubmitted.'. Mechartical Grading plan 2'a Review, ready for corrections%ssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up H.O.A. Approval Plans resubmitted Grading IN ROUSE:- '^' Review; ready for correetionslissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees " Total Permit Fees STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS — WATER HEATER CEC-CFIR-ALT-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E WATER HEATER Prescriptive Residential Alterations for Water Heater (Page 1 of 2) A. GENERAL INFORMATION Site address: Building Type: ❑ Single Family Dwelling i ��� �-l�� ti� lii'� f�� ❑ Multi Family Dwellings City, Zip Code: E CA ( QVi 4T- Climate Zone: 10 G. WATER HEATING SYSTEMS (Section 150.2(b)1G) 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 water Water Water # of Water Fuel Rated Rated Heating Heating Standby Exterior Back -Up Central Dwelling Heating Heating Heater Water Heater Type Input Input Efficiency Efficiency Loss ('Yo) Insul. Solar DHW System Unit DHW System System Type Heaters Storage Type Value Type Value R -Value Savings Distribution System Identification Type in Volume Fraction Type Distribution or system (gal) Type Name Nip _ WATER HEATING SYSTEMS Water heating compliance for an alteration is described in Section 150.2(b)1G. For single dwelling a gas or propane water heater, with a storage tank of 60 gallons maximum or instantaneous (tankless) can be used. Dwelling Unit distribution systems are limited to Standard trunk and branch or demand recirculation for gas or propane water heater. Demand recirculation is not allowed for electric water heater. If there is no natural gas connected to the building, an electric water heater may be replaced with another electric water heater. However, changing from gas to electric is not allowed. Multi -family central systems must use certified equipment as defined under Section 110.1 and 110.3. NOTE: If the proposed installation does not meet the requirements allowed specifically for alterations, use form CF1R-NCB-01 to document the water heater alteration. Instructions for sections with column numbers are given below: 1. Water Heating System Identification or Name: enter a unique name for the Water Heating System. 2. Water heating system type: Domestic Hot Water (DHW), Hydronic, Combined Hydronic, or Central. DHW is for domestic hot water, hydronic is a water heating system used for space heating only; combined hydronic are when the water heater will provide both space conditioning and domestic hot water. 3. Water heater type: For non -central systems only Small Storage or Small Instantaneous are allowed. For central systems pick from Large Storage, Small Storage, Heat Pump, Boiler, Large Instantaneous, Small Instantaneous or Indirect. CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E WATER HEATER Prescriptive Residential Alterations for Water Heater (Page 2 of 2) 4 4. Number of water heaters in system: In single-family and multi -family with water heaters in each dwelling units the value is 1. For multi -family central systems Name: � � oOwner sAuthorized agent ❑Contractor serving multiple dwelling units enter the total number of water heaters. 5. Water heater volume (gal): tank capacity in gallons. For individual water heaters for a dwelling unit this will be 60 gallons or less. If instantaneous, enter n/a. For Address: 1,/ap Itjvett > multi -family central systems enter the total storage volume. c 6. Fuel Type: Gas, Propane, Electric (Only if natural gas is not available) 7. Rated Input Type: Enter the equipment input rating type, for gas or propane fired units are Btuh, for electric fired system the units are kW. 8. Rated Input Value: Enter the numeric value of rated input. 9. Heating Efficiency Type: Energy Factor, AFLIE, or Thermal Efficiency. From product literature or a California Energy Commission directory. 10.. Heating Efficiency Value: Enter the value from product literature or a California Energy Commission directory 11. Standby Loss (percent): Applies only to large storage water heaters, Enter n/a for small storage or instantaneous water heaters. 12. Exterior Insulation R -Value: Enter the R -value if exterior insulation on the storage tank is installed 13. Back-up solar savings fraction: If compliance requires a back-up solar system, indicate the solar contribution (e.g., 0.30). External calculations are required. 14. Central DHW Distribution System: For multi -family buildings with using a central distribution system a demand recirculation system with at least two distribution loops must be installed. This requirement applies to any building with eight or more units. If the system is non -central or project is individual units enter n/a. 15. Dwelling Unit DHW Distribution Type: For a Central DHW this field shall be Standard. If non -central then pick from Standard, Demand Recirculation — Manual Control, Demand Recirculation —Sensor Control. If non -central electric water heater this must be Standard, no recirculation system shall be installed. DOCUMENTATION AUTHOR'S DECLARATION STATEMENT • I certify that this Certificate of Compliance documentation is accurate and complete. Name: � � oOwner sAuthorized agent ❑Contractor Signature: Company: aooq-t Contractor license #: SSS Address: 1,/ap Itjvett > Phone: 01rI 3?' I r City/State/zip: Date: [ For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.