BPLB2015-014678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
"i "F 4�iK'.m'Q
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BPLB2015-0146
56490 LEGENDS CIR CIR
762420015
MANJI / 40 GALLON WATER HEATER CHANGE OUT
$2,185.00
Applicant:
AMERIPAN INC DBA COMPLETE MECHANICAL SER
77564 COUNTRY CLUB DR #368 B
PALM DESERT, CA 92211
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under p visions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business a ' Professions Code,
and my License is in full force and effect.
License Class: 36 05, C20 C10 B Lic nse No.: 8968
Date: Z Contractor:
OWNER -BUILDER D
I hereby affir under penalty of perjury that I �CLARATION
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 proving that
he 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.).
(� 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
48
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/28/2015
Owner:
NEEMIRA MANJI
Contractor:
AMERIPAN INC DBA COMPLETE MECHANICAL SER
77564 COUNTRY CLUB DR #368 B
PALM DESERT, CA 92211
(760)972-8068
Llc. No.: 896899
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
II 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.
t .r ..
,,yl 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 issue- orkers' compensation insurance carrier and policy number are:
Carrier ti PolicyNumbet-1-1 "
_rnN_4-c l ify 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 subje to the workers'
compensation laws of California, and agree that, if I should becom subject to the
workers' compensation provisions of SecAn70 of the Labor: - de, I shall forthwith
comply wi those royisions.
Date: Z 2� I� Applicant:
WARNING FAILUR TO SECURE WORKERENSATION COVERAGE IS UNLAWFUL,
AND SHAL SUBJE AN EMPLOYERTO CPENALTIESAND CIVILFINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($1IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDEDTOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application..
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit. issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
I agree to comply with all city and county ordinances and state laws relating to
construction, and j�ereby authorize representatives of this city o enter upon
above-ment ned roperty for inspection purposes.
r
Date: n :i*) Signature (Applicant orAgent):
• •• •
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DESCRIPTIONt� �{{ACCOUNTS:' YQTyY y PAID PAIU`DATE
.........AMOUNT��
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w<iSE 4n c. n.n. 9 y,..,vt ,•. .�. x 1dL8r a l-EWi">-'$-a, ga'£,sii�'.3�k'.sw,s�'ca. ^.�7ck .n- ,.., rc � Ye$`_a ^SS wi �:.`i"67 Fa :'s.s m i� � ,. �.
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 12/28/15
y
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METIiOD�'*..�kRECE CLTDBY,#
RPAID B_�#��� PT #:, .#
AMERIPAN INC DBA COMPLETE MECH 'DEBIT_' R11794 SGU
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00., $1.00
DESCRIPTION
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�ACCOUNTE�,, f
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PAID DATE
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PERMIT ISSUANCE
101-0000-42404
.0
$91.85
$91.85
12/28/15 "
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CLTD BY
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AMERIPAN INC DBA COMPLETE MECH
DEBIT
R11794
SGU
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
DESCRIPTION
y,
1.. i d
44sQN AMOUNTc
- ,; $ #.i #@ a
N� ACCOUNT s
TePAID'
xQAIDDATE
WATER HEATER/VENT
101-0000-42401
.0 $12.039
$12.09
12/28/15-.
PAID'
.METTHOD
RECEIP
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AMERIPAN INC DBA COMPLETE MECH
'' DEBIT
R11794
SGU
'...,L€C'kr.�.
DESCRIPTION
3e�b3i C'� S�j
�ti".6d'� d`
k +R✓{" {
_
PAID DATE`
��ACCOUNT�QTY
.
�AMOUNT�PAID
$� t„
WATER HEATER/VENT PC
101-0000-42600
0 .
$7.25
$7.25
12/28/15
- r r�;.Ff"
PAID,BY 3
+*� +,aha8rg`;'"
METHODs�nRECEIPTt#
"s?`5=.w'ir-'T?ti
CHECK #7 W'
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sCLTD
AMERIPAN INC DBA COMPLETE MECH
DEBIT
R11794"
SGU
Total Paid for PLUMBING FEES: $19.34 .. $19.34
Description: MANJI / 40 GALLON WATER HEATER CHANGE OUT
Type: PLUMBING Subtype: Status: APPROVED
Applied: 12/28/2015 SGU
Approved: 12/28/2015 SGU
Parcel No: 762420015 Site Address: 56490 LEGENDS CIR CIR LA QUINTA,CA 92253
Subdivision: TR 28838-4 Block: Lot: 15
Issued:
Lot Scl Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $2,185.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NANIt"`I'YNt
Details:' WATER HEATER CHANGE OUT - 40GALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
WDi
CONTACTS
NANIt"`I'YNt
NAME" m•,,,,,
ADDRESSI
CIN'
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
AMERIPAN INC DBA COMPLETE
77564 COUNTRY CLUB
PALM DESERT
CA
92211
john@completemecha
MECHANICAL SER
DR #368 B
nicalservice.com
CONTRACTOR
AMERIPAN INC DBA COMPLETE
77564 COUNTRY CLUB
PALM DESERT
CA
.92211
john@completemecha
MECHANICAL SER
DR #368 B.
nicalservice.com
OWNER
NEEMIRA MANJI
34 MCKENZIE LAKE ISLE
CALGARY AB
I P4
92253
SE
CANADA T2Z
FINANCIAL INFORNINI IUN
Printed:. Monday, December 28, 2015 2:33:39 PM - 1 of 2
CRsysrrnns
_ .._ .._... -
---- --- - ----
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CLTD `
DESCRIPTION
ACCOUNT
QTY-
AMOUNT
PAID
PAID DATE
•
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
12/28/15
R11794
DEBIT
AMERIPAN INC DBA
SGU
COMPLETE MECH
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00
BSA:
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
12/28/15
R11794
DEBIT
AMERIPAN INC DBA
SGU
COMPLETE MECH
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
WATER HEATER/VENT
101-0000-42401
0
$12.09
$12.09
12/28/15
R11794
DEBIT
AMERIPAN INC DBA
SGU
COMPLETE MECH
WATER HEATER/VENT
101-0000-42600
0
$7.25
$7.25
12/28/15
R11794
DEBIT
AMERIPAN INC DBA
SGU
PC
COMPLETE MECH
Total Paid for PLUMBING FEES: $19.34 $19.34
TOTALS: $112.19 $112.19
PARENT PROJECTS
BOND INFORMATION
Printed: Monday, December 28, 2015 2:33:39 PM 2 of 2#?
SYSTEMS
Bill #
City. of La Quints
Building ez Safety Division
Box 1504,78-495 Calle Tampico
61 �-�
� I.a.Quinta, CA 92233 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit#P.O.
P
Project Address:5CAg0 Q
Owner's - N
A. P. Number..
Address: 5 C04 q 0
Legal Description:
Contractor.
CawpLm NAaA&MTCAL
City, ST, Zip: A22S3
Telephone:
PtojedDesaiption: W —t
I — V CAWS
City, ST, Zip: (2A.- aal (
'12S PL.P� —.
Telephone: e((A qu_ 194000IL
State Lia # : .g q Co.B 9q City Lic #
Arch, EW., Designer:
Address:
City, ST, Zip:
Telephone:
Conduction Type:. Qxupancr '
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Storm: #Univ:
Statc Lia #:
Name of Contact Ppison: N
Telephone # of Contact Person: (7(.(3y q'r1'a _g O (.8
Estimated Value of Project: 2 1.85. 00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
ReWd
'Rec'd
TRAQMG
PERM[P FEES
Plan Sets
Plan Check ubmiued
iter Amount
Strgeturaf Calm
_
Reviewed, ready for corrections
Plan Check Deposit. .
Tires Cates.
- Called Contact Person
Pian Check Balance
Title 24 Cates.
Pians picked up
Construction
Flood plain plan
Plans resubmitted..
Mecharikal
Giading plan
2'' RevCew, �eiid'y tov ooi neciioiistcasiie
Eleetdeal
Subcontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review; ready for eorreetionvissue
Developer Impaet Fee
Planning Approval
Called Contact Person
A.LP-P.
Pub. Wins. Appr '
Date of permit issue
School Fees
Total Permit Fees
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS ;
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION C
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E
Prescriptive Residential Alterations on (P ge 3 of 4)
Project Name: St,�9 SDS iQ- M� Date Prepared: JZ 7-%
F. SPACE CONDITIONING(SC) SYSTEMS — HEATING/COOLING (Prescriptive section 150.2(b))
01 02 03 .
Dwelling Unit Name Dwelling Unit CFA (Ft2) ComMp
nts� tte,, �q,
." I`,.`
}
G. WATER HEATING SYSTEMS (Section 150.2(b)1G) Ito
01
02
03
04
05
06
07
08
r ,09.
10
11
3'_'12
13
14
15
Water Heating
# of
Water
10
(
System
Water
Water
Water
Heater
Rated
Rated
Heating
tHea ng
Exterior
Back -Up
Solar
Dwelling Unit DHW
Heaters
Storage
t{
Input-
Identification or
Heating
Heater
in
Volume
Fuel
Input
Efficiency
Efficiency
�'
Standby
Insul.
Savings
Central DHW System
"
System
Name
System Type
Type
system
(gal)
Type
Type
z, Value
Typed
lue
L s,(%)
R -Value
Fraction
Di tribution Type .
Dis ribution Type
140("6C,
1VP7,
f`l
CK
LAO
=
-',
NpT 'I
ty
: lklk
001',
'
'. I`
H. SPACE CONDITIONING SYSTEMS AND WATER HT- NG SYSTEMS I,NNUOLTIFAMILY,D.N/EILING UNITS
01
02 ,
z 03
111& 640
05
06
Dwelling Unit Name
Dwelling UnitfTotal`CFA
Iff2o
Central Wate Hating
System Ide tification or
6' Name ,*.
1� elling Unit
3Water,Heating System
,,,74Identification or Name
Dwelling Unit:
Alteration to the Space
Conditioning System(s)?
Comments
0
Registration Number:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time:
HERS Provider:
I
June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations
Project Name: 5 (pqj& l es t wj4s or, -
Date Prepared
(COMMISSION
CF 1 R -ALT -01-E
(Page 4 of 4)
2_/?_W/ / 'r -
DOCUMENTATION
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT "
1. I certify that th's CArtificate of Compliance documentation is accurate and complete. lot. 4 !�
Docum tationuthor
Qora
Documentation Author Si natur * a
i .
Comp y: j� ,/ e �
� �1 � �.�,
Signat a Date:
li7V GG��(�
lZ - Z,Q
Address:
w C'P7
CEA/ H RS Certifi ation Identificationt(if applicable): 0 1*
City ate/Zip:
P,Oos.6�7 C-� �Zza
Phone:
�A 1d��1 �.$! .
4
SPONSIBLE PERSON'S DECLARATION STATEMENT.1 --".
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct. NIP
2. I am eligible under Division 3 of the Business and Professions Code to accept respons bil ty for the building 8e gh,or system design identified on this Certificate of Compliance (responsible
designer).
3. That the energy features and performance specifications, materials, components, ahtd manufactured device's,for the building design or system design identified on this Certificate of
Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code oPReg dations
4. The building design features or system design features identified on this Certificate of Compliance re consistent wit l information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted to t nd f cement agencf!f6Vpproval with rhh_ib�_ull'ding permit application.
ow
5. 1 will ensure that a registered copy of this Certificate of Compliancetshall be made available with the building pgrmlt(s) issued for the building, and made available to the enforcement agency
of e`d'to be include documentation the builder to the building
for all applicable inspections. I understand that a registered py this Certificate oaf Compliancy ri with the provides
owner at occupa cy ra >
ResponsIeDesigner Nam V w
Itespdnsible D igner sj�natur
at -pi AVAI�AL-
Compa y : n (€
Date Signed:
Z4.9
1�^ I V W lw•��.
Z
Address:Vq�
U) 7 '
License:
13(�'��I�I
rly,State
Phone:
For assistance or -questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number: 1 Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014