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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 ($1IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDEDTOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application.. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit. issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is I agree to comply with all city and county ordinances and state laws relating to construction, and j�ereby authorize representatives of this city o enter upon above-ment ned roperty for inspection purposes. r Date: n :i*) Signature (Applicant orAgent): • •• • £ y:..;;: 1 { '* -i) 5^ \ :ip.'Y,F t.. ' ES DESCRIPTIONt� �{{ACCOUNTS:' YQTyY y PAID PAIU`DATE .........AMOUNT�� ':n,'. ,� '*`�.`"y{,,n, k �'��� �7 . 1 �'i w<iSE 4n c. n.n. 9 y,..,vt ,•. .�. x 1dL8r a l-EWi">-'$-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 '� )A .., k�• 5t^ r A, . , _Sk:4^" x.X k. S'"F.. .. u Y^s P� Y{{Y.4 .a"x e. {, _•iY'f?f 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 : r.' "S `dS- 5ti- - i. 3` :u �ACCOUNTE�,, f 7 QTY %w- _.'s' F t Yra. s t -AMOUNTSPAID .'• ru - s: ?X rot k ,< � �� F -� PAID DATE e'±fYy i a> .Y(.. AM ..2'r-. -k'f` k , -9: _ �v3.e.% `4 PERMIT ISSUANCE 101-0000-42404 .0 $91.85 $91.85 12/28/15 " t 2 xzfii+x', a1 PAID=6Y� r 7. cyk: '�d i`. ,2"X ''. °.� .. '1''s`+Y :--.3$ c, METHOD { J j:£ q'Ci. iy k'?Y;u g `',r 'aR iYi,Yb RECEIPT #y� xY ..�iY` y'r, CHECK # �'^.ri?2'xa .. CLTD BY <F nq V,zf.:.i y 3 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 $12.09 12/28/15-. PAID' .METTHOD RECEIP ', C?K RrM C- L-T.:\.D 4:i�B#`Yf *_1E ✓;.: §,{— r. 'iA:Y�:"*zdr .. . 522_' J .�I+ +w'$p.`?,.Lr iF .. .x•40 , x �5 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' BY T ...:...� :•,:... .._ n.,;n=, ".:. r.� .,. �.,,�� ...s..: 4r ,* _ _...»». a.. ,�a'�5-s',-..9x .,..,.,.�:..z�7Fr�, .�..a. i7.E. ,�,.a. s_s .._ 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 _ .._ .._... - ---- --- - ---- --- . _. - --- - - - - - -- - - -- ---- - — -- - - - ..-- --- - 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