BPLB2016-004478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tiht 4 XP Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPLB2016-0044
Property Address: 52375 AVENIDA NAVARRO
APN: 773274017
Application Description: MANTHEY /WATER HEATER CHANGE OU �
Property Zoning: CITY01=jAWNT;A
Application Valuation: $2,947.00 COMMUNlYDEVEi0?,!Ei.3(-EArhT!KiT
Applicant:
ARCHON ENERGY SOLUTIONS
OUTSIDE CITY LIMITS
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 Professions Code,
and my License is in full force and effect.
Llcense Class: C36 10 C 0 License No.: 7650744
Date: 3116411Z Contractor:'/'L/li��/
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).:
(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 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 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
,2
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner. E
. RCb0/2016
IN
BETTY MANTHEY
, 92253 MAR 10 2016
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD SUITE 201
MEMPHIS, TN 38120
(951)276-9744
LIC. No.: 765074
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
of thew rk for which this permit is issued.
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: _ Polity 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 become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provissiions.
Date: �fJ 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 ($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 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 this city to enter upon the
above-mentio ed pr perty for inspection purposes.
Date: -57/Ng Signature (Applicant or Agent):
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT
QTY AMOUNT PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0 $1.00 $1.00
3/10/16
PAID BY
METHOD
RECEIPT # CHECK #
CLTD BY'
ARCHON ENERGY SOLUTIONS
CHECK
R13779 2282
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
3/10/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
ARCHON ENERGY SOLUTIONS
CHECK
R13779
2282
RSE
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT
101-0000-42401
0
$12.09
$12.09
3/10/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
ARCHON ENERGY SOLUTIONS
CHECK
R13779
2282
RSE
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$7.25
$7.25
3/10/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
ARCHON ENERGY SOLUTIONS
CHECK
R13779
2282
RSE
Total Paid for PLUMBING FEES: $19.34 $19.34
Description: MANTHEY / WATER HEATER CHANGE OUT
CONDITIONS
Type: PLUMBING Subtype:
Status: APPROVED
Applied: 3/10/2016 RSE
Approved: 3/10/2016 RSE
Parcel No: 773274017 Site Address: 52375 AVENIDA NAVARRO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 102
Lot: 6
Issued:
UNIT 11
NAME TYPE
NAME
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $2,947.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
ARCHON ENERGY SOLUTIONS
Details: WATER HEATER CHANGE OUT - 40GALLON/GAS [2013 ENERGY]
CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SI I ES
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
ARCHON ENERGY SOLUTIONS
OUTSIDE CITY LIMITS
CONTRACTOR
A R S AMERICAN RESIDENTIAL
SERVICES OF C
965 RIDGE LAKE BLVD
SUITE 201
MEMPHIS
TN
38120
OWNER
BETTY MANTHEY
i
i
i 92253
FINANCIAL INFORMATION
Printed: Thursday, March 10, 2016 2:50:34 PM 1 of 2 CR
SYSTEMS
Printed: Thursday, March 10, 2016 2:50:34 PM 2 of 2 C
srszrnns
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
3/10/16
R13779
2282
CHECK
ARCHON ENERGY
SOLUTIONS
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00
BSA:
PERMIT ISSUANCE
101-0000-42404:
0
$91.85
$91.85
3/10/16
R13779
2282
CHECK
ARCHON ENERGY
RSE
SOLUTIONS
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
WATER HEATER/VENT
101-0000-42401
0
$12.09
$12.09
3/10/16
R13779
2282
CHECK
ARCHON ENERGY
RSE
SOLUTIONS
WATER HEATER/VENT
101-0000-42600
0
$7.25
$7.25
3/10/16
R13779
2282
CHECK
ARCHON ENERGY
RSE
PC
SOLUTIONS
Total Paid for PLUMBING FEES: $19.34 $19.34
TOTALS: $112.19 $112.19
Printed: Thursday, March 10, 2016 2:50:34 PM 2 of 2 C
srszrnns
Bin #
City of La . Qinntd
Building &r Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
LN Building Permit Application and Tracking Sheet
Permit #
201 b-C)LI
Project Address: 3 -75
Owner's Name'
A. P. Number: ffivowo
Address: l G 1 e✓
Legal Description:
City, ST, Zip:
Contractor:
i In
Tele h Q 9 9
e 7
xx
Address: mut'&rs S4—
Project Description: Q:77 ` '12
�p
City, ST, Zip: (� IVtaV5l1� C- A- "1�i5�3
,1
l't—��Y r1 %fil'F" �/Y P, -e— lot-6e-,leti
Telephone:5 "G.:..
.
.. .. ........: . .........
.....
r� o Ge I
State Lic. # : 7 6 (i -74
i City Lic. #;
5 e 00Q-5757
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Con truct n Type: Occupancy:
State Lic.
#
Project type circle one): New Add'n Alter Repair Demo
"
Name•of Contact Person: A N +�� moi) flf l
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 0
Estimated Value of Project: L %y 7
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
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.I.
I-I.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fees
PLUMBING PERMIT REQUEST
ARCHON
TE
- -_I.iCf.
ROSS STREET : OWUMANUF. HO -MR
CONTRACTOR INFORMATION
CONTRACTOR NAME: RIGHTIME HOME SERVICES
CITY BUSINESS LICENSE #:
PURCHASE ORDER #:
;r VAtUATtO $ • U ()
TYPE OF PERMIT
CONTACT: u n
EXP. DATE:
DATE REQUESTED:'
£?6 START DAT • . lip
PLUMBING:
OT WATER HEATER C ' GALLONS/ OR LLfITRAI (CIRCLE ONE)
OCATIO • KA AS EXTENTIO : !NiAoFT
AN OR ANKLES (CIRCLE ONE)
RECEIVED
I=RO E OR
LACE A "X" FUR LOCATO
ADDITIONAL WORK:
P�-16 - MAR 10 2016
REAR PROPERTY LIINE
HOUSE
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
a -
STAN OF OAUMMIA
RESIDENTIAL ALTERATIONS — WATER HEATER
CW-CFIR-4kI.T-0t-E ! j% 0e114) CALIFORNIA ENO= COMICSSIM
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E WATER HEATER
Prescri a Residential Alterations for Water Heater (Page 1 of 2)
A. GENERAL INFORMATION
She address:
a
(� Navaro
Building Type:
Single Family Dwelling
o Multi Family dwellings
City, Zip Code:
05 1
Climate Zone:
10
G. WATER
HEATING SYSTEMS Se on 160.2
b 1
G
01
02 03 1 04
05 1
06,
07
08
09
10
212
13
14
is
Water
Water Water M of
Water
Fuel
Rated
Rated
Heating
Heating
Standby
Exterior
Back -Up
Central
DwellingHeating
Heating Heater Water
Heater
Type
Input
Input
Efildency
Efficiency
loss (96)
Insui.
Safer
DHW System
Unit DHW
90tem
System Type Heaters
Storage
Type
Value
Type
Value
R -Value
Savings
Distribution
system
Identification
Type In
Volume
Fraction
Type
VsWbution
or
system
(511)
Type
Name
'ca
BTIA
1 0 NO
F,
102N
r
ar
9tyndr
E!1]
E
- -J.
I
WATER HBAT_INS3 SYSTEMS
Water heating compliance for an alteration is desulbed in Section 150.2(b)IG. 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 recimvlatlon 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. Multl-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 MR-NC9-01 to document the water heater alteration.
h1tructlons for -sections &M column numbers are rAven 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 Hydronlc, or Central. DHW Is for domestic hot water, hydropic 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 ":For non -central systems only Small Storage or Small Instantaneous are allowed. For central systems pick from targe Storage, Small Storage,
Heau�'Jy��rgntaneous, Small instantaneous or Indirect.
MAR 10 2016
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
CERTIFICATE OF COMPLIANCE CFIR-ALT-01•E WATER HEATER
Prescriptive Residentlal Alterations for Water Heater (Page 2 of 2)
4. Number of water heaters in system: in single-family and multi -family with water heaters in each dwelling units the value is I. For multi -family central systems
serving multiple dwelling units enter the total number of water heaters.
S. Water heatervolume (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
multi -family central systems enter the total storage volume.
fi. 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.
B. Rated Input Value: Enter the numeric value of rated input.
9. Heating Efficiency Type: Energy Factor, AFUE, 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
IL Standby Loss (percent): Applies only to large storage water heaters, Enter n/a for small storage or instantaneous water heaters,
32. Exterior Insulation R Value: Enter the R -value if exterior insulation on the storage tank is installed
13. Back-up solar savings fractiont 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 appliesto any building with eight or more units: if the system is non -central or pro)ect.is individual units enter n/a.
2S. 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
• 1 certify that this Certificate of Compliance documentation Is accurate and complete.
Name:�„ wner a Authorized agent: j Fontractor
Signature.'
VW &441
Company :24
�rt(j (
ton cense q:
Address: 1
I
Phone: O _ D ,.
City/State/zIp; , :,�
h
Date; r ,,
forawlftance or questions regarding the Energy Standards, contact the Energy Hotline at: 1.800-772-3300.
RECEIVED
MAR 10 2016
CITY OF LA OUINTA
COMMUNITY DEVELOPMENT