BPLB2016-005678-495 CALLE TAMPICO C� 0 D �Cl/
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPLB2016-0056 Owner:
Property Address: 54645 AVENIDA OBREGON FERNANDO PERALTA
APN: 774273019 54645 AVENIDA CBR
Application Description: PERALTA / CHANGE OUT HOT WAER HEATER LA QUINTA, CA 9225
Property Zoning:
Application Valuation: $800.00
Applicant:
ALL STAR WATER HEATERS INC
30300 PUERTO VALLARTA WAY
MENIFEE, CA 92584
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.
License Class: C36 License No.: 812894
Da J. Contract,
OWNER -BUIL -DER 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 applicanYto 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.).
(_) 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 f 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
Lender's Add
11111111111111111111
25
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
ALL STAR WATER HEA
30300 PUERTO VALLA
MENIFEE, CA 92584
(951)301-0067
LIC. No.: 812894
Date: 3 X0./-2016
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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'
comp nsatio , as provided for by Section 3700 of the Labor Code, for the performance
th r which this permit is issued.
1 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: 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 become su% DA
workers' compensation provisions of Section 3700 of the Lab FC e, I sh Ufa with
comply with the/osc�erp"r/,`visions. �— "—
D to Ap ie n
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 tiling
construction, and hereby authorize representatives of this city to e
abov�e-mentioned property for inspection purposes
Dat y —. %�� Signature ( r Agent) �* ►/
DESCRIPTION
FINANCIAL
,ACCOUNT
1 •
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
CITY,
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
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT:; . ,
QTY.
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$7.25
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:00
Description: PERALTA / CHANGE OUT HOT WAER HEATER
CONDITIONS
Type: PLUMBING Subtype:
Status: APPROVED
Applied: 3/30/2016 SKH
Approved: 3/30/2016 SKH
Parcel No: 774273019 Site Address: 54645 AVENIDA OBREGON LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 268
Lot: 7
Issued:
UNIT 25
NAME TYPE
NAME
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $800.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
ALL STAR WATER HEATERS INC
Details: CHANGE OUT HOT WATER HEATER. 2013 CALIFORNIA BUILDING CODES.
MENIFEE
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
ALL STAR WATER HEATERS INC
30300 PUERTO
MENIFEE
CA
92584
KEN4REDWINGS@HOT
VALLARTA WAY
MAIL.COM
CONTRACTOR
ALL STAR WATER HEATERS INC
30300 PUERTO
MENIFEE
CA
92584.
KEN4REDWINGS@HOT
VALLARTA WAY
MAIL.COM
OWNER
FERNANDO PERALTA54645
1 AVENIDA
LA QUINTA
CA
92253
OBREGON
t
Printed: Wednesday, March 30; 2016 11:10:19 AM 1 of 2
SYSTEMS
DESCRIPTION
ACCOUNT
QTY .
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
,
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: $112.19 $0.00
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Wednesday, March 30, 2016 11:10:19 AM 2 of 2 Or
SYSTEti1S
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E WATER HEATER
Prescriotive.Residential Alterations for Water Heater (Page.2 of 2)
4- Number of water heaters in system: In single=farrityand..multi=faty*ily with water heaters in each dwelling uhitsthevalue is. I; for mijIti7bffiiIy central 9yft0MS
serving ihultiple.dw'ellihg un.&.ehtefthe'tof4I number of -water heaters.
S. Water heater volume (ga 1): t capacity 91*apad in gallons For indiVidjW:waterheatEirs fora -dwelling 'uriit,this Will befibgpllons.or less. Ifii-isbritaneous, enter n/a. For
multi=family central systems.enter the totaFstorage volume.
6. fuel Type:.Gas, Pi:606ne, Electrj6(Only if natural gas isnot available)
7. Rated Input Type.:.Enter the leclu.ipment input rating4ype, for,&s or prooanO fired units are: Btuh, for.,—electric—fired sysfern the units are kW..
8. Rated Input Value:`tnterihi6 h6-Irrieric value ofratedinput...
9. Heatin _jEffld ncyType&Energy.Factori.AFOE�,orTheenal Efftienq.FfdrProduct literatiri or jtalO 66. tnergy t,ommission direc.ty,
10. Heating Efficiency Value:- Enter'they ame
I I -fr.o(nproduct:l,iierature,-orai:alifomiaEn&gyCt)mmitsiorid.ieectoi*`
nstantaneous - water heaters.,
ii. 'Standby. Loss (percent): A0plies.'6nIy:ib large stprage. water'heaters, .. eaters,storage qr,i .
12. UtenqrJnsulatl'on RI7Val qe:-Enter. the. R7Va Ime if-exteriorinsolation Pn,.theAdrage't4hk is:ihst4lliid,
13. Back-upsolar savings1iaction: If compliance,requires a baa -up sola(5ygem, indi0te.the,so.lat contribution (e.g., 030). . Exterhil wcjlciildtions are re'q6if.ed.
14. CehWI.:DHW*Distrib4tiibn System: For UM6 ..'a central distributionsystema stem-ademand recirculation sys , tem.wit
_ h at Ipasttwo distribution
loops rriust 4gli,hstiii.10�.d:'This..re*gVtremi'�n,t,,apMii,2rsltd any builftg'With eight or more units, if the-systemis non -central or project is individual units entirn/ii,
15. Dwetiltig,..-U*n'it-614W.61sttib6i!dfi.'T"ypLm* F'ora teintral DkW-this field -shall beStandard-If rio'n-central then pi&from Standard. Demand Recirculation --Manual
6oritioli.Q�?mand,RieCittulaition — Sensor Control. if non-Ceh&aI.-61ecfiic water heitei this mustbe Siandard; no recirculations stern shall. be Instal . led.
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
*11 1 . certify that this Certificate of Compliance documentation is accurate and complete.
",me: Ken Block oOwner o Authorized agent oContractor
Sign
Company: All Star Water Heaters
Contractor license M. 81 28g4
Address: 30300 Puerta Vallarta
Phone: 951-301-0 . 067
City/State/Zip: Menifee, CA 92584
Date:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS -- WATER HEATER
CEC:CF1 R -ALT -01-E (Revised 06114) CALIFORNIAENERGY-COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E WATER HEATER
Prescriptive Residential Alterations for Water Heater, (Page 1 of 2)
A. GENERAL IN
Site addiess:
City, Zip Code: I(�` `a"��L�{ !!a h/CtGi (_t5) U G%'� Z -r"7 Ildimate Zom(- 110
'Oingle Family Dwelling
Multi Familv Dwellinvu
G. WATER,
HEATING SYSTEMS(Se ction;15,0.2(b)l. _
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
Water _
Water
.Water
#ot
Water
Fuel
Rated
Rated
Heating
Heating
Standby
Exterior
Back -Up
Central
Dwelling
Heating
Heating
Heater
Water.
Heater
Type
Input
Input
Efficiency
Efficiency
Loss (%)
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
ame
GasZ
I -,
P11117.
- -
I-
L.'
1 -1
____
I., - - -1
. ..... ... .
I -
I
WATER HEATING SYSTEMS.
Water heating compliance for an alteration is described 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 ordemand.recirculation for gas or propane water
heater. Demand' recirculation' is not allowed for -electric water heater. If there is no natural gas connected to thebuilding, 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 CFVR-NCB.•01 to document the. water heater alteration.
.Instructions for sections with :column numbers are Riven below:
1. Water Heating System Identification or. Name: enter.a unique name for the Water Heating System.
2. Waterheating system type: Domestic Hot Water (DHW), Hydronic, Combined. Hydronic, or Central. DHWiis for domestic hot water, hydronic is a water heating.
system used for space heating only; combined hydronic are wheri 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-
Bin #
Oty of LCI Quinta
Building 81- Safety Division
78-495 Calfe Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Owner's Name: �1
A. P. Number:
Address
Legal Description:
City, ST, Zip
t
Con frac r:
0
e h n
Tel o
P
Address:a-yooa
Project Description: ^
City, ST, Zip:
G
TcIc h e
p d -
a iP
State Lic. # :
City Lie. #t
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Occupancy:
Constructionituc ton TYPe• an cY:
State Lic.
Project type one): New A dd'n Alter Repair a'r Demo
Name of Contact Person:
Sq. Ft,:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: W
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2pd Review, ready for correctionsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
'"' 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