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BPLB2015-012678-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4tit 4 4& Qum&� COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2015-0126 Property Address: 54527 RIVIERA APN: 775031030 Application Description: HUNT/ CHANGE OUT (1) 50 GALLON GAS WATER HEATER Property Zoning: Application Valuation: $900.00 Applicant: STATEWIDE SERVICES INC DBA STATE WIDE PL 36947 COOK STREET SUITE 104 PALM DESERT, CA 92211 PALM DESERT, CA 92211 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 s : C36. A License No.: 936147 Date: Contractor• 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.). (_J 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 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: �l illlli lilil IIII I'll Date: 11/5/2015 02 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 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 the w for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Se ion 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 3 00 of the LC? l abor Code, I shall forthwith comply with those provisions. ^ �---� ,1 Date: _ Applica ' 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 la�/s relating.to building construction, and hereby authorize representatives of this i 'Enter upon the above-mentioned property for inspection purposes. &_ Date: Signature (Applicant or Agen : Date: 11/5/2015 Owner: JAMES B HUNT 54527 RIVIERA LA QUINTA, CA 92253 Contractor: n ro � I CD C p STATEWIDE SERVICES INC DBA S_'TATEIWID�E PL 36947 COOK STREET SUITE 104 PALM DESERT, CA 92211 I Jn a Z o 0 (442)666-8858. M 9 D c n Llc. No.: 936147 m 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 the w for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Se ion 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 3 00 of the LC? l abor Code, I shall forthwith comply with those provisions. ^ �---� ,1 Date: _ Applica ' 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 la�/s relating.to building construction, and hereby authorize representatives of this i 'Enter upon the above-mentioned property for inspection purposes. &_ Date: Signature (Applicant or Agen : a' r ( DESCRIPTION 4 � z. ' - .. s r� _ z - "� I - I i = 5 WINCCOUNT Q�TY� MOUNT PAID IPAIDIDATE� g R+..:- �5`.?:A a .. A,sv k<, �. tli _.i3.'`%`r�E%s:,>�'` .-mr#n-'-sNu,'-ssr"�"m> BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 "- ' R '3 �' Y S R �z� k+`.. �`°: rFX " ETHOD '� ?u, ��RECEIRT # f�� `"`CHECK#� C TDBY Win. r'�t•3;�. � Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 r[ ¢.-•4''h id MEN ESCRIPT[ON E'�1.4Yn �4TY 2gyb'is .k ''fvA Y 5 - b .•v: l aF 9` ui� 2Y.Sai3� -.i M { r'' ..,r %RE ..;. 000UNT<; A� N .PAI s.:?AIDDATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 . tIN,'" PAID,BY� ��.,:;.5.`..'t:9'hCT Y d" ,i Eti y ..'f`. " m .,.' - .. RECEIPT # �. ';"�u'%a^ Po'> ✓€. € z"' HECK# CLTD BY f [. ,,METHOD .�x"W.�.s.kl�S�Y,>x�.f X'R' O. LT`dF1...E.•.:'.C.fi = . ; Total Paid for PERMIT ISSUANCE: $91.85 $0.00 ��.�DESCRIPTION ��R ACCOUNT �� QTY AMOUNT�� PAID` PAIDD TE ': .3 ., . ,ary .. f r...:s-„b" i, r.+rr?„x , ...,•..n .. . > 4.;Y Mf-'�-: i"m.-A.kssm2a;a� "{� ..dY�.--14"i"�c'`29�.ksiR"'t9�H.K, f`2v� sEk �4vD-a�`v; t 2,P�',r4 iR, ��'"�s WATER HEATER/VENT 101-000042401' .0 $12.09 $0.00 .�.,` PAIDK BY ` V1ET OD RECEIP # 14 C # CLTD BY .:J-- .�r.. Y.��.-%�,f�..'.2.�:'2:.., as �:.":_ ..� a?'yE3°EX9��� s3e➢i�S 'e#°4 - ,E.:. s��`LLk..*.<.�.. �',N2�kT.. ,nf:o !x4if� E`a5..^..'ei':3 �k':Xef"<i...Y:.e`��`V.["rk�: ����.-iR�`,hz.Alo. QTY sUNT s AMO MR PAID PAID;DATEx ;t r> ;3v<k+.DESCRI?TION,xA�CCOUNT WE .: re- �+ f!.., •^g;:WC�d WATER HEATER/VENT PC 101-0000-42600 0 $7.25 $0.00y .''a't3x PAID�BY_��:u.�.. "�,.''. Sp vi r K�# fir" CLTOBX .,�..seRECE�.,.��CH Total Paid for PLUMBING FEES: $19.34: '$0.00 Description: HUNT / CHANGE OUT (1) 50 GALLON GAS WATER HEATER Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 11/5/2015 SKH Approved: Parcel No: 775031030 Site Address: 54527 RIVIERA LA QUINTA,CA 92253 Subdivision: TR 24317-1 Block: Lot: 2 Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $900.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 APPLICANT Details: WATER HEATER CHANGE OUT - 50GALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. CHRONOLOGY CONDITIONS NAME TYPE - : NAME ADDRESSI CONTACTS CITY STATE_ ZIP PHONE,, FAX EMAIL APPLICANT STATEWIDE SERVICES INC DBA STATE WIDE PL 36947 COOK STREET SUITE 104 PALM DESERT, CA 92211 CONTRACTOR STATEWIDE SERVICES INC DBA STATE WIDE PL 36947 COOK STREET SUITE 104 PALM DESERT CA 92211 OWNER JAMES B HUNT 54527 RIVIERA LA QUINTA CA 92253 FINANCIAL INFORMATION Printed: Thursday, November 05, 2015 8:28:12 AM 1 of 2 sysrrnns PARENT PROJECTS ATTACHMENTS Printed: Thursday, November 05, 2015 8:28:12 AM 2 of 2 . SYS7Eti13 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:• 00 PARENT PROJECTS ATTACHMENTS Printed: Thursday, November 05, 2015 8:28:12 AM 2 of 2 . SYS7Eti13 Bin # City of La Quinta Building az Safety Division P.O. Box 1504, 78-495 Calle Tampico Permit # La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet FA. t Address: ' j/(i� ' Owner's Name:wa Vy Number: Address: SCj 9,lDescription: City, ST, Zip: si Contractor: i ' L Telephone _ `•„w'w' Address: 3 -7 O Project Description: City. ST, Zip: D /O. Tele hone. •�Y•• i•YK• Sj�h :;...Y,.MJ�.O''.r/ 'M..,SC L,Y . � :~�>,� y \..:vg�;yg!vrsc ;a; � . State Lic. # 3 City Lic. #: Arch., Engr., Designer. -" Address: ,.- City., ST, Zip: Telephone: �„_:•4 ' :;'.�<:zRr Construction Type: Occupancy: `::�t'i�C.Siv: i:\ �i."4:Cij��:^: C•Ltxv`,. Project type (circle one): New Add'n Alter Repair Demo ' Name of Contact Person: Sq. Ft.: n Stories: # Units: Telephone # of Contact Person: 9 Estimated Value of Project: r� APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Cbeck submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Cbeck Deposit Truss Calcs. CalledContact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan god Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE: "d Review, ready for carrectionslissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees •Pcekri tive Certificate of Com !tinea; Residential.:: .: CF=IR-ALT-DHW Residential Atter tions Page i of 2 Project.Natne: Climate Zone: Permit M General Infornra ion 00 Site Address: t (// 6ACI Enforcement Agency: Date Building T in le Family ❑ Multi Family Project Type: ❑'Re lacert>ent or Change Out of Water Heater WATER HEATING List net44r installed water heaters and boilers for bush domestic hot a+ater heaters-(DWH) and indronic space heating. NeKfi• installed MH heaters and boilers must be gas. propane. or itse the existingel h Water Fkater Distribution Type F�cternal Tank Number In Tank Energy Factor or Insulatiou TypdT,-q Type . Res System Capacity (gal) Thermal Efficiency R-Vatuer Company: �1 /� � Aare: Ucenw A07�3 7 :9 V� , I i 1. Indicate Type (Storage Gas, Heat Ptwrp: Instantaneous, etc.) 2. Recirculating systems serving multiple dwriling units shalt meet the recirculation requirements of §IS(l(n). The Prescriptive. requirements do not allow the installation of a recirculating water heating system for single dwoelling units. 3. The eeternal water heating tank and pipes shall be insulated to meet the requirements o Contractor or Homeowner (Documentation Author'sMesponsible BuiMing Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24, Part I and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance arc consistent With dee information provided to document this building design on the other applicable oormpliance forms, Aofkstwets. cal ulainoas plans and specificattorts submitted to the enforccmerd agency for approval with this building rc application. N Si Company: �1 /� � Aare: Ucenw A07�3 7 :9 V� , I Ciryp C'( Bin # Cj�y Of La Quinta Building & Safety Division ` P.O. Box 1504, 78-495 Calle Tampico City Lic. g: Permit # La Quinta, CA 92253 - (760) 777-7012 Arch., Engr., Designer: Building Permit Application and Tracking Sheet Project Address: L t (/(✓L Owner's Name: r A. P. Number: City., ST, Zip: Address: Is t' Legal Description: Telephone: City, ST, Zip: Contractor lL4 telephone -7(6 w" /: � /•' A eifireecc• S< Z % Y / i 0 /a / I n / , n Proiect Description: L!9 1,4011--1 City, ST, Zip: Telephone: 7 State Lic. B : City Lic. g: Arch., Engr., Designer: Address: City., ST, Zip: Telephone: Construction Type'. Occupancy: .Stat 1C. #' Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft: n Stories: #Units: Telephone # of Contact Person 9 a/,,) c, Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE 31 SubmittalReq'd Recd TRACKING PERMIT FEES Plan -Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calrs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan'Plans resubmitted Mechanical Grading plan god Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE: '"` Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees a 9