BPLB2016-000378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BPLB2016-0003
T-it4r °F 4 -Qu&&.
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address: 78293 SCARLET
APN: 604025040
Application Description: PALM ROYAL / DIXON / CHANGE OUT (1) ELECTRIC WATER HEATER
Property Zoning:
Application Valuation: $240.01'
Applicant: -3 IJ P
AMERIPAN INC DBA COMPLETE MECHANICAL SER
77564 COUNTRY CLUB DR #3686 JAN 1 2 2(316
PALM DESERT, CA 92211 1
CI.TYOI Lk,QL,1 JTA
COM` Ib!ITYDEVEL01't,1ENTDEPARMENT
01
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/12/2016
Owner:
DIXSON RAYMOND D & S TRUST
78293 SCARKET CT
LA QUINT, CA 92253
Contractor:
AMERIPAN INC DBA COMPLETE MECHANICAL SER
77564 COUNTRY CLUB DR #368 B
PALM DESERT, CA 92211
.(760)972-8068
Lit. No.: 896899
------------------------------------ ----------------------------------------------------------
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, D35, C20, C10, B Licens N .: 8_968999
Date: 2' Contractor: �L!
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).:
(-) 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 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 Na
Lender's Address:
-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 work for which this permit is issued.
I 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 �t,eorkers' compensation insurance carrier and policy.number are:
Carrier:"Policy Number: _
rtify that in the performance of the work for which this permit is issued, I
shall no 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 37 0 of he Labor Code, I shall forthwith
comply with those provisions. '
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' CO PENSATION 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-mentioned property for inspection purposes.
Date:i /
_ Signature (Applicant or Agent): v
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT
CITY AMOUNT
PAID,
PAIDDATE'
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
e 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
CITY.
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00.
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT•
CITY!
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:• •0
Description: PALM ROYAL / DIXON / CHANGE OUT (1) ELECTRIC WATER HEATER
'CONDITIONS
Type: PLUMBING
Subtype: Status: UNDER REVIEW
Applied: 1/12/2016 SKH
Approved:
Parcel No: 604025040 Site Address: 78293 SCARLET LA QUINTA,CA 922S3
Subdivision: TR 18915
Block: Lot: 13
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $240.01
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
PHONE
Details: CHANGE OUT - (1) 40 GALLON ELECTRIC WATER HEATER. 2013 CALIFORNIA BUILDING.CODES.
EMAIL
CHRONOLOGY
'CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESS1
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
AMERIPAN INC DBA COMPLETE
MECHANICAL SER
77564 COUNTRY CLUB
DR #368 B
PALM DESERT
CA
92211
john@completemecha
nicalservice.com
CONTRACTOR
AMERIPAN INC DBA COMPLETE
MECHANICAL SER
77564 COUNTRY CLUB
DR #368 B
PALM DESERT
CA
92211
john@completemecha
nicalservice.com
OWNER
DIXSON RAYMOND D & S TRUST
78293 SCARKET CT
LA QUINT
CA
92253
FINANCIAL INFORMATION
Printed: Tuesday, January 12, 201612:48:57 PM 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 $0.00
TOTALS:0i
BOND INFORMA1IUN
Printed: Tuesday, January 12, 2016 12:48:57 PM 2 of 2 0?
SYSTEMS
Bin.#
city., Of ici Q[lliltd
Btdlding ar Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Pemut #
Project.Address:75293 �r,
Owner's Name:. r%j ya y d'Or/
A- P. Number.
Address: .,782q3 ,SC p e C7 -
Legal Description:
Contractor M p JF} sip
City, ST, Zip: LA Z$ 3
Telephone:
/�
Address: q?J- — (.:ow a," DR, .. _3(0 ;
. Project Description: wa-we-Q�
City, ST, Zip: PALM-/
-
Telepbone: l?t,o q72 -90U
44 (aA7
State Lic. # : City Lie',#;
Arch., Ew., Designer.
Address:
City., ST, Zip:
Telephone:
Stec Lic. M
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL: # Stories: # Units:
I4tunt of Contact Person: 00RZ d
Telephone # of Contact Person: 040 0.79 -80 &9
Estimated Value of Project: 0 qO. 0.1
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
R 'd
Recd
TRACKING
P6RMIFFE>rS
Plann SetsPian
Check sobmitted
Its Amount
Strgctatal Cales
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Chea Balance
Title 24 Cates.
Plans picked up
Constmetton
Flood plain plan
Plan resubmitted..
Mechamcal
G`radhig plan
V Rid (*, gUily ftir e9rrectiony/tssve
�eci�I¢iil
Subcontattor List
Called Contact Person
Plumbing
. Grant Deed
Plans picked up
ML
H.O.A. Approval
Plans resubmitted
Grading
DH HOUSE:-
3" Review; ready for correetionsllssne
Developer Impact Fee
Planning Appy
Called Contact Person
M.P.P.
Pub. Wks. Appr -
Date of permit issue
School Fen
Tutgl Permit Fees
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS — WATER HEATER
CEC-CFIR-ALT-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF111-ALT-014 WATER HEATER
Prescriptive Residential Alterations for Water Heater (Page 1 of 2)
A. GENERAL INFORMATION
Site address: 7 / Building Type: Single Family Dwelling
Z / CrlE I�❑ Multi Family Dwellings
City, Zip Code: Ofd m Climate Zone: 10
G. WATER HEATING SYSTEMS Section 150.2 b 1G
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
Water
Water
Water
# of
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
Name
0
S
WATER HEATING SYSTEMS
Water heating compliance for an alteration is described in Section 150.2(b)1G. 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 recirculation 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. 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 CFIR-NCB-01 to document the water heater alteration.
Instructions for sections with column numbers are given 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 Hydronic, or Central. DHW is for domestic hot water, hydronic 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 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.
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E WATER HEATER
Prescriptive Residential 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 1. For multi -family central systems
serving multiple dwelling units enter the total number of water heaters.
5. Water heater volume (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.
6. Fuel Type: Gas, Propane, Electric (Only if natural gas isnot 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.
8. Rated Input Value: Enter the numeric value of rated input.
9. Heating Efficiency Type: Energy Factor, AFtUE, 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
11. Standby Loss (percent): Applies only to large storage water heaters, Enter n/a for small storage or instantaneous water heaters.
12. Exterior Insulation R -Value: Enter the R -value if exterior insulation on the storage tank is installed
13. Back-up solar savings fraction: 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 applies to any building with eight or more units. If the system is non -central or project is individual units enter n/a.
15. 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
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name:.
❑Owner o`X uthorized agent ❑Contractor
Signature:
Company:
t e;' .fL
Contractor license #:
Address: TSZ , f .^
�7
C n�
Phon
City/State/Zip: /
L (
Date:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.