BPLB2016-0017Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
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: C20, C36 License No.: 686310
Date: Z-7 .—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
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.).
(� 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
Lender's
09
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/27/2016
EYMPPMENTDBWI EL RUSHBY
L'� yivn� r^ 2950 PANORAMA DR UNIT 904
DEVELOPMEKQUITLAM BC CANADA V3E, C9 92253
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
THOUSAND PALMS, CA -92276
(760)601-3500
Llc. No.: 686310
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.
'S*:- 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 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 subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: t �-, I t —Applicant: Swc a sL �
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-mentioned property for inspection purposes.
Date: I Z� I Signature"(Applicant or Agent):
Taff
78-495 CALLS TAMPICO
4
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEV
BUI
Application Number:
BPLB2016-0017
Property Address:
79786 VIENTO DR
APN:
609610004
Application Description:
RUSHBY RESIDENCE / WATER HEATER CHANab
Property Zoning:
tip+
Application Valuation:
$2,200.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
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: C20, C36 License No.: 686310
Date: Z-7 .—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
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.).
(� 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
Lender's
09
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/27/2016
EYMPPMENTDBWI EL RUSHBY
L'� yivn� r^ 2950 PANORAMA DR UNIT 904
DEVELOPMEKQUITLAM BC CANADA V3E, C9 92253
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
THOUSAND PALMS, CA -92276
(760)601-3500
Llc. No.: 686310
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.
'S*:- 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 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 subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: t �-, I t —Applicant: Swc a sL �
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-mentioned property for inspection purposes.
Date: I Z� I Signature"(Applicant or Agent):
.
FINANCIAL INFORMATITt
DESCRIONx fi r' ti
PTI� ACCOUNT Yrt QTcYAMOUNT k DATE $
. sPAID �iPAIU
:•a. ;;=1 „!,<.: s„ .
BSAS SB1473 FEE 101-0000-20306 0.. $1.00 '$0:00
"$` Ep+^, 'Y�` bP d S{> yscix4 .SEm'hSt YTjF j f -,y.%: E_ 3k- i .a?:�.r Yk }n; -i a�!-.:,.;P:S' eQ,
3 PAID BY '� ., , z4 *RECEIPT # s, ` CHECK # ''CL•TD56Y
a.;MET,HOD e
C-`w'�L``E,;'l.F�v':"'�,w.v,.)'x-K''r,'..s.,fa1
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION x
,ax:s
A000UNT=
QTY
za&s.EiY�zKw'w:y
RAIDS
„* x
Y,Q a ga
M&AM0UNT
¢ 4 E 5
PA!DDATE
PERMIT ISSUANCE
.0
$91.85
$0.00
g101-0000-42404
i 'x •' f f- �• r•d rt` E� �4¢ Y`.y'
PAID BYE
F✓
,, _,
Z:Y4x� d•.y,•
7
•� u1�•' dm•'.. '.
x
,iEr>s,..''?.?'4a���yG,kr�;e�
:#�.a'a .:>"
METHOD£.
itm..:x;�.,"�.LE:�i��rv�aS^ik€s,.a;„�y.€:_�>
RECEIPT #
wsr,�.�.�:,.a.xc�
CHECK #
s��.,.�.3�'>a
CLTD BYE
Total Paid for PERMIT ISSUANCE: $91.85 • $0.00
:' : "x` z$?..: .,�
DESCRIPTION
six%'..."' :..Vt€,'€.X
g
PAID
PAID:DATE
r.
..., .. -;. . .-... ':° ..�., >.
��ACCOUNT -QTY
YAMOUNT
F ry
"¢'3.d'.RSE,n?;kxT'C.
WATER HEATER/VENT
101=000042401
0
$12.09.
$0.00
'-'•Y-`C'vA, �I 'fir E• mi �.,�6�N
PAID`BY t
M4 . -.{ x..d .'r"' r ; it e`e P 1;
}}SCC METHOD
{r L S•4:s!,�u,F'i' iX�'h"I.).4'xx- �' Y� -X 6 $ Uz _
RECEIPT# ��
.°Yh' ,r..:'''� .: as
CHECK#
w5. 4:..,YS• 'M1
C C
E >E
r s.
. gi F_:: ,., .:.::<r zn; Y +., s�, s'Y
DESCRIPTIONk .
.:, -gu �y,R;,gs'; _ ,, e sa a as a,,.,a"
��� ACCOfJNT
QTY
.k h':'e�-ssY^..:
v
T
PAID=
x-77,77 :='r35ki xs '
N , .< X
,
_R« ....
u.:�
� AMOUNT . �.
n
PAID.DATE"
WATER HEATER/VENT PC
101-0000-42600
0-
$7.25
$0.00
' r � x �, � - � .�•, g`�s�a�r - ��'�
�, s
t$e�',>7'*' 'r � .� tL.V� � .. �'�v,�,'+va
_ METHOD
a. [�"-. :s .n<�ST;��' '�-n::`t� }
� � RECEIPT;
.� ..:z;-,:�;d,+ � f s,�qy
CHECK #
� �rt44zu�.. _rox
CLgTD BYr
xr �l..4�..v'' <.._:1�
z` 1 -. .''....•x.,�d..,,ww"£L'- n
y"u8 `sib."-�'+Sd
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:••
r
Description: RUSHBY RESIDENCE / WATER HEATER CHANGE OUT
Type: PLUMBING Subtype: Status: UNDER REVIEW
Applied: 1/27/2016 MFA
Approved: 1/27/2016 MFA
Parcel No: 609610004 Site Address: 79786 VIENTO DR LA QUINTA,CA 92253
Subdivision: TR 2932372 Block: Lot: 27
Issued:
Lot Sq Ft:.O Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $2,200.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: WATER HEATER CHANGE OUT - 50 GALLON/GAS [2013 ENERGY) CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
FINANCIAL INFORMATION
Printed: Wednesday, January 27, 201612:53:21 PM 1 of 2 Cff?.
SYS TF. ti1S
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:00
BOND INFORMATION
Printed: Wednesday, January 27, 2016 12:53:21 PM 2 of 2 mAjr
SYSTEMS
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
:Er-CFIR-ALT-01-E(Revised09/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 6)
Project Name: Date Prepared: 1 Z.'7 lto
A. General Information
01
01
Project Name:
02 Date Prepared: V 1 `7 lL
03
Project Location: i 'yam,
04 Building Front0r*pA61 tdeg.orcardinal)-
05
CA City: L a- cx
06 Number of ALMOMI ing Units: C',A
07
Zip Code:
08 Fuel Type.: K Nip e�_X `bv %Q
09
Climate Zone:
10 Tota C&gditioned Floor &01;#t' -4
11
Building Type
12 SIli� A'r.,ea` rt2) __T
13
Project Scope: rJO t ! `, `
E' eptions to Minimu °'Qg d Solar
`� R'e6flectance ffmd Minix j�um Thermal or SRI
150.2(b)1Hi;
B. Building Insulation Details (Section.150.2(b)1),
01
02
03
04
05
06 C 07 08 09
10
11
01
Proposed
Required
04
06
0
08 9
Frame
11
12
'
7 AppendixJA4
Frame
Continuou
;P.
R_*rence
Tag/ID
Assembly Type
Frame
Type
Depth
(inches)
Spacing
(inches)
CaInsulation i
tt val"Wall u
U-factofk I Cell
U -Factor
Comments
Method of
Roof
P
ID roduc
R-valu
Durk
N
Aged Solar Aged Solar
Reflectance Reflectance
Thermal
SRI
Q
C. Roof Replacement (Section 150.2(b)1H) a `
01
02
03
04
06
0
08 9
IO
11
12
13
14
Proposed
Minimum Required
dud.''
Tag/
Method of
Roof
P
ID roduc
R-valu
Durk
Iniflal Solar Aged Solar Thermal SRI
Aged Solar Aged Solar
Reflectance Reflectance
Thermal
SRI
ID
Compliance
Pitch
r4Fxception
Nury S1 pe
insulatr.9
Reflectance Reflectance Emittance (Optional)
(Max) (Min)
Emittance
(Optional)
V
NOTES �
• Roof area covered by bu j 7n egrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applied dccdtin At comply with installation criteria from section 110.8(1)4.
Registration Number:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time:
HERS Provider:
September 2015
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
SEC-CFIR-ALT-01-E,(Revised 09/45) CALIFORNIA ENERGY COMMISSION '"W'
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 6)
Project Name: Date Prepared: t .Z7 1(0
A. Genera) Information
01
02
01
Project Name:
02
Date Prepared: ` 1 a7 It,
03
Project Location: `yam
04
Building Front OAe.ntatiV'(deg or cardinal):
05
CA City: L G
06
Number of Akf�edt @ ing Units:
07
Zip Code:
08
Fuel Type.: 'S .,,,. �Q
`09
Climate Zone:
10
TotakCbnditioned Floor re (fr2):4
11
Building Type
12
Sl a Area (ft2) s
13
Project Scope: rJ0 tt � 11
3¢'''
Ee tions to Minim`u' �'Qgld Solar
Reflectance &Ad Min7nm`u`m Thermal or SRI
150.2(b)1Hc
B. Building Insulation Details (Section.150.2(b)1) ,.
01
02
03
04
05
06, 07 O8 09
10
11
11
12
13
14
Tag/
ID
Proposed-4-��
Required
„![xcepUon
e C
Product
ID
NuT. ..
R-valu
rodu�tc Oeck
ype Insulatt-n
Proposed
Frame
fo
IRitlal Solar Aged Solar Thermal SRI
Reflectance Reflectance Emittance (Optional)
Aged Solar Aged Solar
Reflectance Reflectance
(Max) (Min)
' Vo Appendix JA4
Frame
Continuous R*rence
Frame
Depth
Spacing
Ca t' Insulation
Tag/ID
Assembly Type
Type
(inches)
(inches)
S vale-val�'ii U-factoF �aB,le= Cell
U -Factor
Comments
• .x `'
14
- 4 1S, QL "% ..�ara� VHA
C. Roof Replacement (Section 150.2(b)1H) i! * a
01
02
03,
04
06 � 0
080p, 09
10
11
12
13
14
Tag/
ID
Method of
Compliance
Roof
Pitch
„![xcepUon
e C
Product
ID
NuT. ..
R-valu
rodu�tc Oeck
ype Insulatt-n
Proposed
Minimum Required
fo
IRitlal Solar Aged Solar Thermal SRI
Reflectance Reflectance Emittance (Optional)
Aged Solar Aged Solar
Reflectance Reflectance
(Max) (Min)
Thermal SRI
Emittance (Optional)
NOTES �
• Roof area covered by buiil �%�njtegrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applieddcc tin List comply with installation criteria from section 110.8(i)4.
S,
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance September 2015
stn.# City Of QuInta
Building 81• Safety Division
Permit # P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: 7.9786 Viento Drive Owner's Name:. Michael & Brenda Rushby
A. P. Number:
Address: 2950 Panorama Drive, Unit 904
Legal Description:
City, ST, Zip: Coquitlam, British Columbia, Canada
Contractor: General Air Conditioning
Telephone: 604-312-14913,6
Address: 31170 Reserve Drive
Project Description: Replace 50 Gallon Water Heater
City, ST, Zip: Thousand Palms, CA 92276.
Telephone: 760-343-7488
State Lie. # : 686310
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: ' ' `°
State Lic. #: ;„:���� �
Name of Contact Person: Steven Schnierer
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: #Unit$:
Telephone # of Contact Person: 8.18-735-7876
Estimated Value of Project: $2,200.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING PERMfI' 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 •
Tide 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
V Review, ready for correctionslissue
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 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