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12-0048 (PLBG)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT _ Date: 1/17/12 Application Number:x`12 Z0 009`048 Owner: Property Address: S�INVERNESS TOM SHERMAN APN: 775-101-•023- - - .54391 INVERNESS Application description: PLUMBING LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1033 I Contractor: JAIL 2012 ! t Applicant: Architect or Engineer: CALIFORNIA DELTA MECHN�I INC J 6052 E. BASELINE 'RD, 1155 CITY OF LA��IN•� MESA, AZ 85206 •�;^�?ijs� (866) 692-5273 �.eN�AAs�Z.- L i c . No.: 811114 P 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 Professionals Code, and my License is in full force and effect. License C ass: C1J0 C20 C3 License No.: 811114 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).: (_) 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 Name: _ Lender's Address: LQPERMIT 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 issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1697823-11 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 of the Labor Codl fortith comply with those provisions. Date: 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 Director of Building and Safety 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. 1 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 co my enter upon the above-mentioned propett spection rposes. Date: � F — _ Signature (Applicant or Agent): Application Number . . . . . 12-00000048 Permit . . . •PLUMBING Additional desc . Permit Fee . . . . 22.50 Plan Check Fee 5.63 Issue Date . . . . Valuation . . . 0 Expiration Date 7/15/12 Qty Unit Charge Per Extension BASE FEE 15.00 1..00 7.5000 EA PLB WATER HEATER/VENT 7.50 ---------------------------------------------------------------------------- Special Notes.and Comments WATER HEATER CHANGE OUT - 40GAL/GAS [2008 ENERGY) 2010 CALIFORNIA BUILDING CODES. January 17, 2012 5:13:22 PM AORTEGA ---------------------------------------------------------------------------- Other Fees. . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 22.50 .00 .00 22.50 Plan Check Total 5.63'. .00 .00 5.63 • Other Fee Total 1.00 .00 .00 1.00 Grand Total 29.13 .00 .00 29.13 LQPERMIT ' Prescri Genn_ Site Address urc :-crrulcate ox ance:.Residential Climate Zone; ea n�, CF-1�t ALT Wx A=e.-7-Zoe t_ WATER �IEATING List water heaters and boilers for both domestic hot water heaters must be gas or propane fired, and may heaters and hydronrc space h I 1a'tchen(s and on all and not exceed 50 gallons, Hot water pfpe insulagaNng. nd eld al dwellingDHW and hot water i t is re red to all co orient a f HW heater to the p clrages to all climate aons:s. w.�e�r Heater e I Put®I Dls4'ibution T�pa Number of Tank Capacity Bnergy Factor or Standard stem P rti' Thermal Extetnal Tank Standard al BIME)ierncv atioa R -Valuer �5� 0 p.6Z 1. Indicate 7e rage Heat pi a. Recp, Insmntaxeous, etC.J� irculating systems 307Mg mulh'pla dwalli Lit a o ng units shall meet the rYcir culatian regufremehts of 150 rP . 3, The wafer h o p F f ala er ac i i ihs Prescriattve raeuf��� .�, eatEng tank and f es shall be Ms:dated to meat rhe sin 4uf ants of S00}. Confl actor R1�,....�-�._., _ • . I oertsfy Wet thlg Certificate of C y ---w-� �� ucr•s �ueclaratioa 5tatelaaent) • Yam eligible under Divieioa 3 of ce documentation is accurate and complete, thle Cettifionto of Co ahfctnia Business anmfhe a ns Code to acoeptrwpansl • mplisaca dPbihty for the building design {dmtitied on t ecstiijr that the energy featun and peribrmaaee ee' to the requircm" of Title 24, Parts 1 sad 6 of the OMions for We begin ng design identified on this C • The bailding designfesiarea t�mia Code of Regulatiops. Certificate of Compliance canforn Identified on this Carmante of Compliance are e budding design on tha other applicable eo ` liemae Com onsistentoVlththe �tioa provided A for mval with this butt ' mP forme, woclarhea�, calctilaHons, plans and P vided to document this Nems D�l to licetioa, apeeiflcatioue aubmittod t the es�Memeat companytallfornla Delta Me soleal - Addm'*8056 E. 6asallndRd., #155 city/Seateizlp:Mesa, AZ 86206 .008 Data r 2912, L10C�s'811114 L'M"'866-882-5273 Tote1 Permit Fees 3A31S NS E Z101 `9[ 'uPr. Din # ity of La Quanta Building BrSafetyplvlslon pQ#Permit 7BU11ding # Box 1504, 78-495 Calle Tarrrpinoq t A 4a r 91 cat�o.2253, 760� 77y7� pp n and Tracking CJ Project Address; �, VV_S S Owner's Name; V1/11 A. P. Number: Log nJ Dcscrl tion: Address; q �� W Contractor.', City, ST, Zlp; L„ 61 Address: 90S6 U� Telephone; �' Project Deseription; City, ST. zip: des Z 6 Telephone: 4q? -• 52 ' � State Lie. # : � � • City Lie, Arcb,, Angn, Designer: " Address: > City,, ST, Zip: Telephone: State Lt., {�; Consavctlon Type: Occupaaay: ; Name of Contact Person- n: Projocttype (olteleone); New Add'n Alter' ��pt►ir Dea;,o Telephone Tele hone # of Confect Person: 86 6�6 q Z^ 2 # Unita' Mtimeded Value of Project; , aPPLICANT; DO NOT WIiM MELOW THIS LINE; � Buhmlttal Re 'd Recta. TRAQaNG Plan Bets PLrktlYIIT SES Plea Check submitkd Structural Cales. Item Reviewed, ready, for correctimm Amount Trnsa Calci. Plan Plan Check Deposit Called Contact pereo,, Title 24 Calce, Plan Check Falanee plana plelced up Flood plain plan Construction plana resubmfw Grading plan Mechanical 2' Review, ready for correetlons&yue Subcontactor L14 )ffecerlca[ Called Contact Poison Grant Deed • Plumbing Plans picked up H.O.A. Approval 9.M.I- Plane raubtnitted IN HOUSE:. Grading Rulew, ready for correetionunssuo • Planning Approval Daveloper impact Fee Called ContactPerson Pub' Wks' Appy Date of permit issue School Fees " Tote1 Permit Fees 3A31S NS E Z101 `9[ 'uPr.