13-1624 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00001624
Property Address:
54524 INVERNESS
APN:
775 -101 -006 -
Application description:
PLUMBING
Property Zoning: -
LOW DENSITY RESIDENTIAL
Application valuation:
800
Applicant: Architect or Engineer:
4 4a" C
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
HANNA ZERRES
54524 INVERNESS
LA QUINTA, CA 92253
(
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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.
LicenseClass:Class:. C36 a No.: 812894
Dare: /� Co tor:
ILDER DECLARATION
I hereby affirm under, y 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.l. '
(_) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/17/13
Contractor:
ALL STAR WATER HEATERS INC
30300 PUERTO VALLARTA WAY D
MENIFEE, CA 92584
(951)301-0067DECy 2U13
LiC. No.: 812894
CITY 0�A ��N7A
----------------------------------------------—
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 OAK RIVER INS Policy Number 2200062086121
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 orkers' compensation laws of California,
and agree that, if I should becomes 1� o t e wor s' compensation provisions of Section
`J 3700 of the Labor Co ofi rthwith co pl with those provisions.
�Y�•^��� Appl
WARNING: FAIL TO SE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT ANE 0 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.
I certify that I have read this application and stat to above information is c act. I agree to comply with all
city and county ordinances and state law ting to building construc ' hereby authorize representatives
oft is county to enter upon the abo -mentioned propert pect(on purposes.
te. 2 Signature (Ap
r.-,
Application Number . . . . . 13-00001624
Permit. . . PLUMBING 2013
Additional desc .
Permit Fee 11.92 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 6/15/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA PLBG WATER HEATER/VENT
11.92
----------------------------------------------------------------------------
Special Notes and Comments
WATER HEATER CHANGE OUT 40 GALLON 2008
ENERGY CODE] CARBON MONOXIDE ALARM(S) TO
BE INSTALLED PRIOR TO FINAL INSPECTION.
2010 CALIFORNIA BUILDING CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, PLUMBING
7.15
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 11.92 .00 .00
11.92
Plan Check Total .00 .00 .00
.00
Other Fee Total 98.72 .00 .00
98.72
Grand Total 110.64 .00 .00
110.64
LQPERM[T
Bin #
City of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
i�J \
Project Address: Ist -
Owner's Name:F)QtA,O,)gZ
A. P. Number:
Address:
Legal Description:
' r�
Contractor: ' (
City, ST, Zip: L w I
f %�n:'.'4 `}:fi:�:: fi'i � �' in:;i� ii;J:+•I:Y.
Address: 3o o� C
Project Description:
p
City, ST, Zip:
Teleph /L./''
L n
1.it �:i;:1��iiF�� i. `>}y4l.i:'.:k;:ri:.;!(:Lv;:j i:::.
Y.:..f4C:ir •... y.. ....
State Lic. # :
City Lic. #..
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lic. #
:;;;;•; w<;: <:;:::>:.:<:ss <:>:<:::<.«
:< f..w ✓.,..:.....: .:.:::..:.
; ::Project
Construction Type: Occupancy:
type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:Sq.
Ft.:
#Stories:
#Units:
Telephone #,of Contact Person:
Estimated Value of Project: ROO,
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2' Review, ready for corrections/issue
Electrical
Subcon factor List
Called Contact Person
Plumbing
Grant Decd
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
.J7
r
'pu;A Put 9utu01u;"
3usJf t '0tnls;o>t '142;IUM 01 en' 18 1 iu n WF '039* *64 Pti09l0ad s; uo;letniul :Yt(E)0gt
'f►,.i'Lt 'Frill IRIO U jo slusass;nbez •
Ay1 110a8 'F 4t< ewlsis t016A soy so enaleAs 2u;lssy a;uotpxq tt01s soj uo;lttneu; �d;d :g )O9i
'►-091 us;i pue $-at 4t4► 0.1 fat"Poul 'Fq tilqs tuft IWW loy zastipu; put omos
2u;sny usealaq pslornsur. 2v;dT!. put' 204;1 suFs . is 'Aa1tA pp t;4a 'ito;;ons ; 2u;d.;d e101242 24Ft00J :20021
1-091..tgsj epttputls' lea pe2tlnsu.; an socta .101" 104 jo sugjoss xv;jItnastost jo glsuar SAFIUa
P" -401 salts4 sales of 1taslts Bodo .049411'" Pv* 104 j0 lssj 9 16JU :9 09.1
'Nuel sq1 jo so;a0ln 64.1 u0 pylo;pu; s; antwaq-401jetniv touayv;
Aq1 urgA u0;,etnAu; 1e1140lu; 9.1-8 to uo;islnsu; tstt2alxa tt-I OAsit s>tutl te10A 104 tau;pu; jaylo
to mills tetos toj evust dn4ceq to•t4Vlt Ovial2 is gone 41,4uti time psltlun :at (E),09t
.540-0 to Li.y jo 90e6ltp64 INUOg1 p0litlt4; ue u;esq doEj*1n2Ut'yt-;A Foam lteuti ars ase
ptspuets tte{u•;t fenp?j sy1 uog1 ss1e021 ou tslst Rtssu ui q1;A potet stolny jo.1sA 1s2 0264016
'!{e)tttI 3e..'Fi vapsouuos .0061
erOtnAttnt put 'aAttA uo;let02; d=d W0;1UaA62d Aatjj9§q 'tAt6A 8699104Us;t 141 TOM 90;a400000
taF1u�Plati aFY-gltH pub s1FUfi 'ftFtt'FAP Std 1. rue 9utAset adoot uo;lernas a0t..fu in4 asst .:4 ?)Cit.
'U0182. 1003 igu7 Vii{; iq H;j;ytss st9 ei01n4 10164 :tit s• -Ott
lAMtp a7*P�f �► pl pt ti ;.ilt}Rjy�
_ 0d,il si0ringi;le ssie:K •sa;0b
' 11r W
' "I.. .tlrwrrup> Pow offommiAW i'. 4'W"trw0m.ou.v
Vo iYJJpY # A/2w 1A`Yfallpe.l6llMy dolm lr!!s/=Pu s/b uOJvgisAxl a4t,xryN bar or nw wmsjw
MAtrdtvfw -14 j '(yo0%If'A hwU wp*" uo/Mxww byt f1dom tow" rwlbiib rrtM=ppIf .z
'all 'toanavnuuu ' -PO ' a so 0>r bleo 1 '(:
er
"..
�
:( uFlttcips;'Fay
tan1sA-y uottatnsul
. Aauai011-n tnagl (162) 11tbtde� -2801S...
'Ptdpuijs) IWAI tond/addj
>(uel te4t01it6
to sploy',s2t04g Xi[t ut 1t�quriH_
_ 0d,il si0ringi;le ssie:K •sa;0b
' 11r W
(VWWM RIP N AMIAM.100 MV"Mwl ed) omu-rll.'AVIlb1'Pr pA"W ON b w 'twi f ftma rt.t. its e4 o mi onlay
Aga 'Ar sr JOB* a iu g'px ffj s vossay omnorz
obuyu wMUTAK