BPLB2017-001578-495 CALLE TAMPICO D �Cl/
LA QUINTA; CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPLB2017-0015
Property Address:
44065 CARMEN PL PL
APN:
604151005
Application Description:
PRESTON / CHANGE OUT 40 GALLON GAS WATER HEATER
Property Zoning:
Application Valuation:
$950.00
Applicant:
STEPHEN PRESTON -
44065 CARMEN PL
LA QUINTA, CA 92253
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/30/2017
Owner:
PRESTON STEPHEN & JOYCE REV
, 92253
Contractor:
OWNER BUILDER
Llc. No.:
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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: _ License No.:
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
ba is for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
p mit subjects the applicant to a civil penalty of not more than five hundred dollars
( 0).:
,Ml, as owner of the property, or my employees with wages as their sole
c pensation, 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
wi . one year of'completion, the owner -builder will have the burden of proving that
he he did not build or improve for the purpose of sale.).
, as owner of the property, am exclusively contracting with licensed contractors
to c nstruct the project. (Sec. 7044, Business and Professions Code: The Contractors'
St4te License Law does not apply to an owner of property who builds or improves
th reon, and who contracts for the projects with a contractor(s) licensed pursuant to
t ontractors' State License Law.).
�( am exempt under Sec. . B.&P.C. f his .son
Dat X611 YaC�
-'
/ V V - —._..
CONSTRUCTION LE DING AGENCY. '
I hereby affirm under penalty of perjury tha, 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
WORKER'S COMPENSATDN 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: _ Policy Number: _
I certify that in the performance of 11he work forwhich thi ermit is issued, I
shall not employ any person in any manner so as to become sub' to he workers'
compensation laws of California, and agree that, if I sho be me su ject to the
workers' compensation provisions of Section 3 700 of a La or Code, shall forthwith
comply with thos provisions.
Date: Applican
WARNING: FAILURE TO SECURE WORKERS' COLAP SATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,003). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOP 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 thi= 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 tke work being performed under or
following issuance of thi
2. Any permit iChin
—s a res If' this application becomes null and void if work is
not commence w180 days fr date of issuance of such permit, or cessation of
workfor180daysubject per t to cancetation.
I certify that I have read this application and state that the above informati orrect.
I agree to comply with all city and county ordi,iances and state laws I ing t uilding
construction, and hereby authorize representatives of this city to r u n e
above-mentione prop rty forinspection purposes.
Dat �'Sfgnature (Applicantor Agent):
Application Number:
BPLB2017-0015 .
Property Address:
44065 CARMEN PL PL
APN:
604151005
Application Description:
PRESTON / CHANGE OUT 40 GALLON GAS WATER HEATER
Property Zoning:
Application Valuation:
$950.00
Applicant:
STEPHEN PRESTON
44065 CARMEN PL
LA QUINTA,CA 92253
Date: 1/30/2017
Owner:
PRESTON STEPHEN & JOYCE REV
92253
Contractor:
OWNER BUILDER
Llc. No.:
---------------=-------------------------------------------------------=---------------------
Detail: WATER HEATER CHANGE OUT - 40GALLON/GAS [2016 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNTCITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE:
$96.27
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WATER HEATER/VENT
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WATER HEATER/VENT PC
101-0000=42600
0
$7.60
Total Paid for PLUMBING FEES:
$20.27
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS — WATER HEATER
JEG-GFIR-ALT-01-E (Revised 06114) GALWUKNIA t:NLKUr UUMMIb wry
CERTIFICATE OF COMPLIANCE CF111-ALT-014 WATER HEATER
Prescriptive Residential Alterations for Water Heater (Page 1 of 2)
A. GENERAL INFORMATION
Site address: a� Building Type: 7Single Family Dwelling
0. -Multi Family Dwellings
City, Zip Code: (_ C Climate Zone: I
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
H 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
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 CF1R-NCB-01 to document the water heater alteration.
Instructions for sections With column wimbprs arP aivPn heinw-
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 CF111-ALT-014 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 is not 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, AFUE, 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 t t this Cert' ' ompllance documentation is accurate and complete.
N e 5owner o Authorized agent ocontractor
Signature:
Comp—ane:
Contractor licen a #:
Address: 14-0 /
Phone: •%�� r� Q
City/State/Zip: / j %N�,�
Date: ?j
For assistance or questions regarding the Energy Standards, contact the. Energy Hotline at: 1-800-772-3300. -
q
i
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
Considering Becoming an Owner -Builder?
Important information you need to know BEFORE pulling your permit!
The term "Owner -Builder" can mean three different things:
"Owner as Worker", "Owner as Contractor" or "Owner as Employer"
Understand each has Benefits or Risk, 'and it is possible to combine them!
Hiring a California Licensed Contractor means you do not personally perform any of the construction work, the permit is not taken
out in your name, you are not personally responsible for the construction and you are not an Owner -:Builder. Instead, you become a
"Customer" and California law provides you the benefit of protection from.poor workmanship, failure to finish the job and financial
risk due to worker injury.
Benefit/Risk: Highest Benefits and.the Least amount of Risk
Owner -as -Worker is a type of Owner -Builder where you personally perform the construction. work, the permit is taken out in your
name and you are personally responsible for the construction management, knowledge, workmanship, and completion of the job. You
benefit by not paying others to perform this work for you and your risk depends on your own ability to complete the job successfully.
Benefit/Risk: Possible Benefit with Low Financial Risk
Owner -as -Contractor is a type of Owner -Builder where you personally act as your own General Contractor, the permit is taken out in
your name and you hire California licensed sub -contractors to perform portions of the construction work. WARNING: The benefit of
protection provided by law when you hire only. California licensed sub -contractors can turn to serious financial risk if you hire
unlicensed contractors to perform any of the work. .
Benefit/Risk: Possible Benefit and Significant Financial Risk
Owner -as -Employer is a type of.Owner=Builder where you pay any unlicensed individual to perform any construction work valued at
more than $500.00, the permit is taken .out in your name and you are. personally responsible for their employment requirements,
supervision, perfokmarice, safety and welfare.while on your property. WARNING: Cost savings benefit can turnto serious financial
risk if you fail to deduct payroll taxes or provide workers compensation insurance for each worker.
Benefit/Risk: Possible. Benefit with Significant Financial Risk
(Health and Safety Code Section 19827) The California Legislature declares an "urgent and statewide
public interest in assuring" that contractors comply with Contractors' License Law, .Business and
Professions Code and Workers' Compensation Insurance requirements to ensure property owners are
informed about, and protected from the following when improving their property as Owner -Builders:
Fraudulent representations Liability for worker's injuries • Liability for -material and labor costs unpaid b-
contractors • Licensing requirements • Employers tax liabilities
Over 20,000 consumer complaints are filed each year. Many complaints relate to owner/builder projects
and include workmanship and workers' compensation issues' Homeowners suffer financial harm due to
defective workmanship and injured employees.
Following are alarming examples of what has occurred with Owner -Builder permits:
Example 1: Homeowner received insurance money to rebuild burned -down home.
• Owner/Builder permit pulled to rebuild structure.
■ Unlicensed contractor built substandard structure —must be torn down and replaced.
■ Estimated financial injury is $225,000. .
■ Additional financial injury - IRS threatened to tax insurance payout if house not completed by the end of
the year.
Example 2: Brother-in-law had active license but fled an exemption from Workers Comp.
■ Owner -Builder hires brother-in-law to install.a new roof.
■
.Employee falls and sustains multiple spinal and extremity fractures as. well as a head injury and
remains in a coma to this day.
The Owner -Builder, who has sold the home, is now a defendant. in a. lawsuit for reimbursement for
benefits paid to the injured worker.
Example 3: Employee of contractor without Workers Comp is hired by Owner -Builder to install septic
system and suffers injury that results in permanent disability..
■. The Owner -Builder did not have a homeowners insurance policy on the house against which to submit
a claim.
•
The -Owner -Builder is now a defendant in a lawsuit for reimbursement for benefits paid to the injured
worker.
Did you know unlicensed persons frequently have the property.owner obtain an "Owner -Builder" building
permit which erroneously implies that the property owner is providing -his or her own labor and material .
personally?
Did you know —your' homeowner's insurance may not provide coverage for injuries sustained on your
property by an unlicensed contractor anddhis/her employees?
Did you know if you are considered an "employer" under state and federal law, you mustregister with
the state.and federal government; with hold.payroll.taxes, provide -workers. compensation -and- disability
insurance and contribute to unemployment compensation for each "employee"? ti .
Did you know — that if you fail to abide by these laws you,may be subjected to serious financial risk?..
OWNERS BEWARE AND CONSIDER THE RISK BEFORE ACCEPTING FULL RESPONSIBILITY FOR
YOUR CONSTRUCTION PERMIT .
P.D. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT -
PROPERTY OWNER'S PACKAGE
(760)777 -7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has een submitted in your ,zkajne listing your the builder of the property
improvements specified at
We are providing you with an wner-Builder Aclmowledgment and Information Verificatio orm to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision,
signed, and returned this form to us at our official address indicated. An agent of the owner carrot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION 1
DIRE TONS: Read and initial each statement below to signs you understand or verify this information.
a 1. I understand a frequent practice of unlicensed persons is to have the property owner obtai-i an "Owner -Builder"
building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as
an Owner -Builder, may be held liable and subject to serious financial risk .for.any injuries sustained by an unlicensed person
and his or'her employees while working on my property. My homeowner's insurance may not prov-_de coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on my pr perty.
2. I understand buildingpermits are not
p required to be signed by property owners unless they Ere responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
3. I understand as an "Owner -Builder" I, am the responsible party of record on the permit. I unders-.and that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
understand Contractors are required bylaw to be licensed and bonded in California and to list their license numbers on
permits
/and. contracts.
I� 5. I understand if I employ or otherwise engage any persons, other than California licensed Contracbrs, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
P-_6_,_1 I understand if I am considered an "employer" under.state and federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to.serious financial
risk.
I understand under California Contractors' State License Law, an Owner -Builder who builds sirgle-family residential
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or.all of tae work is performed
under contract with a licensed general building Contractor.
stand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
L19. iZlerstand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
Service, the United States Small -Business Administration, the California Department of Benefit Payments, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
10. I am aware of and consent to an Owner -Builder building permit. applied for in my name, and understand that I am the
party legally,
g �ly: a ncL finanLi lly responsible �or proposed construction activity at the following address:
agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner -Builders as mell as employers.
gree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also
important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working
on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and. wish to hire Contractors,
you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, form must be
the agency responsible for issuing the R. Note: -coF
other verification acceptable to the. is r
owner's signature. 0,
Signature of property owner
ted and signed by the property owner and returned to
property owner's driver's license, form notarization, or
entg,d�lvhen the permit is 'issued to verify the property
I
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION. OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign; and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or. Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy.' Note. 4 copy of the.owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owners signature.
Property Owner's Signature: Date:
Bin #
Qty of L Chu nta
Building K Safety Division
Permit;; 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
�J J Building Permit Application and Tracking Sly =et
lR�oject Address: b tuner's Name:
A. P. Number:
`JAddress:
Legal Description:
Contractor:
ircity, ST, Zip:
,�
bTele h n
P o c:
Address:
Project Description:
City, ST, Zip-
ip:
Telephone:
TelePo .
h ne-
State Lic. # :
City Lia
Arch.,`Engr., Designer:
Address:
City, ST, Zip:
Telephone:
P o .
aneY
Con tructi n Type: Occupancy:
:
Statei-
L c t'. •
Project type (circle one):: New Add'n Alter Repair Demo
0
Name of Contact Person:Sq.
Ft-:
#Stories:
# Units:
r Telephone # of Contact Person: za
l
�E"stimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
tl
Submittal
Req'd.
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted.
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balaece
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical .
Subcontacl'or List
Called Contact Person
Plumbing
•
Grant Deed
Plans picked up
S.M.I.
lLO.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Jrd Review, ready for corrcctidns/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
i