BPLB2019-0021U� VOICE (760) 777-7125
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/6/2019
Permit Type/Subtype: PLUMBING/ Owner:
Application Number: BPLB2019-0021 10SEPH RAITI
Property Address: 81943 PRISM DR 81943 PRISM DR
APN: 764360048 LA QUINTA, CA 92253
Application Description: RAITI / 50GALLON WATER HEATER CHANGE OUT
Property Zoning:
Application Valuation: $900.00
Applicant: / L a� Contractor:
TRICIA MORA - STATEWIDE SERVICES INC DBA STATE WI E L-/`TLl STATEWIDE SERVICES INC DBA STATE WIDE PL
73-700 DINAH SHORE DRIVE 73-700 DINAH SHORE DRIVE
SUITE 405 FEB 0 b 2019 SUITE 405
PALM DESERT, CA 92211 - PALM DESERT, CA 92211
CITY OF LA QUINTA (760)699-5434
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 936147
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 1commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C36, C33, C10, A LiJne93614749
Contract
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
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 forwhich this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Sec Ian 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: BENCHMARK JNSURAHCE COMPANY , Policy Number: CST5015156
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 a Labor Code, I shall forthwith
comply with those provisions.
ho
Dater `� • I 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 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 clt enter upon the
above -mentioned property for inspection purposes.
f
Date: Signature (Applicant orAgor
Date: 2/6/2019
Application Number:
BPLB2019-0021
Property Address:
81943 PRISM DR
APN:
764360048
Application Description:
RAITI / 50GALLON WATER HEATER CHANGE OUT
Property Zoning:
Application Valuation:
$900.00
Applicant:
TRICIA MORA - STATEWIDE SERVICES INC DBA STATE WIDE PL
73-700 DINAH SHORE DRIVE
SUITE 405
PALM DESERT, CA 92211
Owner:
JOSEPH RAITI
81943 PRISM DR
LA QUINTA, CA 92253
Contractor:
STATEWIDE SERVICES INC DBA STATE WIDE PL
73-700 DINAH SHORE DRIVE
SUITE 405
PALM DESERT, CA 92211
(760)699-5434
LIc. No.: 936147
Detail: 50GALLON WATER HEATER CHANGE OUT [GAS] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA
BUILDING CODES.
DESCRIPTION
ACCOUNT CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
7 +,I n..:.4 i... nCORAIT!CCA w1/`e.
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT
101-0000-42401
0
$13.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT PC
101-0000-42600
0
$8.00
Total Paid for PLUMBING FEES:
$21.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE:
$10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
S02-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS — WATER HEATER
GEC-CF1 R-ALT-01-E (Revised 0312017 - AOP,)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations for Water H
A. GENERAL INFORMATION
Site address: Oe� q5 ! ��
City, Zip Code: LA QUINTA, CA Y
CALIFORNIA ENERGY COMMISSION
CFIR-ALT-01-E WATER HEATER
(Page 1 of 21
Building Type: ingle Family Dwelling
❑ Multi Family Dwellings
Climate Zone: 1 15
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
Heating
Water
Heating
Wati&
Heater
#of
Water
Water
Heater
Fuel
Type
Rated
Input
Rated
Input
Heating
Efficiency
Heatl4
Efficleltsy
Standby
Loss (%)
Exterior
Insul.
Back -Up
Solar
Central
DHW System
Dwelling
Unit DHW
System
Identificgtivn
or
System
Type
Type
Heaters
in
system
Storage
Volume
(gal)
Type
Value
Type
Value
R-Value
Savings
Fraction
Distributign
Type
System
Distribution
Type
Name
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 11mlted to Standard trunk and branch or demand recirculation for gas or propane water
heater. [,)errand 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 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 spate heating only, combined hydronic are when tKLe 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 CRR-ALT-01-E - WATER HEATER
Prescriptive Residential Alterations for Water Heater (Page 2 of 2)
A. 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-famlly 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 stuh, 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 Ft -Value: Enter the R-va;Iue 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 multl-family buildings with Using a central dlstributlpn 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 note -central then pick from Standard, Demand Recirculation — Manual
Control, Demand Recirculation — Sensor Control. If non -central electric water heater this most be Standard, no recirculation system shall be installed.
DOCUMENTATION AUTHORS DECLARATION STATEMENT
I certify that this Certificate of Compliance documentation is accurate and,cotnplete.
Name- ❑Owner 4 Authorized agent ontractor Slonature: t
f /71_2v-
Corripany Contractor license #:
Address: %,3,00 �� i'wl-1 !I Phone: 7,�-,i'
City/State/zip: -� G , f D-ate;
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at.,1-800-772-3300.
1 ,
PL3 2-a 1 � -no 21
Bin �l
Permit
Project F / Address: �l
City of La Q uil i to
Guffding a Safety Division
78-495 Caffe Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name: c
l� 1
A. P. Number:
Address: Cldlg3 Y'
Legal Description:
City, ST, Zip: & a t ryl--?
CoiAractor' 1
TelephoneJV
ra
Address: 7
- eU r
�� _
Project Description: � �� �' 'o
City` ST, Zip;
h
Telephone:
State Lic. # _
Arch., ] ngr., Designer:
City Lic. #:
Address:
City, ST, Zip:
Telephone:
State Lic.
y
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: L� ql
Mzv-
Sq. Ft: #Stories:
#Units:
Telephone # of Contact Person: Q
ilk QL
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
77
it Submittal Req'd Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Plan Check Deposit
Amount
Structural Calcs.
Revicived, ready for corrections
Truss Calcs.
Called Contact person
Plan Check Balance,
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°' Reviciv, ready for correctionslissue
Electrical
S.TcO ntoc f.1zzSt
Called Contact Person
I
Plumbing
y
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I•P.P.
I'ub. Wks. Appr
Date of permit issue
School Fees,
J—,otal
Permit tees