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BPLB2019-005578-495 CALLE TAMPICO C� 0 U 4�L1iA.) LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: PLUMBING/ Application Number: BPLB2019-0055 Property Address: 78540 VIA SONATA APN: 646290013 Application Description: PALMISANO /WATER HEATER CHANGEOUT Property Zoning: Application Valuation: $900.00 Applicant: n STATEWIDE SERVICES INC DBA STATE WIDE PL D 73700 DINAH SHORE STE 405 SUITE 405 APIA 0 9 2019 PALM DESERT, CA 92211 CITY OF LA QUINTA DESIGN & DEVELOPMENT DEPARTMENT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing 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, B _ License Np ; 936147 Ll-- 0 i-1 cont 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 DlvisjD 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/9/2019 Owner: RICHARD PALMISANO 92253 Contractor: STATEWIDE SERVICES INC DBA STATE WIDE PL 73700 DINAH SHORE STE 405 SUITE 405 PALM DESERT, CA 92211 (760)699-5434 Llc. No.: 936147 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 ork for which this permit is issued. v 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: BENCHMARK INSURANCE 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 gf the Labor Code, I shall forthwith comply with those provisions. !I 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- Sigpplicant or Age 117' Application Number: BPLB2019-0055 Property Address: 78540 VIA SONATA APN: 646290013 Application Description. PALMISANO / WATER HEATER CHANGEOUT Property Zoning: Application Valuation: $900.00 Applicant: STATEWIDE SERVICES INC DBA STATE WIDE PL 73700 DINAH SHORE STE 405 SUITE 405 PALM DESERT, CA 92211 Data? 4/9/,2019 Owner: RICHARD PALMISANO 92253 Contractor: STATEWIDE SERVICES INC DBA STATE WIDE PL 73700 DINAH SHORE STE 405 SUITE 405 PALM DESERT, CA 92211 (760)699-5434 Llc. No.: 936147 Detail: 50 GALLON WATER HEATER CHANGE OUT [GAS] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES DESCRIPTION ACCOUNT QTY 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 Total Paid for PERMIT ISSUANCE: $101.40 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 QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 Bin # Perr * # A fizp%5- GtoSS Project Address: A. P. Number. City. ST, Zip: Telephone: Q i Arch., Eng., Designer: Address: City, ST, Zip: Telephone: Statc Lie. it: Name ofContnct Person: F Telephone # of Contact Personr-It'd # Submittal Plan Sets Structural C61cs. Truss Cales. Title.24 Calc. Flood plain plan Grading plan SubcodNctor Lith Grant Decd iLO.A.Approval IN HOUSE: - Planning Approval Pub. Wks. Appr sebaall'eea PC City Of La QUlnia Building ez Safety Division P.O. Box 1504, 78-4.95 Cage i'amplco, La Quinta; CA 92253.(760) 777-7012 Building permit Application and Tracking MAddrownws'ld me: City, ST, Zip: mess-. Talephmo!�Project Description: Lie. M t Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo R Sq. Ft: # Stories: # Units: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE Reed 'TRACIMG PERMIT REFS Item Amondt Revicwtd=rcady for corrcctlons Plan.CGeelcDepasit Called Contact Person Plan Check Balance. Plaus picked up Cons -traction Plans resubmitted Mechanical 21. Review, ready for correciionslissue Electrical CQk4 Contact Person Plumbing Plans picked up S.M:I. Plans resubmitted Grading, Review, ready for correctionslissue Developer impact Fee Called Contact Person A.LP.P. Date of permit issue Total Permit Fees STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS — WATER HEATER CEC-CF1 R-Al,T-01-E (Revised 03/2017- AOR) CERTIFICATE OF COMPLIANCE Prescriptive Residential Alterations for Water H A. GENERAL INFORMATION Site address: City, zip Code: LA QUINTA, CA G. WATER HEATING SYSTEMS (Section 1 01 0203 07 04 05 Water Water Water # of Water Heating Heating Heater Water Heater System System Type Heaters Storage Identifigotion Type I ValLve Type in Volume or system (gal) Nance Building Type: Climate Zone: 06 07 08 09 10 Dwelling Unit DHW Fuel f Rated Rated HeatingI HeatlFrg 51 Type l Input Input Efficiency Efflclericy I Li Type I ValLve Type Value La at,,, m4 RAI IF()A1111e or.ican_v n CFIR-ALT-01-E ❑ Single Family Dwelling 13Multi Family Dwellings 3.5 WATER HEATER (Page 1 of 2) 11 12 13 14 15 andby Iss K Exterior 1 Back -Up Insul. Solar Central DHW System Dwelling Unit DHW R -Value Savings Distributipn System Fraction Type Distribution Type f WATER HEATING SYSTEMS Water heating compliance for an alteration is described In Sectlon 150.2(b)1G. For single dwelling a gas or propane water heater, with a storage tank of 6.0 gallons maximum or instantaneous (tankless) can be'used. Dwelling Unit distribution systems are ilimited to Standard trunk and branch or demand recirculation for gas or propane water heater. Demand recirculation isnot 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, Multl-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 spedflcally for alterations, use form CF1R-NCB-01 to document the water heater alteration. Instructions for sections with column numbers are iven below: I. 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 tate water heater will provide both space conditioning and domestic hot water, 3. Water heater type: For non -central systems only Small Storage or SImall Instantaneous are allowed. For central systems pick from Large Storage, Small Storage, Heat Pump, Boiler, Large Instantaneous, Small Instantaneous or Indlrrect, CERTIFICATE OF COMPLIANCE CF1R-ALT-41-E , 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, AFLIE, 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 CoMmisslon directory 11. Standby Loss (percent): Applies only to large storage water heaters, Enter n/a for small stofage 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., 030). External calculations are required. 14. Central DHW Distribution System: For mWItl-famlly 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. 1.5. 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 most be Standard, no recirculation system shall be installed. DOCMENTATION AUTHOR'S DECLARATION STATEf,IIENT • I certify that this Certificate of Compliance documentation is accurate and, complete. Nam loaOL ❑Owner r uthoriiecl agent z<ontractor 1111 Slpt tune: Company )tCJ Cgptractor license #: to PY Address: Phone: L �Le city/state/zipo` Dote: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-77,2.3300.