BPLB2019-006378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Tihi ^& 4& Q"
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
PLUMBING/
BPLB2019-0063
78915 VILLETA DR
604151037
TORRES / WATER HEATER CHANGE OUT
$1,612.50
Applicant:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201
MEMPHIS, TN 38120
Z �_ 0 _.
APR 2 3 2019
CITY OF LA QUINTA
DESIGN & DEVEL.OHOL NT DEPARTMENT
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: C36, C10, C20 License No.: 7 54
Contr'di :
OWNER -BUILDER D£CLARATIOW
I hereby affirm under penalty of perjury that I am exempt from the Contras '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.).
(_) 1, 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: 4/23/2019
Owner:
SAMUEL TORRES
78915 VILLETA DR
LA QUINTA, CA 92253
Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201
MEMPHIS, TN 38120
(951)276-9744
Llc. No.: 765074
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 Lit rk for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Sectin 3700 of the Labor Code, for the performance of the work for which this permit
is iss ed. My workers' compensation insurance carrier and policy number are:
Carrier: LIBERTY INSURANCE -CORPORATION Policy Number:
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 the Labor Code, I shall forthwith
comply with those provisions.
0111141111, 1
Date:/ Appllc'911llt
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAIS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CI/L 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
foltowing 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.
b9l ^� Signature (App IIcant or Agent):
Application Number:
BPLB2019-0063
Property Address:
78915 VILLETA DR
APN:
604151037
Application Description:
TORRES / WATER HEATER CHANGE OUT
Property Zoning:
Application Valuation:
$1,612.50
Applicant:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201
MEMPHIS, TN 38120
Date: 4/23/2019
Owner:
SAMUEL TORRES
78915 VILLETA DR
LA QUINTA, CA 92253
Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201
MEMPHIS, TN 38120
(951)276-9744
Llc. No.: 765074
Detail: 50GALLON WATER HEATER CHANGE OUT [GAS] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. PER 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
taW
CALIFORNIA
Project Address: 789 15
. f f 1
APN #:
Applicant Name: Y�
Address:
City, ST, Zip: 0,1, ,AJT-4 CA
Telephone:C76,P 17 -cIcY4y
Email:
IT # 1JP1 AL -A 5 -
Project Description:
56],1L�
Valuation of Project $ 1Y4J,�2,se)
/8495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal Required ` Received
Pian Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
i_.
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS — WATER HEATER
CFC-CF1 R -ALT of -E IRevimed 061141
CERTIFICATE QF COMPLIANCE
CALIFORNIA ENERGY COA%1tSSIOr:
Residential Alterations for Water Heater CFIR-ALT-01-E WATER HEATER
kL INFORMATION
Site address:
10
11
12
Heating
Heating
Standby
V�Lcf
TA
Pa.
City, Zip Code: I.A QdtJTA
r,',
3
---------------
G. WATER HEATING SYSTEMS Sectian 150.2 b 1 G
01
02
1 03
04
Os
06
Water
Heating
Water
Heating
Water
N of
Water
Fuel
System
Heater
Water
heater
Type
Identification
System
Type
Type
Heaters
Storage
in
Volume
or
Name
system
(gal)
07 OB
Rated Rated
Input Input
TYPe Value
F47�`� 4rc-
Building Type:
Climate Zone:
fK Single family Dwelling
❑ Multi Family Dwellings
10
09
10
11
12
Heating
Heating
Standby
Exterior
Efficiency
EfRclenri
Loss (45J
Insul.
Type
Value
Distribution
R -Value
13
14
15
Back -Up
I Central
Dwelling
Solar
DHW System
Unit DHW
Savings
Dlstributlon
System
Fraction
Type
Distribution
iyps
WATER IjEATIN sySTEMI
Water heating compliance for an alteration is described in Section 1S0.2(b)113. For single dwelling a gas or propane water heater, with a storage'ank or60 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.
(VOTE, If the proposed Installation does not meet the requirements allowed specifically for alterations, use form CF1R-h'CB-0_ to document the water heater alteration
Instructions far recti ns with olurnn numbers are loan befovr:
1. Water Heating System Identification or Name: enter a unique name for tire Water Heating System.
2. Water heating system type: Domestic Hot Water (DHW), Hydronlc, Combined Hydronic, or Central. DHW is for domestic hot water, hydronc is a water heating
system used for space heating only; combined hydropic 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 system pick from Large Storage, Small Storage.
Heat Pump, Boiler, Large Instantaneous, Small Instantaneous or Indirect,
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E WATER HEATER
Prescriptive Residential Alterations for Water Heater !Page 2 of 2'y
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 systerrs
serving multiple dwelling units enter the total number of water heaters.
S. 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 .1,%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 M
S. Rated Input Value: Enter the numeric value of rated Input.
9. Heating Efficlency Type: Energy Factor, AFUE, or Thermal Efficiency. From product literature or a California Energy Commission directory_
10. Heating Effkiency 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 :jith at least two distribution
loops must be installed. This requirement applies to any building with a ght or more units. If the system is non -central or prefect 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 Reci%'Aatioe — "✓anual
Control, Demand Recirculation — Sensor Control. If non -central e'ectric water heater this must be Standarc, no recirculation system shall be irscalled_
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
• I certlfy that this Certificate of Compliance documentation is accurate and complete,
Name: Ton
DOwner OAuthorized agent Aoitractor
Signature: �
Company
Contractor license N:
Address:jC)�
Phone -r .7
City/State/21p:
ti r Jt'll-�ff i
��
Date:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.