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BRES2019-029978-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-itr4Zw4u&rw DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: BUILDING RESIDENTIAL/REMODEL Application Number: BRES2019-0299 Property Address: 53620 AVENIDA CORTEZ APN: 774102006 Application Description: JOWREY / ELECTRIC WATER HEATER RELOCATION Property Zoning: Application Valuation: $500.00 Applicant: ��� a DIAMANTINAJOWREY (`j !■J—�\ 53620 AVENIDA CORTEZ U LA QUINTA, CA 92253 AUG 3 0 2019 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: DIAMANTINA 10WREY 53620 AVENIDA CORTEZ LA QUINTA, CA 92253 Contractor: OWNER BUILDER Date: 10/1/2019 CITY OF LA QUINTA Uc. No.: ___________________________________DE%Qq 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: 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 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 Address: 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:_ 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. Date: 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 behalfthis 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 ofthis 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. Date: Signature (Applicant or Agent): 1(0.6rrwc C 'row SFD re "mWLm Date: 10/1/2019 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: DIAMANTINA JOWREY 53620 AVENIDA CORTEZ LA QUINTA, CA 92253 BRES2019-0299 53620 AVENIDA CORTEZ 774102006 JOWREY / ELECTRIC WATER HEATER RELOCATION $500.00 Owner: DIAMANTINA JOWREY 53620 AVENIDA CORTEZ LA QUINTA, CA 92253 Contractor: OWNER BUILDER Llc. No Detail: PRE EXISTING ELECTRIC WATER HEATER RELOCATION FROM GARAGE TO EXTERIOR OF DWELLING. HEATER TO BE INSTALLED IN A GALVANIZED STEEL ENCLOSURE. ENCLOSURE TO BE ATTACHED TO STUDS AND EARTH QUAKE STRAPS TO BE INSTALLED. PER 2016 CALIFORNIA BUILDING CODES. �Pt�3A os q�2 Ho�`� �•oa� �►`cr�2 FINANCIAL INFORMATION 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 DEVICES, FIRST 20 101-0000-42403 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $26.68 Total Paid for ELECTRICAL: $53.36 DESCRIPTION ACCOUNT CITY AMOUNT .PERMIT ISSUANCE 101-0000-42404 0 $101.40 Total Paid for PERMIT ISSUANCE: $101.40 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $26.68 Total Paid for PLUMBING FEES: $53.36 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $0.50 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: DIAMANTINA JOWREY 53620 AVENIDA CORTEZ LA QUINTA, CA 92253 T-4bt 4 leF Qaba DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT BUILDING RESIDENTIAL/DWELLING - SINGLE FAMILY DETACHED BRES2019-0299 53620 AVENIDA CORTEZ 774102006 JOWREY / ELECTRIC WATER HEATER RELOCATION $500.00 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: DIAMANTINA JOWREY 53620 AVENIDA CORTEZ LA QUINTA, CA 92253 Contractor: Z� DP OWNER BUILDER AUG 3 0 2019 Date: 8/30/2019 CITY OF LA QUINTALlc. No.: NT ------------------------------ DESIGN ----------DEVELOPMENT ---------DEPART------------------------------------------- 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: 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 basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit s jects the applicant to a civil penaltyof not more than five hundred dollars ($500).: (lAuLl owner of the property, or my employees with wages as their sale cti0ensation, 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 ors a did not build or improve for the purpose of sale.). ( s owner of the property, am exclusively contracting with licensed contractors to c%fiWuct 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 C tractors' State License Law.). (xempt under Sec. . B.&P.C. f s reason Date:--e— , '� i Owner: CONSTRUCTIOJI j, ING AGENCY I hereby affirm under penalty of perjury at there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Na Lender's Add WORKER'S COMPENSATION DECLARATION 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' ompensation, as provided for by Section 3700 of the Labor Code, for the performance f the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by ection 3700 of the Labor Code, for the performance of the work for which this permit is ;sued. My workers' compensation insurance carrier and policy number are: :arr r: Policy Number:_ certify that in the performance of the work for which this permit is issued, I halot employ any person in any manner so as to become subject to the workers' ompensation laws of California, and agree that, if I should become subject to the corkers' compensation provisions of Section 37 the L bor Code, I shall forthwith omply with those provisions. iate::h_:[I r i Applicanti&' VARNING: FAILURE TO SECURE WORKERS' OMP COVERAGbS UNLAWFUL, ,ND SHALL SUBJECT AN EMPLOYER TO CRIMINAL EWA[TIES AND CIVIL FINES UP TO )NE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE VTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT APORTANT: Application is hereby made to the Building Official for a permit subject to ie conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose =quest and for whose benefit work is performed under or pursuant to any permit issued s a result of this application , the owner, and the applicant, each agrees to, and shall efend, indemnify and hold harmless the City of La Quinta, its officers, agents, and mployees for any actor omission related to the work being performed under or )Ilowing issuance ofthis permit. 2. Any permit issued as a result of this application becomes null and void if work is not ammenced within 180 days from date of issuance of such permit, or cessation of work )r 180 days will subject permit to cancellation. certify that I have read this application and state that the above information is correct. agree to comply with all city and county ordinances and state laws relating to building instruction, and hereby authorize representatives of this city to enter upon the above- ientioned property for inspection purposes. ate: / �" Signature (Applicant or Agent): Date: 8/30/2019 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: DIAMANTINA JOWREY 53620 AVENIDA CORTEZ LA QUINTA, CA 92253 BRES2019-0299 53620 AVENIDA CORTEZ 774102006 JOWREY/ ELECTRIC WATER HEATER RELOCATION $500.00 Owner: DIAMANTINA JOWREY 53620 AVENIDA CORTEZ LA QUINTA, CA 92253 Contractor: OWNER BUILDER Llc. No.: Detail: PRE EXISTING ELECTRIC WATER HEATER RELOCATION FROM GARAGE TO EXTERIOR OF DWELLING. HEATER TO BE INSTALLED IN A GALVANIZED STEEL ENCLOSURE. ENCLOSURE TO BE ATTACHED TO STUDS AND EARTH QUAKE :STRAPS TO BE INSTALLED. PER 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 CITY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $26.68 Total Paid for ELECTRICAL: $53.36 DESCRIPTION ACCOUNT CITY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $101.40 Total Paid for PERMIT ISSUANCE: $101.40 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $26.68 Total Paid for PLUMBING FEES: $53.36 DESCRIPTION ACCOUNT CITY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $0.50 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 EY REAR YARD � e 10 Feet Minimum ; i 1. f4-QP�t i I �}GVIQls PCa I 0;� feet -� /3&Es20►q- o1R 5 5-36zo A VE ITlr UF l..A a1d1I iVfA BUILDING DIVISION REVIEWED FOR CODE COMPLIANCE DRNEWAY ctry Go2TEz- /.Tr6 -- c Al-WOKNIA -- PERMIT # Q� PLAN LOCATION: -5 56, 9.O Av C Cs r't'Z Project Address: C — 5 a-a-S- 3 Project Description: APN #: 46yn -5; sJP o� 6 a rr. elt 4Dgu t 12.0 . Applicant Name: Address: 4 7j(pgo City, ST, Zip: Telephone: -%o q i�SCe �-�— Email: Project Valuation $ SbJ Contractor Name: J f New Construction: Address: Conditioned Space SF City, St, Zip Garage SF Telephone: Patio/Po eIS� SF Email: Fire Sprinklers SF State Lic: City Bus Lic: Architect/Engineer Name: Construction Occupancy: Address: Grading: City, St, Zip Telephone: Bedrooms: Stories: # Units: Email: State Lic: City Bus Lic: Property Owner's Name: New Commercial / Tenant Improvements: Address: Total Building SF City, ST, Zip Construction Type: Occupancy: Telephone: Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 OFFICE USE ONLY # Submittal I Required Received Plan Sets Structural Calcs Truss Calcs Title 24 Calcs CVWD Fire Flow Letter Soils Report Grading Plan (PM10) Landscape Plan Subcontractor List Grant Deed HOA Approval School Fees Burrtec Debris Plan Planning approval Public Works approval Fire approval City Business License Holdrite 24 in. Galvanized Steel Water Heater Enclosure-QS-E24 - The Home Depot Page ] of 5 Home / Plumbing / Water Heaters / Water Heater Parts / Water Heater Parts & Accessories Internel #206035055 Model # OS-E24 Slore SKU #1001378322 Share Save to Favorites Print Holdrite 24 in. Galvanized Steel Water Heater Enclosure * * * 4 (45) Write a Review Questions & Answers (28) Constructed from Galvanized Steel Water Heater Enclosure Protects Water Healers from the outdoor elements $11800 Save up to $100 on your qualifying purchase. Apply for a Home Depot Consumer Card Quantity _ 1 + Pick Up In Store Today Add to Cart in stock at La Quinta Aisle 14, Bay 009 Text to Me Check Nearby Stores Or buy now with Product Overview We'll Deliver It to You Express Delivery Get it as soon as tomorrow Schedule delivery to your home or jobsite on the day of your convenience Your local store: La Ouinta Easy returns in store and online Store Details & Services Learn about our return policy Holdrile Quick Shed water healer enclosures are constructed of galvanized steel and protect water Info & Guides healers installed outdoors from weather and tampering. These enclosures create additional indoor • Installation Guide space by moving water healers from the inside to the outside of a building structure while still • shielding them from weather conditions. Inskuclions'Assembly https://www.homedepot.com/p/Holdrite-24-1n-Galvanized-Steel-Water-Heater-Enclosure-... 8/29/2019 Holdrite 24 in. 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Galvanized Steel Water Heater Enclosure-QS-E24 - The Home Depot Page 5 of 5 Warranty / Certifications Manufacturer Warranty HOLDRITE warrants that HOLDRITE products conform to Manufacturers published specifications and are free from defects in material or workmanship. For a period or one year from date of bLAding ocr Upancy Manufacturer will provide free replacement for any Product found to have defects in material or workmanship which prevent it from functioning as provided in Manufacturer's published specifications How can we improve our product information? Provide feedback. Recently Viewed Items Holdrite 24 in, Galvanized Steel Water Heater (45) https://www.homedepot.com/p/Holdrite-24-in-Galvanized-Steel-Water-Heater-Enclosure-... 8/29/2019 PRODUCT SPECIFICATION DRAWING QUICK_ SHED #E241E24-B, #E261E26-B. #E301E30-B & #E36-B Water Heater Enclosures for 24", 26", 30" & 36" (-B indicates Models that include Back Panel) Rear Panel (-B Models ONLY) 0 3.75" HARDWARE #7 x 7/16"L Phillips Pan Head [ Sheet Metal Screws [ (Included / Qty as Required) #E24-13 Model Shown Vent Cap available, to cover opening (Not included) { 24" 74" 24" The HOLDRITE® QUICK SHEDT"" Water Heater Enclosures are constructed of galvanized steel and provide protection for water heaters installed in outdoor locations. Anchor points at the rear of the enclosure allows for optional attachment to the adjacent building structure. Rear panel (-B version ONLY) provides a four-sided enclosure. Product Information: • Material: Top, Door, Left & Right Side and Rear Panel (Opt):.018" - .021" Thick, Galvanized CRS Back Brace & Beam:.023" - .026" Thick, Galvanized CRS Handle: 16GA, Galvanized CRS • Material (#E36-B ONLY): Top, Door, Left & Right Side and Rear Panel:.025" Thick, Galvanized CRS Back Brace & Beam: 030" Thick, Galvanized CRS Handle: 16GA, Galvanized CRS • Weight (without Packaging & Water Heater): • Model #QS-E24 = 39 LBS / E24-B = 50 LBS • Model #QS-E26 = 42 LBS / E26-B = 54 LBS • Model #QS-E30 = 49 LBS / E30-B = 63 LBS • Model #QS-E36-B = 107 LBS Outside dimensions: • Model #QS-E24 = 24" x 24" x 74" • Model #QS-E26 = 26" x 26" x 74" • Model #QS-E30 = 30" x 30" x 74" • Model #QS-E36 = 36" x 36" x 84" • Water Heater Dimensions: • QS-E24: Up to 40 gallons or 22" diameter by 68" high • QS-E26: Up to 40 gallons or 24" diameter by 68" high • QS-E30: Up to 80. gallons or 27" diameter by 68" high • QS-E36: Up to 120 gallons or 33" diameter by 78" high I Product Submittal Job Name: ner: TO CHANGE WITHOUT NOTICE. IT MAY NOT BE REPRODUCED IN PART OR WHOLE WITHOUT WRITTEN AUTHORIZATION. �J INIt Cr, TAR'M 41-?F-=HFT VETH-7)M 14M=%GWEFIE) SA.Lir1W,` 800-321-0316 OR 760-744-6944 / FAX: 760-744-0507 / WWW.HOLDRITE.COM spe c_QuickS hed_E24/-B_E26/-B_ E30/-B_ E36/B_ RevG QUICK SHE[] TM E= QS-E24 • Superior engineered design • Meets code requirements QS-E24-13 • Galvanized steel construction • Protects outside water heater from weather and tampering QS-E26 • Provides neat and orderly appearance QS-E26-13 • Move water heater outside to increase inside space • Easy assembly with basic tools QS-E30 • Screws provide secure installation • Superior front panel design provides access door for service QS-E30-B • Air space crush zone packaging protects corners and transfers QS-E36-13 weight evenly across product during transportation • Model -B includes back panel QS-EVC 24" Shed Enclosure (24" x 74" x 24") 1 24" Shed Enclosure (24" x 74" x 24") with back panel 1 26" Shed Enclosure (26" x 74" x 26") 1 26" Shed Enclosure (26" x 74" x 26") with back panel 1 30" Shed Enclosure (30" x 74" x 30") 1 30" Shed Enclosure (30" x 74" x 30") with back panel 1 36" Shed Enclosure (36" x 84" x 36") with hack nanel 1 Vent Cap QUICK SHE OTM VENT CAP • Allows air circulation • Prevent excess heat accumulation • Keeps most rain and weather out • Ideal for electric water heaters QUICK STRAP" Expansion Tank Mounting Brackets • Secures tank to wall and takes weight load off pipes • Galvanized and stainless steel construction • QS-5 Supports tanks up to 9" diameter • QS-12 Supports tanks from 91/2" to 13" diameter • Includes mounting bracket, (2) support straps, and #8 x 11/2" mounting screws QS-5 Up to 2.5 Gallons; Up to 9" Diameter r]C_17 I In to �, (,allnnc• I In +n Q G" t.. 1Z" fliomo+or QUICK STAN[]TM Equipment Platform • Equipment stand, unassembled • Galvanized steel construction • Meets Codes • Independently lab tested RATEO UP TO 2,00040-S-34-U Up to 2,000 lbs. 34" x 34" top QUICK PAN" • Meets Code Requirements • Use with gas or electric water heaters • Rolled edges for safety • Now with a compact 1" Bulkhead Fitting -Aluminum pan with 1" PVC •Add -C to model # for 1" CPVC drain fitting or CPVC drain fitting Descriptionr QP-20 20" Aluminum Water Heater Pan with drain fitting 6 QP-22 22" Aluminum Water Heater Pan with drain fitting 6 QP-24 24" Aluminum Water Heater Pan with drain fitting 6 QP-26 26" Aluminum Water Heater Pan with drain fitting 6 QP-28 28" Aluminum Water Heater Pan with drain fitting 6 QP-30 30" Aluminum Water Heater Pan with drain fitting 6 y� QUICK STRAP-50 J J J QUICK S T R A P° AE5 0 `�� QUICKSTRAP-50-D J J �= QUICK BELT-Wf J J J QUICK STRAP-50-P STRAP C=37- r LI J J QUICK STRAP-M J J J J QUICK STRAP® DELUXE PC • The most tested and recognized water heater restraint • Powder -coated steel water heater strap with (2) safety caps • Supports up to 80 gallon water heaters • Customized label available with your company name Modell# Size BOX Pallet CKY QS-50-D Up to 80 gal. 15 120 QUICK STRAP® �P • The most tested and recognized water heater restraint -Galvanized water heater strap in box • QS-50, QS-50-P Supports up to 80 gallon water heaters • QS-120 Supports up to 120 gallon water heaters <. QS-50 Up to 80 gal. 15/Box 120 QS-50-S Up to 80 gal, 15/Box 120 QS-50-P Up to 80 gal. 15/Bag 180 QS-120 Up to 120 gal. 12 60 QUICK BELTTM PG • The most tested and recognized water heater restraint • Soft -belt style water heater strap • #QB-50-F supports up to 80 gallon water heaters P OB-50-F Up to 80 gal. 20 120 QUICK STANDTM • Water heater stand, both assembled and unassembled • Galvanized steel construction • "-U" Models are unassembled. "-A" models are pre -assembled. 40-S-22-U Up to 52 gal. / 650 lbs. 1 24 40-S-22-A Up to 52 gal. / 650 lbs. 1 24 40-S-24-U Up to 100 gal. / 1,200 lbs. 1 18 40-S-24-A Up to 100 gal. / 1,200 lbs. 1 18 40-S-30-U Up to 100 gal../ 1,200 lbs. 1 12 40-S-34-U Up to 2,000 lbs. 34" x 34" top 1 Titf 4 4 Q" P.O. 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 been submitted in your name listing yourself as the builder of the property improvements specified at " (cw- e- [', We are providing you with A Owner -Builder Acknowledgment and Information Verification Form 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 cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verb this information. I. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. 1, 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 provide 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 property. 2. I understand building permits are not required to be signed by property owners unless they are responsible for the nstruction 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 understand that I may protect s if from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. l understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on rmits and contracts. 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value QOFmconstruction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 6. I understand if I am considered an "employer' under state and federal law, I must register with the state and federal ve ment, 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. J I understand under California Contractors' State License Law, an Owner -Builder who builds single-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 the work is performed under contract with a licensed general building Contractor. 8. I understand 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. -9. I understand 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. 0. 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 and financially responsible for proposed construction activity at the following address: 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all a icable laws and requirements that govern Owner -Builders as well as employers. � 2. I agree 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, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agenc is re uired to be presented when the permit is issued to verify the property owner's signature. o, Signature of property owner. r T Date: r 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): %� f / Project Location or Address: sz3 6k rT{�(� I TQ� 1�t� GoI'l r-4—(Q , 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 : A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is requ'(d to 0 presented when the permit is issued to verify the property owner's signature. Property Owner's Signatur f _Y, _ Date: � T'