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BPLB2019-013778-495 CALLE TAMPICO D 4 � LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: PLUMBING/ Application Number: BPLB2019-0137 Property Address: 79115 CANTERRA CIR APN: 604262020 Application Description: RUDOLPH / 40GALLON WATER HEATER CHANGE OUT Property Zoning: Application Valuation: $1,200.00 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: TRACI RUDOLPH 79115 CANTERRA CIR LA QUINTA, CA 92253 Date: 10/15/2019 Applicant: Contractor: S -PLUMBING a S -PLUMBING 82165 DR CARREON BLVD #1A1 DL/J �V\ 82165 DR CARREON BLVD #1A1 INDIO, CA 92201 INDIO, CA 92201 OCT 15 2019 (760)404-8600 CITY OFLAQUINTA Llc. No.: 861785 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 7000) of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C36 License No.: 861785 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.). (_) 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 Addres 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 th work for which this permit is issued. 61have 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: STATE COMPENSATIONINSURANCE NSURANCE FUND Policy Number: 1948610 1 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: � 7 � � 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 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. 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: f� �� I Signature (Applicant or Agent): Date: 10/15/2019 Application Number: BPLB2019-0137 Property Address: 79115 CANTERRA CIR APN: 604262020 Application Description: RUDOLPH / 40GALLON WATER HEATER CHANGE OUT Property Zoning: Application Valuation: $1,200.00 Applicant: S- PLUMBING 82165 DR CARREON BLVD #1A1 INDIO, CA 92201 Owner: TRACI RUDOLPH 79115 CANTERRA CIR LA QUINTA, CA 92253 Contractor: S- PLUMBING 82165 DR CARREON BLVD #1A1 INDIO, CA 92201 (760)404-8600 Llc. No.: 861785 Detail: 40GALLON 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 CITY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $101.97 Total Paid for PERMIT ISSUANCE: $101.97 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $13.42 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $8.05 Total Paid for PLUMBING 2019: $21.47 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 PERMIT # PLAN LOCATION: Project Address: ` Ul'J-Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #: +� Applicant Name: ILL Address: 9,, 4 City, ST, Zip: �� L Telephone: Email: A 'r ci !� AL) Valuation of Projects I �� 700 x� J 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CF1 R-ALT-05-E (Revised 04i16) CERTIFICATE OF COMPLIANCE - -- - CALIFORNIA ENERGY COMMISSION Prescriptive Residential Alterations That Do Not Require HERS Field Verification CF1R-ALT-05-E Mleamsme: LA i �X � Pagel of 3 Date AreparcQ- This compliance document is only applicable to simple alterations that do not require HERS verification for compliance. When HERS verification is required, a CF1R-ALT- 01 shall first be r with a HERS Provider Data Registry. egistered Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CF1R-ALT 0S and CF2R- ALT-05 Compliance Documents. Possible exemptions from duct leakage testing include: less than 40 ft of ducts were added or replaced; or the existing duct system was insulated with asbestos; or the existing duct system was previously tested and passed by a HERS Rater. if space conditioning systems are altered and ore not exempt from HERS verification, then a CFIR-ALT--02 must be completed and registered with a HERS Provider Data Registry. Alterations that utilize close Cell Spray polyurethane Foam (ccSPF) with a density of 1.5 to less than 2.5 pounds per cubic foot having on R-value other than 5.8 per inch, or Open Cell Spray Polyurethane Foam focSPF) with a density of 0.4 to less than 1.5 pounds per cubic foot having on R-value of 3.6 per inch, shall complete and register a CF1R-ALT-01 with a HERS Provider Doto Registry. If more than one person has responsibility for installation of the items on this certificate, each person shall prepare and sign a certificate applicable to the portion of construction for which they are responsible. Alternatively, the person with chief responsibility for construction shall prepare and sign this certificate for the entire construction- All applicable Mandatory Measures shall be met. Temporary labels shall not be removed before verification by the building inspector. A. General Information 01 Project �Name-: 02 Date Prepared: 03 05 Project Location: CA City: �O`, / ��—// rr�/ )el �. j 04 06 Building Front Orientation (deg or cardinal): i Number of Altered Dwelling Units: 07 Zip Code: Z2S 3 08 Fuel Type: /ll�,/ / `6,. 09 Climate Zone: 10 Total Conditioned Floor Area (ft): 11 Building Type: 12 Slab Area (ft2) 13 Project Scope (Select all that apply): ❑ B. Insulation ❑ D. & E. Fenestration/Glazing - ADD ❑ G. Space Conditioning System (Heating, Cooling, Duct system) ❑ Lighting ❑ C. Roof Replacement ❑ D. & F. Fenestration/Glazing - REPLACE ✓❑ H. Water Heating System ❑ Include Mandatory Measures? CA Building Energy Efficiency Standards - 2016 Residential Compliance -- — — --- April 2016 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CF1R-ALT-05-E(R"sed04/16) CERTIFICATE OF COMPLIANCE Prescriptive Residential Alterations That Do Not Require HERS Field Verification Piojec[ NIM4 G r� H. Water Heating Systems (Section 150.2(b)1G) 01 02 03 04 05 Water Water Heating iHeating System I Dwelling System Location or Water Heating Water Unit Name i ID or Name Area -Served— System Type Heater Ty Add Row Delete Row 06 07 08 09 # of Water Water Heaters Heater in Storage Fuel Rated System Volume (gal)l Type Input Ty 01- a 0 10 11 1 12 ` 13 14 15 Back -Up Rated Heating Heating Exterior Solar Input Efficiency Efficiency Standby Insulation Savings Value Type Value Loss (%) R-Value Fraction 3B qbV eov)®— y % 1 G 1111A CA Building Energy Efficiency Standards - 2016 Residential Compliance April 2016 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CF9R-ALT-05-E Revisedf4116) CERTIFICATE OF CQiV(PLJANCE — — — — — CALIFORNIA ENERGY COMMISSION Prescriptive Residential Alteration�Do Not Require HERS Field Verificatloll CF1It-ALT-05-E Project Name: Page 3 of 3 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ----------------- 1. i certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: �— �� Documentation Au r ignature: �� Company: f Signature Date: r { Address: I 1 j � I 'I n CCN HERS Certff4aoon Iden "ration (If applicable]: CftylStatel2ip: YrFone. w 60 (oo© RESPONSIBLE PERSO 'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 1. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. >. i will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. lespansfbfe Designer Name: _ ReSppnsible Designer Si$naty: �� - Company For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. CA Building Energy Efficiency Standards - 2016 Residential Compliance — — — — — - — — — — — April 2016