BPLB2019-015178-495 CALLE TAMPICO D 4�11
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: PLUMBING/
Application Number: BPLB2019-0151
Property Address: 78760 RIO SECO
APN: 646330009
Application Description: SKETOCH / 50GALLON WATER HEATER CHANGE OUT
Property Zoning:
Application Valuation: $1,400.00
Applicant: 0 D
VALLEYWIDE PLUMBING SERVICES D
LA QUIN Al, CA 92253 480 NOV 2 5 2019
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 7000) of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: C36 License No.: 1032877 7J
Date: i1 + 2 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).:
(_) 1, 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 Addre:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/25/2019
Owner:
Skeoch , Alexis B Walker / Alexis B Walker Skeoch
Trust
78760 RIO SECO
LA QUINTA, CA 92253
Contractor:
VALLEYWIDE PLUMBING SERVICES
79405 HWY 111 STE 9-480
LA QUINTA, CA 92253
(760)272-5222
Llc. No.: 1032877
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: J4E M PT 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 wish these provisions.
Date: 11 1 L2 / C, 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 city to enter upon the above -
mentioned property for inspection purposes.
Date: j 1 Signature (Applicant or Agent):
Date: 11/25/2019
Application Number:
BPLB2019-0151
Property Address:
78760 RIO SECO
APN:
646330009
Application Description:
SKETOCH / 50GALLON WATER HEATER CHANGE OUT
Property Zoning:
Application Valuation:
$1,400.00
Applicant:
VALLEYWIDE PLUMBING
SERVICES
79405 HWY 111 STE 9-480
LA QUINTA, CA 92253
Owner:
Skeoch , Alexis B Walker / Alexis B Walker Skeoch
Trust
78760 RIO SECO
LA QUINTA, CA 92253
Contractor:
VALLEYWIDE PLUMBING SERVICES
79405 HWY 111 STE 9-480
LA QUINTA, CA 92253
(760)272-5222
Llc. No.: 1032877
Detail: 50 GALLON WATER HEATER CHANGE OUT [GAS] - CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 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
PERMIT ISSUANCE
101-0000-42404
0
$101.97
Total Paid for PERMIT ISSUANCE: $101.97
DESCRIPTION
ACCOUNT
CITY
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
CITY
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
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
1�7 I i .-) n i 9— r+-, /` 7
Project Address: —1
CALIFORNIA
;
PERMIT #
PLAN LOCATION:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
�. n
Applicant Name:
Address:
City, ST, Zip:
L(-t
Go -Ala, C 9 2
Telephone:
0 4aaa
2-2 52 Z
Email: '
CO
Valuation of Project
Contractor Name:
`
New SFD Construction:
Address:
• �' .
Conditioned Space SF
City, St, Zip
J ;
Z 25
Garage SF
Telephone: 212 2_Z
Patio/Porch SF
Email:
v�
• J .J
Fire Sprinklers SF
State Lic: �� 32
City Bus Lic: '?
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms:
Stories: F#Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: l Q S !�,
New Commercial / Tenant Improvements:
Address: —18 o
Total Building SF
City, ST, Zip L.C%. ai , }—Q � 2-2
Construction Type: Occupancy:
Telephone: O
78495 CALLE TAMPICO LA QUINTA, CA 92253 (760)777-7125
WWW.LAQUINTACA.GOV
OFFICE USE ONLY
# Submittal Req'd Req'd
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
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
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CFIR-ALT-05-E [Revised 0411fi)
CERTIFICATE OF COMPLIANCE — — — - -
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
This compliance document is only applicable to simple
with a HERS Provider Data Registry.
ENERGY COMMISSION
:M
CF 1 R-ALT-05-E
Page 1 of 3
«yutrr ncn-) venlicanon ror compliance. When HERS verification is required, o CFIR-ALT- 01 shall first be registered
Alterotions to Space Conditioning Systems that are exempt from HERS verification requirements may use the CFIR-ALT 05 and CFIR- ALT-DS Compliance Documents. Possible efrom
leakage testing include: less than 40 ft of ducts were added or replaced, • or the existing duct system was insulated with asbestos; xemptions duct or the existing dart system was Previously rested 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-volue other than 5.8 per inch, or Open Cell Spray
Polyurethane Foam (ocSPF) 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 CFIR-AL T-01 with a HERS Provider Data
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
J 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.
L Temporary labels shall not be removed before verification by the building inspector.
A. General intormatiorll
01 Project Nam,
03 Project Location: 71 ,
05 :CA:C I t y:
07 Zip Code:
09 ' Climate Zone: I 1 J
11 I BuildingType S .F-Dweu,(W�
13 Project Scope (Select all that apply):
❑ B. Insulation ❑ D. & E. Fenestration/Glazing - ADD
❑ C. Roof Replacement
02 Date Prepared:
04 Building Front Orientation (deg or cardinal):
06 Number of Altered Dwelling Units:
08 Fuel Type:
10 I Total Conditioned Floor Area (ft2):
12 + Slab Area (ftz)
❑ G. Space Conditioning System (Heating, Cooling, Duct system) ❑ Lighting
❑ D. & F. Fenestration/GlazingREPLACE
- i ...f ' � .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
0EC-CF1 R-ALT-05-E Revised 04116
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
Project No me:
H. Water Heating
Systems
(Section 150.2(b)1G)
04
05
01
�::fLater
02
03
Water
Heating
'Heating System
Dwelling
System
Location or
Water Heating
Water
Unit Name
ID orNameArea
Served
System Type
Heater
//Tj
Add Row
Delete Row
CF111-ALT-05-E
Page 2 of 3
08
09
10
11
12
13
14
15
j#0�6��F07
of
Back Up
Water
Heaters I
Water
Heater
Rated
Heating
Heating
Exterior
Solar
in
Storage
Fuel
Rated
Input
Efficiency
Efficiency
Standby
Insulation
Savings
Sylstem
V�ojl�ujme (gal)
Ty1pe
Input Type
Value
Type
Value
Loss (%)
R-Value
Fraction
April 2016
CA Building Energy Efficiency Standards - 2016 Residential Compliance
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verificati
' CEC•CriR-ALT-a5-E (Revised U4116 On
CERTIFICATE OF COMPLIANCE — — - — -- -- e4LrFORNIAENei-�rcorvsMlsslo�v
Prescriptive Residential Alterations That Do Not Require HERS Field Verification CF1R-ALT-[05-E
Project Name: Page 3 OI 3
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certifythatthis Cert11111 le of Compliance documentation is accurate and complete.
nnriimen4�finn e.nh.., u�.�.
men
ZSj
f LEAS HER LerWicatiah identification (If applicable):
RESPONSIBLE PERSON'S DECLARATION STATEMENT - -- — - _ _
I certify the following under penalty of perjury, under the laws of the State of California:
I. 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.
4. 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.
5. 1 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-
?esponsioie Designer PN
Responsible ❑es- net Signature:
.Orn any
C Oa(e Signed:
aty�5tatejZip: r 0 3 2 �s
' c �72 2--� Phone:
® 2 72 � Z�2
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