BMCH2014-1074LICENSED 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: C20, C38 License No.: 967982
Dat Contractors
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 tM permit.tojile 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
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 theiraole
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,no
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 th'e 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 fo
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'
compe ation,-as provided for by*Section 3700 of the Labor Code, for the performance
oft rk for which this permit is issued.
bhave and
'maintain workers' compensation insurance, as required by,
Sec ion 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' Scompensation ,provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
3 q/`3�
Date (_/y Applicant: r`tG�C LrPta�,�.a�'
� t
Ozo
WARNING: FAILURE TOSECURE 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,
t INTEREST, AND ATTORNEY'S FEES. -
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby madeto 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 thispermit.
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 complywith all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter on the above-
mentioned property for inspection purposes.
m
Date Signature (Applicant or Agent
VOICE (760)777-7125
78-495 CALLE TAMPICO
'
FAX
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY.DEVELOPMENT DEPARTMENT
(760) 777-7153
BUILDING PERMIT
Date: 9/9/2014
Application Number: BMCH2O14-1074
Owner:
Property Address: 52530 AVENIDA OBREGON
MANVEL TABAKIAN
APN: 773285002
3770 CARELL DR
Application Description: R & R 4 TON COMPRESSOR
ONLY
LOS ANGELES -.CA 92253
rL
Property Zoning:
Application Valuation: $1,000.00
( %
0 C=
�J.
cV
LU
Applicant:
/
Contractor:
g
BEST IN THE WEST AIR CONDITION
BESTiN THE WEST AIR CONDITION
p
,L w
255 N ELCIELO ROAD #140-125
255 N ELCIELO ROAD #1140-125
'PALM
� �
� it
PALM SPRINGS, CA 92262
SPRINGS, CA 92262
co
cw
/
(760)3434002
Llc. No.: 967982-�
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: C20, C38 License No.: 967982
Dat Contractors
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 tM permit.tojile 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
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 theiraole
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,no
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 th'e 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 fo
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'
compe ation,-as provided for by*Section 3700 of the Labor Code, for the performance
oft rk for which this permit is issued.
bhave and
'maintain workers' compensation insurance, as required by,
Sec ion 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' Scompensation ,provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
3 q/`3�
Date (_/y Applicant: r`tG�C LrPta�,�.a�'
� t
Ozo
WARNING: FAILURE TOSECURE 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,
t INTEREST, AND ATTORNEY'S FEES. -
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby madeto 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 thispermit.
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 complywith all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter on the above-
mentioned property for inspection purposes.
m
Date Signature (Applicant or Agent
lig
iT,Cyu'�w 3:4.-'42 Z xh�''Y..'Y. i . : 4"F";i:xYv' 'S* v 2 n: x ipt. F: FIW1 i. £-:v{^
hi w? .' y':✓_.. 'S .'Lk. R`'P+M1 3• L4'oYihLY 3•'` _:.
, x. x _Ex4=3x�. "SA? €''x N�z : V `. ,.f. .�, 'i 4 i AMOUNTS
�� sE xDESCRIPTION��x `. ACCOUNTf QTY 4x� AMOUNT PAID ,r PAIDviDATE
'a ;'�",.»�0.240r.%' ° .�`. � �.'': �;k>�F. rax
BSAS SB3473iFEE "'• 101 0000=20306' 0
$1:00, $0:00
¢`Yx.j' lrei`".<`*�'Y W d1WXy"e' _
.� , HMETIiOD. .k,. g -SUN RECEIPRwiziwirmwT # t� `�H K r
NRMT
Total Paid"for86ILDING STANDARDS ADMINISTRATION BS.A $0.00 .
'W-
-�..:
.YOF.
1 ulua—Ia:&.5:1P1Atn0—IDs;E",:_F.n�
HVAC CHANGEOUT - REPAIR/ALTERATION
i•�.
.101 0000=42402
0
$11.92
$0.00
:g 3^IaEI.` YS ;.-'9'A-._v 9.iry L.<s:..ay4
M...:'§aPA1DkBY` .
§„E_t, 4 k rn''�''�'
•vF".-E},"`Ea):�.ay,`2
{r METHODS
�t':�x :.. }sdn'4;€Fitii.'7n Vii? ��5. - . 1. d"*".
k�:eF3...st x. lP4 "'' 2,00M
�. RECEIPT #
` e��x.�•8.f,5`.�.�:&<<rs+:- a: ei'w'-f+Yi 4�H
EC #,�x:;
CLTD BY :.
IMEM,'_s ,"L t� "3`}.,±. "'.�`•`.' _', € .;. yr -'✓
',DESCRIPTION r�
,.€`. ...,:.a �
g$3 7 _� 1'"';3.e @ :Y`ga*L:: nB"� ,`�
ACCOUNTS _
�.,,t. < �-s�, �:��ss ,><.�a�..Y � � �.:.. �:. A
:,�.i u. �P` R t ,'`°n cT ;1 lam. Y _ . 'n .�a
gTFY AMOUNT
.�. �:�3� - �i?.��'is`�xRsrt��* �.�..�...?r?� �i�r4
j :...3', +'t'�R .Y;z"?°Fs _
Bf?pID ham_
�`M„ . p�d�«.in=�mr,, ��'�„�:.�-'r
aS'' .v. .w°%'w33*
PAIR DATE
�;��.�r.�;�TR
HVAC CHANGEOUT -REPAIR/ALTERATION
PC
101-000042600-
0.. $4.77
$0:00
7�i '� L�k':.,'p t pie','' t, 'i
gg. RAID BYE;
``.v6, . - ; {$
METHODS
;RECEIPTS# �'
a��`�'E;4e
CHECK # _
`�OlgF.t^sia;s`fi"'s=E`3w(A`,:-...:e.:`r
S'i:O§{mv"�Y:".:s' ?.
CLTDBY
[L.<„a+,^'3X:�e'�et4'ae`.
`Total Paid:66ANGEOUT: ; .' $16.69: $0.00
".����,° .y�r'� da'4�rvY-iE' i..r;:�`c�a i”`
€� ; k DESCRIPTION> :� ��
._ .
6 y'S, N7.. 43....yw.,>r
"' ACCOUNT
2'
' QT=Y
j"
:. AMO,UNTE
x.��..x
PAID
::::i''�fdS Fi;tff,
PAID;DATE
PERMIT ISSUANCE'
010000-42404
101-00R. 404
0 .
`.$90x57
$0:00
$d'..,SF .i` 'qi,K:fir:
BY�W + eE Y5METIIOD{�'5�RECEIP„T#�:CLTDBY'”
.b5a^.4;.r5'xE'V wz�'mi'dlaS,$&: eve1H'.,T6�,W�h1
me: fA,€1�,4 etc T:..,is �enr;`f'.t'�3.:1`�.�3Fs.e:�+�aZ:
:..
Total Paid torPERMIT ISSUANCE $90 57 i . $0,00
IlIggg in
KENN 0I 1 //
I
F•"o
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Wi'
` .cx. '`
Description: R &. R 4 TON COMPRESSOR ONLY
����;
Process�Su
i-
Type: MECHANICAL Subtype:
Status: SUBMITTED
Applied: 9/9/2014 AZA
Approved:
Parcel No: 773285002 Site Address: 52530 AVENIDA OBREGON LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE.LA QUINTA Block: 162
Lot:'1
Issued:
UNITr17 .
Lot 5q Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $1,000.00 Occupancy Type:
Construction Type:
Expired:
No.'Buildings:,0 No. Stories: 0:.
.No. Unites: 0
D"etails: HVAGCHANGE OUT - R & R 4"TON COMPRESSOR ONLY.. 2013'CALIFORNIA BUILDING` CODES.
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A
Printed: Tuesday, September 09, 2014 2:40:16 PM 1 of 2
srsrrrts
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$11.92
$0.00
REPAIR/ALTERATION
HVAC CHANGEOUT -
101-0000-42600
0
$4.77
$0.00
REPAIR/ALTERATION PC
Total Paid forCHANGEOUT: $16.69 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
TOTALS:00
PARENT PROJECTS
S. NQ INFO?
�, RMATION
ATTACHMENTS
Printed: Tuesday, September 09, 2014 2:40:16 PM 2 of 2 m
SYSTEMS
CERTIFICATE OF COMPLIANCE CF1R-AL-T-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 4 )
Project Name: j Manzel Tabakian' Date Prepared: 2014-09-09
I i
A. General Information
CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use orile CF1R-ALT 02 document for each dwelling unit.
01
Project Name
Manzel Tabakian
•02
Date Prepared
2014-09-09
03
Project Locationii
52530 Ave Obregon
04
Building,Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Manzel Tabakian
07
Code 'I
92253
08 -
Dwelling.Unit.Conditioned
1600
>a ! M e;Y:�.•-,q
J'Zip
•
Floor Area (ft2)
SC System
SC System .
CFQ served
.M4:Isthe�SC=,�
systema
Number -of space conditioning
Installing new SC
09
Climate Zone !
15
10
(SC) systems in this dwelling
1
by^this SC
ducted
containing
system
unit..
entirely -new
'NIX.
B. Space Conditioning (SC) Systemslnformation91
ilUM
.. k� _•vd... .;'' .k s.- ✓a'& }rertl.:(r. ..Ca'a..If::... .�v3'ii..
01
02
03
1 04� °
05
06
�
07
.J u
"`"r08ay .M
09
10
I5
.'f..,r.. .:r.wt+
?y��
Yat?.c4G:. '4. t'".i4r..�
•rn ;: ..3r-..F'rk`..: yN
,._.Y.,«;cY.- A _., .3 t.r,z
......:.i .siX...
%.. ,fa'� xv ..;..:'
/.�'rt.'41C` 'kd'vyj 5
h Y t3 rtwa
>a ! M e;Y:�.•-,q
c�. +Wirt P+j�..3'17-1711
Y T� �
SC System
SC System .
CFQ served
.M4:Isthe�SC=,�
systema
.�,-lnstallmga4�.
refrigerant
Installing new SC
Installing
Installing ;
Installing: .
.
Identification or
Location or Area
by^this SC
ducted
containing
system
more.tliari 40
entirely -new
entirely.new
Name
j Served
System (ft2),
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
:i
Altered space
System 1
+ hole House
1600
Yes
Yes
No
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 214-A0090823A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2014-09-09 11:01:52
Report Version: 2014-03-31
HERS Provider: CaICERTS
Report Generated: 2014-09-09 11:01:53
CERTIFICATE OF COMPLIANCE
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 4 )
I
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
06
07
08
09
10
r11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type,
Duct Length
R -Value
Central
No heating
This field or
This field or
Central
This field or
This field or
System 1
packaged HP
component
section is not
section is not
Packaged HP
Compressor
SEER
13
Setback
section is not
section is not
altered
applicable
pP
applicable
pp
applicable
applicable
Required Documentation*
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF213-11VICH-20-H & CF3R-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: <_ 15%, or <_ 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in C2 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow >_ 300 CFM/ton required when MGH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
I
-Heating-only systems and Air Handler/Furnace. changes do not require verification of Air Flow MCW23,'or Refrigerant Charge MECH-25.
-Existing duct systems constructed, insulated or sealed with.asbestos are exempt.from MCH -20 Duct Leakage Testing requirements.
r.
f µ .
E. Entirely New or Complete Replacement Duct -System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F)
This section does not apply to this project.
I.
Registration Number: 214-A0090823A-000000000-0000
Registration Date/Time
2014-09-09 11:01:52
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-09 11:01:53
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 3 of 4 )
F. Entirely New or Complete Replacement Space Conditioning System (Section 150:2(b)1C)
I
This section does not apply to this project.
i .
Registration Number: 214-A0090823A-000000000-0000 Registration Date/Time: 2014-09-09 11:01:52 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-09 11:01:53
CERTIFICATE OF COMPLIANCE
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Stewart, Wendy
Company:
Signature Date:
Best in the West Air Conditioning & Heating Inc
2014-09-09 11:01:52
Address: -
CEA/ HERS Certification Identification (if applicable):
31225 Plantation Dr
City/State/Zip:
Phone:
Thousand Palms CA 92276
1(760) 343-1002
Responsible Person'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.
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 enforcementagency 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 bermit(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.
Responsible Designer Name:
Responsible Designer Signature:
Stewart, Wendy
Company:
Date Signed:
Best in the West Air Conditioning & Heating Inc
2014-09-09 11:01:52
Address:
License:
31225 Plantation Dr
967982
City/State/Zip:
Phone:
Thousand Palms CA 92276
(760) 343-1002
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the
information.
Registration Number: 214-A0090823A-000000000-0000 Registration Date/Time: 2014-09-09 11:01:52 !HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-09 11:01:53
Bin. #
Ctyof La Quinta
Blilfdtng st Safety Division
P.O. Box 1504;=78-495 611e:Tamplw
la.Qidnta, CA 92253 ''(760) 777-7012
: Building Per►nit Appl►Cation and"Trkft,,Sheet
Permit #
PX
Project Address:
Owner's,Alame:..C�Vt �Q G : c. sq
A. P. Number'
Legal Description:
gty,.ST, Zip:. /
Contractor. � g `
Telephone:,. 323-376 d2 ZZ Z
Address:91Ct °Plo
..Project Description: K�tr✓1, 6' OL e .f' , •
City, ST, Zip: r -h- .92 . ,' .
n'' r
Telephone -MO- 4s/0 .
State Lic. 4: 9 Z City Lic, 9,
Arch., Eagn, Designer.
Address:
City., ST, Zip:
Telt e:
State Lic. #:
Name of Contact Person: �, G� •�
Gotistruction Type:. 2 Occupancy:
Project type{circle one): New • Add'n Alter epair Demo
Sq: Ft: #Stories: # Unita:
Telephone # of Contact Person: `7
�� Ud'Z .:.:. Estimates Value. of Proj ...' .•J,00Q
..-.. APPLICANT: DO NOT -MM- --PELpW; THIS UNE .
#
Submittal
Req'd
Bec'd ..
, _. TRACIMG PERMIT FEES
PIP Sets
Plan Cheek submitted Item Amount
Structural -Calm
qReviewed, ready for corrections Plan Chcck Deposit. .
Truss Cala.
Called Contact Pcrson Plan Check Balance
'nde 24 Calcs.
Plans plcked uP. Construction
Flood plalo plan
Plains resubmitted...° -" Mechanical
Giading plan
V Review, ready.for correctiionsnasue Electrical .
Subcontactor List
Called Contact Person, Plumbing"
Grant Deed
'Plans.picked up
H.OA; Approval
¢Plaus resubmitted GradingIN `
IiOUSBt':
''' Review; ready for correctionsilssue Developer Impact Fee
Planoing Approval
Called Contact Person
Pub. Wks. APpr -
Date of peimlt issue'
School Fees
Total Permit Fees
1441-15085 9/9/2014, . .
Fidelity National Home Warranty
P.O. Box 8127
Walnut Creek, CA 94596
F .5.
1
Conditioning, 4 Hewing
255 N EI' Cieio Rd, PM8.125
Palm Springs, CA 92262
760.343-1002
www.gotcoolair.com
,Tech;
:A -.
ANGELA
Job Narrei
Tabakian
52530 Avenida Obregon
La Quinta, CA 92253
800-208-3151 800-308-142 /S 323-376-2222-MANZEL 323-871-2337
Description of Work
swo4431865 $60 Inv-31785'(wip2)
replacing 4ton Comp,run. cap and 1 2" �i—f�In
united PD)
lockbox left of driveway -979 then on door-2014—key for front door
call Nadia when job is finished -310-500-7979
All material is guaranteed to be as specified. All work to be completed in a professional manner according'to standard practices. Any alteration or deviation
from above specifications involving extra costs will be executed only upon written orders�and will become an extra charge over and above the estimate. All
agreements contingent upon delays beyond our control. Purchaser agrees to pay all costs of collection; including attorneys fees.
Signature
Date