09-0269 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: - 09-00000269;
Property Address: 53781 AVENIDA OBREGON
APN: 774-154-016-4 -000000-
Application description: MECHANICAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 700
T,4'h
t44Q"
App%ljcant: Architect or Engineer:
�4--C�k X-1-9-
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
----------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury tha censed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busi ss d r essionals Code, and my License is in full force and effect.
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License Class: C20 -C3,8 License No.: 826714
r� .
Date-,?:'? ntitraao% ,
NER-BUILDER DECLARATION
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 (5500).:
(_ I 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 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.).
1 _) 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:.
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/24/09
Owner:
ALBIR DAVID
53781 AVENIDA OBREGON
LA QUINTA, CA 92253
(760)413.5146.
Contractor. r R
BEST IN THE WEST ,4B
255 N. EL CIEI;O, 40- ,II
SPRINGS,PALM CA 9 62�,
(760)3220202
Lic. No.: 826714
-----------'---------------- - - - - -- ayf----- - - - - - —
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
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 STATE FUND Policy Number0023975-2008
I certify that, in the performa ce o e work for which this permit is issued, I shall not employ any ,
person in any manner a eCli o e subject to the -workers' compensation laws of California,
and agree that, if I sh a s bject to the workers' compensation provisions of Section
3700 f the Labor with comply with those provisions. _
Date: Z� �� pp"cant: - -
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 Director of Building and Safety 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 motto is correct. I agree to comply with all
city and county ordinances and state laws relating to el in 0str tion, and herebyauthorizerepresentatives
of this county to enter upon.the above -mention ropert Wrposes.
Date:—Si nature (Applicant or Agent): -- '
Application Number . . . . 09-00000269
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 21.50
Plan Check
Fee
5.38
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date ". 9/20/09
' Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 6.5000 EA MECH
AH'<=10K CFM
6.50
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Special Notes and Comments
AIR CONDITIONING CHANGE OUT OF 4
TON AIR
HANDLER.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
---------------------------
Paid Credited
Due
----------
Permit Fee Total 21.50
----------
.00
----------
.00
21.50
Plan Check Total 5.38
.00
.00
5.38
Other Fee Total 1.00
.00
.00
1.00
Grand Total 27.88
.00
.00
27.88
OPERMIT
CERTIFICATE OF COMPL
HVAC
(Page )
Proj Title
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Project
Proect Address
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Date
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Bwldtng Pemut # �,
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Documentation u or -'
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Elan Check /�Date�u s ,
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❑
Compliance Method (Prescriptive — HVAC and/
or Duct System Alteration - 152(b)IC, D and E
y `J s )
Climate Zone f
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E reemenYAgency UseOnly�
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HVAC SYSTEMS
IANCE: RESYDENTIAL Pa e 1 of 1 CF -1R -A - P�
Heating Equipment Type Minimum
and Capacity (furnace, heat Efficiency
pump, boiler, etc. (AFUE or HSPF)
Distribution Type '
and Location (ducts,
attic, etc.
Duct or Piping
Thermostat Type, Configuration
.. Insulation, (setback)- (split or package)
R -Value -
Sealed -Ducts (Climate Zones 2 and 9-16) - Installer testing and HERS Rater field verification required
❑
TXV (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required
/
Refrigerant Charge (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
❑
❑
Duct systems with less than 40 linear feet of ducts in unconditioned space.
❑
Refrigerant Charge
Cooling Equipment Type Minimum
Duct Location . :Duct Insulation' � .Thermostat Type ; Configuration
and Capacity (A/C, heat Efficiency r
pump, ev cooling) SEER or EER) (attic, etc.) R -Value " ' (setback) (split or package)
_ z
SEALED DUCTS, REFRIGERANT CHARGE (TXV) AND EER
Before the.permit can be finalized, a signed CF -6R Form and CFAR Form must be provided to the building depattmentfor any of the
followine comnliance reauirements that are ✓ r
✓'Compfiance
Requirements
Exceptions
Sealed -Ducts (Climate Zones 2 and 9-16) - Installer testing and HERS Rater field verification required
❑
TXV (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required
❑
Refrigerant Charge (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
❑
ALTERNTAVE to Duct Testing- High EER as indicated in Table 8-3 of the Residential Compliance Manual (SEE Table 8-3 for
additional requirements and available Compliance tions - Installer testis and HERS Rater field verification required
' The prescriptive requirement for either a refrigerant charge or a TXV does not apply to packaged units.
EXCEPTIONS
If anv of the fnilowinrr three excentinns are,/- the duct svctern is exempt from sealed ducts_ `
#
✓
Exceptions
I
Duct systems that are documented to have been previously sealed as confirmed through field verification and diagnostic
testis in accordance with procedures in the Residential ACM Manual.
2
❑
Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.2
3
❑
Duct systems with less than 40 linear feet of ducts in unconditioned space.
` Duct alterations are exempt from duct sealing ONLY if they meet Exception 2 above:
SPECIAL FEATURES REQUIRING HERS RATING VERIFICATION
A ✓ inOicates which compliance requirements are part of this project and need HERS rater verification.
✓
Compliance Requirements
Installer Forms (iifappgcable)
HERS Rater Forms Cirappacabie).
Duct Sealing
CF -6R pages 3 and 4 of 12 ':' .
CF -4R page _ I of 8 ,
❑
Thermostatic Expansion Valve (TXV)
CF -6R pages 3 and 5 of 12
CF -4R page 3 of 8
❑
Refrigerant Charge
CF -6R pages 3, 5 and 6 of 12 -
CF -4R pages 3 and 4 of 8
❑
High EER
CF -6R pages 3 and 8 of 12
CF -4R page 5 of 8' '
r _
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Bin #
City of La Quin'ta -
Building 8i Safety Division{'
P.O. Box 1504,78-495 Calle Tampico '
La Quinta, CA 92253 - (760),777-7012
Building PermivApplication and Tracking Sheet
Permit #
Project Address: ,S� AVE—
Owner's Name:
'A. P. Number:
Address:
Legal Description:
City, ST, Zip: -2 '
Contractor: S9-- 14,
Telephone:
Address: .2 ;VV . / JOfiZ
Project Description:_.�L
City, ST, Zip -A62' /. OW , zc L
Telephone: 6to
'
State Lic. # : /
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
'•
Telephone:
Construction. Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:#Stories: #Units:
Name of Contact Person: (� r4�a��
Telephone # of Contact Person: (,Vol
Estimated Value.of Project:, d0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd.
TRACIONG .
pERMIIT FEES
Plan.Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calc&
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading, plan
god Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmittedGra
ding
IN HOUSE:
"d Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
IA.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
'
Total Permit Fees