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08-1980 (RR)P.O..BOX 1504 78-495 CALLE TAMPICO ' LA QUINTA, CALIFORNIA 92253 Application Number: .08-00001980 Property Address: 54591 RIVIERA APN: 775 -031 -020 - Application description: RE -ROOF Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3680 . Applicant: e( A— / �/. tk(. vi-"1J�-- Architect or Engineer: / (/4 -- 'LICENSED CONTRACTOR'S DECLARATION 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Professionals Code, and my License is in full force and effect. License Class: C10 C16 C2 c s No.: 4 7554 Date: zz q1X �"Contractor: (OW ER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am.ex pt 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 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 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 appjy to an owner of property who builds or improves thereon, and who contracts for the projects with a contractorls) 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: LQPERMIT Owner: OLSSON, RICHARD 54591 RIVIERA LA QUINTA, CA 92253 ( Contractor: PREFERRED PLUMBING P.O. BOX 5120 PALM SPRINGS, CA 92263 (760)322-3173 Lic. No.: 457554 VOICE .(760) 777-7012 FAX (760) 777-7011 INSPECTIONS (76.0) 777-7153 Date: 12/29/08 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 DELOS INS CO Policy Number 01DKRM12002143 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 became subject to th rkers' compensation provisions of Section 3700 of the Labor Code l.shall forth t ly ith dose provi Date: / Applicant.' G WARNING: FAILURE TO SECURE WORKERS CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS J$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 of 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 buildin construction nd h authorize representatives of this county to enter upon the above-mentioned property r in/s/p/echo pur s. .Date/ Signature (Applicant or Agentl: i!/�'� LQPEnlIT Application Number . . . . . 08-000019.80 Permit RE -ROOF Additional desc . Permit 'Fee. . . . 30.00 Plan Check .Fee .00 Issue Date . . . Valuation . . . . 0 Expiration -Date 6/27/09 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE EXISTING 4 TON UNIT 14 SEER Fee summary Charged Paid Credited Due. ------------------------------------- Permit Fee Total 30.00 ---------- .00 ---------- .00 30:00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 LQPEnlIT .CERTIFICATE OF COMPLIANCE: RESIDENTIAL age 1 of 1) CF -IR -A. Project Title Date Building Permit # Project Address 5Y-S9i �i ✓/�2A� �A Q�i�� gaas 2 ❑ Documentation Author Telephone Plan Check % Date Duct systems with less than 40 linear feet of ducts in unconditioned space. � CF -6R pages 3 and 8 of 12 Field Check/ Date:... Compliance Method (Prescriptive — HVAC and/ Climate Zone Enforcement Agency Use Only or Duct System Alteration - § 152(b)1C, D, and E) HVAC SYSTEMS Heating Equipment Type Minimum Distribution Type Duct or Piping Thermostat Type Configuration and Capacity (fimmace, heat Efficiency and Location (ducts, Insulation (setback) (split or package) um , boiler, etc. (AFUE or HSPF) attic, etc. R -Value Cooling Equipment Type Minimum Duct Location Duct Insulation Thermostat Type Configuration and Capacity (A/C, heat Efficiency (attic, etc.) R -Value (setback) (split or package) pump, evap cooling) (SEER or EER) o2c'f,� A4191- Ail e- "001-171 oU,u _ SIG Py Oe,,l &,,, r /c'40G SEALED DUCTS, REFRIGERANT CHARGE (TXV) AND EER Before the permit can be finalized, a signed CF -6R Form and CF -4R Form must be provided to the building department for any of the following compliance requirements that are ✓ : ✓ om liance Requirements sled 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 Options) - Installer testing 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 any of the following three exceptions are ✓, the duct system is exempt from sealed ducts # ✓ I Exceptions 1 ❑ Duct systems that are documented to have been previously sealed as confirmed through field verification and diagnostic testing in accordance with procedures'in the Residential ACM Manual. 2 ❑ Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos? 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 ✓ indicates which compliance requirements are Dart of this Droiect and need HERS rater verification ✓ Compliance Requirements Installer Forms (if applicable) HERS Rater Forms (itapplicable) ❑ Puct Sealing CF -6R pages 3 and 4 of 12 CF -4R page 1 of 8 ermostatic Expansion Valve (TXV) CF -6R pages 3 and 5 of 12 CF -4R page 3 of 8 CV 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: Bin # City of La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit.# . �`L Project Address:', j 4LS9/ 1?/ 1114? Owner's Name: A. P. Number: Address: 15' y1ge.Q Legal Description: City, ST, Zip: %H/�Cf • ��Zajl3 Conn cto erred Air Conditioning d b a Preferred Plumbin Heatin &Ai Telephone:Address:-PO Box 5120 Project Description: City,ST,Zip:Pa'lm Springs, CA'92263 // Telephone: ( 760 ) 32 2—'3173 - Q State Lic. #: 45755-4 City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lic. #: Name of Contact Person: &� , Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 76,9 p? j Q - Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING. PERMIT FEES Plan Sets Plan Check submitted Iten Amount Structural Calcs. Reviewed, ready for corrections Plat Check Deposit Truss Calcs. Called Contact Person Plat Check Balance Energy Calcs. Plans Dicked up Con truction Flood plain plan Plans. resubmitted Mec anical Grading. plan' 2"a Review, ready foi'correctionsrssue Ele rical Subcontactor List Called Contact Person Plu T bing Grant Deed Plans picked up S.M I. H.O.A. Approval Plans resubmitted Gra ing IN HOUSE:- "d Review, ready for correctionsrssue Dev toper Impact Fee Planning Approval Called Contact Person Axis.. Pub. Wks. Appr Date of permit issue School Fees " Tot 1 Permit Fees