07-2945 (MECH)a
'.. I I.. . ( -4
iO _ -
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
y Date: 11/14/07
Application Number: 07-00002945 Owner:
Property Address: 56060 RIVIERA BASIC EVA
APN: 762-021-004- - .. 56060 RIVIERA r
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL ( n
Application valuation: 7000
Contractor: U
Applicant: Architect or Engineer: PALM DESERT AIR CO 0 I�IaV
42081 BEACON HILL I yU • 1 5
^'� PALM DESERT CA 9 211 �oo�
`V
C
�� (760) 346-0677 C1T�.OF -
Lic. No.: 374937 FINA�C�FPAfrA
--------------------------------------------------
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 Professionals Code, and my License is in full force and effect.
License Class: C20 LicenseNo.: 374937
.-DateAI-AK_-o'l- Contractor: fi
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 ISec. 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 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 notapply 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 construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: i
Lender's Address:
LQPERMIT
--------------- - - -
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 STATE FUND Policy Number 1795546-2007
_ 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
11 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: -.a 4L!�-45_VApplicant:'
WARNING: FAILURE TO SECURE WORK ' 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 cessationof 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 county to enter upon the above-mentioned property for inspection purposes.
9 s
Date: '40A Signature (Applicant or Agent): `
LQPERMIT
Application Number 07-00002945
Permit . . . MECHANICAL
Additional desc .
Permit Fee'- 33.00
Plan Check Fee
8.25
-Issue Date r
Valuation
0
Expiration Date 5/12/08
Qty Unit Charge Per
Extension
BASE
FEE
15.00.
1.00 9.0000 EA MECH
FURNACE <=100K
q.. bo
1.0'0. .9.0000 EA MEC14:8/C
<=AHP/100K BTU
9.00
Special'Notes and Comments
------------------
REPLACE (1)FOUR TON 14 SEER HEAT
PUMP
HEATING & AIR-COOLING SYSTEM
Fee summary Charged
Paid Credited
Due
Permit Fee Total 33.00
.00 .00
33.00'
Plan Check Total" 8.25
.00 .00
8.25
Grand.Total 41.25
.00 .00
41.25
LQPERMIT
E d
Certificate of Comoliance Prescriptive Method -HVAC-only Alteration CFAR-ALT
Proj e:. �, Date:
0 CaICERTS 2005
IMPORTANT: This CF -1R -ALT form Is only for use when an HVAC -only alta tion Is made to an e>�g home -
Use one forth for each system beim altered. This Is system # of s tems altered In this house.
Section 8 - Minimum Requirements for EquipmeM.lo be Installed/Altered.
Installed equipment must match typelbcatlan and meet or exceed c4fldendes/11-vales:
28 Cates Split system 13 Package Una
29 ❑ Handler lies tumace, AFUE: OHeatptmp FAU r1Hv&cnc FAV 130dw
30
31 Cald unn C OFfea p SEERM EER Ure32
$w heat• and I3Hea rn❑H roNc33
❑ acatlonc ILerQth (ft R-Vafue:
All mandatory measures apply to an altered component. See MFAR - ALT forn.
Compliance Statement:
Thls certificate of compliance fists the building features and specifications needed to comply with Title 24, marts 1 and 8 of the
California Code of Regulations, and the administrative regulations to Implement them. This certificate has been signed by the
Individual with averall project responsibility_ The undersigned recognizes that compliance using duct seellag, verification of refrigerant
charge, and TXV require installer testing and certification and verification by an approved HERS rater.
Home Owner or Authorized Agent
Documentation Au or
Name:
Name:
Address:
Com.p9hy Name:
City/State/Zip:Address:
.PALM DESW.AIA CoNcimoma Camp'
42081 BU
Phone:
CIty/Stateop: ESERT;CA S122t1-510-:
(7130) 340-06"
Phone:
Signature:
Signature: I
r /
Enforcement A en (BuildingBe artment
NotesJComm 1s:
Name:
Title:
Department:
Phone 4:
Fax #7
Signature of Stamp:
Required forms:
CF -IR -ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS raver.
CF43R-ALT:'by installing contractor. Required to dose permit. Copies to home owner, enforcement agen•:y, HERS rater.
CF -4R -ALT: by HERS rater. Required to dose pemdL Copies to home owner, enforcement agency, inst®ler.. The CF -4R forms for a.
sample group shall not be released until all testing and verification is mm leted and passed for the entire r -roup.
•GI OIVII VTIV'VV
This form can only be used on projects being verified by CaICERTS certified raters.
XU_A 13C213SH1 dH
nage z of 2
www.calcerts.com
WASE:B LOOZ 61 IoW
F
a - d
�rtifir�fp of 1 mmnGancP PrPscrintive Method - HVAC-oniv Alteration . CF -1 R -ALT
Pr ' Itie:
Date�/0*2
//
0 CaICERTS 2005
Entorcernert enc Use Only
Pro ddress: _
Cli ate Zone:
Building Permit •
Do u to on Au r.
Telephone:
Ian Check Dane
telt Check Date
IMPORTANT: This CF -1R -ALT form is only for use when a VAC -only a ration is made to an existing home
Use one form for each system being altered. This is system # of systems altered in this house.
Check all Imes that apply, Check lines that apply.
Scope of Alterations:
1 ❑
An Air Handter is to be installed or replaced. Duct sealingtobedetermined. Contirns to next line.
2,9
A Funnaee Heat exchanger is to be installed or replaced. Dud sealin to be determined. Continue to ned live.
3 A6
An outdoor condensing unit Is to be installed er replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line.
4 r3,
A coofing or heatina cools to be installed or MIlaced. Dud Sealing and/or TXV(RCA) to be determined. Continue to next One.
5 D
More than 40 feet d new or replacement duct are to be Installed in unconditioned space. Duct sealing to be determined.
D Check here 8 the faft duct system is also to be new or replaced. Canfi ue toned line.
6 ❑
f none of Ones 1-5 are checked neither Duct Sealing nor TXV RCA are reguired. Go to Section &
Section 1 - Duct Sealing Ord if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked.
7 ❑is Watern Is in Climate Zone 1 3 4 S t3 7 .or S. No duct sealing is required. Go to Section Z
8 ❑ Is system has less than 40 feet of ducts In unconditioned space No duct sealing is required. Go to Section 2.
9 103 system was Previously sealed and tested, and was.certifled by a HERS rater......, .... .
o dud seo-In is ired. Attach prwWous CF -411 form. Go to Section 7-
10 [133 duct system Is sealed or Insulated with asbestos. No duct sealing is regWred. Cao to Section 2.
Note: If the entire ducts stem is to to new or replaoed, Lines 11-14 do not apply.
11 ❑ n Crimate Zones 2,12 and 16: An 0.92 AFUE furnace well be installed in Bou of duct sealing and TXV if cable .
12 O n Climate Zones 10, 13 and 15: An SEER 14 AW EER 12 condenser will be Installed with TXV(RCA)
added dud Insulation R4 wrap an existing ducts R-8 new ducW in lieu of dud seaW& Go to Section 1
13 ❑ . n Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 AM EER 12 condense[ will be installed with TXV(RCA)
a 0.92 AFUE hunace will be Installed In lieu of duct sealing. Go to Section 2.
14 ❑ n Climate Zones 2, 8;11, 12,14 or 18: An SEER 14 6M EER 12 condenser will be Installed with TXV(RCAs
an 0.82 AFU E furnace will be Installed with increased duct insulation in lieu of dud sealing. Go to Section 2.
15 J7 lNom of linea 7-14 above are checked. Duct Sealing Is Required Continue.....
Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked otherwise got to Section 3
16 ❑
The system beinit altered is a packagle unit. No TXV is required. Gots Section 3.
17 ❑
This system is in timate Zone 0 and a 14 SEER air conditioner or 0.82 AFUE hmraoe Is being inalalied.
No TXV(RCA) is required. Go to Section 3.
18 ❑
This System Is In Climate Zone 1 3 4 S 8 or 7. No TXV(RCA) iced. Go to Section 3.
19 ❑
This system is In Climate Zone 18 and line 14 is not checked. No TXV(RCA) to requilred. Go to Section 3.
20 ❑
PIS s stem is In Mmate Zone 18 and line 14 Is Checked and not One 18. TORCA) is required. Go to Section 3.
21 17
rnft system is in Climate Zone 2 or 8-15 and tine 11,18 or 17 is net checked. TXV(RCA) Is required. Go to Section 3.
Section 3 - HERS Rater verification
22 0
23 'Or
titin 1s is checked, HERS verification is required for Dud Sean► .
f One 12, 13, 14, 20 or 21 are checked and not line 18 or 17. HERS verification Is required for TXV CA) :
24"0
Pf line 12,13 or 14 are checked, HERS vertneation Is required for 12 EER.
Section 4 - Equipment Efficiencies
25 ❑ f lures 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List In section S.
Section 5- Dud R -Values
28 ❑
hf more than 40 feet of dud is being histalled or replaced, dud R value must meet or exceed Package 0-requiremeift
27 D
bflws than 40 feet of dud is being huatalled or replaced, dud 11 -value must meet or exceed R-4.2
Section 8 - see next
version us-w-uti Nage 1 of 2
This form can only be used on projects using verified by CaICERTS certified raters. ww-calcerts.com
Xd3 131783SU1 dH W JSE :6 L002 61 AoW
' #City
of La Quints
Burldmg BE Safety Division
Box 1504, 78495 Calle Tampico
!a Qudnta, G4 92253 • (760) 777-7012
Building Permit Application and Tracking Sheet
PermkP.O.
i�
r \
Project Address:
Owner's Name: l
A_ P. Number.
Address:,
Legal Description:
City, ST, Zi
Contractor.
Address: tDA DESERT MR Cotonw11iG
Telephone: ��
Project Description:
City. ST, zip:PAt.IA DESERZ CA 92211 .-
�T ` a S
Telephone:
State Lie. #:, City Lie,
Arch.. Engr_ Designer.
Address:
City, ST, Zip:
Telephone:
Construetion Type: Occn_3ancy:
State Lie. #:
Project type (circle one): New Add'n Repair Demo
Sq. R: # Stories: l< Units:
Name of Contact Person
Telephone # of Contact Person:
Estimated Value of Proj=4 7 Cb19.6
APPUCANT: DO NOT WRITE BELOW THM UNE
#
Submittal
Req'd
Reed
TPAMING
EERMIT FEES
Pfau seta
Plan Cheek submitted
[hem
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
11 uss Cala.
filled Contact Person
Plan Cheek Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'! Review, ready for eorreetionslissae
EleeW ail
Sabeontactor List
Called Contact Person
Plumbing
Grant Deed
r
Plans picked up
S.M.L
E.LGA. Approval
Plans resubmitted
Grading
IN ROUSE:-
'`' Rtvlew, ready for eorrections/rssne
Developer Impact Ree
Planning Approval
Called Contact Person
Pub. Wks. Appr
Datc of permit issue
School Pees
Total Permit Fees
0
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