05-4683 (MECH)y, � •If
• 1.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: r 05-00004683
Property Address:5620-5--RIVIERA—J
APN: 762-021-022- - -
Application description: MECHANICAL
PrO06f•fy LOhlhg: LOW DENSITY RESIDENTIAL
Application valuation: 15411
Applicant:
Architect or Engineer
PIP
------------------
LICENSED CONTRACTOR'S DECLARATION
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: C20 License No.: 374937
e: Q ractor:
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 155001.:
1 _ 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, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7644, 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 contractors) licensed
pursuant to the Contractors' State License Law.).
I—) 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: r
LQPERMIT
VOICE (760) 777-7012'
FAX (760) 777 -7011 -
INSPECTIONS (760) 777-7153
Date: 10/17/05
Owner:
GOTTLIEB JANICE
1610 N. ORANGE AVE
LOS ANGELES, CA 90046
Contractor:
PALM DESERT AIR CONDITIONING
42081 BEACON HILL
PALM DESERT, CA 92211
(760)346-0677
Lic. No.: 374937
------------------
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 FLTND Policy Number 1795546
1 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 with those provisions.
i
Date:'! h icant:
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 1$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 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 upor ,the above-mentioned property for inspection purposes.
(Applicant or Agent):
R
Application Number . . . 05-00004683
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 51.00
Plan Check Fee
12.75
Issue Date . . . .
-Valuation
0
Expiration Date 4/15/06
Qty 'Unit Charge Per
Extension
BASE
FEE
15.00
2.00 9.0000 EA MECH
FURNACE --<=100K
18.00
2.00 9.0000 EA MECH
B/C <=3HP/100K BTU
18.00
Special Notes. and Comments.
CHANGE OUT 2 HVAC SYSTEMS & SEAL.ALL
ACCESSIBLE DUCT WORK. ARI # 390284,
39.0314
Fee summary Charged
Paid Credited
Due
----------------- --
Permit Fee Total 51.00
.00 .00
51.00
Plan Check Total 12.75
.00. .00
12.75.
Grand Total 63.75
.00 .00
63.75
LQPERMIT
f
4 -
CERTIFICATE OF COMPLIANCE:'RESIDENTIAL (Page 1 of 4) CF -1R
Project Title
• L �C6
DateBuilding
0-1 `off'
Permit,#, Q _
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Project Addresss�
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'Plan Clieck / Date "
�`'•t, y r,s w."
Documentation. Author•
Telephone
'
Field Check
,' rJtr� ' f'
Compliance Method (Prescriptive)/
Climate Zone
xEnforceiiient`A enc Use'Onl '' l:
• ' ✓ ❑ Alternative Component Package Method: (check one) • C D D (Alternative)
Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -IR page 3)
• For Package D'41ternative see Appendix B Table 751-C Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) - ft2 ,
Average Ceiling Height: ft . .
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C ---- (5% X CFA) ft'
Maximum Allowed Total Fenestration Products, Per Table 151-B or, 151-C ----(20% X CFA) fe
~: ✓❑'Building Type: (check one or more Single Family Multifamily * Addition Alteration
(If adding fenestration fill out WS -4R, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
-
Number of Stories: Number of Dwelling Units:
Floor Construction Type: Slab/Raised Floor (circle one or both)
Front Orientation: North / South / East / West / All Orientations (input front orientation in degrees from True North
an ircle one). „ • ;'
✓ ❑RADIANT BARRIER (required in climate zones 2, 4, 8-151 `
OPAQUE SURFACES -INCLUDING OPAQUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors
Frame
Type
(Wood or
Metal
Assembly U -
factor (for wood,
Cavity Continuous metal frame and
Insulation Insulation ' mass
R -Value R -Value ' assemblies)Reference
-Joint
Appendix
IV
Roof Radiant
Barrier
Installed
Yes or No
Location
Comments
(attic, garage,
'ical, etc.
.
�
r
-
C
All
1) See Joint Appendix I in Section 1V.2, 1V.3 and 1VA, which si c rs can not exceed
prescriptive value to show equivalence to R -values. ' , ' '
r APPROVED
Residential Compliance Forms ' April 2005
- /a /*
r
.� ' . ' - ss +'� _ � + .fit'• - t
t CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 4) 'CF -1R
Project Title C.61TUF8�Date. •Q
a FENESTRATION PRODUCTS, 'U -FACTOR AND SHGC ' +
✓ ❑ FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET•WS-4R—must be included for New Construction,
Additions and Alterations. ' 4, , +
4
Y
Fenestration '
#/Type/Pos.
(Front, Left, Orien-
• Rear, Right, tation,,
Skylight) N, S, E, W'ft
Exterior
Shading/Overhangs6'''
Area • U -factor• SHGC ✓ box if WS -3R is
. U -facto? Source SHGC' Sources included
-Distribution
Type and Location
ducts, attic, etc.
13
y
' • K ❑ • • ..
-S/2
13
13
11 Ql&
❑
`
❑
❑
1) Skylights are now included in West -facing fenestration area if the skylights are tilted to the west or tilt:d in any direction
when the pitch is less than 1:12. See §1.51(f)3C and in Section 3.2.3 of the Residential Manual - k
2) Enter values in this column are either NFRC Rated value or from Standards default Table I I6A. w
f }
3) Indicate source either from NFRC or Table I I6A,
4) Enter values in this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -3R.
5) Indicate source either from NFRC or Table 116B. '
6) Shading Devices are defined in Table 3-3 in the Residential Manual and see WS -3R to calculate Exterior Shading devices.
7)` See Section 3.2.4 in the Residential Manual.
HVAC SYSTEMS - b
+ Heating Equipment
Type and Capacity
fumace, heat pump, boiler, etc.
Minimum
Efficiency
(A UE or HSPF
-Distribution
Type and Location
ducts, attic, etc.
Duct, or Piping Thermostat Configuration
R -Value Type (split or package)
y
- IC
-S/2
/1
t,
11 Ql&
ni
Cooling Equipment-
Type and Capacity
(A/C, heat pump, evap.
coolin •)
., Minimum
Efficiency Duct Location
(SEER or EER attic, etc.
,
Duct Thermostat
R -Value Type
Configuration
s l t or package)
y
- IC
-S/2
S
t,
11 Ql&
ni
,f - • s
Residential Compliance Forms.,, , April 2005
SEALED DUCTS and TXVs (or Alternative Measures)
A Signe CF -4R Form must be provided to the building department for each home for which a followieg. are required.
✓ * �Pk£ r �s u e o 6u 'rias
lir Sealed Ducts all climate zones Installer testin and certification and HERS
-OR
Alternative to Sealed Ducts and Refrigerant Charge iTXVs (See Package D Alternative Package Features for
OR
For additions and alterations, duct systems that are not documented to have been previously
❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures :n the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
rater field verification:re uired.
�I
TXVs, readily accessible (climate zones 2 and 8-15 only)
Energy
Factor' or
Thermal
Efficiency
Installer testing and certification and HERS Rater field verification required.)
❑
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
-OR
Alternative to Sealed Ducts and Refrigerant Charge iTXVs (See Package D Alternative Package Features for
OR
For additions and alterations, duct systems that are not documented to have been previously
❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures :n the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
Svstems serving single dwelling units
0
Water Heater
Type/Fuel Type
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Energy
Factor' or
Thermal
Efficiency
not allowed.
10
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the system complies automatically.
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Svstems serving single dwelling units
0
Water Heater
Type/Fuel Type
Distribution
Type
Rated
Input'
Number (kW or
in System Btu/hr(gallons)
Tank
Capacity
Energy
Factor' or
Thermal
Efficiency
Standby
Loss %
Tank
External
Insulation
R -Value
Tank
External
Insulation
'R -Value
Svstem servinu multinle dwellinu units
Water Heater
Type
Distribution
Type
Number
in System
Rated
Input'
(kw or
Btu/hr(gallons)
Tank
Capacity
Energy
Factor or
Thermal
Efficiency
Standby
Loss %
Tank
External
Insulation
'R -Value
1) For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat pump
water heaters, list Energy Factor. For large•gas storage water heaters (rated input of greater than 75,000 .Btu/hr), list Rated
Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and
Thermal Efficiencies.
Pipe Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitche® fixtures
that are 1/4 inches or greater in diameter shall be thermally insulated as specified by Section 150 (j) 2 A or 150 (j) 2 B.
Residential Compliance Forms April 2005
CERTIFICATE, OF COMPLIANCE: RESIDENTIAL . (Page 4 of 4) CF -1R
Project Title 1 J Date f Q
SPECIAL FEATURES NOT REOUMING HERS VERIFICATION (add extra sheet:: if necessary)
\ Indicate which special features are part of this project. The list below only represents special features re;evant to the
Nprescri tive method.
✓
Feature
Required Forms if applicable)
Descri tion •
❑
Metal Framed Walls
CF -1R '
❑
Radiant Barriers
CF -1R
'
❑
Exterior Shades
WS -4R
❑
Cool Roof
N/A; Attach CRRC Label to
Forms.
❑
Dedicated Hydronic Heating
Performance Calculation
System
Required; Attach Run to Forms.
❑
Combined Hydronic System '
Performance, Calculation
Required; Attach Run to Forms.,
❑
Gas Cooling
Performance Calculation
Required.
+
❑
Buried Ducts
N/A; Indicate on building plans.
❑
Kitchen Pipe Insulation
See Section 5.6.2 Distribution
Systems in Residential Manual.
Multiple Water Heaters Per '
See Table 5-13 or use ,
❑
•
Performance Calculation and
Dwelling Unit
attach Run to Forms.
'
❑
Central Water Heating System
Performance Calculation and
Serving Multiple Dwellings
attach Run to Forms.
Non-NAECA Large Water
CF -1R
Heater
See Table 5-13 or use , -
❑
Indirect Water Heater
Performance Calculation and
attach Run to Forms
'
See Table 5-13 or use
❑
Instantaneous Gas Water Heater
Performance Calculation and
'
attach Run to Forms
'
'
See Table 5-13 or use
❑
'Solar Water Heating System •
Performance Calculation and
'
' attach Run 'to Forms
❑
1 Wood Stove Boiler
Performance Calculation and
attach Run to Forms
SPECIAL FEATURES REQUIRING HERS RATER, VERIFICATION '
add extra sheetsif necessa Indicate to the HERS Rater which credits are art of this project and need verification.
✓ Feature Required Forms if applicable) Description
11F
DuctSealing - CF -6R part 4 of 12
❑ Refrigerant Charge- CF -6R part 5 of 12
Thermostatic Expansion Valve CF -6R part 6 of 12
Residential Compliance Forms April 2005
R+ 4
s
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 3) CF -1R
Glo'f Otib i< Jr4y+� c�(c to �') . os
Project Title Date
COMPLIANCE STATEMENT �•
• This certificate of compliance lists the building features and performance specifications needed to comply .with
Title 24, Parts I and 6 of the California Code of Regulations, and the administrative regulations to implement
• them. This certificate has been signed by the individual with overall design responsibility. When this certificate
of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that
is varied is indicated in the Special Features/Remarks section. The undersigned recognize that compliance using
duct sealing and TXVs requires installer testing and certification and field verification by an approved HERS
rater. -
Designer
orrOwner (per Business and Professions Code) Documentation Author ,
Name: �i • `"L1� . •. Name:
TitTe�•irm: T461-6 •{ It eAViI;I+iM61 S i4 ^�'� Title/Firm: +
Address: Az-oO l -bE'AWP-4 A -U i ( Address:
• Telephone: - Telephone:
L.ic. #: ' -I')` 937 (CA C •20�
(signature) (date) (signature) (date)
+ M + t
Fnfnrcement Avenev S a
Name:
I itle:
Agency:
Telephone:
(signature / stamp) (date) '
+
Compliance Forms August 2001 A-4
AIR HANDLER
MFG
MODEL
SERIAL
REQ.CFM
REQ.S.P.
CONDENSING UNIT
MFG LNdO'A p
MODEL1A41q-qV1'% 3 f
TONS 3Yi.-Oti
SERIAL GLI U40$
INDOOR COIL
MFG
MODEL
TONS
SERIAL
11.
i
Fan CFM at Total SP
Supply CFM
Supply Loss
Return CFM
Return Loss
Total Duct Loss
Static Pressure Supply
Static Pressure Return
Total Static Pressure
Fan Speed
Ret. Grille Temp.
Sup. Grille Temp
�m Temp Change
rA
11.08 X CFM X AT I I I
GRILLES AND DIFFUSERS
:OMMENTS. ,f
CXCE-FAS i� LGOwC� l
2001 NCI
DATE
CUSTOMER
6oTTl.itS SAMA
ADDRESS
640.247:9.
1?4 V; "a
" Q •ti i.4 v*4
SYSTEM
L%\1IkVA, 0106 w1
b"tro-t ftK
JOB NUMBER
5
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AIR HANDLER
MFG L OW
MODEL6A1631Kf0q
Fan CFM at Total SP
Supply CFM
SERIAL 5$j01P0"*1D
Supply Loss
REQ.CFM l600
Return CFM
REQ.S.P.
Return Loss
CONDENSING UNIT
Total Duct Loss
MFG LENlJO�
.. _
MODEL j+Sj4-Lj4L0-3Q
Static Pressure Supply
TONS 3` L JVA)S
Static .Pressure Return
SERIAL S I $gVp(nj 2
Total Static Pressure
INDOOR COIL
Fan Speed
MFG LC-r.1a016
M7_1
MODEL b/-a;L5
Avg. Ret. Grille Temp.
TONS 470!45
Avg. Sup. Grille Temp.
SERIAL'Lt $ 6
System Temp Change
COMMENTS.
COPYRIGHT 2001 NCI
:PORT
GN ACTUAL VARIANCE
C
11.08XCFM XAT I I I
GRILLES AND DIFFUSERS
0
57
77
ADDRESS
5-9- S
vav%ea4
L-A aujoiN
SYSTEM
K1tL Ajt 0W1v1#k
LWaY, ME1SM
,Q��iR�t73�
JOB NUMBER
P,415r-- .