09-1172 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09-00001172
Property Address:
78680 ALDEN CIR
APN:
604-225-011-94 723268 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
8267
T,iht
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
co
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 Busines nd Professionals Cooe and my License is in full force and effect.
License Class: C10 C16 C2 Lic fis No 457554
f / o �«
Date: 71/ ✓ Contractor: 4
OW ER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that exe 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 isnot 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 contractors) 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: '
` I III III I III III VIII IIII 13
IE
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/05/09
Owner: _ --
AGUILAR ANA
78680 ALDEN CIRCLE 1 D
LA QUINTA, CA 92253 111
�
eiJ
(323)573-4343 p`'1 �'
l ��,-1 �
Q 9 �
WRTA
Contractor: CITY O �
PREFERRED PLUMBING HT /r `r.
P.O. BOX 5120
PALM SPRINGS, CA 92263
(760)322-3173
Lic. No.: 457554
-----------------------------------------------
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 02DKRM12002143
_ I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
person in any manner so to become subject to the workers' compensation laws of California,
and agree that, if I sho d ecome subject to th orker ' compensation provisions of Section
3700 of the Labor Co , I, I s�r it o ply ith ose provis ns.
Date: 1% S Applicant: ` ^
F
WAR ING: FAILURE TO SECURE WORK S' C PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PE S 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 abo information is correc I agree to comply with all
city and county ordinances and state laws relating to buildin pristruction, here y th Pze representatives
of this county to enter upon the above-mentioned property or inspect�qn purpo es. i 9^
Date: Signature (Applicant. or Agent):
Application Number . . . . . 09-00001172
Permit MECHANICAL
Additional desc .
Permit Fee 33.00 Plan Check Fee 8.25
Issue Date . . . . Valuation . . . . 0
Expiration Date 5/04/10
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K' 9.00
1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00
----------------------------------------------------------------------------
Special Notes and.Comments
'HVAC REPLACEMENT LIKE FOR LIKE 5 TON
GROUND SPLIT SYSTEM. 13 SEER
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 33.00 .00 .00 33.00
Plan Check Total 8.25' .00 .00 8.25
Other Fee Total 1.00 .00 .00 1-.00
Grand Total 42.25 .00 .00 42.25
LQPERMIT
C+ RTIFICATE OF COMPLIANCE: RESIDENTIAL, (Page 1 of 1) CF -Int -.A
Project Title
AIA AGoti-4A .
. Date
Building Pemiit #
Project Address
8!0 9a ,�c D�nl C41
Documentation Author
Telephone
Plan Check / Date
Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos?
3 03 -- S 5?3 _ 3 y3
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
and Capacity (furnace, heat
boiler, etc.
Minimum Distribution Type
Efficiency and Location (ducts,
(AFUE or HSPF) attic, etc.
Duct or Piping Thermostat Type Configuration
Insulation (setback) (split or package)
R -Value
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.
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, evop cooling) (SEER or EER)
ys
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
fo11 wing compliance requirements that are ✓
✓ Compliance Requirements
Ea Sealed Ducts (Climate Zones 2 and 9-16) - Installer testing and HERS Rater field verification required
J_R 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 anv of the followine three exceptions are V. the duct system is exempt from sealed ducts
#
✓
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.
Z 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 art of this project and need HERS rater verification.
✓ Compliance Requirements
Installer Forms (if appticable)
HERS Rater Forms (irgpplicable)
❑ Duct Sealing
CF -6R pages 3 and 4 of 12
CF -4R page 1 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
�ns
B`" #
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 #
Project Address:
Owner's Name: ANI AGUlL,12
A. P. Number:
Address:
Legal Description:
City, ST, Zip: A_ �o7as
Preferred Air Conditioning dba
Contractor: P r e f e r r e d Plumbing. Heatin &A•i
Telephone: .3o?_ ._ $-73-`f�5F3
Address: PO Box 5120
Project Description: L �w T -
City, ST,Zip:Palm Springs, CA•.92263
sC42 - 5 20 til
Telephone: ( 760 322-'3173
S S r -
State Lic. #: 457554 City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: a (p 00
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
Plai Check Deposit
Truss Calcs.
Called Contact Person
Plai Check Balance
Energy Calcs.
Plans picked up
Con truction
Flood plain plan
Plans. resubmitted
Mec anical
Grading, plan'
2"A Review, ready for correctionsfissue
Ele ical
Subcontactor List
Called Contact Person
Plu Bing
Grant Deed
Plans picked up
S.M I.
H.O.A. Approval
Plans resubmitted
Gra ling
IN HOUSE:-
7n° Review, ready for corrections/issue
Dev loper Impact Fee
Planning Approval
Called Contact Person
A.I..P.
Pub. Wks. Appr
Date of permit issue
School Fees
Tots I Permit Fees