MECH (08-1429)54620 Avenida Madero
08-1429
. T
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00001429
Property Address:
54620 AVENIDA MADERO
APN:
774-262-006-19 -000000-
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
5000
Applicant- Architect or Engineer:
Cv OVt y
-----------------
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.
LicensCl ss: B -C10 -C20- License Nm 856936
Date: v Contractor: C_/,
NER-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 ($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.).
(_) 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.).
( 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:
LQPERMIT
Owner:
MACK HARLEY F
54620 AVENIDA MADERO
LA QUINTA, CA 92253
(760)782-0129
VOICE (760) 777-7012
FAX (760) 777-7011
/+ E S (760) 777-7153
A (7
,79 8/19/08
C/ ?ooa
Contractor:
TELFORDJONES, INC.
25920 IRIS AVE, STE 13A-400
MORENO VALLEY, CA 92551
(951)486-0337
Lic. No.: 856936
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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 238-0005911
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 worke s' compensation provisions of Section
3700 of the Labor Code, I s all forthwith co y it hose provisions.
Date: Applicant:
WAR #1G.AILURE TO SECURE WORKERS OMPENSATION 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 above information is correct. agree to comply with all
city and county ordinances and state laws relating to building constructiM& _
resentatives
of this cou ty t enter upon the above-mentioned property for inspectio
Date: Signature (Applicant or Agent):
Application Number .. . . 08-00001429
Permit . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 24.00
Plan Check Fee
6.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 2/15/09
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
B/C <=3HP/100K BTU
9.00
---------------------------------------
Special Notes and Comments
-----------------------
-------=-------
CHANGE OUT FURNACE CONDENSER AND
COIL
13 -SEER
Fee summary Charged
-----------------
Paid Credited
Due
--------------------
Permit Fee Total 24.00
--------------------
.00 .00
24.00
Plan Check Total 6.00
.00 .00
6.00
Grand Total 30.00
.00 .00
30.00
0
LQPERMIT
07/27/2003 09:42 FAX 8585869098 SEARS SAN DIEGO JONES 1a006/007
Aug 16 08 07;31a Den Hart (951) 242-4750 P,10
Certificate of Compliance Prescriptive Method - HVAConly Alteration CF -1R -ALT
r ct
' Uate:
It CalCENTS 7005
IMPORTANT; Thia CF -1R -ALT tofnl ly only for" when an HVA only d ration b made to an sum soma
Use one form for each system Del W,.W, Th,, Is s stem # I of terra ffittrred 1n this trtw3o.
Sedlon 6 - lit, Raqulrements for Equipment to be InstalledlAftered.
In"Wd ■*"ff MCI malt "ftcatton and ma■t or card aMchnCftq-"ws
7B Conlh aydon $ABs v Pegra uta
r Doe. G.. ApL a: ■olmmo rAu O`i rone FAu p9nYlr
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Dusssm A!C of]rMb■s■ i■n a ro oc
R PF322 arNo cog
9 3 w ' R i
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All Mandifta mepeurea a to any a toed Co orient gee AOP-7R =ALT tam_
Compliance Statema^p:
his rgnMCate of cornolance pate the butldfrtg teelurez; and specifleaUone deeded to Comply YAin Ttrb 24, P&M 1 and 6 or the
Cuffbmla Coot of Regulations, and the adminlstrative regulatltlna to Implement them, This ndicate two beer aWted by the
"vidual Ntph overap project reapormU tyr, The taldaralgnm recognties that COmpPence usingduet seal
ft". end TXV raquhe inataltar teand ling eoenlffeatlon and vertttelnim by an approved HERratef, verlMeatlal refrtgofent
Home Omar orAUUiorizsd of Dtseurnsvrtellp Autnar
Nemo;
Nene:
agrtarure or Stamp:
4113
CFNR,Al.r;
by anyone, Requeed at ema of permlf soplicatlon. Copies to home ownar. enforcement
F -OR -ALT: Dy Inetalftng contractor, Required to Vase permh Copies to home owner, enforcement yERg Yater
CF -4R -ALT: by }ERS rater. Required Io dose f emn. Cop►ea to home owner, enforaamaru
sere b r shell eteae until all test and verification Com oted end eased for ^Asper. 7ha CF -R tomo for e
Venwon 0,1 vo
Ttva form Can only be used on pn leos bale vertHed Pape 2 of 2
p by Ctl <;RT9 cenNled Talars, w wv.caloer oom
Received on 8/15/2008 10:45:19 AM
07/27/2003 09:42 FAX 8585869098 SEARS SAN DIEGO d JONES 1x007/007
Aug 16 08 07320 Den Hart (951) 242-4750 p.11
Certificate' of Compliance Prescrlp a Meftd - HVAC -Only Aftera49on CF -1 R -ALT
Protect Title:
m CaICERTS 2005
L59620Au;v%,,A.Anr, der /b
Documentation Acthar, Telephone: Plan Checlt Date
Company Name: 'Q6
Sea is Field crreck
IMPORTANT. This QF-Ia2"B ulem forin is only fpr use when an HVA ► Y sltetation is made to an existing home
Us one forth for each s stem baIng altered. This Is tem ! of 1 s ems altered in this house.
Scop of Alterations: JUUUYL
1 n Air Nandlerls to be Installed or Du7
datenn ed, Continue to next One
2 ❑ A Pumaea Neat aRChan or la to
be inreatled ar seal/ tobedetetmkred. Continuetonpd Ortt,3 puldoor condenalrt unRls ba Installed orp9oed. Duct Soaring and/or T>[ CN to be determined. Coorkm to next lire.
4 Q A m heath colt la to ba asstadled or Duct Sep/ andrer 1]tv RCA t0 be determined Coreuwe to need One,
5 ❑ Q>en all teat of new Or repla metq duct arra to be Ene lled rn r>q zpaca. Duct a1,apng to b1, Qeteimk,ed.
❑ Check hwe N lfle duct tem 19 ileo to be mmw a noplaced,
6 ❑ 1f r=L d livres 1-9 are Checked ndthpr tAtt# Saalin nor TXV Cardhm m not 6ne.
BedlamnulllIln Oare ' Go to man S.
7 A Chrtate 1.3 4r 56 7 or e. -gyp duct aoa >n h Ski rf tine t3 Is chad.8❑ less thafeet of ducts In urtcand►tlorred ge to Loft Y.
9 d 7w!
al d and tested, acrd was eottRied by a Hp3$ uAad Go 10 Secd2.
lakettufi F 4R form, Oke to Bedlam Z10 ❑alenseated wan ssbea0as. No dukx seas Is ubW. Cao to Bedlam 2.
Note: If the duds tem Is to be naw or laced Lines 17-14 do not I .
11 ❑ n Calm Zonas 2,12 ia: - b 9¢ AFLIE willbe Installed In of mWi d K kaDle
12 ❑ C rI Zonae 10,13 and 15: An SCER 14 A&Q EER 12 COndalltls! wIR be bateaed with 7XV(RXV,
D added dud Insulatlon R4 wa an ecdstrn duds, R naw duCl M Oeu of d= saaltt . Go to Sedan 2.
13 Cl A7 QlmRIG Zones 8, 10, 11, 13,14, Or 15: An SEER 14 6M EER T2 c0ndCnwWpl to Intrad with TXV(RCA)
0 a 0-92 AFUE futnaoe will to Installed in Ileu of duce smang. Go to SOI 2_
14 C3 In gfmata 7Aneg Z. 8, 11, 12, U Or 16: An SEER 14 MM EER 12 c,
042 be InatalDpd with Tx1/tRCA)
0 an O.E2 AFUE rvI . Ug with Inceamad duct r sulaticn In Rau ordum 1680 . Go to Seotlon 2.
15 Nora 8111"1 ",1 7.14 above me ohr>iked pug 8e.ltrrp b rCoqulratl, oarmnuo.
Section 2. TXV On Ff Li M4 9re chadced otherwise of to' Section 3
10 ❑ anmraa lenIL No ntv Is ulrad_ Ootosectfm+ 3.
17 13 s Syy em Is In PlIgn" Zone4 SEER air cmdf fmw or 0.82 A furnace Is being tnslellom
No Tx1/ RCA b .iced Cio t0 Se n 9.
18 ❑ hl tar, Is In mate 1 5. B 7. No TW
19 ❑ t r CRmane Zone 19 end Ane 1A la ndt Chsokad. 11Ip C A o
20 ❑ Is In CllrtrapeZone ie and tine f4Is ofmkod and not One 19. MCA Is m aired d0o to Saigon 3.
ion 3_
21 t fila>hrdsT Is fn Gim1,ts Zmte 2 kx
8-150,11 d line 11,18 or 1719 hat ch )OW. TXViRCA) h PoVuitod, 00 m Sedw 3,
Section 3 - HERS Rmer verification
22 fjr1; irllne 1511, checked, hrR9 verfRosUon i 1------ -- ptr 9o.
21111,01
3 5k If Ilne 12, 13,14, 20 or 21 am cheokee and not One 18 or 17, HERS vorMresRlon In arced lb► aCA
24 ❑ t111ne 12, T3 Or 14 ars choom. H RD v@mtoBdon is nqultsd for 12 EER.
5ectlon 4 - i E cienOles
25 D (f 0nae 11, 12, 13, 14 Or 17 en OheCl ' upgraded equlpffmm emmwncins are reoulfed. List In SocNon 6,
Secdon 5- Duct R-Va ues
26 O If mpro than 40 fast pf duct Is bft InefeJled a circ Riralue must meat of weed P Dukenents_
27 Q Plese thon 40 fbd of duct Is boI Inatblled Or MId, duct R -value m
9ectlon a - age mead a ust meat or eoa agd R -4.z
Version D3.1Pop
Q-08
This form Can only be used on projeI being verified by C810ERTS certified raters. www.cs,loar m f Z '
Received on 8/15/200@ 10:45:19 AM
' Bid;fO
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Permit #
g
Project Address: .
A. P. Number:
Legal Description:
Contractor: Q
Address:IOLA
i S
City, ST, Zip: b lv l'!/i/e
Telepho 6 r
State Lie. # :
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
f F-1 A
City of La Quinta -
Building a Safety Division
P.O. Box 1504, 78.495 Calle Tampico
La Qulnta, CA 92253 - (760) 777-7012
BUilding Permit Application and Tracking Sheet
Owner's Name:
Address:
CLholne
, Zip: '
3 - 6191
Project Description:
v L
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft: # Stories: # Units -
Telephone, # of Contact Person:/—
# I Submittal
Plan Sets
Structural Ca[cs.
Truss Cales.
Title 24 Calce.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
Estimated Value of project. Q .
APPLICANT: DO NOT WRITE BELOW THIS LINE ,
Recd I
Plan Check submitted
Reviewed, ready for c
JPIans
Contact Person
cked up
submitted
2! Review, ready for c
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready for v
Called Contact Person
Date of permit issue
RACKING PERMIT FEES
Item Amount
orreetions Plan Check Deposit
Plan Check Balance •
' Construction '
Mechanical
orrections/Iseue Electrical
Pinbing
S.Md.
Grading
rrectlons/lssue Developer Impact Fee
A.I.P.P.
Total Permit Fees