MECH (10-0045)79655 Mandarina
10-0045
-t ;,1
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: T0-00000045
Property Address: 79655 MANDARINA
APN: 772 -191 -009 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 850
ntApplicant:' -} ^
T4ht 4 4a Qa&Z
Architect or Engineer:
A-#-
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
----------------------- 7 --------------------------
IUCEN
ONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury th icensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busi s n rofe rsionals Code, and my License is in full force and effect.
License Class: C20 -C38 LicenseNo.: 826714
_.
' Date:_ /` Contractor.
WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjuryt at 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.).
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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 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:
MOSER , PAUL
79655 MANDARINA
LA QUINTA, CA 92253
(760)619-2460
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/19/10
Contractor: // Q
BEST IN THE WEST v
255 N. EL CIELO, 140- 25 -14*0
PALM SPRINGS, CA 92 2 1
(760)322-0202
L i c. No.: 826714
-------- - - - - -- - --- ----
WORKER'S COMPENSATION DECLARATION
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 1932774-09
_ 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 o—Become subject to the workers' compensation laws of California,
and agree that, if I sh come subject to the workers' compensation provisions of Section
3700 'off the LabkWO
I with comply with those provisions.
Dater-,/applicant
WARNING: FAILURE TO SECURRS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,0001 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 Wthevermation is correct.I agree to comply with all
city and county ordinances and state laws relati toction, and hereby authorize representatives
of this county to enter upon the above-mentio d prtion purposes.
Date/ /; "/O .Signature (Applicant or Age
Application Number . . . . . 10-00000045
Permit . . . .
. MECHANICAL
Additional desc .
Permit Fee . . .
. 21.50
Plan Check Fee
5.38
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date
7/18/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.5000
EA MECH OTHER
MECH EQUIPMENT
6.50
----------------------------------------------------------------------------
Special Notes and
Comments
REPLCAE EVAP. COIL
APPROVED PER AJ
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . .BLDG STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged Paid
--------------------
Credited
--------------------
Due
Permit Fee Total
21.50
.00 .00
21.50
Plan Check Total
5.38
.00 .00
5.38
Other Fee Total
1.00
.00 .00
1.00
Grand Total
27.88
.00 .00
27.88
LQPERMIT
Certificate of Compliance Prescriptive Nkdhod - HVAC -only Alteration CF -1 R -ALT
r
f 17 —/ ® yrs 2005
124; q e . _..a, a~.. ,..,e.. ,. I ,er- n s awe to an ®Home
Use one foml for 6841 aaa m 1 F15 m u : w
6. -Min j;;j ;-1ta11s for to be 6ab0b10v we&
wgdn ed equ%Knerd ewtmereb/ Ve foeeiae ad meager m=ead ere
28 Carfpaaim[ 0 spa ystto U P
29 O
F=t'
30 031 tb CINC s32 eei nvk- k4obw-
ee iicate oi eornp0arloe fists the burg des end spools needed to eompty vM Tile 24. Parts 1 and 6 of the
Cafifomb Code of Regetlatiolls, and the eda mGm re rls to impf Mmt UMUL Thta cue has been signed by the
vAh operaProject respol NMV- The ttmt ecroPiianoeizsbg dint seaafnG. ver an of refrige and
• ertd T" nxp*e mer teo ft and ce to l and v 1 by an appmed tM rater_
7 vz-
(Jame:
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760 6/q 2460
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T: by a qmw- Rea*ed at Erne CO PwM ap *Caftm Copies to hone www. erdor=nmd agenW. HEM rater_
T: by ir>t:tAirg cm odor. Required to dose pia- Capbs to twme own" enftmeumt agem* HEM rates.
T: by HERS raters Regemed to dose permit. Copies to home owner, a nfa cmmrrt 89MW. kWOWThe CF 4R forms for a
:/easion 03-10-06 vrww
'aft form can w f be used on projeds beke vel by 5 e raters
Cerfr kata Of Compliance Prescriptive MettHod - HVAC -only Alteration CF -IR -ALT
p TrioDaft ® C aK;ERTS 2005
Pl ojed Address: Climate Zone: Peratt a
Doc.,,rnentation Author et oxm Cheek Date
b 3 3 /00 Z
Name:
Check Date
Comemw an'20MANT: This CF -111 -ALT farm is only for use when at HVAC -only afbera 6ort Is made b an existing home
Use am *m for each aftered. This is of altered in oft house.
Scope of Alterations:
1 ❑ AUHargdtesiota beinsUffiedor Dud bbedeftgnkw& Can6nuebne ffm
2 ❑ t=oeaolbwt isbbsimtetledar Duct bbeddia hW& CwWnMbnsdiae.
$ ❑ orr door aatiaHDbeirrsfdiedor Duct andfor bbedeierrained Car-nuebnetkrn
4 ❑ a oo-i:bbeimte-edar Dud anww bbe Caramio mollrte.
5 ❑ ban 40 seat orrrew ar iepboenent dud woe b be irreta-ed in irpomdNo0edapace Dud snake b bedetemir>ed
❑ Check henstf the dud is dw lobe new cr b `red tins
60 norre of -nes 1-6 are ne-her Dud nar ars Gob Serpi 5_
1 - Duct 6 of lines 1 3 4 or 5 are " dm*ed. ff Line Els d wkad.
F703 rd
isfnC§mebZcml 4 7ars. NDdud is GDto acdcn2_.
haslwa#sn40fmadfducftimuroorrd0awd NvdwA is GDbSw*m2-
lea was preriou* waded aid tested and was ger--ed by a HERS =ML
An9ch CF-4RSorm.GDbSee-m2
10 ❑ct is saeled ar it *ltd wrh arbedoe. No duet -GiDll0WAM&GovxSmcMan2L
Notes if the entire duct system is b be new or Lines 11-14 do not
11 ❑rOMAFUE*m vA
es 12 aid 18: An 0.92 AFUE Anraoewi be to *dbd to leu of duet TXV 8
12 ❑rwe 10.13 and l& An ' '' 14 AMQEM 12 mrderrserwi be bmtdled wir TXVO CN
d imddim m dwcW R-8 near iA tau -dud GD b Seeian 2-
13 ❑res9.10.11.13`14.orl&An5 214aWEE§t12candmw rwibeirde-edwiibTXV Jy
tE turmmv M be'rata-ed in leu of dud =WWj4 Ga b Section 2
14 Oes2.9.11.12.14or18:AnSit146l8i 12mWwmwwMbekatMeduftT MWM
FUE i arra vA be* I - duet iratian it leu afduct Gob Sac -an 2-
15 ❑cfroes 7-14 above ale -reg load Ood 8as>Tig is itegiired. Ocntiras
Section. 2 - TXV 9 Lines 3 or 4 are chedwd. otherwise got b SecSon
16 ❑ a%mmd s a u`0. WTxvotm is looks& Go b Sacdm 3.
17 ❑system is in C maieZorre 8=4 a 14 SEER drearaMa rar 0.82 AFUE ttartsoe is bsinp bsbffa&
No s GobSacbm&
1t3 ❑ is inCRaaleZare a7_ Pb s' GDbSerlim3
19 E3!sin CkaaW Zxw 16 wad tirre 14 isnot dredged No is Go b Sec*m 3.
20 13 wAtern is in C-msb Zara 16 aid lire 14 B dredged and nd-ne 1& TXY b GDb Sadao 3.
210 wM=sinCkrraleZone2ar8-15andbne11.16cr1Tsact-reeled TXVftCQtomq bwL GDteSectionS
Section 3 - HERS Rata verification
22 ❑ ins 15 is ctreciged, HERS verM=Woa Ta Tor Du*
23 -rre 12.13.14.20 ar2t ala d 1 1, d and nat rrs 16 ar 17. HERB vadOcvG ors for
24 ❑ PbwlZ13 or 14 are-recI L HERR rerffiea0oa b nrquieed Tier 12 EEt.
Section 4 - Eatftrnent EWkbmdes
25 E3foes 11, 12.13.14 ar t7 se cl ; ,'are I apgraded egp%=m* M' ,es are wgnirad t7st Hs 8ec8oa 6.
Section 5- Dud R -Values
L26
❑ mare than 4O teat of duct is bvMAed a duct R -value anrst meet ar eceed D
27 ❑ ffess am 40 Seel orduet fs hrstdW a dud R eko must meet ar®woes- l2 42
6-amrmd paw
Version O3-10-06 Page 1 of 2
This form can only be used on projects being verified by Ca10ERTS eertfied raters. www.doom
Bi" #
City of La Quinta
Building a 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: U L
A. P. Number.
Address: 7 D IA.) Ar-
-Legal
Legal Description:
City, ST, Zip:
Contractor: qr
Address:- Z A-) , ,tj/ y0 ^l Z' '
Telephone:740 . /66
Project Description:
City, ST, Zip: gL [ Z.
Telephone:760'
State Lie. #: -7
City Lic. #:
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Constr .ctionType: 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:
APPLICANT: DO NOT WRITE BELOW THIS LINE
a
Submittal
Req'd
Reed
TRACKING.
PERMiT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan.
Pians resubmitted
Mechanical
Grading.p Ian
2" Review, ready for correctionsfissue
Electrical
Subcontiactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted .
Grading
IN HOUSE:-
'"' Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees