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MECH (10-0498) + PAT (15134)44525 Marguerite Ct 10-0498 15134 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 10-00000498 2 MARGUI 1TE C 4 ^^ MADTroTmy rm r-- 5 Property Address: 414-525 APN:. 604-252-036-56 -24208 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 19260 Applicant: Architect or Engineer: 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 forceandeffect. License C ss: ItC20 License No.: 489046 ntractor: 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 Cade) 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 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 _ 1 I am exempt under Sec. B.&P.C. for this reason Date: 617 1 10 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/09/10 Owner: JUAN RUIZ 44-515 MA96uAATE C& lG LA QUINTA, CA 92253. Contractor: ESSER AIR CONDIT P.O. BOX 1636 CATHEDRAL CITY, (760)324-0550 LiC: NO.: 489046 jll Al `'-`---_ F&Hik,,tION N "o Q ZO10 CA 2235 G4'.yr r y'.` 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. 1A I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor T 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 1891568-2009 _ 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, nd agree that, if I should become subject to the workers' compensation provisions of Section /3700 of the Labor Code, II.shall forttTith omply with those provisions. /WARN( G: 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 ($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 -6r 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 th thepnformration is correct. I agree t omply with all city and co ty rdinances and state laws relating ttruc.4Aut ize representatives of this cou ty t enter upon the above-mentioned pr f5'ate: C 01 ! V S' ature (Applicant or Agent). Application.Number 10-00000498 Permit MECHANICAL Additional.desc ... Permit Fee 51-00 Plan Check Fee 12.75 Issue Date Valuation 0 Expiration .Date. 12/06/10 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 REPLACE EXISTING AIR CONDITIONING AND HEATING SYSTEMS.WITH 3 TON 18 SEER AND 4 TON 16..SEER SYSTEMS TO EXISTING LOCATIONS.'.2007. CODES. Other Fees . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit'Fee Total 51.00 .00 .00 51.00 Plan Check Total 12.75 .00. .00 12.75 Other Fee Total •1.00. .00 ..00 1.00 Grand Total 64.75. .00 .00. 64.75 LQPERMIT , - Simplified Prescriptive Certificate of Compliance: 200E Residential HI'AC Alterations -CF-I R- !I T H ),"AC Climate Zones 10 to is 2UU6 Residential Compliapc•e Forms March 2010 Site Address: _ n9 Enforcement Agency: Date: IC ef r p Permit #: l Equipment T et List Minimum Efficienc Z Duct insulation requirement Conditioned Floor Area ►a Thermostat ❑ Packaged Unit AFurnace ¢ZZ. AFUE gbh ❑ COP Over 40 R of ducts added or ❑ Setback Indoor Coil SEER /G ❑ HSPF replaced in unconditioned space Served by system (ffnor already CondensingUnit EER _ ❑Resistance ❑ R 6 (CZ 10-13) V sf T present, must he ❑ Other ❑ R 8 (CZ 14-15) installed) 1. Equipment Tj pe: Choose the equipment being installed: if more than one system, use another CF -1 R-.1 LT-11PAC.fitr each .srstent. 2. Minimum Equipment Efficiencies: 13 SEER, 78o.3FUE, 7.711SPF%r ttpic•al residential sestems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The'installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF4Rs allowed) are filled out and si ned. Beginning October 1, 2010, a registered copy of the CF -IR and CF -6111 shall also be on site for final inspection. 0 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF4R forms: MECH- 21 and fors lits stems) MECH-25 • Condenser Coi I and/or • Indoor Coil and/or CF-611forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -41K forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA _> 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or 112. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all new ui merit) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting CF -611 forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF4R forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 linear feet ofduct in unconditioned space. CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the Califomia Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information • mented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with t rmit Name: DAVID WILLIAMS Signature: Company: ESSER SERVICES INC. Date: e ; Ct d Address: P O. BOX 1 6 3 6 License d4 City/State/Zip: C1P:m CITY. CA 99215 Phone: 760.324.05 5 0 2UU6 Residential Compliapc•e Forms March 2010 Simplified Preserip tiv e Certificate of Compliance: 2008 Residential ffl AC Alteradionc CF -I R -ALT -14 4C Climate Zones 10 to 15 Sile Address: 1 LT - 2; Enforcement Agency: Date:. / . r G Permit #: Equipment T e' List Minimum Efficiency r Duct insulation requirement Conditioned Floor Area G Thermostat ❑ Packaged Unit Furnace G ,4,AFUE U" ❑ COP Over 40 R of ducts added or ❑ Setback Indoor Coil Condensing EER ❑ HSPF replaced in unconditioned space 13R 6 (CZ 10-13) Served by system 11-00 sf (l/•notalreach- he Unit EER ❑ Resistance present, must ❑ ther ❑ R 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment heitrg installed: iJ'ntore than one system, use another CF -IR ALT-HV4C.fin• each .[_'stem. 2. Minimum Equipment Efficiencies: 13 SEER, 78% .4FUE, 7.711SPF%r (ypic•al residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -611 and registered CF -411 forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -IR and CF -6R shall also be on site for final inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -411 forms: MECH- 21 and fors lits stems) MECH-25 • Condenser Coil and/or • Indoor Coil and/or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -4R forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS • Cut s: al Chang outducting ducts: (all new ducting and all CF -411 forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 new equipment) For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF -411 forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA :>: 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than CF-6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 linear feet of duct in unconditioned space. For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. - Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the Califomia Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets. calculations, plans and specifications submitted to the enforcement agency for approval with thett a ica Name: DAVID WILLIAMS Signature: Company: ESSER SERVICES INC. Date: Address: P O, BOX 1636 License: O y/ ! , City/State/Zip: T, C Phone: 760.324.0550 2008 Residential Cornplianc•e For -ins March 2010 Bin # Qty ®f Lel Quinta Building 8i Safety Division P.O. Box 1504, 7&495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 1 ( "► v Project Address: S f"VEL v c f' I'r C-1 Owner's Name: 'XVA J V 1 Z A- P. Number Address: S Z 7 QITJ 6-ft % [ ' C 1 Legal Description: City, ST, Zip: `h 62111 ,fA- eA - 22 J 3 Contractor: °J c PV 1 C ES AV C . Telephone Address: o. Z(>X fG3 6 Project Description: P(4 Geste f-'K1 <(/Yo G City, ST, Zip: CA-11I t -D AA L of 9 T y C' . `j z 2 3 s s 1 t- (,aw'p l) e- 0) /'/1i/l r l li -S 1,, `f Telephone: 7(,v • 3 2 tt - 0 `i S D , /i 3 ' ►UC V Q N ' Oe11 State Lic. # : City Lie. #; ( . c t: — ✓ '%c w: S ` 7t/fT/v1%G Arch., Engr., Designer. 1`j ce2 O A) S Address: City., ST, Zip: Telephone: b State Lic. #: - ; •,,,_ -- Name of Contact Pelson: VA V1 D w t L t-1,4 M.5 Construction Type: Occupancy: Project type (circle one): New. Add'n Alter Repair Demo Sq. FL: #Stories: #Units: Telephone # of Contact Person: % 'J z ° '•- S© / Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE H Submittal Req'd Reed TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Calkd Contact Person Plan Check Balance. Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan V Review, ready for corrections/issue Electrical Subcontactor Inst Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Renew, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees L I Total Permit Fees Gcrjr P.O. BOX 1504 No. 15134 ' Building ' 78-495 CALLE TAMPICO . . Address dt9« to " i - LA QUINTA, CALIFORNIA 92253 ' Owner Gary Doty _ BUILDING: TYPE CONST. OCC: GRP: Mailing Address 44--525 Mar uer to Court r A.P. Number City Zip Tel. Lal 13i Pi c : ' . 92253 772--491-2 Legal Description Contractor ` ' r f. -FS -6 standing$:>t Project Description Ra g O Cons tiuctio 1 , Address `F -a 4. n_s ,a : « .a ' 9 _ s i R s r 4, ' 13a-285 Cactus Drive ratio Cove CityZlp Driveway Enc. Tel.. > DH51. '. 92240 329-5,755: I hereby affirm that I have a certificate of consent to self -insure, or a certificate of State Llc. City 'Policy No. Company . • . : c dsrf c, .! L , & Classif. 7I Q55 -Lic. # 167T Sq. Ft. No'` 1 No. Dw. CERTIFICATE OF EXEMPTION FROM W ORKERS' COMPENSATION INSURANCE REMARKS - y Size .254 ':.. :_,Stories. Units - Arch., Engr.,' I certify that in the performance of the work for which this.permit is issued, I shall not . Designer ° ,'; .` -., •.. New ❑ Add"O . j-` Alter ❑ Repair ❑ Demolition 0: Address Tel. NOTICE TO APPLICANT. lt;. after making this Certificate of Exemption' you • should. become • . -ZONE: BY: subject to the Workers' 'Compensation provisions of -the Labor Code, you must forthwith' comply with such provisions or this permit shall be deemed revoked.' '. Minimum Setback Distances:.,, - • Front Setback f/o en r Line City r Zip State t :; SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE ., • HUNDRED THOUSAND DOLLARS.($100,000), IN ADDITION TO THE COST OF rte Seta k fro/Property Line COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR INTEREST, LIC. # .CODE, AND. • ATTORNEY'S FEES. - - .' vy- T riis'is a buildin g permit when property filled out, signed and validated, and is subject to- - expiration it work thereunder is suspended for 180 days. - , FINAL.DATE INSPEC_ TOR r I certify that I have read. this application and state that the above information is correct: -Issued by:.: DaTlit /! I agree to comply with all city and county ordinances and state laws relating to building , construction, hereby r , LICENSED CONTRACTOR'S DECLARATION and authorize representatives --of this city. to enter the, above-. mentioned for Inspection I hereby affirm that,l,am licensed under, provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code, license is in full z Signature of applicant Date' and my force and effec! Validation: SIGNATURE •°' - Y ! DATE OWNER -BUILDER DECLARATION'.. . Y Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for.the following requires - .reason: (Sec. 17031.5,Bustness and Professions. Code: Any city or county, which a' permit to construct, after,- improve, demolish, or repair any- structure,- prior to its issuance. also .requires the applicant for such permit to file a signed statement that he.is licensed. pursuant to .. PERMIT.-"'. AMOUNT - ' the provision s of the Contractor's License law, Chapter 9 (commencing with 'Section 7000) o/ -the Division 3 of the Business and Professions Code•, or that.he is exempt therefrom, and basis _ for the alleged exemption. Any violation of Section 7031.5 by 'any applicant .for a .permit - Plan Chk. Dep. - subjects the applicant to a civil penalty of not more than rove hundred dollars ($500)., •' Plan -Chk. Bal. ❑ 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, Buisness and Professions Code:. The Contractor's - COr1St. - t • License Law does not apply to an owner of property who builds or Improves 'thereon and who does such work himself or through his own employees, that improvements Intended ',sale. . Mech. ' provided such are not or offered for If, however, the building or Improvement is sold within one year of completion, the owner -builder will have the burden EIBCtfICdl ' . of proving that he did not build or Improve for the purpose of.sa/e.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing i struct the project. (Sec. 7044; Business and.Prolessions Code: The Contractor's License. Law .. . does not apply to. an owner of property who builds or improves thereon, and who contracts, for such projects with a controctor(s) licensed pursuant to the Contractor's License Law.) S.M.1. 's' .', •. Grading ❑ 1 am exempt under Sec.- B & P.C.for this reason City, State, Zip Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. -(Sec. 3800, Labor Code.) ' 3• 'Policy No. Company . • . : c dsrf c, .! L ❑ Copy is filed with the city. O Certified copy is hereby furnished. TOTAL1104.29 CERTIFICATE OF EXEMPTION FROM W ORKERS' COMPENSATION INSURANCE REMARKS - (This section need. not be completed if the permit is for one hundred dollars - (S f 00) valuation - " or less.) - I certify that in the performance of the work for which this.permit is issued, I shall not y employ any person in any manner so'as to become subject to the Workers' Compensation Laws of California -• Date -"Owner _ NOTICE TO APPLICANT. lt;. after making this Certificate of Exemption' you • should. become • . -ZONE: BY: subject to the Workers' 'Compensation provisions of -the Labor Code, you must forthwith' comply with such provisions or this permit shall be deemed revoked.' '. Minimum Setback Distances:.,, - • Front Setback f/o en r Line Rear Setback f Rear P • Line WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND ` ) SIde.Streeti ack fro Irte SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE ., • HUNDRED THOUSAND DOLLARS.($100,000), IN ADDITION TO THE COST OF rte Seta k fro/Property Line COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR INTEREST, Side .CODE, AND. • ATTORNEY'S FEES. - - .' vy- T riis'is a buildin g permit when property filled out, signed and validated, and is subject to- - expiration it work thereunder is suspended for 180 days. - , FINAL.DATE INSPEC_ TOR r I certify that I have read. this application and state that the above information is correct: -Issued by:.: DaTlit /! I agree to comply with all city and county ordinances and state laws relating to building , construction, hereby , and authorize representatives --of this city. to enter the, above-. mentioned for Inspection property purposes.' Validated by: Signature of applicant Date' Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. p' POR. SO. FT. ® GAR. SQ. FT. ® CARP. SQ. FT. WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1 Va c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: VENTILATION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. _ FRAMING 3 FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL I 0 V\j o tp I 4 a-0.-- 4LI.. I See 16DfLas VDIG below Orecift baskad, a S%sethlair at ftet Latilce %in. wor rootlet 11' 3/8-81- log acre".1ble stwb @I IC O.C. 11alow cute O tfauwu ledger Provide 1" learan ost To ConcretYK 4L--Jelst mosger w Solid Blectiog mail to blocku% ALL 4 IS "lie Of bell MOZ.L TPM_ ucywh wile i6 Ss re Ir Is Cast. C= 4, 1W '11S 3 _r j 1.41yop or "A Ile orLOr "Its pistil 1 4" 7-1- L 6-9. 5-2 -0-1 O.C. Crate 24' 124 5_2 7-1 '0 1 1 15.4 6-3 1 12 1 124 -5-0 .134 10 204 7-4 V V $0 1-1 3 fr dog]ims fir no. I aim open S" S, I 7. W4.......30• ka.firq vote a- wad shakes 4112 pitch (3/22 lmiL pitch w--th 301 felt ade--lay) CUSS A D. ftW, cm;Mitim e=Nhs 4.122 pitch 13/12 min. ;dtch tr-th 150 felt WAVISY, - Class A c. lk—It, W rolled rcc! sic;e to dra--.. d- Axit rm! 3/12 mLx;.-Zr pitch. UPICAL P&M C(WER 1.41yop or "A Ile orLOr "Its pistil L Crate dog]ims fir no. I aim open S" S, I 7. W4.......30• ka.firq vote a- wad shakes 4112 pitch (3/22 lmiL pitch w--th 301 felt ade--lay) CUSS A D. ftW, cm;Mitim e=Nhs 4.122 pitch 13/12 min. ;dtch tr-th 150 felt WAVISY, - Class A c. lk—It, W rolled rcc! sic;e to dra--.. d- Axit rm! 3/12 mLx;.-Zr pitch. UPICAL P&M C(WER ! P.O. BOX 1504 No. 08,354 Building78-105 CALLE ESTADO Address 44-525 e&.ite CoUrt,_ LA QUINTA, CALIFORNIA 92253 Owner La 0"InEA AaRecI tan BUILDING: TYPE CONST. • . Mailing OCC, GRP. Address t'%_ !.cZ ,fr A.P. Number Tract 24208 phask i City - Zlp Tel. 0,0=_; .; . a Legal Description CACtua Ficsr;itar paGaContractor _ Project Description tl*" A{6 tot 52 ?i111LR ' • Address. City Zip Tela State Lic. City & Classif. $ ,3 Lic. # 23 Sq. Ft. No. No. Dw. Size 2328. Stories . Units Arch., Engr., 'Designer New ❑ - Add 07, :'1 - Alter ❑ Repair ❑ Demolition ❑ . Address Tel. ,•. ;City : Zip State ... Lic. #. ' LICENSED CONTRACTOR'S DECLARATION _ I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with•Section. 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. +...r r SIGNATURE DATE , • OWNER -BUILDER DECLARATION' Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following q reason: (Seca iGV !s 7031.5, Business, and Professions Code: Any city or county which requires a 1 •00 - permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires -the applicant for, such permit to rile a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions; of the Contractor's License Law, Chapter •9 (commencing with Section 7000) or e:r, • Division 3 of the Business and Professions Code, or that.he is exempt therefrom, and the basis 4' '',.'tor, the :alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit ...Plan Chk.'Dep. subjects the applicant to a. civil penalty of not. more than five hundred dollars ($500). - - ', O I,.as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.61-1.20 do -the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and r Const. '.- Professions Code: The 'Contractor's License Law does not apply to an owner of property who ","builds or improves thereon.and whokdoes such work himself or through'his own employees, .,Mach. . I', provided that' such 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 - Electrical ' of proving that he did not build or improve for the purpose of sale.) . 1 O I, as owner of the property, am exclusively contracting with licensed contractors to con- • Plumbing struct the project. (Sec. 7044, Business and•Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improvesthereon, and who contracts for ~ S. M.1. such projects with a contractor(s) licensed pursuant to the Contiactor'sLicense Law.) - Grading ❑ I am exempt under Sec. - B. 8 P.C. for this reason Driveway Enc.- Date nw„er i<•,✓..I' e -•-.;...+ •".i - ,Infrastructure - - ! 4 • WORKERS'. COMPENSATION DECLARATION r I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) _ - ; Policy No. ' Company ` ❑Copy is filed with the city. O Certified copy is hereby furnished. TOTAL 4,574-2 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit is for one hundred dollars ($100) valuationf•,.;y;, ,, ;aa;a_ .r x i or less.) . t -. .1 lit LW .f al..r 1 yi > .I..sJC V.: 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. Date Owner NOTICE TO APPLICANT:- If, alter making this Certificate of Exemption you should become ZONE: ' BY: "subject to the Workers'. Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: Front Setback from. Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING,AGENCY `' Side Street Setback from Center Line Ihereby affirm that there is a construction lending agency: for the performance of the work for which this permit. is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address This Is a building permit when properly filled out, signed and validated, and is subject.to • . FINAL DATE INSPECTOR expiration if work thereunder is suspended for 180 days. I certify •that I have read this application and state that the above information is correct. Issued by: Date Permit I agree to comply with all ciy and county ordinances and state laws relating to building , construction, and hereby authorize representatives of this city to enter the above-. mentioned property for inspection purposes. ` Validated by: Signature of,applicant Date' _Mailing Address ;,Validation: City, State, Zip 2 a.'s . s . r " S {. ..yr z .. v zs. c^t?a .,. e,c•.. F4 w , ♦ ' ' t • F = ,. • o- ` +.. a. T p. • ; ' c . t t., a7E. ,.• ,r 1Zj' 'et ' -s t ..t f .leC .. f v;y. .. 'Sa+. _.- ,-t. ..i. i2, <a._ :F, 4r.. .t .sfb•r C,:tf '-s n:.R .. teYS • r:t .. :. c.<, ! CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. @ FOR. SO. FT. ® GAR. SQ, FT. ® CAR P. SO. FT. WALL SO. FT. ® SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES STORAGE TANK WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER ROCK STORAGE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH)Sl LAUNDRY TRAY AIR HANDLING UNIT CFM OTHER APPJEQU1P. KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/. c SEWAGE DISPOSAL FINAL INSP. &` Q LV SQ.FT.GAR ® 3/ac HOUSE SEWER ROOFING 3 ( ` /O GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBINGl 4 -ClLQ UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH)Sl METER LOOP HEATING (FINAL) OTHER APPJEQU1P. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING Cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. &` Q LV FRAMINGMt7/ r FINAL INSP/ ROOFING 3 ( ` /O REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL Piz LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL