09-1286 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09-00001286
Property Address:
78690 NAPLES DR
APN:
609-512-007-21 -28457 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
700
Ti&t 4 4 Q"
Applicant: Architect or Engineer:
------------------
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 fcommencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicenseClass: C20 -C36 L' N : 818759
,16at,. >,Ia-cto,:
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 ($500).:
1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and I'll,
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, as owner of the property, am exclusively contracting with licensed contractors to construct the project JSec.
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 l3rojects with a contractoris) licensed
pursuant to the Contractors' State License Law.).
I I am exempt under Sec. _, BAP.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 fSec. 3097, Civ. C.).
Lender's Name: , I
Lender 's Address: VI
LQPERMIT
Owner:
WILLIAM FERSTENFELD
36 PEMBROKE
MENDHEM, NJ 07945
Contractor:
PREC H & A INC
P.O. BOX 11090
PALM DESERT, CA 92255
(760)776-1550
Lic. No.: 818759
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (7,60Rt,7-7153
------------------
WORKER'S COMPENSATION DECLARATION
1 2 1/ 0\9
try
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.
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 FARMERS INS— Policy Number N 2008 71 19
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 workers' compensation provisions of Section
3 700 of the �Olao . r Code, I Vail forthwith comply wit those provisions.
Xa'le
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 ($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 d di d I I i g to building construction, and hereby authorize representatives
,�a atin
th oned property I t �urposes.
.te_ 2—
Agent):
Application Number . . . . . 09-00001286
Permit . . ... .
. MECHANICAL
Additional desc
Permit Fee . . .
. 24.00
Plan Check Fee
6.00
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date
6/19/10
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
APPL REP/ALT/ADD
9.00
----------------------------------------------------------------------------
Special Notes and
Comments
EVAPORATIVE COIL CHANGE -OUT. 2007
CODES
--------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged
----------
Paid Credited
---------- ----------
Due
-----------------
Permit Fee Total
----------
24.00
.0,0 .00
24.00
�Plan Check Total
6.00
.00 .00
6.00
Other Fee Total
1.00
.00 .00
1.00
Grand Total
31.00
.00 .00
31.00
LQPERMIT
Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT
Project Title:
�W TeP FeL 0 P -697 -RL
Date:
C CaICERTS 2005
Enforcement Agency
Project Address: LCL QvititaPlimate
1-s -,�qo Ncycts Dr.
Zone:
I's
Building Permit #
Documentation Author:
kc,�ibn Rea 9, Mr
Telephone:
3�-6 IZD
Plan Check Date
Company Name:
PkCd1V(1 Air
ield Check Date
IMPORTANT: This CF -1 R -ALT form is only for use when an HVA only alteration is made to an eAsting home
Use one form for each system being altered. This is system # � of systems altered in this house.
Check all lines that apply. Check only lines that aanty-
Scope f Alterations:
1 0
An AJr Handler is to be installed or replaced. Duct sealing to be determined. Continue to ne)d line.
2 (:]
A Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to ne)d line.
3 0
An ouWoor condensing unftis to be Installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to ne)d line.
4 Y
A cooling or heating coil is to be installed or replaced. Duct Sealing andfor TXV(RCA) to be determined. Continue to ne)d line.
5 0
More than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined.
[3 Check here if the otim duct system is also to be new or replaced. Continue to ne)d line.
6 0
�if none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5.
Section 1 - Duct Sealing (Only if any of Lines 1, 2, 3. 4 or 5 are checked. Skip if Line 6 is checked.)
7 13
This system Is In Climate Zone 1, 3, 4, 5, 6. 7, or 8. No duct sealing is required. Go to Section 2.
8 0
This system has less than 40 feet of ducts in unconditioned space, No duct sealing is required. Go to Section 2.
9 0
This system was previously sealed and t I I, and was certified by a HERS rater.
No duct sealina is required. Attach preAous CF4R form. Go to Section 2.
10 13
This duct system is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2.
Not
If the entire duct system is to be new or replaced, Lines 11-14 do not apply.
11 [3
In Climate Zones 2, 12 and 16: An 0.92 AFUE furnace will be Installed In lieu of duct sealing (and TXV, If applicable).
12 0
In Climate Zones 10, 13 and 15: An SEER 14 AbM EER 12 condenser will be installed with TXV(RCA)
AND added duct Insulation (R4 wrap on eAsting ducts, R-8 new ducts) In lieu of duct sealing. Go to Section 2.
,13 0
In Climate Zones 9, 10,11, 13_14, or 15: An SEER,14 AM EER 12 condenser will be installed with.TXV(RCA)
AND a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2.
140
In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 AM EER 12 condenser will be Installed with TXV(RCA)
IMD an 0.82 AFUE furnace will be Installed with increased duct Insulation in lieu of duct sealing. Go to Section 2.
150
lNone of lines 7-14 above are checked. Duct Sealing Is Required. Continue.
Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, othervAse got to Section 3)
16 13 The system being altered is a package unit. No TXV(RCA) is required. Go to Section 3.
17 13 This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFLIE furnace is being installed.
No TXV(RCA) is required. Go to Section 3.
18 13 i7his system is in Climate Zone 1. 3. 4. 5, 6, or 7. No TXV(RCA) is required. Go to Section 3.
19 13 This system is in Climate Zone 16 and line 14 is not checked. No TXVJRCA) is required. Go to Section 3.
20 0 This system is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. GotoSection3.
Se,
21 [This system Is In Climate Zone 2 or 8-15 and line 11, 16 or 17 Is not checked. TXV(RCA) Is required. Go to Section 3.
Section 3 - HERS Rater verification
22 0
If line 15 Is checked, HERS verification Is required for Duct Sealing.
23 5J,*'
If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS vertfication Is required for TXV(RCA).
24 0
If line 12,13 or 14 are checked, HERS verification Is required for 12 EER.
Section 4 - Equipment Efficiencies
25 0 Flf lines 11, 12,13.14 or 17 arechecked, upgraded equipment efficiencies are required. List in Section 6.
Section 5- Duct R -Values
26 0
Ilf more than 40 feet of duct is being installed or replaced, duct R -value must meet or aceed Package D requirements.
27 0
Illf less than 40 feet of duct is being Installed or replaced, duct R -value must meet or exceed R4.2
Section 6 - see ne)d page
version ozi-io-w Page 1 of 2
This form can only be used on projects being verified by CaICERTS; certified raters. www.calcerts.com
Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -IR -ALT
Project Title:
Date:
I
I @ CaICERTS 2005
IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alt9ration is made to an eAsting home
Use one form for each system being altered. This is system #_L_ of ___L_ systems altered in this house.
Section 6 - Minimum Requirements for Equipment to be Installed/Aftered.
Instaged equipm
',ent must match "allocation and meet or exceed efficiencles/R-vatuas.
28 configuration: (3 SpR system 0 Package unit
29 0
Air Handier Mas furnace, AFUE:_ 01-leatpurnp FAU 13Hydronic FAU 00ther
30 0
Heat Exchanger
31 13
Outdoor Gondenshy unit DA/C 01-leatpump hffidercv SEER/HSPF: 1EER (if m-qd):
32 0
cooting or heating coo 0A(C OHeatpump CHydronic
33 0
Ducts Kocation: —TL. M —th If t): JR-vatue:
All mandatory measures apply to any altered component. See MF -1 R - ALT form.
Compliance Statement:
This certificate of compliance lists the building features and 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 project responsibility. The undersigned recognizes that compliance using duct sealing, verification of refrigerant
charge, and TXV require installer testing and certification and verification by an approved HERS rater.
Home Owner or Authorized Agent
Documentation Author
Name: GtW-J1
Name: Gw" 00WhS
Address:
pptu;sl�h CW
Company Name:
Jk&V � r
NCU5 U9 YA 4r
City/State0p:
r akk VV&�b ( (A- qi 2
Address:
P'0�
Phone-
City/State/Zip:
mcic
Phone: 156;b
Signature:
Signature:
Enforcement Agency (Building Department)
Notes/Comments:
Name:
Title:
Department:
Phone #:
Fax
Signature or Stamp:
Required forms:
CF -1 R -ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater.
CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement agency, HERS rater.
CF -4R -ALT: by HERS rater. Required to dose permit. Copies to home owner, enforcement agency, installer. The CF -4R forms for a
sample group shall not be released until all testing and verification is completed and passed for the entire grout).
version w-iu-w Page 2 of 2
This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com
Bin #
City of La Quinta
Building a Safety Dim' ton
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
ock
Project Address: 7?-Od
Owner's Name: ax,\ 4 4 IM
A. P. Number:
Address: 3�' Ao) 1,njuk-c
Legal Description:
City, ST, Zip: Ab'd 1,1,7,- 4) Z�
Contractor: PILL- Ir -1-1c
Telephone:q 7.� 7/� t1, �e
I
Address: loe> d4 /X) 9d
Project Description: 12" V4 42 5 C
City, ST, Zip: AZL�-;
OF
Telephone: -7Zd 7
State Lic.#:
City Lie.
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.: -T#
Stories:
# Units:
Telephone # of Contact Person:
61 --
Estimated Value of Proiect: 7
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Reqld
Rec1d
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calts.
Reviewed, ready for corrections
Plan Check Deposit
Truss CaIcs.
Called Contact Person
Plan Check Balance.
Ilde 24 CaIcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' Review, ready for corrections/issue
Electrical
Subcontactor 1A st
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O-A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees