07-1837 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&-ty/ 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Application Number: 07-00001837 Owner:
Property Address: 51585 AVENIDA CARRANZA BERTRAND FRANCES L.
APN: 773-124-017-5 -000000- 51-585 AVENIDA CARRANZA
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL
Application valuation: 7000 -
Contractor:
�I
Applicant: Architect or Engineer: PALOMA AIR CONDITI B G . JUN 2 J 2007
P.O. BOX 3501
PALM DESERT, CA 92261 CITE®
(760)347-1212 IWC� �
Lic. No.: 619091
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 force and effect.
Licensee C-laasss:: C�2.0 (i% License No.: 619091
Date:VT� Contr ctor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury. that 1 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 exempttherefrom 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 _) 1, 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 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
Date: 6/25/07
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 ENDURANCE WRKR Policy Number WEN000141801
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
3700 of theJ,jj�or Code, I shall forthwith comply with those provisions.
A 6 -I-
Date: Applicant:
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 and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon tee abAe-mentioned property for inspection purposes.
Date: -1:� Signature (Applicant or Agent):
v
Application Number . . . . 07-00001837
Permit. . . MECHANICAL
Additional desc .
Permit Fee . . . . 42.00 Plan Check Fee
10.50
Issue Date . . . Valuation
0
Expiration Date 12/22/07
Qty Unit Charge. Per
Extension
BASE FEE
15.00
1.00 9.0000 EAMECH FURNACE <=100K
9.00
1.00 .9.0000 EA MECH APPL REP/ALT/ADD
9:00
"1.00 9.0000 EA MECH B/C <=3HP/100K BTU
9.00
----------------------------------------------------------------------------
Special Notes and Comments
HVAC SYSTEM CHANGE OUT- 16 SEER/2005
ENERGY. THIS PERMIT DOES NOT INCLUDE
DUCTS, DUCTS TO REMAIN. June 25, 2007
10:10:42 AM AORTEGA
Fee summary Charged Paid- Credited
Due
---------------------------------------------------------
Permit Fee Total 42..00 .00 .00
42.00
Plan Check Total 10.50 .00 .00
10.50
Grand Total. '52.50 .00 .00
.52.50
LQPERMIT
F cgA B �t d +va CA J
INSTALLATION CERTIFICATE
(Page 4 of 12) CF -6R
Site Address T� �. ��� (,Q ��1c,._
PermitNumber
INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE
INSTALLER COMPLIANCE STATEMENT
The building was: ✓ ❑Tested at Final ✓ ❑ Tested at Rough -in
INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE:
❑ Remove at least one supply and one return register, and verify that the spaces between the register boot and the interior
finishing wall are properly sealed.
❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points
between the air handler and the supply and return plenums to verify that the connection points are properly sealed.
❑ Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used
❑ New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platforms returns in lieu of
ducts).
✓ ❑ DUCT LEAKAGE REDUCTION
Procedures for field verification and diagnostic testing of air distribution systems are available in RA CM, Appendix RC4.3
NEW CONSTRUCTION:
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
Values
1
Enter Tested Leakage Flow in CFM:
"`.,. ';, r r;..4:.•.
Fan Flow: Calculated (Nominal: ✓ ❑ Cooling ✓ ❑ Heating) or ✓ ❑ Measured
2
If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cfm/(kBtu/hr) x Heating
aci in Thousands of Btu/hr, enter total calculated or measured fan flow in CFM here:
I/ V/Ca
3
Pass if Leakage Percentage<_ 6% for Final or <_ 4% at Rough -in:
❑Pass ❑Fail
100 x Line # 1 / Line # 2
ALTERATIONS:
Duct System and/or HVAC Equipment Change -Out
-4�1��*�;;;,�,
Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct
4
System Alteration and/or Equipment Change -Out.
Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct
5..
S stem for Duct S stem Alteration and/or E Equipment ment Chan Change -Out.
A",-.
;
Enter Reduction in Leakage for Altered Duct System"�t'}
.
6
Line # 4 Minus Line # 5 —(Only if Applicable)
7
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)
✓ ✓
Entire New Duct System - Pass if Leakage Percentage <_ 6% for Final
❑Pass El Fail
8
100 x Line # 5 / Line # 2)11
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change-
Out Use one of the following four Test or Verification Standards for compliance:
9
Pass if Leakage Percentage:5 15% [100 x [ (Line # 5) / (Line # 2)]]
❑ Pass ❑ Fail
10
Pass if Leakage to Outside Percentage <_ 10% [100 x [_(Line # 7) / (Line # 2)11
❑ Pass ❑ Fail
Pass if Leakage Reduction Percentage >: 60% [100 x [_(Line # 6) / (Line # 4)]]
❑ Pass ❑ Fail
11
and Verification by Smoke Test and Visual Inspection
12
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
:.a:i{ a `5: ,.
❑ Pass ❑ Fail
Pass if One of Lines # 9 through # 12 pass
"`+ `: ° +; .
❑ Pass ❑ Fail
✓ ❑I, the undersigned, verify that the above diagnostic test results were performed in conformance with the requirements for
compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and
Fans comply with Mandatory requirements specified in Section 150 (m) of the 2005 Building Energy Efficiency standards.
Installing Subcontractor (Co. Name) OR General
Contractor (Co. Name) OR Owner
Signature: Date:
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms September 2005
Y AWjc:�`S i3� I�r�►
INSTALLATION CERTIFICATE (Page 3 of 12) CF -6R
Site Address L r a (, &.—
Permit Number
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (Tile
information provided on this form is required) After completion of final inspection, a copy must be.provided to the building
department (upon request) and the building owner at occupancy, per Section 10-103(a).
HVAC SYSTEMS:
Healing Equipment
Equip Type
k . heat p um
CEC Certified Mfr.
Name and Model
Number
N of
Identical
Symms
Efficiency
(AFUF, IAC.)'
2CF-1Rvalue
Duct
Location
attl etc.
Dud or
Piping
R -value
Heating
Load
hOv
Heating
Capacity
oft
P2 u� �iW
V op
'(9 a v AV 60,
°.�
t Z�vvo
2 oma
Cooling Equipment
Equip Type
heat um
CEC Certified Mfr.
Name and Model
Number
N of
Identical
Uncieney t
(SEER or' EER)
2CF-iRvalue)
Duct
Location
(Atdr, etc.
Dud
R -value
Cooling
Load
tu/ty
Cooling
Capacity
t Aj
64; 0 04 V,
ha an472t
1. > symbol reads greater than or equal to what .Is lndlcated on the CF -1R value.
Include both SEER and EER if compliance credit for high EER air conditioner is claimed.
I, the undersigned, verify that equipment listed above is:. l) is the actual equipment installed, 2) equivalent to or more
efficient than that specified in the certificate of compliance (Form CF-1R)'submitted for compliance with the Energy
Efficiency &andardr for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for
manufactured devices (from the Appliance Efficiency Regulatlons or Part 6), where applicable.
Signature, Date
COPY TO: Building Department
HERS Rater (if applicable)
Building Owner at Occupancy
Residential Compliance Foims
�Ovx vee
Installing Subcontractor (Co. Name)
OR General Contractor (Co. Name) OR Owner
March 2005
Bin #
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 #
6)• 4�?j7
Project Address:' . 5 j �' d1/1-0 (1 X IMR V'
Owner's Name:
A. P. Number:
Address: SW • G / 5 Q— if to 1/0
Legal Description:
City, ST, Zip: G (qVr I (�v. ��Z 0Contractor:
() 0 m t'
1.'�
Telephone: �.
� �� �
•z; ...; .,.,
3 r
"' " `•` - '
Address:
Project Description: to
City, ST, Zip: v1yut (Y !
v 2 lid GI a -i r
Telephone: `� 1 L
.-Q. c�
State Lic. #
City-Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
: • ;"'gin= Z77
)' Z ;.
" f
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: NJ 0 n
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIMG .
PERMIT FEES
Plan Sets
Plan Check submitted
em
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading, plan
2n4 Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
'
Grading
IN HOUSE:-
Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
L
Total Permit Fees
INSTALLATION CERTIFICATE (Page 4. of 12) CF -6R I
Site Address r)m Q (� V Va �1 I Permit Number
INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE
INSTALLER COMPLIANCE STATEMENT
The building was: ✓ ❑Tested at Final. ✓ ❑ Tested at Rough -in
INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE:
❑ Remove at least one supply and one return register, and verify that the spaces between the register boot and the interior
finishing wall are properly sealed.
❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points
between the air handler and the supply and return plenums to verify that the connection points are properly sealed.
❑ Inspect all joints to ensure that.no cloth backed rubber adhesive duct tape is used,
❑ New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platforms returns in lieu of
ducts).
✓ ❑ DUCT LEAKAGE REDUCTION
Procedures for field verification and diagnostic testing of air distribution systems are available in RACM, Appendix RC4.3
NEW CONSTRUCTION:
-- -
Duct. Pressurization Test Results (CFM @ 25 Pa)
Measured
:Values
1
Enter Tested Leakage Flow in CFM:x.
Fan Flow: Calculated (Nominal: ✓ CI Cooling ✓ ❑ Heating) or ✓ ❑ Measured
2
If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21..7 cfm/(kBtu/hr) x Heating:
C40.
Capacity in Thousands of Btu/hr, enter total calculated or measured fan flow in CFM here:
`/
3
Pass if Leakage Percentages 6% for Final or <_ 4% at Rough -in: ..
❑Pass ❑Fail
100 x Line # 1 / Line # 2
ALTERATIONS:
Duct System and/or HVAC Equipment Change -Out,
Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct
4
System Alteration and/or Equipment Change -Out.
`L /� 0
Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered'Duct
r�
f .f
5
System for Duct System Alteration and/or Equipment Chan a -Out:
I 8
_ r+
Enter Reduction in`Leakage for Altered Duct System
,
6
L. y� Line # 4 Minus � Line # 5 =(Only if Applicable)
K,
7
Enter Tested Leakage Flow in'CFM to Outside (Only if Applicable)
✓ ✓
Entire New System -'Pass if Leakage Percentage <_ 6% for Final
13 Fail
8
[100x Line # S / Line # 2
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change-
I/
Out Use one of the folloMng four Test or Verificationtandards for compliance:
9
Pass if Leakage Percentage <_ IS% [100 x [ (Line # S) / ' 00Line # 2)1]
nlQ ❑ Fail
10
Pass if Leakage to Outside Percentage <_ 10% [100 x [_(Line # 7)./ (Line # 2)]]
❑ Pass ❑ Fail
Pass if Leakage Reduction Percentage >_ 60% [100 x [_(Line # 6) / (Line # 4)]]
❑ Pass ❑ Fail
11
and Verification by Smoke Test and Visual Inspection
12
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
;,. 3 _
❑ Pass ❑ Fail
Pass if One of Lines # 9 through # 12 pass
... `�
❑ Pass ❑ Fail
✓ ❑I, the undersigned, verify that the above diagnostic test results were performed in conformance with the requirements for
compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and
Fans comply with Mandatory req irements specified in Section 150 (m) of the 2005 Building Energy Efficiency standards.
Installing Subcontractor_(Co...Name)_OR General
Contractor (Co- Name) OR Owner
-- -
Signature: -1k _
Date: - -Z
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms --=-- — - --September 2005
� � �� C .lc S � � I � 1rtc �►
INSTALLATION CERTIFICATE (Page 3 of 12) CF -6R
I V Q U4 e- al Y ►meq Y -76, -
Site Address l— , CA, („oma
Permit Number
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
information provided on this form is required) After completion of final inspection, a copy must be.provided to the building
department (upon request) and the building owner at occupancy, per Section 10-103(a).
HVAC SYSTEMS:
Heating Equipment
Equip Type
k . heat um
CEC Certified Mfr.
Name and Model
Number
M of
Identical
S rru
Efficiency �
(AFM etc.)Loation
2CF-1Rvalue)
Dud
(attk, etc.
Duct or
Piping
R -value
Heating
Load
(13h0r)
Heating
Capacity
(BLAV
tm V
e o v v
t fr-
'
2 coo
..
t V
l
Cooling.Equipment
Equip Type
heat urn
CBC Certified Mir.
Name sod Model
Number(?CF-IRvalue
/ of
Identical
Eff clency i
(SEER or EER)
Dud
Location
atd etc.
Dud
R -value
Cooling
Load
WAV
Cooling
Capacity
bAV
tm V
/ab
t fr-
..
t V
l
1. > symbol reads greater that or equal to what Is Indleated on the CF -IR value:
Include both SEER and EER If compliance credit for high EER air conditioner is claimed.
I, the undersigned, verify that equipment listed above Is:. 1) is the actual equipment installed, 2) equivalent to or more
efficient than that specified in the certificate of compliance (Form CF-1R)'submittod for compliance with the Energy
Efficiency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for
manufactured devices (from the Appliance E„f?clency Regulations or Part 6), where applicable.
Signature, Date
COPY TO: Building Department
HERS Rater (if applicable)
Building Owner at Occupancy
Residential Compliance Fobs
Installing Subcontractor (Co. Name)`
OR General Contractor (Co. Name) OR Owner
March -2005— /