10-0692 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
069.277
-
Property Address:
VENIDk RUB I0
APN:
773-252-018-7 -000000-
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
6055
cio 000�o
52405�A
Applicant: _ �i Architect or Engineer:
r
3�.4
�
� J.
BUILDING &' SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm underpenalty of perjury that-) am lice under provisions of Chapter =9 (commencing with
Section 70001 of Division 3 of the Business and Pr a ionalsCode, and my License is in full force and effect.
Lic lasts: B. license No.: 884275
Date: _` 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 70001 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
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 improvesthereon, 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:
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: Ir h
LQPERA11T
Owner:
PAGE J ROBERT
52-405 AVENIDA RUBIO
LA QUINTA, CA 92253
_._Contractor:- _
HOPKINS, DAVID
269.LITTON AVENUE
COLTON, CA 92324
(951)522-5218
Lic. No.: 884275
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/28/10
JUL 2, 2010
mr OF LA QUINTA
FINARCE DEIN
------------------
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 whichthispermit is issued. My workers'. compensation
insurance carrier and policy number are: -
Carrier OK Policy Number OK
I certify that, in the performance of thewor or which this permit is issued, I shall not employ any
person in any manner -so as to beco s iect to tt;e'workers' compensation laws of California,
. and agree that, if I should become cf to the workers' compensation provisions of Section
3700 of the LaW Code, I tall h i omply with those provisions.
/
/Afe�
�: 7 2�y" cant:
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 15100,0001- 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 atwhose request and for
whose benefit work is performedunder 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 actor 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 inf9m5&tion is correct. I agree to comply with all
city and county ordinances and sta a laws relating to builAo
in, and hereby authorize representatives
of thi �coounnttyy to enter upon th give -mentioned propertn purposes.
ate: /—v`r_eo Si cure (Applicant or Agent):
a
Application Number . . . . . 10-00000692
Permit MECHANICAL
Additional desc . .
Permit Fee . . . . 33.00 Plan Check Fee
8.25
Issue Date . . . . Valuation . . .
. 0
Expiration Date 1/24/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH FURNACE <=100K
9.00
1.00 9.0000 EA MECH B/C <=3HP/100K BTU
9.00
----------------------------------------------------------------------------
Special Notes and Comments
---"—.-INSTALL-NEW4-TON;13---SEER--PACKAGE-UNIT------
— -- -------"—.-INSTALL-NEW-4-TON-13---SEER--PACKAGE-UNIT-------
ON ROOF OF SFD - NO SCREENING REQUIRED.
ON
2007 CODES.
--------------------------------------------
Other Fees . . . ... . . . . BLDG STDS ADMIN (SB1473)
1.00
:;. Fee summary Charged Paid Credited
Due .
Permit')Fee Total 33.00 .00 .00
33.00
Plan Check Total 8.25 .00 .00
8.25
'._ Other Fee Total 1.00 .00 .00
1.00
Grand Total 42.25 .00 .00
42.25
LQPERMIT
Certificate of
QjMte Zones 10 to 15
Site Address:
S2-05- AJ E:vJ - DA P—i 6c'
List Mini' um Efficienty 2
OD
2008 Residential HVAC Alterations CF -IR -ALT -HVAC
-Enforcem.ent-Agency: Date:Permit
&d to
X Conditibried"Fli0 or;..-.
Duct inSUlatJon-tecluitement Area:. T Ofmostat
[VPackaged Unit gb0 Cop Over 40 11 oI ducts added or actul.11C.
0 Furnace WAFUE replaced in unconditioned space Served by system not olread),
0 Indoor Coil 9'E ER 13 HSPF OR 6 (CZ 10-13) present. must -lye
0 Condensing Unit EER
tl10 0 Resistance 0 R 8 (CZ /4-15) installed)
0 Other
IF. Equipment Type: Choose the equipment being installed: if more than one si'steln. Ianother CF -1R - ALT -HVAC for each sYStey.n.
2. Minimum Equipment Jqficiencies: 13 SEER. 78%, A FUE. 7.7HSPFfor . 1)"Pical residential sYsieins.
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer dcdides- what work is b6ing done;jnd:
Option lists the HERS measures that must be conducted. A copy o('theforms shdil-he kft-od-siic for final
picks one of the appropriate Options. Each the inspector verifies inspection and a copy given to the homeowner. At [ s that the work listed on this lorm was in fact the work.completed-by the
-trial. fie
install r. The inspector also vcrifics that each appropriate CF -6R and registered CF 4R forms (no hand tilled CF-4Rs allowed) are filled out and
sigv Beginning October 1, 2014), a registered copy of the CF -IR and CF -6R shall also be on site for final ins eect . i I on.
Rrl. HVAC Changedut Re-46ired Forms.: MECH- 25 HERS
CF -6R forms.: MECH-04, MECH-2I-HERS and (for split systems) M
• All HVAC Equipment replaced CF -4R forms: MECH- 21 and (fors lits stems) MECH-25
• Condenser Coil and/or CF -6R forms: MECH-21-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and /or CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace CCA >_ 300 CFM/tonWiniMUrn Air Flow RdqUirementj,.TMAH
For Split Systems: Duct leakage < 1.5 percent;
For Packaged Units:* Duct leakage < 15 percent
Exempted from duct leakage testing if:
0 I. DUCI System was documented to have been previously scaled and confirmed through HERS verillcation, or
0 2. Duct systems with less than 40 linear I*cct in Unconditioned space. or
0 3. Existing duct systems arc constructed, insulated or scaled with ashesto.s.
0 2. New HVAC System Required Forms:
0 CLIt in or Chanecoul with new CF -6R forms: MECH-04; MECH-20-HERS:and (I'dr split systems) MECH-22-HERS;1knd_:M..E1CH -25 -HERS
ducts: (all new ducting and all CF -4R forms: MECH 20-. and (l'orsplij %ystems)MECH-22. and MECH 25
For Split. Systems: Duct leakage < 6 percent; RC, CCA > 350'CFM/ton, FWD, I MAH, 3 1 rvio, anu CILIMI
For Packaged Units: Duct leakage < 6 percent
0 3. New Ducts with Replacement Required Forms:
0 ducting - CF -6R forms: MECH-04. MECH-20--H-ERS.and (ror.split systems). M ECH-257 HERS
Includes replacing.or instalfing all new CF 4R forms: MECH 20 and (for split systems) MECH-25
outdoor condensing Unit and/or indoor
coil and/or, furnace. Not all CqLlipl-ncnt changed.
For Split Systems: Duct. leakage.< 6 percent. RC, CCA > 300 CFM/ton, TMAH
For Packaged Units:, Duct leakage < 6. percent
0 4. New Ducting over 401eet Required'Forms:
0 includes adding or-rcolacing more than 40 CF -6R forms: MECH-04. MECH-21-HERS CF -4R. forms.: MECH-21
linear 1'ect t)l'duct in Unconditioned splice.
For split system or;paek*aged -units: Duct- leakage < 15 percent
0 EXCEPTION: Existing duels stems cons(rL[Ctcd, insulated or scaled with asbestos.
Contractor (Documentation Author's /Responsibl ' e Designer's Declaration Statement)
* I certify that this Certificate of Compliance documentation is and complete.
o I am eligible tin -der Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Cerfificatebl'bompliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate ofCompliance conform tothe requirern . chis . oil Ti . ile 24,
Parts I and 6 of the California Code of Regulations. -1 'anon. on -other applicable compliance foifms�.workshects,
9 The design features identified on this Certificate of Compliance are consistent with the information doctim
Kiihmitted to the enforcement agency for approval with the pernill'.
1:d, ...w,.,,..... - -
ignaittire:
Name: tWtF'V— J7 Date:
Company:'
License:
Z
Address.
2-a Cl, L_ Phone:
Ci1y/SV_a1`c/_ZTPZ'N 1
7T7- CA - q 23
Alf,,- -I, WWI
I
Bin #
Qtrof La Quinta }
: Building 8i' Safety. Division
P.O. Box 1504, 78-495 Calle Tampico
La Quints, CA 92253 -'(T60)- 777-7012.
Building PerrrmitAnolication and Tracking Sheet
Permit #
��
Project Address: SIL4 pS A J Fn); DA ., ?_J Q c' t)
Owner's Name: T%0 H,,)
A. P. Number:
Address: 52y 05- .A J FL,) J D A (2-1 (3 t-6
Legal Description:
City, ST, Zip: J W( A CA 4 2 2Q S 3
Contractor. R J i -aD P.'NS
f
Telephone:.? k�y:<;;
- . �...
Address: 2&C,t i_� 1-ti9� /�-J YL'
-Project Descri tion:
j P efTO.i PA&K A6(z
City,'ST, Zip: CD (^V� .C:a 23 2`I
wd Eie
Telephone: lS -$ — Sz 19•
State Lic. #: 7 s City Lic. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone::tik::
State Lic. #: :<;,zx:� ,. • fF ,: y , ^._
Name of Contact Person: i
Construction Type: Occupancy:
YP
- Project typo (circle one): New Add'n Alter Repair Demo
Sq. FL:
#Stories: (
T# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal'
Req'd.
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amoant
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Caics•
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
q
Plans resubmitted
Mechanical
Grading plan
2°° Review, ready for correctionsAssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I:
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready. for corrections/issue
Developer Impact Fee
Planning Approval
Called ContactYPerson
A II.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
i
Total Permit Fees